Balloon mitral commissurotomy (BMC) has become widely accepted as the treatment of choice for mitral stenosis in patients with favorable anatomy, but few tools are available to predict its long-term outcome.

We sought to determine a simple score to predict late outcome of BMC in patients with mitral stenosis.

Late results of BMC were assessed in 1035 consecutive patients at our institution. A good immediate result was defined as valve area ≥1.5 cm² without mitral regurgitation>2/4. BMC procedure was performed using the double balloon or the Inoue balloon techniques. Ore to predict late outcome of BMC in patients with mitral stenosis.

Mean age of our population was 35.6±12 years. A successful procedure was observed in 92.4% of cases. At a mean follow-up of 20 years, the rate of survival with freedom from mitral surgery, or repeat percutaneous mitral commissurotomy and with New York Heart Association class I or II was of 47.6±2.4%. By multivariate analysis using Cox regression model, three predictors of poor late functional results were identified: prior commissurotomy (P=0.014), Wilkins score >8 (P<0.0001) and final mitral valve area <1.8 cm² (P<0.0001). From the results of this analysis, we sought to develop a scoring system using the items indicated in the table below. Patients were considered at low risk if the score was of 0 to 5 (17.6% of patients). They were considered at middle risk if the score was of 6 to 8 (37.8% of patients) and were considered at high risk if the score was of 9 to 14 (51% of patients) (Table 1).

Twenty-year outcome of balloon mitral commissurotomy in a relatively young population is very encouraging and can be predicted by a simple score.