Mitral restenosis and mitral regurgitation 1 year after Inoue mitral balloon valvotomy in a population of patients with pliable mitral valve stenosis.
To determine the rate of mitral restenosis and mitral regurgitation increase 1 year after mitral valvotomy using the Inoue balloon catheter, 66 consecutive patients with severe, pliable mitral stenosis had their mitral valve area (MVA) calculated by two-dimensional echocardiography (2DE) and Doppler before, immediately after balloon valvotomy, and at 1-year follow-up. Color Doppler studies were also done to detect small atrial septal defects (ASDs) and mitral regurgitation. The mean age of the patients was 31 +/- 12 years. Three patients were in New York Heart Association (NYHA) class II and 63 patients were in NYHA class III to IV. Sixty-two of the 66 patients had an echo score (Boston) of < or = 8. After Inoue balloon valvotomy (IBV), the MVA (2DE) increased from 0.8 +/- 0.2 to 1.9 +/- 0.3 cm2 (p < 0.001), and the Doppler MVA increased from 0.8 +/- 0.2 to 1.8 +/- 0.3 cm2 (p < 0.001). We detected 4 of 66 cases (6%) with significant residual mitral stenosis (MVA < 1.5 cm2). Mitral regurgitation increased in 14 of 66 patients (21%), but no patient developed severe mitral regurgitation. Fourteen out of 66 patients (20%) had ASDs that were detected on color Doppler. At 1-year follow-up the mean Doppler MVA was maintained at 1.8 +/- 0.4 cm2, with 6 of 66 patients (9%) exhibiting significant mitral valve restenosis. Residual significant mitral stenosis must be differentiated from mitral restenosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Ribeiro
P A
PA
King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Fawzy
M E
ME
Mimish
L
L
Awad
M
M
Dunn
B E
BE
Arafah
M R
MR
Duran
C G
CG
D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology; D006346:Heart Septum / Q000473:pathology; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology*; D008946:Mitral Valve Stenosis / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence