AIMS: The optimal timing of percutaneous mitral commissurotomy (PMC) remains controversial in asymptomatic @entity1 with moderate @entity4794 ( @entity4794 ). We sought to compare the long-term outcomes of early preemptive PMC and a conventional treatment strategy. METHODS AND RESULTS: From 1997 to 2007, we prospectively enrolled 244 consecutive asymptomatic @entity1 (191 @entity1 , age 51    11 years) with moderate @entity4794 who were potential candidates for early PMC. The treatment groups were not randomly assigned and the choice of early PMC or conventional treatment for each @entity1 was at the discretion of the attending physician. The primary endpoint was defined as the composite of @entity65 , @entity385 , and @entity532 . In the PMC group, there were no procedure-related @entity204 and mitral valve area was increased from 1.26    0.11 to 2.07    0.28 cm(2) immediately after PMC (P < 0.001). During a median follow-up of 8.3 years, there were 3 @entity65 and 5 @entity385 in the PMC group (n= 106) compared with 16 @entity65 , 12 @entity385 in the CONV group (n = 138). The estimated actuarial 11-year event-free survival rate was 89    4% in the PMC group and 69    5% in the CONV group (P < 0.001) but not significantly different in those without @entity955 and previous @entity887 (86    5% in the PMC group and 79    6% in the CONV group at 11 years, P = 0.28). For the 62 propensity score-matched pairs, the risk of cardiovascular endpoint was significantly lower in the PMC than in the CONV group (hazard ratio: 0.327; 95% CI: 0.112-0.954; P = 0.041). CONCLUSION: In asymptomatic @entity1 with moderate @entity4794 and favourable valve morphology, the clinical benefits of early PMC may outweigh the risks associated with early intervention, but prospective randomized trials are required to confirm the efficacy of early PMC.

Early percutaneous mitral commissurotomy vs. conventional management in asymptomatic moderate XXXX .

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient'] @entity532 :: ('MESH:D003925', 'Disease') :: ['PMC-related complications'] @entity887 :: ('MESH:D004617', 'Disease') :: ['embolism'] @entity955 :: ('MESH:D001281', 'Disease') :: ['atrial fibrillation'] @entity4794 :: ('MESH:D008946', 'Disease') :: ['MS', 'rheumatic MS', 'mitral stenosis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular deaths', 'cardiovascular mortality'] @entity385 :: ('MESH:D002544', 'Disease') :: ['cerebral infarctions, and 7 systemic embolic events', 'cerebral infarctions', 'cerebral infarction, systemic embolic events']
@entity4794 :: (MESH:D008946,Disease) :: ['mitral stenosis']
