Percutaneous balloon commissurotomy reduces incidence of ischemic cerebral stroke in patients with symptomatic rheumatic mitral stenosis.

Whether percutaneous balloon commissurotomy reduces cerebral stroke in patients with symptomatic rheumatic mitral stenosis remains obscure. This study enrolled 170 such patients undergoing either medical therapy alone (n=71) or balloon commissurotomy (n=99). In the short term, balloon commissurotomy was successfully accomplished in 99% patients without embolic complications. At follow-up (mean 4.2+/-3.2 years), patients undergoing commissurotomy encountered significantly rarer ischemic stroke than the medicine group (2% vs. 13%, p=0.043). Multivariate Cox regression analysis further confirmed balloon commissurotomy as a negative predictor for ischemic stroke (hazard ratio 0.135, p=0.011). These results lead to the conclusion that percutaneous balloon commissurotomy could substantially decrease the long-term incidence of ischemic cerebral stroke in eligible patients with symptomatic rheumatic mitral stenosis.