[Clinical and haemodynamic results after repeat valvotomy of the mitral valve using the Inoue balloon. A comparison with the results after primary valvotomy].
OBJECTIVE
Percutaneous mitral valvotomy (MVT) with the Inoue balloon is the most frequently performed therapeutic alternative to surgical commissurotomy in patients with symptomatic mitral valve stenosis. Few data are available on the results of repeat MVT.


METHODS
We compared the immediate and 3-month results of all patients who had a repeat MVT (n = 39) with those who had a primary intervention (n = 1,117) in our institution between February 1989 and January 2001. Mean age of the 31 women and 8 men with repeat MVT was 53 +/- 14 years at the first and 57 +/- 14 years at the second intervention performed 3 - 10 years later.


RESULTS
Following primary intervention the invasively assessed mitral valve are (MVA) had increased from an average of 1.0 +/- 0.2 cm(2) to 1.7 +/- 0.4 cm(2). Echocardiography three months after the intervention revealed a MVA of 1.7 +/- 0.3 cm(2). Repeat MVT resulted in an immediate increase of MVA from 1.0 +/- 0.2 cm(2) to 1.6 +/- 0.4 cm(2), after 3 months the average MVA was 1.6 +/- 0.3 cm(2). According to the NYHA classification clinical symptoms had improved on average from 2.6 to 1.6 three months after primay intervention and from 2.8 to 2.1 three months following the repeat procedure. The incidence of significant procedure-related complications was less than 3 % for both primary and repeat MVT.


CONCLUSIONS
The clinical and hemodynamic results demonstrated in our patients suggests repeat MVT as the treatment option of choice in mitral restenosis after previous balloon intervention, if mitral valve morphology is still suitable.
Neumayer
U
U
Kardiologische Klinik, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universtät Bochum, Bad Oeynhausen.
Schmidt
H K
HK
Fassbender
D
D
Mannebach
H
H
Bogunovic
N
N
Horstkotte
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects / Q000592:standards*; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008946:Mitral Valve Stenosis / Q000628:therapy*; D012008:Recurrence; D013997:Time Factors