Balloon mitral valvotomy with a single catheter: a comparison between bifoil/trefoil and the Inoue balloon.
Results of percutaneous mitral valvotomy were compared in two groups undergoing the procedure at our institution. Group I: 100 patients having had percutaneous valvotomy with the Schneider-Medintag bifoil (2 x 19 mm) or trefoil (3 x 15 mm or 3 x 12 mm) catheters, and group II; 150 patients in whom the procedure was performed with the Inoue balloon (24-30 mm). Baseline clinical (age, gender, NYHA class and echo score) and haemodynamic variables were similar in both groups. Haemodynamic improvement occurred in both groups. Although the reduction in left atrial pressure did not differ significantly between the two groups, the increase in mitral valve area was significantly (P < 0.001) higher for group I (0.8 +/- 0.2 to 1.9 +/- 0.7 and 0.8 +/- 0.3 to 1.6 +/- 0.3 cm2 respectively for mitral area, and 22 +/- 6 to 13 +/- 5 and 21 +/- 6 to 13 +/- 5 mmHg respectively for mean left atrial pressure). The increase in cardiac output was statistically significant in group I (3.2 +/- 0.7 to 4.0 +/- 0.9 l.min-1, P < 0.05) but not in group II (3.5 +/- 2.0 to 3.7 +/- 0.9 l.min-1, ns). Inter-atrial shunting immediately after valvotomy was recorded in 19% of group I patients compared with 6% in group II (P < 0.001). The overall incidence of significant mitral regurgitation (3+ or 4+) was similar in both groups (5% and 4% respectively). However, when the stepwise dilatation technique was employed in group II, the incidence had dropped to 2.1%.(ABSTRACT TRUNCATED AT 250 WORDS)
Patel
J J
JJ
Cardiology Department, University of Natal/Wentworth Hospital, Durban, South Africa.
Mitha
A S
AS
Chetty
S
S
Hung
J S
JS
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002404:Catheterization / Q000295:instrumentation*; D015150:Echocardiography, Doppler; D004867:Equipment Design; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies