title: Percutaneous balloon valvuloplasty of coexisting mitral and tricuspid stenosis: single-wire, double-balloon technique.
abstract: BACKGROUND
  Percutaneous transmitral commissurotomy (PTMC) was first described by Inoue as an alternative to surgical closed mitral commissurotomy for severe rheumatic mitral stenosis. Two techniques - single- and double-balloon methods and percutaneous metallic devices - have been described for mitral dilatation. The Multi-Track system, a single-wire, double-balloon device was introduced by Bonhoeffer for mitral valve dilatation. We describe a case of mitral and tricuspid valve dilatation employing this double-balloon technique.
  
  
  METHODS
  A 25-year-old male with combined rheumatic mitral and tricuspid stenosis and severe pulmonary hypertension underwent simultaneous double-valve dilatation in a single setting using different sizes of the Multi-Track balloon catheter.
  
  
  RESULTS
  The patient's transmitral gradient decreased from 15 to 2 mmHg and his mitral valve area increased from 1 cm(2) to 2.2 cm(2). Similarly, his tricuspid valve gradient dropped from 7 to 3 mmHg and his tricuspid valve area increased from 0.9 cm(2) to 3.0 cm(2).
  
  
  CONCLUSIONS
  Percutaneous balloon valvuloplasty using the Multi-Track system for combined mitral and tricuspid stenosis is cost effective and simple to use.
authors.affiliation: Incharge Cath Lab, National Institute of Cardiovascular Diseases, NICVD Karachi, Karachi, Pakistan. tariqash@cyber.net.pk
authors.forename: Tariq
authors.initials: T
authors.lastname: Ashraf
authors.forename: Asad
authors.initials: A
authors.lastname: Pathan
authors.forename: Asadullah
authors.initials: A
authors.lastname: Kundi
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D008297:Male; D008946:Mitral Valve Stenosis / Q000209:etiology / Q000601:surgery*; D012214:Rheumatic Heart Disease / Q000150:complications*; D014264:Tricuspid Valve Stenosis / Q000209:etiology / Q000601:surgery*