title: Comparison of immediate and long-term results of mitral balloon valvotomy with the double-balloon versus Inoue techniques.
abstract: There is controversy as to whether the double-balloon or Inoue technique of percutaneous mitral balloon valvotomy (PMBV) provides superior immediate and long-term results. This study compares the immediate procedural and long-term outcomes of patients undergoing PMBV using the double-balloon versus the Inoue techniques. Seven hundred thirty-four consecutive patients who underwent PMBV using the double-balloon (n = 621) or Inoue technique (n = 113) were studied. There were no statistically significant differences in baseline clinical and morphologic characteristics between the double-balloon and Inoue patients. The double-balloon technique resulted in superior immediate outcome, as reflected in a larger post-PMBV mitral valve area (1.9 +/- 0.7 vs 1.7 +/- 0.6 cm2; p = 0.005) and a lower incidence of 3+ mitral regurgitation after PMBV (5.4% vs 10.6%; p = 0.05). This superior immediate outcome of the double-balloon technique was observed only in the group of patients with echocardiographic score < or = 8 (post-PMBV mitral valve areas 2.1 +/- 0.7 vs 1.8 +/- 0.6; p = 0.004). Despite the difference in immediate outcome, there were no significant differences in event-free survival at long-term follow-up between the 2 techniques. Our study demonstrates that compared with the Inoue technique, the double-balloon technique results in a larger mitral valve area and less degree of severe mitral regurgitation after PMBV. Despite the difference in immediate outcome between both techniques, there were no significant differences in event-free survival at long-term follow-up.
authors.affiliation: Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA.
authors.forename: M N
authors.initials: MN
authors.lastname: Leon
authors.forename: L C
authors.initials: LC
authors.lastname: Harrell
authors.forename: H F
authors.initials: HF
authors.lastname: Simosa
authors.forename: N A
authors.initials: NA
authors.lastname: Mahdi
authors.forename: A Z
authors.initials: AZ
authors.lastname: Pathan
authors.forename: J
authors.initials: J
authors.lastname: Lopez-Cuellar
authors.forename: I F
authors.initials: IF
authors.lastname: Palacios
mesh_terms: D000368:Aged; D002404:Catheterization / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014463:Ultrasonography