[Mitral valvuloplasty with double balloon catheter. Analysis of 200 cases].
OBJECTIVE
To study the immediate clinical, echocardiographic and hemodynamic results of 200 patients who underwent percutaneous mitral balloon valvotomy (PMV) with double balloon technique.


METHODS
Two hundred patients were submitted to PVM for treatment of congestive heart failure secondary to severe mitral stenosis, between August 1987 to July 1991. Their mean age was 35.2 years, and 86.5% were female patients: 81% of them was in functional class, New York Heart Association (NYHA) III or IV; 4% was in atrial fibrilation and 4% had previous surgical commissurotomy.


RESULTS
PMV was successfully performed in 89% of the patients. The mitral valve area, by pressure half time method, increased from 0.91 +/- 0.27 to 2.10 +/- 0.47 cm2, p < 0.001; the mean mitral gradient decreased from 20.86 +/- 6.16 to 4.26 +/- 3.13 mmHg, p < 0.001; the left atrium and mean pulmonary artery pressure decreased from 22.3 +/- 7.1 to 11.9 +/- 8.3 and 36.47 +/- 12.93 to 24.56 +/- 9.98 mmHg, p < 0.001, respectively. Complications related to transeptal technique occurred in 12 patients, which resulted in cardiac tamponade in 5 and death in 1. In 19 patients the punction of the atrial septum could not be performed. Mitral regurgitation (MR) immediately after PMV appeared 1+ or more grade in 50 patients, increased in 8 patients and remained unchanged in 11 patients. Ten patients needed mitral valve replacement in the first 48h after PMV, for treatment of severe MR.


CONCLUSIONS
PMV produces excellent immediate results and can be considered an alternative to surgery for the relief of mitral stenosis.
Gomes
N L
NL
Instituto Dante Pazzanese de Cardiologia, São Paulo.
Esteves
C A
CA
Braga
S L
SL
Ramos
A I
AI
Meneghelo
Z M
ZM
Mattos
L A
LA
Pontes Júnior
S C
SC
Arnoni
A S
AS
Fontes
V F
VF
Sousa
J E
JE
D021721:Balloon Occlusion; D002404:Catheterization / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000209:etiology / Q000628:therapy*
Valvoplastia mitral com duplo cateter-balão. Análise de 200 casos.