TY - JOUR
T1 - Comparison of results of percutaneous balloon mitral commissurotomy in patients aged ≥65 years with those in patients aged <65 years
AU - Krasuski, Richard A.
AU - Warner, John J.
AU - Peterson, Gail
AU - Wang, Andrew
AU - Harrison, J. Kevin
AU - Kisslo, Katherine B.
AU - Bashore, Thomas M.
PY - 2001/11/1
Y1 - 2001/11/1
N2 - Percutaneous balloon mitral commissurotomy (PBMC) is now first-line therapy in patients with symptomatic mitral stenosis (MS) and favorable valve morphology. Unfortunately, the outcome of Medicare-aged patients undergoing this procedure has not previously been defined. The results of PBMC in 55 patients ≥65 years old (71 ± 6 years) with moderate or severe MS were compared with 268 younger patients (47 ± 10). Preprocedural New York Heart Association functional class and pulmonary pressures did not differ. The older patients had higher blood pressure, were more likely to be in atrial fibrillation and had higher valve scores (9.9 ± 2.5 vs 8.6 ± 2.2, p = 0.001). Procedural success was higher in the younger group (71% vs 55%, p = 0.013), with a greater increase in mitral valve area. Complications were similar in both groups and there were no periprocedural deaths. At 6 months a significant improvement in function class was seen in both groups. Restenosis, as assessed by serial echocardiography, occurred at a rate of 0.06 cm2/year in both groups, and functional class remained unchanged over 3 years. Event-free survival was similar at 48 months: 76% in the younger group and 69% in the older group. Our data thus demonstrates that PBMC can be safely performed in the Medicare-aged population. Despite less acute success in the older population, complication rates do not differ and decrement in valve area over time occurs at a similar rate. Functional class remains improved and event-free survival over 4 years appears similar in both groups. PBMC should thus be offered to patients with MS and suitable anatomy regardless of their age.
AB - Percutaneous balloon mitral commissurotomy (PBMC) is now first-line therapy in patients with symptomatic mitral stenosis (MS) and favorable valve morphology. Unfortunately, the outcome of Medicare-aged patients undergoing this procedure has not previously been defined. The results of PBMC in 55 patients ≥65 years old (71 ± 6 years) with moderate or severe MS were compared with 268 younger patients (47 ± 10). Preprocedural New York Heart Association functional class and pulmonary pressures did not differ. The older patients had higher blood pressure, were more likely to be in atrial fibrillation and had higher valve scores (9.9 ± 2.5 vs 8.6 ± 2.2, p = 0.001). Procedural success was higher in the younger group (71% vs 55%, p = 0.013), with a greater increase in mitral valve area. Complications were similar in both groups and there were no periprocedural deaths. At 6 months a significant improvement in function class was seen in both groups. Restenosis, as assessed by serial echocardiography, occurred at a rate of 0.06 cm2/year in both groups, and functional class remained unchanged over 3 years. Event-free survival was similar at 48 months: 76% in the younger group and 69% in the older group. Our data thus demonstrates that PBMC can be safely performed in the Medicare-aged population. Despite less acute success in the older population, complication rates do not differ and decrement in valve area over time occurs at a similar rate. Functional class remains improved and event-free survival over 4 years appears similar in both groups. PBMC should thus be offered to patients with MS and suitable anatomy regardless of their age.
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U2 - 10.1016/S0002-9149(01)01976-2
DO - 10.1016/S0002-9149(01)01976-2
M3 - Article
C2 - 11703995
AN - SCOPUS:0035498954
SN - 0002-9149
VL - 88
SP - 994
EP - 1000
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 9
ER -