[Long-term results of mitral percutaneous valvuloplasty with Inoue technique. Seven-years experience at the Cardiology Hospital of the National Medical Center "Siglo XXI", IMSS].
Since the last decade, percutaneous balloon mitral valvuloplasty with Inoue catheter is considered the treatment of choice for selected patients (mobile valve, no calcification and minimal subvalvular disease) with rheumatic mitral stenosis.


OBJECTIVE
We present the seven-year follow-up experience of 456 patients treated with this technique in the catheter laboratory of the Cardiology Hospital in National Medical Center SXXI.


METHODS
It is a retrospective, transversal and observational study performed with data obtained from January 1994 and December 2000, with a follow-up of 58.5 +/- 26.6 months (range 12-96 mean 22).


RESULTS
We achieve an initial success of 82.8%, improvement of initial mitral valve area from 0.9 +/- 0.1 to 1.8 +/- 0.3 cm2, with a gain area from 88 to 106% (p < or = 0.001). At the end of the follow-up, the mean valvular area was maintained in 1.7 +/- 0.3 cm2 in 69.8% of the cases. We found a significant reduction of transmitral gradient and of the pulmonary artery systolic pressure immediately after the procedure; 93.1% of patients were in NYHA functional class II at the end of the follow-up, 11.6% presented complications (mitral regurgitation as the most important), in 15.9% of them, due to leaflet rupture, but only 9.1% corresponded to severe grade Ill-IV.


RESULTS
Only one patient died due to septal perforation; 93.8% of the patients remained free of major cardiac events at the end of the study. Only 6.1% of the patients required surgery at the end of the follow-up; 5.5% were in functional class NYHA Ill-IV and restenosis occurred in 14.6%.


CONCLUSIONS
Percutaneous balloon mitral valvuloplasty with Inoue balloon catheter is a safe and effective technique for treating rheumatic mitral stenosis with Wilkins score < 10, with minimal risk and complications and offers good life expectancy with absence of major cardiac events in > 90%. From these patients, 93.1% remained in NYHA-II or -I functional class and the incidence of restenosis decreased.
Flores Flores
Jesús
J
Servicio de Hemodinamia, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Institute Mexicano del Seguro Social, México, DF.
Ledesma Velasco
Mariano
M
Palomo Villada
José Antonio
JA
Montoya Guerrero
Silvestre
S
Estrada Gallegos
Joel
J
Astudillo Sandoval
Raúl
R
Abundes Velasco
Arturo
A
González Díaz
Belinda
B
Argüero Sánchez
Rubén
R
Farell Campa
Javier
J
D000328:Adult; D002404:Catheterization / Q000379:methods*; D003430:Cross-Sectional Studies; D018572:Disease-Free Survival; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors