Abstract
BACKGROUND AND AIM OF THE STUDYThe study aim was to evaluate and compare the hemodynamic benefits of mitral balloon valvotomy (MBV) in young (child/adolescent) and older (adult) patients with severe mitral stenosis.METHODSThe younger group comprised 61 patients (mean age 17 +/- 3 years), and the older group 264 patients (mean age 35 +/- 10 years). All patients underwent MBV using an Inoue balloon to treat symptomatic and severe mitral stenosis. The long-term follow up of both groups was monitored on a comparative basis.RESULTSThe success rate of MBV was similar in both groups (95% in younger patients, 96% in older patients) (p = 0.36). Mitral valve area (MVA) was increased from 0.8 +/- 0.2 to 2.0 +/- 0.3 cm2 in the younger group, and from 0.8 +/- 0.3 to 1.9 +/- 0.3 cm2 in the older group. The mean mitral valve gradient was decreased significantly both in the younger group (from 13 +/- 5 to 5 +/- 2 mmHg) and older group (from 12 +/- 5 to 5 +/- 3 mmHg) (p < 0.001). Both groups had similar MVA and mean gradient at baseline and follow up. At follow up (mean 37 +/- 27 months), MVA monitored by Doppler echocardiography remained at 1.7 +/- 0.4 and 1.6 +/- 0.4 cm2 (p = 0.08). Similarly, the mitral valve mean gradient remained stable (p = 0.92). Severe mitral regurgitation developed in one younger patient, and in seven older patients (p = 0.66). Two cases of tamponade occurred in each group, and one older patient suffered a transient stroke. There was no mortality in either group.CONCLUSIONIn patients with rheumatic mitral stenosis, the outcome of MBV in children and adolescents was at least comparable with that in adults. In addition, the benefits were similar in each age group on completion of follow up.