[Percutaneous mitral valvuloplasty in mitral restinosis after surgical commissurotomy].
The frequency of mitral restenosis after surgical commissurotomy has been estimated between 10 and 30% up to 10 years and 85% up to 28 years. Aim of this study was to analyze the results of balloon mitral valvuloplasty (BMV) in a series of patients with previous surgical commissurotomy.


METHODS
Between December 1988 and December 1995 432 patients underwent BMV. Of these patients, 30 (6.9%; 10 men, 20 women, aged 53 +/- 12 years) had recurrent mitral stenosis after surgical commissurotomy. Contraindications to BMV were the evidence of left atrial thrombi at transesophageal echocardiography and/or of mitral insufficiency > 2+/4+. The Inoue's single balloon catheter was used for all the procedures.


RESULTS
BMV resulted in a decrease in mean mitral gradient from 12.6 +/- 3.8 to 6.1 +/- 2.9 mmHg, and an increase in mitral valve area from 1.03 +/- 0.19 cm2 to 1.95 +/- 0.40 cm2. A mitral insufficiency > or = 3+/4+ occurred in 4/30 BMV (13%). At follow-up (mean 27 +/- 18 months) 20/26 patients (77%) remained clinically improved: 54% were in NYHA class I and 23% in class II.


CONCLUSIONS
BMV is an effective short- and long-term procedure for patients with previous surgical commissurotomy, with a low additional risk of complications. Thus, BMV can be considered the treatment of choice in these patients.
Ramondo
A
A
Cattedra di Cardiologia, Servizio di Emodinamica, Università di Padova.
Bertaglia
E
E
Marchiori
M C
MC
Razzolini
R
R
Isabella
G
G
Cardaioli
P
P
Chioin
R
R
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D002404:Catheterization; D000075202:Contraindications; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D013923:Thromboembolism / Q000150:complications / Q000628:therapy
Valvuloplastica mitralica percutanea nella restenosi mitralica dopo commissurotomia chirurgica.