Percutaneous mitral commissurotomy(PMC) has been known as an effective therapeutic modality for moderate to severe mitral stenosis. However, long-term results and factors influencing late outcome after PMC remain to be elucidated.

Three hundred and forty-six patients received PMC at Seoul National University Hospital between August, 1988 and March, 1996. We evaluated long-term results of these patients and assessed demographic, clinical, echocardiographic and hemodynamic variables in order to identify predictors of immediate and late outcomes.

PMC was completed without major complication or technical failure in 339(98%) out of 346 cases. A good immediate result was obtained in 67% of cases. Multivariate study identified echocardiographic score(P=0.004) and left atrial volume(P=0.009) as independent predictors of immediate outcome. The estimated 3-year and 5-year event-free survival rates were 95.8±2.5% and 90.6±4.3%, respectively. According to multivariate analysis, the independent predictors of late outcome were pre-PMC left atrial volume(P=0.03), post-PMC mitral valve area(P=0.01), and severity of mitral regurgitation after PMC(P=0.03).

Percutaneous mitral commissurotomy as a treatment for patients with mitral stenosis is safe, and achives good long-term results. Pre-procedural echocardiographic score, left atrial volume, post-procedural mitral valve area, and severity of mitral regurgitation affect the immediate and late outcomes after PMC.