0019: Immediate and long-term results of repeat percutaneous mitral valvuloplasty

Introduction It is unknown whether patients who developed symptomatic mitral restenosis after percutaneous mitral valvuloplasty (PMV) may benefit from repeat PMV (re-PMV).The purpose of this study is to assess the immediate and long-term results of the re-PMV in patients with mitral restenosis following to previous PMV. Methods Retrospective study from a series of 40 procedures of re-PMV with the Inoue balloon at 8±4 years after prior procedure, performed between 1996 and 2012. A clinical and ultrasound follow-up was achieved in 31 patients with a mean follow-up period of 43±26 months. Results The mean age of patients was 43±11 years [23; 63]. 87,5% of the population being female (5 men and 35 women). The immediate procedural success was achieved in 31 patients (77.5%). A severe mitral regurgitation (MR) was observed in 3 patients (7.5%). A cerebrovascular stroke occurred in 1 patient (2.5%). No death or cardiac tamponade were noted. Class III or IV of NYHA, a pre-procedural MR, pulmonary hypertension and a Padial score >10 were identified as predictors of failure. More the score of Wilkins is high (>8), more it is predictive of failure. Only a left atrial area ≤ 25 cm 2 was linked to high risk of severe MR. At long-term, most patients (84%) had no functional impairment, the mean mitral valve area was 1,5±0,33 cm 2 [0,9;2,2], mitral restenosis was observed in 13 patients (42%) at 53±30 months [9;128] after re-PMV. 9 patients had mitral valve replacement (32%), 4 patients underwent a re-PMV (13%), 2 patients presented thromboembolic events (6%) and no death. Only the male had been identified as a predictor of restenosis. Conclusion Re-PMV in patients with restenosis after a prior PMV is feasible, effective and achieves interesting immediate and long-term results.