[Percutaneous mitral commissurotomy in patients with mitral valve stenosis and thrombosis of the left atrium].
Mitral percutaneous valvotomy (MPV) is an effective therapeutic alternative in the treatment of patients with mitral stenosis (MS) and thrombus in the left atrium have been an absolute contraindication to this procedure. The aim of our study is to evaluate the safety of MPV in patients with MS and thrombus in the appendix of the left atrium (ALA). Between September 1996 and April 1997, we performed ten procedures of MPV with Inoue's technique in patients with MS and thrombus in ALA. Nine females and 1 male were included. Their were 41 +/- 7.6 years old. The Wilkins score in our patients were 8 +/- 1.2. All were treated with oral anticoagulants between three and twelve months but the thrombus did not resolved. With transesophagic echocardiogram and fluoroscopic control we avoided the contact between wires and Inoue's catheter with ALA. Results were positive. Mitral valve area increased from 0.8 +/- 0.2 cm2 to 1.95 +/- 0.3 cm2. There was no case of systemic embolism or others major complications during the MVP and during following one year.


CONCLUSIONS
MPV is a safe and efficient therapeutic alternative in the treatment of selected patients with MS and thrombus in ALA.
Murillo
H
H
Servicio de Cardiología, Hospital de Especialidades, Centro Médico La Raza, IMSS, México D. F.
Ayala
F
F
Lepe
L
L
Madrid
R
R
Solorio
S
S
Lara
A
A
Enciso
R
R
Chávez
E
E
Rangel
A
A
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D016279:Atrial Function, Left; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*
D000925:Anticoagulants