[Balloon mitral valvuloplasty].
Since March 1990 we performed 100 balloon mitral valvuloplasties (BMV) in 82 females and 18 males (mean age 37 +/- 1 years; range 16 - 81) Initially we used the single shaft, dual or triple balloon system, while during the past 3 years we have been using the Inoue balloon system with step-wise inflation, monitoring with trans-thoracic echo (TTE) for immediate evaluation of mitral valve area (MVA) and/or severity of mitral regurgitation (MR), with 93% technical success. Hemodynamic data before and immediately after the procedure are in table below: [table: see text] C.O. cardiac output, DGR diastolic gradient, LAP left atrial pressure, MVA mitral valve area; all differences significant, p < 0.05. Acute complications included cardiac tamponade in 4/100; severe, acute MR in 2/100; only 5 were referred for urgent surgery. Neither cardiac tamponade nor severe MR were noted in the past 3 years. There was no periprocedural mortality in the past 5 years. Of 93 patients followed for 27 +/- 6 months (range 0-60), 90 (96%) were in NYHA classes I and II, 5 had late MVR, 2 underwent repeated BMV, and there was 1 death 16 months after the procedure. Immediate hemodynamic improvement followed BMV in most patients with pliable mitral stenosis. The Inoue system, with step-wise inflation and monitoring by TTE, proved to be a safe procedure. Symptomatic improvement continues during more than 4 years of follow-up.
Turgeman
Y
Y
Heart Institute, Central Hospital of the Emek, Afula.
Bloch
L
L
Suleiman
K
K
Rosenfeld
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion; D002404:Catheterization / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome