BACKGROUND: Balloon mitral valvotomy ( @entity1899 ) is a well-established therapeutic modality for @entity4794 ( @entity4794 ). However, there are chances of procedural failure and the more ominous post-procedural severe @entity339 . There are only a few prospective studies, which have evaluated the pathogenic mechanisms for these major complications of @entity1899 , especially in relation to the subvalvular apparatus (SVA) pathology. METHODS: All symptomatic @entity1 of @entity4794 suitable for @entity1899 by echocardiographic criteria in a span of 1 year were selected. In addition to the standard echocardiographic assessment of @entity4794 (Wilkins score and score by Padial et al.), a separate grading and scoring system was assigned to evaluate the severity of the SVA pathology. The SVA score was 'I', when none of the two SVAs had severe disease, 'II' when one of the two SVAs has severe disease, and 'III' when both SVAs had severe disease. With these scoring systems, the outcomes of @entity1899 (successful procedure, failure, and post-procedural @entity339 ) were analyzed. @entity340 was performed depending on clinical situation, and in cases of replacement, the pathology of the excised mitral valves were compared with echocardiographic findings. RESULTS: Of the 356 BMVs performed in a year, 43 @entity1 had adverse outcomes in the form of failed procedure (14 @entity1 ) and @entity339 (29 @entity1 ). Forty-one among these had a SVA score of III. The sensitivity and specificity of the MR score was lesser than the SVA score (sensitivity 0.34 vs. 1.00, specificity 0.92 vs. 0.99, respectively). The mitral valvular morphology in 39 @entity1 who underwent post-procedural valve replacements correlated well with echocardiography findings. CONCLUSION: It is important to assess the degree of SVA pathology in the conventional echocardiographic assessment for @entity4794 , as @entity1899 would have adverse events when both SVAs were severely diseased.

Subvalvular apparatus and adverse outcome of balloon valvotomy in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity339 :: ('MESH:D008944', 'Disease') :: ['mitral regurgitation'] @entity1899 :: ('12302', 'Species') :: ['BMV'] @entity4794 :: ('MESH:D008946', 'Disease') :: ['RMS', 'rheumatic mitral stenosis'] @entity340 :: ('MESH:D006349', 'Disease') :: ['Emergency valve replacement']
@entity4794 :: (MESH:D008946,Disease) :: ['rheumatic mitral stenosis']
