Immediate and long-term results of percutaneous Inoue balloon mitral commissurotomy with use of a simple height-derived balloon sizing method for the stepwise dilation technique.
OBJECTIVE
To assess the short- and long-term efficacy of Inoue balloon percutaneous transvenous mitral commissurotomy (PTMC) with use of our simple balloon sizing method based on patient height.


METHODS
Data from 105 consecutive patients with symptomatic mitral stenosis who underwent 107 PTMC procedures between October 1991 and April 1995 at our hospital were analyzed.


RESULTS
All PTMC procedures were successfully completed with no instances of cardiac perforation, systemic embolism, severe mitral regurgitation (grade 3 or more angiographically), or death. The mean mitral valve area increased from 0.8 +/- 0.2 cm2 to 1.7 +/- 0.4 cm2 (P = 0.0001), as assessed echocardiographically. Optimal results -- defined as an improvement in valve area of 50% or more or a final valve area of 1.5 cm2 or more without significant mitral regurgitation (an increase in mitral regurgitation of two or more grades or a final regurgitation of grade 3 or more) -- were obtained in 96% of patients. At a mean follow-up interval of 20 months, symptomatic benefit was maintained in 97% of patients. Echocardiographic evidence of restenosis (loss of more than 50% initial gain in valve area, a valve area of less than 1.5 cm2, or both) was noted in 9.8%.


CONCLUSIONS
Inoue balloon PTMC with use of our simple balloon sizing method yielded excellent short- and long-term results in terms of mitral valve enlargement and sustained symptomatic benefit without the creation of severe mitral regurgitation.
Lau
K W
KW
Department of Cardiology, Singapore General Hospital, Singapore.
Gao
W
W
Ding
Z P
ZP
Hung
J S
JS
D000328:Adult; D000368:Aged; D001827:Body Height; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D004452:Echocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000517:prevention & control; D008946:Mitral Valve Stenosis / Q000145:classification / Q000628:therapy*; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome