title: Comparative results of percutaneous balloon mitral valvuloplasty using the Trefoil/Bifoil and Inoue balloon techniques.
abstract: This study compared the results in 150 consecutive patients with rheumatic mitral stenosis who underwent percutaneous balloon mitral valvuloplasty by means of a Trefoil/Bifoil balloon catheter (n = 100, Group 1) or the Inoue balloon catheter (n = 50, Group 2). There was significant improvement in mitral valve area after valvuloplasty in both groups: in Group 1 mitral valve area improved from 0.92 +/- 0.22 to 2.14 +/- 0.64 cm2 (P < 0.001) and in Group 2 from 1.0 +/- 0.26 to 2.06 +/- 0.59 cm2 (P < 0.001). There was no significant difference in the mitral valve area, mean diastolic gradient or mean left atrial pressure between Group 1 and Group 2 patients after valvuloplasty. There was a higher complication rate in Group 1 patients but this was largely related to our early learning experience with the procedure. The Trefoil/Bifoil catheter technique is more complex and involved a longer screening time: Group 1 (39 +/- 15 min) vs. Group 2 (22 +/- 10 min); P < 0.001. The cost of the Inoue balloon technique, however, was almost twice that of the Trefoil/Bifoil technique. This may have important implications for developing countries with limited health care budgets and a high prevalence of rheumatic heart disease.
authors.affiliation: Department of Cardiology, Johannesburg Hospital, South Africa.
authors.forename: P
authors.initials: P
authors.lastname: Manga
authors.forename: P
authors.initials: P
authors.lastname: Landless
authors.forename: M
authors.initials: M
authors.lastname: Gebka
mesh_terms: D000328:Adult; D002404:Catheterization / Q000191:economics / Q000379:methods*; D003365:Costs and Cost Analysis; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000503:physiopathology / Q000628:therapy*; D012214:Rheumatic Heart Disease / Q000503:physiopathology / Q000628:therapy*