Immediate and Long-term Results Following Balloon Mitral Valvotomy in Patients With Atrial Fibrillation

Authors

  • Krishna Kumar Mohanan Nair MD,

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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  • Harikrishnan Sivadasan Pillai MD, FACC,

    Corresponding author
    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
    • Department of Cardiology. Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India 695011
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  • Anees Thajudeen MD,

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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  • Kavassery Mahadevan Krishnamoorthy MD,

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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  • Sivasankaran Sivasubramonian MD,

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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  • Narayanan Namboodiri MD,

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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  • Bijulal Sasidharan MD,

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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  • Sanjay Ganapathy MD,

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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  • Ajitkumar Varaparambil MD,

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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  • Thomas Titus MD,

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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  • Jaganmohan Tharakan MD

    1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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Abstract

Background:

The purpose of this study was to examine the influence of atrial fibrillation (AF) on the immediate and long-term outcome of patients undergoing balloon mitral valvotomy (BMV).

Hypothesis:

Patients with atrial fibrillation fair poorly after balloon mitral valvotomy.

Methods:

There were a total of 818 consecutive patients who underwent elective BMV in this institute from 1997 to 2003, with either double-lumen or triple-lumen BMV catheters included in the study. Of them, 95 were with AF. The clinical, echocardiographic, and hemodynamic data of these patients were compared with those of 723 patients in normal sinus rhythm (NSR). Immediate procedural results and long-term events were compared between the 2 study groups.

Results:

Patients with AF were older (39.9 ± 9.9 years vs 29.4 ± 10.1, P < 0.001) and presented more frequently with New York Heart Association (NYHA) class III-IV (53.7% vs 32.9%, P < 0.001), echocardiographic score >8 (47.4% vs 24.9%, P < 0.001), and with history of previous surgical commissurotomy (33.7% vs 11.5%, P < 0.001). In patients with AF, BMV resulted in inferior immediate and long-term outcomes, as reflected in a lesser post-BMV mitral valve area (1.3 ± 0.4 vs 1.6 ± 0.4 cm2, P = 0.032) and higher event rate on follow-up.

Conclusions:

Patients with AF were older, sicker, and had advanced rheumatic mitral valve disease. They had a higher incidence of stroke, new onset heart failure, and need for reinterventions on long-term follow-up. These patients need intense and more frequent follow-up. Clin. Cardiol. 2011 DOI: 10.1002/clc.22068

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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