Comparison of long-term results of percutaneous mitral balloon valvotomy with closed transventricular mitral commissurotomy at a single North American institution

Long-term (>3 years) follow-up data were obtained from 102 consecutive patients undergoing percutaneous mitral balloon valvotomy (PMBV). Data were collected prospectively by review of the medical record, mailed questionnaire, and/or telephone. Data on patients with closed mitral commissurotomy (CMC) at our institution have been previously reported and serve as the comparison group, Follow-up data was 98% complete at a mean of 57 months for PMBV patients. Compared with patients undergoing CMC, these patients were older (54 +/- 14 vs 43.6 +/- 10 years, p <0.001) and more likely to have undergone previous mitral valve surgery (17% vs 4%, p < 0.001). The observed 5-year survival in the PMBV group was no different from that observed in the CMC group (83% vs 90 %, p NS) or from that predicted by the model developed from the CMC patients. Commissural calcium was associated with death and death or repeat mitral valve procedure in the multivariate analysis. Long-term survival free from repeat procedures was equivalent when patients with commissural calcium were excluded. Thus, PMBV offers longterm survival and freedom from subsequent mitral valve procedures similar to CMC, (C) 1999 by Excerpta Medica, Inc.