[Percutaneous valvuloplasty in mitral stenosis].
Since May 1991 to July 1992, 83 patients (mean age 49 +/- 13 years, 17 males and 66 females) underwent percutaneous mitral valvuloplasty according to Inoue's technique. Following Wilkins' criteria echo-score was < or = 8 in 46 patients and mono-commissural calcifications were present in 8 cases. Sixteen (19%) patients had previous surgical mitral commissurotomy and 15 (18%) had previous embolic events. The indications for the procedure were given on the basis of the echo-score (ideal cases with score < or = 8). All patients but 2 were successfully treated. Two patients who developed mitral regurgitation grade 3+/4+ were referred to elective surgery. Mitral valve area increased from 1.1 +/- 0.2 to 2 +/- 0.3 cm2 (p < 0.001) and transvalvular pressure gradient fell from 16 +/- 5 to 6 +/- 3 mmHg (p < 0.001). Patients with previous surgical commissurotomy had a lower increase in mitral valve area than patients without previous surgery (p < 0.02). Patients with echo-score > 8 presented a more evident increase in mitral regurgitation than patients with good valvular anatomy, even if this difference was not significant. At 6 and 12 month follow-up respectively 2 and 1 restenosis occurred, but in 1 of these cases the residual valvular area was > 1.5 cm2. The authors conclude that in selected patients with mitral stenosis percutaneous mitral valvuloplasty seems to be an effective and safe treatment. Furthermore, immediate and middle-term results show that this technique can be performed without adjunctive risks and with satisfactory results also in cases of no ideal clinical and/or valvular conditions (echo-score > 8, previous surgical commissurotomy, history of embolism, mono-commissural calcifications).
Istituto di Cardiologia, Università degli Studi, Catania.
C
C
Tamburino
G
G
Russo
R
R
Di Paola
A
A
Drago
R
R
Aiello
G
G
Greco
S
S
Felis
G
G
Castania
W
W
Deste
V
V
Calvi
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D002933:Cineradiography; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*
La valvuloplastica percutanea nella stenosi mitralica.