title: Percutaneous balloon valvuloplasty for bioprosthetic mitral valve stenosis.
abstract: Percutaneous transcatheter mitral valvuloplasty is the indicated treatment of choice for symptomatic native mitral valve stenosis, but there have been limited reports of successful procedures of balloon valvuloplasty for bioprosthetic mitral valve stenosis. We present the case of a 62-year-old woman suffering from progressive dyspnea due to bioprosthetic mitral valve stenosis. The measured mean pressure gradient across the mitral valve was 30 mmHg and the mitral valve area was 0.73 cm(2). Redoing mitral replacement was considered high risk and was refused by the patient. Percutaneous balloon valvuloplasty was performed with an Inoue balloon catheter inflated to 20 mm. The patient's symptoms immediately improved after the procedure, with no procedure-related complications. The mean pressure gradient across the valve decreased to 19 mmHg, and the mitral valve area increased to 1.21 cm(2) in postprocedural echocardiography. We conducted a literature search and identified 26 cases of balloon valvuloplasty for degenerated bioprosthetic valves. Of these, 14 cases were bioprosthetic mitral valves, and the results were favorable. However, more case reports are required to establish an evidence base for future expert recommendation of balloon valvuloplasty of prosthetic mitral valve. Meanwhile, balloon valvuloplasty will serve a niche role in highly selected patients with prosthetic mitral valve stenosis.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hamatani
authors.forename: Naritatsu
authors.initials: N
authors.lastname: Saito
authors.forename: Junichi
authors.initials: J
authors.lastname: Tazaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Natsuaki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakai
authors.forename: Takeru
authors.initials: T
authors.lastname: Makiyama
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Masao
authors.initials: M
authors.lastname: Imai
authors.forename: Shin
authors.initials: S
authors.lastname: Watanabe
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shioi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.forename: Kanji
authors.initials: K
authors.lastname: Inoue
mesh_terms: D063126:Balloon Valvuloplasty; D001705:Bioprosthesis; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011474:Prosthesis Design; D016896:Treatment Outcome