Describe the immediate and final outcome of percutaneous mitral balloon commissurotomy (PMC) with Inoue balloon in patients over 50 years old and associate complications with age and Wilkins score.

A retrospective and analytic study was performed with a data base of 480 patients. We included all the patients proceeding in our department from January 1998 to December 2012. 75 were > or = 50-years old (group1). Immediate and late outcomes in this group (group 1) were compared with those in the patients aged < 50-years (group 2).

Baseline hemodynamic parameters were comparable in the two groups. The Wilkins score was> 8 in 11 patients We found a Mitral Valvular Area (MVA) before the PMC proceeding of 0.99cm²±0.2 and 1.87cm²±0.38 post PMC (P < 0.001), with pre procedure transmitral gradient of 12.7±4.05mm Hg and of 4.4±2.3mm Hg post (P < 0.001). Similar significant improvements were seen in group 2. In 72 patients (96%) the immediate proceeding was considered successful.The hemodynamic result was good in 85.3% of group 1 patients. Tamponade occurred in one patient. Mitral regurgitation grade I or II developed in 8 patients and remained stable in 19 patients. These complication rates were comparable to those seen in group 2. A clinical and echocardiographic follow-up was performed in 68 patients (93%). In the group 1, a good result was maintained in 60% of patients after 75.8±40 months of follow-up. Although restenosis was observed in 28% of patients, functional amelioration was obtained in most of cases. Survival free of mitral valve intervention or heart failure ≥ NYHA III was significantly better for patients with good immediate result.

PMC is safe and efficacious in elderly patients with symptomatic mitral stenosis. Long-term results are good and related mainly to the quality of the procedure.