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Clin Cardiol. 2011;34:401�C406. To the Editor: We read with great interest the report by Aslanabadi et al published in the Clinical Investigations section of this journal.1 We have some comments to make. The two groups were not randomized. Clearly, patients in the mitral valve replacement (MVR) group were sicker. They were older, with a higher New York Heart Association-Functional Class mitral valve area, mitral regurgitation grade, and pulmonary artery systolic pressure, as well as a higher prevalence http://www.selleckchem.com/GSK-3.html of atrial fibrillation and lower left ventricular function, although left atrial sizes and pressures, echo scores, and transvalvular gradients were similar between the groups. In addition, criteria for choosing MVR or repeating percutaneous balloon mitral valvotomy (re-PBMV) in these patients were ��at the discretion of the attending physician and patient preference.�� http://www.selleckchem.com/screening/tyrosine-kinase-inhibitor-library.html As such, it is not surprising that the 10-year survival was significantly higher in re-PBMV vs MVR (96% vs 72.7%, respectively, (P http://en.wikipedia.org/wiki/VAV2 paper,2 we had shown that following balloon mitral valvotomy for mitral restenosis, patients with prior balloon mitral valvotomy were found to have lesser event rates on follow-up compared to patients with prior closed mitral valvotomy, although procedural success rates are similar. We invite the authors' response to these comments. ""We appreciate Dr. ?uli?'s interest in our study, ��Role of Age, Sex, and Race on Cardiac and Total Mortality Associated With Super Bowl Wins and Losses.