الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
• Mitral balloon valvuloplasty, which is a landmark in the treatment of rheumatic mitral stenosis, has excellent immediate and short-term results in patients with favorable mitral valve morphology but those with less favorable anatomy may still have reasonably good for hemodynamic and symptomatic relief. This technique is associated with less morbidity and short-term results are better than the historical reported surgical results. The long-term outcome can be predicted from baseline clinical and valvular characteristics.
• The experience and clinical success rates at this study are comparable with those reported at other large centers treating initial series of BMV patients.
• PBMV is safe and effective when treating patients with MS and severe pulmonary hypertension, the latter condition being normalized over 6–12 months after successful PBMV. Severe TR regresses after successful PBMV in the presence of severe pulmonary hypertension.
• This study agreed with the observations of others that the ideal candidate for balloon mitral valvuloplasty is young and has favorable mitral valve structure, satisfactory left ventricular function, and good general health. Although this procedure can be applied to elderly patients and to those with less favorable valve morphology, PBMV is a safe and effective procedure in both wilkin’s score groups. Optimal results of PBMV can be achieved in patients with higher wilkin’s score if they are carefully selected and operated at experienced centers. Without questioning the value of the wilkin’s score, or its cut-off point, the current study showed that, in our population, there was still a chance for successful PBMV in patients with wilkin’s score between 9 and 11.
• Balloon mitral valvuloplasty can be safely performed during pregnancy and is effective in relieving symptoms of congestive heart failure in patients with severe MS who fail to respond to drug treatment. When feasible, it is the treatment of choice for these patients; although few patients have been studied, the risk to the mother and particularly to the fetus appears to be low.
• Repeat percutaneous mitral valvuloplasty in patients with restenosis after a prior percutaneous valvuloplasty is feasible and can be accomplished with acceptable morbidity and mortality. Immediate procedural success is achieved in most of patients. In patients with low echo scores and no comorbid diseases, repeat PBMV should be the procedure of choice. Although mitral valve surgery should be the treatment of choice for patients with more extensive valvular and subvalvular deformity, redo PBMV can be used as a palliative technique in these patients when they are at high risk of morbidity and mortality with MVR due to the presence of associated significant comorbid diseases. another important respect is that most Patients who underwent repeated procedures were younger as a group than those who had only a single procedure. This may attributed to the greater likelihood of repeated episodes of active rheumatic disease in this younger group and this highlights the importance of remembering to administer rheumatic fever prophylaxis to younger patients undergoing PBMV procedures.