Transarterial balloon mitral valvuloplasty.
Between February 1985 and November 1986, 36 patients, aged between 15 and 67 years (mean 39 years), with moderate (27 patients) and severe (9) mitral valvular stenosis (MS) underwent percutaneous transarterial balloon mitral valvuloplasty (PTBMV). Originally, a right femoral vein-LA-LV-aorta-left femoral artery track had been formed with a long guide wire, which had been advanced transseptally through the Brockenbrough catheter to the LV, where its distal end was caught by means of a retriever set and exteriorized through the femoral artery. Introduction of the transseptal sheath through the LA-LV to the aorta with the Swan-Ganz catheter as a guidance, made the formation of two long guide tracks much easier and enabled the application of the double balloon technique. PTBMV was performed in 15 patients using the single balloon technique with a balloon of 25 mm in diameter and in 19 patients using double-balloon technique (18 + 15 mm in one patient, 20 + 18 mm in two patients and 18 + 18 mm in 16 patients). The mitral valve gradient decreased from 18 +/- 4.3 to 8.4 +/- 4.4 mm Hg (p less than 0.001) and the mitral valve area (MVA) enlarged from 1.26 +/- 0.025 to 2.3 +/- 0.66 cm2 (p less than 0.001) (87%) immediately after valvuloplasty. PTBMV produced significant mitral regurgitation in two patients (grade IV and II). Enlargement of the MVA by 127% was achieved in patients with type A MS and only by 53% in patients with type B MS.(ABSTRACT TRUNCATED AT 250 WORDS)
Babic
U U
UU
Cardiovascular Center Dragisa Misovic, Beograd, Yugoslavia.
Pejcic
P
P
Djurisic
Z
Z
Vucinic
M
M
Grujicic
S M
SM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000628:therapy*