Tabriz University of Medical Sciences Journal of Cardiovascular and Thoracic Research 2008-5117 14 2 2022 06 30 Long-term outcomes of severe rheumatic mitral stenosis after undergoing percutaneous mitral commissurotomy and mitral valve replacement: A 10-year experience 101 107 10.34172/jcvtr.2022.16 EN Wasinee Promratpan https://orcid.org/0000-0003-0679-5644 Nonthikorn Theerasuwipakorn https://orcid.org/0000-0002-3521-7715 Vorarit Lertsuwunseri https://orcid.org/0000-0003-2772-1695 Suphot Srimahachota Journal Article 10.34172/jcvtr.2022.16 2021 12 26 2022 05 08 Introduction: Percutaneous mitral commissurotomy (PTMC) and mitral valve replacement (MVR) are treatments of choice for severe rheumatic mitral stenosis (MS). Data regarding the long-term outcomes of patients who underwent PTMC and MVR are limited. Methods: A retrospective cohort study was conducted to evaluate the long-term outcomes of patients with severe rheumatic MS who underwent PTMC or MVR between 2010 to 2020. The primary outcome comprised of all-cause death, stroke or systemic embolism, heart failure hospitalization and re-intervention. Cox regression was used to investigate predictors of the primary outcome. Results: 264 patients were included in analysis, 164 patients (62.1%) in PTMC group and 100 patients in MVR group (37.9%). The majority were females (80.7%) and had atrial fibrillation (68.6%). The mean age was 49.52 (SD: 13.03) years old. MVR group had more age and AF, higher Wilkins’ score with smaller MVA. Primary outcome occurred significantly higher in PTMC group (37.2% vs 22%, P=0.002), as well as, re-intervention (18.3% vs 0%, P<0.001). However, all-cause mortality, stroke or systemic embolism and heart failure hospitalization were not significantly different. In multivariate Cox regression analysis, PTMC (HR 1.94; 95%CI 1.14, 3.32; P=0.015), older age (HR 1.03; 95%CI 1.01, 1.06; P=0.009) and SPAP > 50 mmHg (HR 2.99; 95%CI 1.01, 8.84; P=0.047) were the only predictors of primary outcome. Conclusion: Primary outcome occurred in PTMC group more than MVR group which was driven by re-intervention. However, all-cause mortality, stroke or systemic embolism and heart failure hospitalization were not significantly different.