title: Percutaneous mitral balloon valvuloplasty--a comparative evaluation of two transatrial techniques.
abstract: The efficacy and safety of two different percutaneous transfemoral mitral balloon valvuloplasty procedures were evaluated in 45 patients. A double-balloon technique with Mansfield balloons was applied in the first 22 patients (group A), and an Inoue single-balloon technique was used in the subsequent 23 patients (group B). Mean diastolic gradient decreased from 17 +/- 7 mm Hg to 8 +/- 3 mm Hg (p < 0.001) in group A and from 13 +/- 4 mm Hg to 8 +/- 3 mm Hg (p < 0.001) in group B. The mitral orifice area increased from 1.1 +/- 0.3 cm2 to 2.2 +/- 0.8 cm2 (p < 0.001) in group A and from 1.2 +/- 0.4 cm2 to 1.7 +/- 0.7 cm2 (p < 0.001) in group B. The length of the total procedure and the total fluoroscopy time were considerably shorter in group B (86 +/- 24 minutes and 18 +/- 7 minutes) compared with group A (128 +/- 38 minutes and 35 +/- 14 minutes; p < 0.001). Mitral regurgitation (grade 3/4) was observed after the procedure in two patients in group A but in nine patients in group B. Cardiac tamponade occurred in two patients in group A, but no major complications were seen in group B. The Inoue single-balloon technique seemed to be safe, easier to perform, and equally effective.
authors.affiliation: Klinikum, Albert-Ludwigs-Universität, Freiburg, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Kasper
authors.forename: H
authors.initials: H
authors.lastname: Wollschläger
authors.forename: A
authors.initials: A
authors.lastname: Geibel
authors.forename: T
authors.initials: T
authors.lastname: Meinertz
authors.forename: H
authors.initials: H
authors.lastname: Just
mesh_terms: D000328:Adult; D000368:Aged; D021721:Balloon Occlusion; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000453:epidemiology; D008946:Mitral Valve Stenosis / Q000628:therapy*; D011183:Postoperative Complications / Q000453:epidemiology; D012214:Rheumatic Heart Disease / Q000628:therapy*; D016896:Treatment Outcome