{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T04:04:36Z","timestamp":1749269076512,"version":"3.41.0"},"reference-count":19,"publisher":"PAGEPress Publications","issue":"1","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Percutaneous mitral valve commissurotomy (PMC) is a viable alternative to mitral valve (MV) surgery in the treatment of patients with rheumatic mitral stenosis (RMS). In this single-center retrospective study of consecutive patients with RMS submitted to PMC from 1991 to 2008, we analyzed clinical, echocardiographic, and hemodynamic data and events during follow-up (FUP) until December 2021. Major adverse cardiovascular events (MACE) were a combined endpoint of all-cause death, cardiovascular hospitalization, and MV re-intervention. A total of 124 patients were enrolled: 108 (87.1%) were female, with a mean age at PMC of 46 [standard deviation (SD) 11] years. PMC was successful in 91.1%, with a mean reduction in invasive transmitral pressure gradient (TMPG) of 8 (SD 7) mmHg at PMC time. During the mean FUP of 20 (SD 6) years, 51 (41.1%) patients had MV re-intervention (86.3% surgery and 13.7% redo-PMC), 37 (29.8%) were hospitalized, and 30 (24.2%) died. Approximately 75% of patients remained MACE-free after 10 years, and this percentage decreased to around 40% after 20 years; at this time mark, about 8 in 10 patients were alive. A reduction of &lt;5 mmHg in TMPG at PMC time was associated with a 2.7-fold greater rate of MACE compared to a reduction of \u22655 mmHg, independent of MV regurgitation after PMC and moderate disease of other valves (adjusted hazard ratio 2.7; 95% confidence interval 1.395-5.298, p=0.003). In this cohort with favorable long-term results after PMC, a reduction of &lt;5 mmHg in TMPG at PMC time was associated with MACE during FUP. More studies are needed to validate this independent predictor.<\/jats:p>","DOI":"10.4081\/monaldi.2024.2941","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T12:54:25Z","timestamp":1710161665000},"source":"Crossref","is-referenced-by-count":0,"title":["20-year follow-up of rheumatic mitral stenosis patients after percutaneous mitral commissurotomy: invasive transmitral gradient differential as a predictor of events"],"prefix":"10.4081","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2410-7075","authenticated-orcid":false,"given":"Ana Filipa","family":"Amador","sequence":"first","affiliation":[]},{"given":"Catarina","family":"Costa","sequence":"additional","affiliation":[]},{"given":"Ricardo","family":"Pinto","sequence":"additional","affiliation":[]},{"given":"Miguel","family":"Carvalho","sequence":"additional","affiliation":[]},{"given":"T\u00e2nia","family":"Proen\u00e7a","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o","family":"Calv\u00e3o","sequence":"additional","affiliation":[]},{"given":"Sandra","family":"Amorim","sequence":"additional","affiliation":[]},{"given":"Mariana","family":"Paiva","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o Carlos","family":"Silva","sequence":"additional","affiliation":[]},{"given":"Rui","family":"Rodrigues","sequence":"additional","affiliation":[]}],"member":"2549","published-online":{"date-parts":[[2024,3,11]]},"reference":[{"key":"37697","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.09.050"},{"key":"37698","unstructured":"Kumar RK, Antunes MJ, Beaton A, et al. Contemporary diagnosis and management of rheumatic heart disease: implications for closing the gap: a scientific statement from the American Heart Association. Circulation 2020;142:e337-57."},{"key":"37699","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezac209"},{"key":"37700","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-315906"},{"key":"37701","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)37390-8"},{"key":"37702","unstructured":"Feldman T, Herrmann HC, Inoue K. Technique of percutaneous transvenous mitral commissurotomy using the Inoue balloon catheter. Cathet Cardiovasc Diagn 1994;2:26-34."},{"key":"37703","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.009449"},{"key":"37704","unstructured":"Chmielak Z, Kruk M, Demkow M, et al. Long-term follow-up of patients with percutaneous mitral commissurotomy. Kardiol Pol 2008;66:525-30."},{"key":"37705","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.1726"},{"key":"37706","doi-asserted-by":"publisher","DOI":"10.4103\/heartviews.heartviews_78_22"},{"key":"37707","doi-asserted-by":"publisher","DOI":"10.1177\/0218492309349258"},{"key":"37708","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht097"},{"key":"37709","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.20-082"},{"key":"37710","unstructured":"Braiteh N, Zgheib A, Kashou AH, et al. Immediate and long-term results of percutaneous mitral commissurotomy: up to 15 years. Am J Cardiovasc Dis 2019;15:34-41."},{"key":"37711","unstructured":"Macrotrends. Portugal Life Expectancy 1950-2024. Available from: https:\/\/www.macrotrends.net\/countries\/PRT\/portugal\/life-expectancy. Accessed on: 21\/02\/2024."},{"key":"37712","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-019-1099-7"},{"key":"37713","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00142-2"},{"key":"37714","doi-asserted-by":"publisher","DOI":"10.25270\/jic\/22.00328"},{"key":"37715","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.055905"}],"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/2941\/1864","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/2941\/1864","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T11:56:20Z","timestamp":1749210980000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/view\/2941"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,11]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3,31]]}},"URL":"https:\/\/doi.org\/10.4081\/monaldi.2024.2941","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"type":"electronic","value":"2532-5264"},{"type":"print","value":"1122-0643"}],"subject":[],"published":{"date-parts":[[2024,3,11]]}}}