Pooled Analysis of Percutaneous Mitral Valvuloplasty in Egypt

Background: Till now, no pooled analysis summarizing the Egyptian experience in percutaneous mitral valvuloplasty (PMV) exists. Objectives and Methods: To pool the data of PMV procedures and perform a new analysis regarding the immediate outcome and follow-up results as well as to compare the results of different techniques. Results: Patients (2,256) with mitral stenosis of rheumatic origin were included, 292 males and 1,964 females. Double balloon (DB) was used in 1,148 patients (51%), Inoue balloon (IB) in 914 patients (40.5%), metallic commissurotome (MC) in 142 patients (6%), Multi-Track in 33 patients (1.5%), and single balloon in 19 patients (1%). The mitral valve area (MVA) increased from 0.94 +/- 0.18 cm(2) to 1.92 +/- 0.36 cm(2); mean pressure gradient dropped from 15.94 +/- 5.46 mmHg to 5.85 +/- 2.6 mmHg. The most common complication was the occurrence of a new mitral regurgitation (MR) and/or increase in its grade (36%). Inadequate dilatation occurred in 192 patients (8.5%). Follow-up data (for 5.7 +/- 5.9 months) showed that the immediate results of PMV on MVA persisted through the follow-up period (1.78 +/- 0.35 cm(2)). Multi-Track system resulted in the largest increase in MVA and also resulted in the largest immediate increase in the grade of MR. Conclusions: This study confirms the success of PMV and its results during follow-up. The Multi-Track system, and the DB resulted in the largest MVA, the IB and the single balloon resulted in the least increase in MR. The most common complication of PMV is the increase in the degree of MR. (c) 2009 Wiley-Liss, Inc.