title: Elevated left atrial pressure does not cause left-to-right shunting after mitral balloon valvuloplasty.
abstract: To assess the hemodynamic factors affecting left-to-right shunting following balloon mitral valvuloplasty we studied 10 patients at 3 points during the procedure: pre-septal dilation, post-septal dilation pre-valvuloplasty, and post-valvuloplasty. Hemodynamic parameters were recorded and an oximetry run was obtained at each stage. Mitral valvuloplasty was successful in 8 and unsuccessful in 2 patients. No patient had a significant oxygen step-up at any stage, including the 2 patients with unsuccessful valvuloplasty. Significant left-to-right shunting through the atrial septal puncture in mitral valvuloplasty is infrequent, even before successful balloon valvuloplasty when left atrial pressure is maximally elevated.
authors.affiliation: Department of Medicine, St. Michael's Hospital, University of Toronto, Ontario, Canada.
authors.forename: K R
authors.initials: KR
authors.lastname: Watson
authors.forename: R J
authors.initials: RJ
authors.lastname: Chisholm
authors.forename: J R
authors.initials: JR
authors.lastname: Azpiri
authors.forename: P W
authors.initials: PW
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006346:Heart Septum / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000503:physiopathology / Q000628:therapy*; D011652:Pulmonary Circulation; D011677:Punctures