Mitral balloon valvotomy in children with Inoue balloon technique: immediate and intermediate-term result.
Percutaneous mitral balloon valvotomy (PMV) using the Inoue balloon technique was attempted in 170 patients. Of these, 30 patients were children aged 10 to 18 years (mean 15.9 +/- 2.7 years). There were 16 female and 14 male patients. All were in sinus rhythm. The procedure was successful in 28 patients (93%). PMV was performed using 20 to 28 mm (mean 25 mm) diameter balloon catheters with an echo-Doppler guided stepwise mitral dilation technique. After PMV, the mean left atrial pressure decreased from 25 +/- 5 to 14 +/- 4 mm Hg (p < 0.001). The mean mitral valve gradient (MVG) decreased from 16 +/- 4 to 6 +/- 3 mm Hg (p < 0.001). The mitral valve area (MVA) by catheter increased from 0.7 +/- 0.2 to 1.7 +/- 0.5 cm2 (p < 0.001), and MVA as determined by echocardiography (2DE) increased from 0.8 +/- 0.1 to 1.9 +/- 0.3 cm2 (p < 0.01). There were no deaths or thromboembolic complications; cardiac tamponade developed in one patient, mild mitral regurgitation (MR) developed in three patients (10%) and increased by one grade from (1+ to 2+) in another two patients (8%). A small atrial septal defect (ASD) assessed by color flow mapping developed in seven patients (25%); 90% were closed at 3 months. The Doppler and 2DE MVAs were maintained at 1.8 +/- 0.4 cm2 at 17 months' mean follow-up; one patient developed restenosis. We conclude the PMV using the Inoue balloon catheter is safe and effective in the treatment of severe mitral stenosis in children, with a low complication rate.
Fawzy
M E
ME
Department of Cardiovascular Diseases, King Faisal Specialist Hospital, Riyadh, Saudi Arabia.
Mimish
L
L
Awad
M
M
Galal
O
O
el-Deeb
F
F
Khan
B
B
D000293:Adolescent; D021721:Balloon Occlusion; D006328:Cardiac Catheterization; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008943:Mitral Valve; D008946:Mitral Valve Stenosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors