Mitral Balloon Valvotomy for the Treatment of Mitral Stenosis in Octogenarians
OBJECTIVES: To study the safety and benefit of mitral balloon valvotomy (MBV) in patients aged ≥ 80 years. SETTING: A tertiary cardiac centre DESIGN: A retrospective study of 20 octogenarians (mean age 83, range 80–89 years) in whom percutaneous MBV was performed as a definitive or palliative treatm...
Gespeichert in:
| Veröffentlicht in: | Journal of the American Geriatrics Society 2000-08, Vol.48 (8), p.971-974 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 974 |
|---|---|
| container_issue | 8 |
| container_start_page | 971 |
| container_title | Journal of the American Geriatrics Society |
| container_volume | 48 |
| creator | Sutaria, Nilesh Elder, Andrew T. Shaw, Thomas R. D. |
| description | OBJECTIVES: To study the safety and benefit of mitral balloon valvotomy (MBV) in patients aged ≥ 80 years.
SETTING: A tertiary cardiac centre
DESIGN: A retrospective study of 20 octogenarians (mean age 83, range 80–89 years) in whom percutaneous MBV was performed as a definitive or palliative treatment for severe mitral stenosis. All were in New York Heart Association (NYHA) symptom class III or IV. Fourteen had been judged unfit for cardiac surgery. Hemodynamic data was recorded before and after MBV. Symptomatic outcome was documented at 1 month for all patients. Outcome at 1 year was available for 16 patients.
RESULTS: Dilatation of the mitral valve was achieved in all patients without major complications. Mean mitral valve area increased 106% from 0.81 (± 0.3) to 1.67 (± 0.8) cm2, transvalvular gradient decreased from 11.8 (± 4.8) to 5.6 (± 2.9) mm Hg, cardiac output increased from 3.1 (± 0.6) to 4.1 (± 1.4) 1/min (all P < .01). Eight of these 20 patients obtained a valve area ≥ 1.5 cm2, and 16 obtained an area ≥ 1.2 cm2. One month after BMV, all patients were alive, and 16 of the 20 patients were improved by at least one NYHA class. This improvement was sustained in 7 of 16 patients followed up for 1 year. More severe mitral valve degenerative change, determined by echocardiography, was associated with poorer outcome.
CONCLUSIONS: In this group of very old and frail patients, MBV was safe and resulted in significant immediate improvement. Sustained symptomatic benefit at 1 year was obtained in those with less extensive leaflet and subvalvular disease. In patients with severe degenerative valve disease on echocardiography, but unacceptable surgical risk, MBV offers short‐term palliation. J Am Geriatr Soc 48:971–974, 2000. |
| doi_str_mv | 10.1111/j.1532-5415.2000.tb06897.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72222037</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>58501636</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4657-dbd97ea63ea369006a74890bfe66580fe973741fbf370d0d7c23c09521e9282b3</originalsourceid><addsrcrecordid>eNqVkE1v1DAQhi0EotvCX0BWhbgljO3EdrigUsGWqh-HFnq0nMSBLIldbG_Z_fc4SlQQN-ZiS_PM6_GD0DGBnKR6u8lJyWhWFqTMKQDksQYuK5HvnqDVY-spWqUezSQnxQE6DGEDQChI-RwdEKi4ZFCs0NVlH70e8Ac9DM5Z_FUPDy66cY8753H8bvCtNzqOxkbsOrzQN9FYF_qAe4uvm-i-Gat9r214gZ51egjm5XIeoS-fPt6enmUX1-vPpycXWVPwUmRt3VbCaM6MZrwC4FoUsoK6M5yXEjpTCSYK0tUdE9BCKxrKGqhKSkxFJa3ZEXoz595793NrQlRjHxozDNoatw1K0FTARAKP_wE3butt2k1RkoBkSybo3Qw13oXgTafufT9qv1cE1KRcbdTkVU1e1aRcLcrVLg2_Wl7Y1qNp_xqdHSfg9QLo0Oih89o2ffjDlQTS1xL2fsZ-9YPZ_8cG6nx9M91SQjYn9CGa3WOC9j8UTz5LdXe1VnfV-oyyc6Yu2W_lP6uF</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>210375328</pqid></control><display><type>article</type><title>Mitral Balloon Valvotomy for the Treatment of Mitral Stenosis in Octogenarians</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Sutaria, Nilesh ; Elder, Andrew T. ; Shaw, Thomas R. D.</creator><creatorcontrib>Sutaria, Nilesh ; Elder, Andrew T. ; Shaw, Thomas R. D.</creatorcontrib><description>OBJECTIVES: To study the safety and benefit of mitral balloon valvotomy (MBV) in patients aged ≥ 80 years.
SETTING: A tertiary cardiac centre
DESIGN: A retrospective study of 20 octogenarians (mean age 83, range 80–89 years) in whom percutaneous MBV was performed as a definitive or palliative treatment for severe mitral stenosis. All were in New York Heart Association (NYHA) symptom class III or IV. Fourteen had been judged unfit for cardiac surgery. Hemodynamic data was recorded before and after MBV. Symptomatic outcome was documented at 1 month for all patients. Outcome at 1 year was available for 16 patients.
RESULTS: Dilatation of the mitral valve was achieved in all patients without major complications. Mean mitral valve area increased 106% from 0.81 (± 0.3) to 1.67 (± 0.8) cm2, transvalvular gradient decreased from 11.8 (± 4.8) to 5.6 (± 2.9) mm Hg, cardiac output increased from 3.1 (± 0.6) to 4.1 (± 1.4) 1/min (all P < .01). Eight of these 20 patients obtained a valve area ≥ 1.5 cm2, and 16 obtained an area ≥ 1.2 cm2. One month after BMV, all patients were alive, and 16 of the 20 patients were improved by at least one NYHA class. This improvement was sustained in 7 of 16 patients followed up for 1 year. More severe mitral valve degenerative change, determined by echocardiography, was associated with poorer outcome.
CONCLUSIONS: In this group of very old and frail patients, MBV was safe and resulted in significant immediate improvement. Sustained symptomatic benefit at 1 year was obtained in those with less extensive leaflet and subvalvular disease. In patients with severe degenerative valve disease on echocardiography, but unacceptable surgical risk, MBV offers short‐term palliation. J Am Geriatr Soc 48:971–974, 2000.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/j.1532-5415.2000.tb06897.x</identifier><identifier>PMID: 10968304</identifier><identifier>CODEN: JAGSAF</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular disease ; Catheterization - adverse effects ; Catheterization - methods ; Comorbidity ; Echocardiography ; Endocardial and cardiac valvular diseases ; Female ; Frail Elderly ; Geriatric Assessment ; Geriatrics ; Heart ; Hemodynamics ; Humans ; Male ; Medical sciences ; mitral balloon valvotomy ; mitral stenosis ; Mitral Valve Stenosis - classification ; Mitral Valve Stenosis - diagnostic imaging ; Mitral Valve Stenosis - physiopathology ; Mitral Valve Stenosis - therapy ; octogenarian ; Older people ; Patient Selection ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Surgery ; Treatment Outcome</subject><ispartof>Journal of the American Geriatrics Society, 2000-08, Vol.48 (8), p.971-974</ispartof><rights>2000 The American Geriatrics Society</rights><rights>2000 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Aug 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4657-dbd97ea63ea369006a74890bfe66580fe973741fbf370d0d7c23c09521e9282b3</citedby><cites>FETCH-LOGICAL-c4657-dbd97ea63ea369006a74890bfe66580fe973741fbf370d0d7c23c09521e9282b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1532-5415.2000.tb06897.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1532-5415.2000.tb06897.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>309,310,314,778,782,787,788,1414,23913,23914,25123,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1510095$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10968304$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sutaria, Nilesh</creatorcontrib><creatorcontrib>Elder, Andrew T.</creatorcontrib><creatorcontrib>Shaw, Thomas R. D.</creatorcontrib><title>Mitral Balloon Valvotomy for the Treatment of Mitral Stenosis in Octogenarians</title><title>Journal of the American Geriatrics Society</title><addtitle>J Am Geriatr Soc</addtitle><description>OBJECTIVES: To study the safety and benefit of mitral balloon valvotomy (MBV) in patients aged ≥ 80 years.
SETTING: A tertiary cardiac centre
DESIGN: A retrospective study of 20 octogenarians (mean age 83, range 80–89 years) in whom percutaneous MBV was performed as a definitive or palliative treatment for severe mitral stenosis. All were in New York Heart Association (NYHA) symptom class III or IV. Fourteen had been judged unfit for cardiac surgery. Hemodynamic data was recorded before and after MBV. Symptomatic outcome was documented at 1 month for all patients. Outcome at 1 year was available for 16 patients.
RESULTS: Dilatation of the mitral valve was achieved in all patients without major complications. Mean mitral valve area increased 106% from 0.81 (± 0.3) to 1.67 (± 0.8) cm2, transvalvular gradient decreased from 11.8 (± 4.8) to 5.6 (± 2.9) mm Hg, cardiac output increased from 3.1 (± 0.6) to 4.1 (± 1.4) 1/min (all P < .01). Eight of these 20 patients obtained a valve area ≥ 1.5 cm2, and 16 obtained an area ≥ 1.2 cm2. One month after BMV, all patients were alive, and 16 of the 20 patients were improved by at least one NYHA class. This improvement was sustained in 7 of 16 patients followed up for 1 year. More severe mitral valve degenerative change, determined by echocardiography, was associated with poorer outcome.
CONCLUSIONS: In this group of very old and frail patients, MBV was safe and resulted in significant immediate improvement. Sustained symptomatic benefit at 1 year was obtained in those with less extensive leaflet and subvalvular disease. In patients with severe degenerative valve disease on echocardiography, but unacceptable surgical risk, MBV offers short‐term palliation. J Am Geriatr Soc 48:971–974, 2000.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Catheterization - adverse effects</subject><subject>Catheterization - methods</subject><subject>Comorbidity</subject><subject>Echocardiography</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Female</subject><subject>Frail Elderly</subject><subject>Geriatric Assessment</subject><subject>Geriatrics</subject><subject>Heart</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>mitral balloon valvotomy</subject><subject>mitral stenosis</subject><subject>Mitral Valve Stenosis - classification</subject><subject>Mitral Valve Stenosis - diagnostic imaging</subject><subject>Mitral Valve Stenosis - physiopathology</subject><subject>Mitral Valve Stenosis - therapy</subject><subject>octogenarian</subject><subject>Older people</subject><subject>Patient Selection</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkE1v1DAQhi0EotvCX0BWhbgljO3EdrigUsGWqh-HFnq0nMSBLIldbG_Z_fc4SlQQN-ZiS_PM6_GD0DGBnKR6u8lJyWhWFqTMKQDksQYuK5HvnqDVY-spWqUezSQnxQE6DGEDQChI-RwdEKi4ZFCs0NVlH70e8Ac9DM5Z_FUPDy66cY8753H8bvCtNzqOxkbsOrzQN9FYF_qAe4uvm-i-Gat9r214gZ51egjm5XIeoS-fPt6enmUX1-vPpycXWVPwUmRt3VbCaM6MZrwC4FoUsoK6M5yXEjpTCSYK0tUdE9BCKxrKGqhKSkxFJa3ZEXoz595793NrQlRjHxozDNoatw1K0FTARAKP_wE3butt2k1RkoBkSybo3Qw13oXgTafufT9qv1cE1KRcbdTkVU1e1aRcLcrVLg2_Wl7Y1qNp_xqdHSfg9QLo0Oih89o2ffjDlQTS1xL2fsZ-9YPZ_8cG6nx9M91SQjYn9CGa3WOC9j8UTz5LdXe1VnfV-oyyc6Yu2W_lP6uF</recordid><startdate>200008</startdate><enddate>200008</enddate><creator>Sutaria, Nilesh</creator><creator>Elder, Andrew T.</creator><creator>Shaw, Thomas R. D.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>200008</creationdate><title>Mitral Balloon Valvotomy for the Treatment of Mitral Stenosis in Octogenarians</title><author>Sutaria, Nilesh ; Elder, Andrew T. ; Shaw, Thomas R. D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4657-dbd97ea63ea369006a74890bfe66580fe973741fbf370d0d7c23c09521e9282b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Catheterization - adverse effects</topic><topic>Catheterization - methods</topic><topic>Comorbidity</topic><topic>Echocardiography</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Female</topic><topic>Frail Elderly</topic><topic>Geriatric Assessment</topic><topic>Geriatrics</topic><topic>Heart</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>mitral balloon valvotomy</topic><topic>mitral stenosis</topic><topic>Mitral Valve Stenosis - classification</topic><topic>Mitral Valve Stenosis - diagnostic imaging</topic><topic>Mitral Valve Stenosis - physiopathology</topic><topic>Mitral Valve Stenosis - therapy</topic><topic>octogenarian</topic><topic>Older people</topic><topic>Patient Selection</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sutaria, Nilesh</creatorcontrib><creatorcontrib>Elder, Andrew T.</creatorcontrib><creatorcontrib>Shaw, Thomas R. D.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Geriatrics Society</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sutaria, Nilesh</au><au>Elder, Andrew T.</au><au>Shaw, Thomas R. D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mitral Balloon Valvotomy for the Treatment of Mitral Stenosis in Octogenarians</atitle><jtitle>Journal of the American Geriatrics Society</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2000-08</date><risdate>2000</risdate><volume>48</volume><issue>8</issue><spage>971</spage><epage>974</epage><pages>971-974</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><coden>JAGSAF</coden><abstract>OBJECTIVES: To study the safety and benefit of mitral balloon valvotomy (MBV) in patients aged ≥ 80 years.
SETTING: A tertiary cardiac centre
DESIGN: A retrospective study of 20 octogenarians (mean age 83, range 80–89 years) in whom percutaneous MBV was performed as a definitive or palliative treatment for severe mitral stenosis. All were in New York Heart Association (NYHA) symptom class III or IV. Fourteen had been judged unfit for cardiac surgery. Hemodynamic data was recorded before and after MBV. Symptomatic outcome was documented at 1 month for all patients. Outcome at 1 year was available for 16 patients.
RESULTS: Dilatation of the mitral valve was achieved in all patients without major complications. Mean mitral valve area increased 106% from 0.81 (± 0.3) to 1.67 (± 0.8) cm2, transvalvular gradient decreased from 11.8 (± 4.8) to 5.6 (± 2.9) mm Hg, cardiac output increased from 3.1 (± 0.6) to 4.1 (± 1.4) 1/min (all P < .01). Eight of these 20 patients obtained a valve area ≥ 1.5 cm2, and 16 obtained an area ≥ 1.2 cm2. One month after BMV, all patients were alive, and 16 of the 20 patients were improved by at least one NYHA class. This improvement was sustained in 7 of 16 patients followed up for 1 year. More severe mitral valve degenerative change, determined by echocardiography, was associated with poorer outcome.
CONCLUSIONS: In this group of very old and frail patients, MBV was safe and resulted in significant immediate improvement. Sustained symptomatic benefit at 1 year was obtained in those with less extensive leaflet and subvalvular disease. In patients with severe degenerative valve disease on echocardiography, but unacceptable surgical risk, MBV offers short‐term palliation. J Am Geriatr Soc 48:971–974, 2000.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>10968304</pmid><doi>10.1111/j.1532-5415.2000.tb06897.x</doi><tpages>4</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8614 |
| ispartof | Journal of the American Geriatrics Society, 2000-08, Vol.48 (8), p.971-974 |
| issn | 0002-8614 1532-5415 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72222037 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Activities of Daily Living Aged Aged, 80 and over Biological and medical sciences Cardiology. Vascular system Cardiovascular disease Catheterization - adverse effects Catheterization - methods Comorbidity Echocardiography Endocardial and cardiac valvular diseases Female Frail Elderly Geriatric Assessment Geriatrics Heart Hemodynamics Humans Male Medical sciences mitral balloon valvotomy mitral stenosis Mitral Valve Stenosis - classification Mitral Valve Stenosis - diagnostic imaging Mitral Valve Stenosis - physiopathology Mitral Valve Stenosis - therapy octogenarian Older people Patient Selection Predictive Value of Tests Prognosis Retrospective Studies Severity of Illness Index Surgery Treatment Outcome |
| title | Mitral Balloon Valvotomy for the Treatment of Mitral Stenosis in Octogenarians |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T20%3A04%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Mitral%20Balloon%20Valvotomy%20for%20the%20Treatment%20of%20Mitral%20Stenosis%20in%20Octogenarians&rft.jtitle=Journal%20of%20the%20American%20Geriatrics%20Society&rft.au=Sutaria,%20Nilesh&rft.date=2000-08&rft.volume=48&rft.issue=8&rft.spage=971&rft.epage=974&rft.pages=971-974&rft.issn=0002-8614&rft.eissn=1532-5415&rft.coden=JAGSAF&rft_id=info:doi/10.1111/j.1532-5415.2000.tb06897.x&rft_dat=%3Cproquest_cross%3E58501636%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=210375328&rft_id=info:pmid/10968304&rfr_iscdi=true |