Comparison of results of percutaneous balloon mitral commissurotomy in patients aged ≥65 years with those in patients aged <65 years

Richard A. Krasuski, John J. Warner, Gail Peterson, Andrew Wang, J. Kevin Harrison, Katherine B. Kisslo, Thomas M. Bashore

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)994-1000
Number of pages7
JournalAmerican Journal of Cardiology
Volume88
Issue number9
DOIs
StatePublished - Nov 1 2001

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Mitral Valve Stenosis
Medicare
Disease-Free Survival
Mitral Valve
Atrial Fibrillation
Population
Echocardiography
Anatomy
Hypertension
Pressure
Lung
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of results of percutaneous balloon mitral commissurotomy in patients aged ≥65 years with those in patients aged <65 years. / Krasuski, Richard A.; Warner, John J.; Peterson, Gail; Wang, Andrew; Harrison, J. Kevin; Kisslo, Katherine B.; Bashore, Thomas M.

In: American Journal of Cardiology, Vol. 88, No. 9, 01.11.2001, p. 994-1000.

Research output: Contribution to journalArticle

Krasuski, Richard A. ; Warner, John J. ; Peterson, Gail ; Wang, Andrew ; Harrison, J. Kevin ; Kisslo, Katherine B. ; Bashore, Thomas M. / Comparison of results of percutaneous balloon mitral commissurotomy in patients aged ≥65 years with those in patients aged <65 years. In: American Journal of Cardiology. 2001 ; Vol. 88, No. 9. pp. 994-1000.
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