Clinical and Echocardiographic Trends in Percutaneous Balloon Mitral Valvuloplasty
Abstract Background Percutaneous balloon mitral valvuloplasty (PBMV) is the current standard of care for selected patients with rheumatic mitral stenosis. We examined trends in patient demographics, Wilkins score and additional echocardiographic characteristics, success rates, and complications over a 30-year period.Methods We conducted a retrospective observational descriptive study. The study population consists of patients hospitalized in intensive cardiac care (ICCU) due to significant symptomatic MS, from January 1990 to May 2019.Results 417 patients who underwent PBMV were eligible. Age did not change significantly over time. Male patients who were smoking and had multiple comorbidities such as hypertension, dyslipidemia, ischemic heart disease, and chronic kidney disease became more prevalence (p=0.02, p=0.02, p=0.001, p=0.01, p=0.02, and p=0.001 respectively). Wilkins score and all its components increased over time, which was higher in females (p=0.01), and was not correlated with age (p=0.95). Severe leaflets immobility (Grade 4) predicted complications (p=0.03, respectively). Wilkins over 9 successfully predicted the occurrence of complications, conversely, no efficient cutoff was found in the following decades. Wilkins score managed to predict a technically successful procedure (p=0.02), but not complications (p=0.12). Lastly, complication rates did not significantly change over the years.Conclusion Our research covers three decades of experience in PBMV and shows several trends: We see more male patients, who have multiple comorbidities. The Wilkins score increased over the years and was predictive of successful operations as opposed to complications who were predicted mainly by the leaflet mobility index.