comparação da evolução a longo prazo da valvoplastia mitral percutânea por balão com a técnica de inoue versus a do balão único: análise dos fatores de risco para óbito e eventos maiores comparison of the inoue and single balloon techniques during long term percutaneous balloon mitral valvoplasty follow-up: analysis of risk factors for death and major events

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ID: 224857
2007
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Abstract
OBJETIVO: Analisar a evolução a longo prazo de pacientes submetidos a valvoplastia mitral percutânea por balão com a técnica do balão de Inoue versus a técnica do balão único Balt, identificando os fatores que predisseram óbito e eventos maiores (óbito, nova valvoplastia mitral por balão ou cirurgia valvar mitral). MÉTODOS: O período de seguimento, nos grupos do balão único e do balão de Inoue, foi de 54 ± 31 (1 a 126) meses e de 34 ± 26 (2 a 105) meses, respectivamente (p < 0,0001). O balão único Balt foi usado em 254 (84,1%) pacientes e o balão de Inoue, em 48 (15,9%). RESULTADOS: Foram encontrados os seguintes dados, respectivamente, no grupo do balão de Inoue e do balão único: idade, 36,9 ± 10,4 (19 a 63) anos e 38,0 ± 12,6 (13 a 83) anos (p = 0,5769); escore ecocardiográfico, 7,5 ± 1,3 pontos e 7,2 ± 1,5 pontos (p = 0,1307); sexo feminino, 72,9% e 87,4% (p = 0,0097); fibrilação atrial, 10,4% e 16,1% (p = 0,4275); mortalidade no seguimento, 2,1% e 4,3% (0,6984); e eventos maiores, 8,3% e 17,7% (p = 0,1642). Não houve, na análise univariada e nas curvas de Kaplan-Meier, diferença entre as técnicas de Inoue e do balão único Balt para sobrevida e sobrevida livre de eventos maiores. Na análise multivariada, idade > 50 anos e escore ecocardiográfico > 8 predisseram, independentemente, óbito, e escore ecocardiográfico > 8 e área valvar mitral pós-procedimento < 1,50 cm² predisseram eventos maiores. CONCLUSÃO: Não houve diferença na evolução a longo prazo dos pacientes submetidos a técnica de Inoue versus a do balão único. Predisseram óbito e/ou eventos maiores: idade > 50 anos, escore ecocardiográfico > 8 e área valvar mitral pós-procedimento < 1,50 cm².
OBJECTIVE: To analyze the long term evolution of patients undergoing percutaneous balloon mitral valvoplasty comparing the Inoue and Balt single balloon methods, and to identify predictors of death and major events (death, repeat balloon mitral valvoplasty or mitral valve surgery). METHODS: The follow-up for the single and Inoue balloon groups were 54 ± 31 (1 to 126) months and 34 ± 26 (2 to 105) months, respectively (p < 0.0001). The Balt single balloon was used in 254 (84.1%) patients and the Inoue balloon in 48 (15.9%). RESULTS: The following data were found for the Inoue and single balloon groups, respectively: age, 36.9 ± 10.4 (19 to 63) years and 38.0 ± 12.6 (13 to 83) years (p = 0.5769); echocardiographic score, 7.5 ± 1.3 points and 7.2 ± 1.5 points (p = 0.1307); female gender, 72.9% and 87.4% (p = 0.0097); atrial fibrillation, 10.4% and 16.1% (p = 0.4275); mortality during follow-up, 2.1% and 4.3% (0.6984); and major events, 8.3% and 17.7% (p = 0.1642). Univariate and Kaplan-Meier curve analyses revealed no differences between the Inoue and Balt single balloon techniques in relation to survival and major event free survival. In the multivariate analysis, age > 50 years and an echocardiographic score > 8 were independent predictors of death; and an echocardiographic score > 8 and post operative mitral valve area < 1.50 cm² were predictors for major events. CONCLUSION: No differences were found in the long term evolution of patients undergoing the Inoue versus the single balloon technique. Predictors of death and/or major events were: age > 50 years, echocardiographic score > 8 and mitral valve area < 1.50 cm² after the procedure.
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Authors Ivana Picone Borges, Edison Carvalho Sandoval Peixoto, Rodrigo Trajano Sandoval Peixoto, Paulo Sergio de Oliveira, Mario Salles Netto, Ricardo Trajano Sandoval Peixoto, Marta Labrunie, Pierre Labrunie, Ronaldo de Amorim Villela, Aristarco Gonçalves Siqueira-Filho
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Journal revista cubana de ciencias informáticas
Year 2007
DOI
10.1590/S0066-782X2007001300009
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2007001300009
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