Late Results of Percutaneous Balloon Mitral Commissurotomy in Patients with Restenosis after Surgical Commissurotomy Compared to Patients with ‘De-Novo’: Stenosis
Zbigniew Chmielak MD, Witold Ruzyllo MD, Marcin Demkow MD, Magdalena Soroka MD, Maciej Karcz MD, Marek Konka MD, Pawel Bekta MD, Cezary Kepka MD

Between October 1988 and September 1999, a total of 1,027 patients underwent percutaneous balloon mitral commissurotomy (BMC). Of these patients, 169 (16.5%) were examined at 17 ± 7 years (range: 2-33 years) after surgical commissurotomy (group 1), and 858 (83.5%) had Œde-novoš mitral stenosis (group 2). After BMC, mitral valve area (MVA) was significantly increased (1.82 ± 0.3 cm2 in group 1; 1.93 ± 0.40 cm2 in group 2; p <0.05). Four patients (2.4%) from group 1, and 24 (2.8%) from group 2 required mitral valve replacement due to severe regurgitation (p = NS). Multivariate analysis showed that MVA <1.5 cm2 after BMC, mitral regurgitation grade >2/4, Wilkins score >8 and mean transmitral gradient and left atrial mean pressure post BMC to be independent predictors of an adverse event occurring during follow up. In conclusion, BMC in patients with restenosis after surgical commissurotomy is an effective method of treatment that can help to avoid valve surgery in most cases.