[Percutaneous mitral valvuloplasty with the single balloon technique. Short-term results, complications and in-hospital follow-up].
OBJECTIVE
To study the short-term results, complication and in-hospital follow-up of 268 percutaneous mitral balloon valvuloplasty (PMBV) procedures performed with the low-profile monofoil balloon (LPMB) technique from 1990 to 1995.


METHODS
A single 30mm balloon diameter was used in 247 (92.9%) procedures, a single 25mm balloon diameter in 9 (3.3%), a single 25mm balloon followed by a single 30mm balloon diameter in 7 (2.6%) and in 5 procedures a balloon was not used. The mean age group was 36 +/- 12 years. Two hundred nineteen (81.7%) procedures were performed in women (mean age 36 +/- 12 years) and 49 (18.3%) in men (mean age, 35 +/- 14 years) (p = 0.78). Patients were in functional class II (NYHA) in 39 (14.5%), class III in 198 (73.9%) and class IV in 31 (11.6%). Patients were in sinus rhythm in 228 (85.1%) procedures and in atrial fibrillation in 40 (14.9%). The echocardiographic score ranged from 4 to 14 (mean 7.2 +/- 1.5).


RESULTS
There were 256 complete procedures, 249 of which were successful (mitral valve area (MVA) > or = 1.5cm2 after PMBV). Echocardiographic calculated MVA before PMBV was 0.9 +/- 0.2cm2. Hemodynamic calculated MVA before PMBV was 0.9 +/- 0.2cm2 and after was 2.0 +/- 0.4cm2 (p < 0.000001). Mean pulmonary artery pressure decreased from 40 +/- 15mmHg to 28 +/- 10mmHg (p < 0.000001) and mitral mean gradient from 20 +/- 7mmHg to 5 +/- 4mmHg (p < 0.000001). In the 256 complete procedures mitral valve (MV) was competent in 214 and there was 1+ mitral regurgitation (MR) in 42. After PMBV, MV was competent in 166 and there was 1+ MR in 68, 2+ in 16, 3+ in 5 and 4+ MR in 1. There were complications in 14 (5.2%) procedures, severe MR in 6 (3 or 4+), stroke in 2 and cardiac tamponade in 6. Two patients died during emergency cardiac surgery after left ventricular perforation and 1 after stroke.


CONCLUSIONS
PMBV with the LPMB was an effective procedure with a high success rate and a low rate of complications as the more usual double-balloon and Inoue balloon techniques.
Peixoto
E C
EC
Cinecor (Pró-Cardíaco e 4 degrees Centenário), Rio de Janeiro e Hospital Universitário Antônio Pedro (UFF), Niterói.
de Oliveira
P S
PS
Netto
M S
MS
Villela
R A
RA
Labrunie
P
P
Borges
I P
IP
Peixoto
R T
RT
Neves
A C
AC
Ribeiro
M L
ML
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D021721:Balloon Occlusion; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002648:Child; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000628:therapy*; D016896:Treatment Outcome