**7.1. Immediate results**

A good immediate result is defined as an MVA > 1.5 cm<sup>2</sup> without MR more than moderate and is most probably achieved in patients with favorable morphologic features; nonetheless, other factors including age, history of previous commissurotomy, smaller baseline MVA, preexisting MR, pulmonary artery pressure, sinus rhythm, functional status, and technical issues are also determining [43, 44].

#### **7.2. Long-term results**

When BMV has a good acute result, the long-term survival rate is high and the need for reintervention is infrequent. Anatomical characteristics and age are important predictors of long-term outcomes. Midterm outcomes (3–7 y) are favorable and comparable with open mitral valvulotomy and better than closed mitral valvulotomy [5].

Restenosis can occur after successful BMV, but its incidence is difficult to determine due to the absence of a uniform definition and different follow-up periods in the studies. An MVA < 1.5 cm2 or a 50% loss in the initial MVA is generally defined as restenosis. The possible mechanisms include suboptimal initial results, recurrent rheumatic attacks, and a hemodynamicrelated degenerative process. In patients with symptomatic severe restenosis, repeat BMV or mitral valve surgery should be selected according to the guidelines.
