title: Initial experience of using intracardiac echocardiography (ICE) for guiding balloon mitral valvuloplasty (BMV).
abstract: OBJECTIVE
  BMV is an established treatment for rheumatic mitral valve stenosis. The procedure is historically guided by fluoroscopy, and the role of intracardiac echocardiogram (ICE) guidance is not well defined. We report our initial experience of using ICE to guide BMV procedures.
  
  
  METHODS
  During BMV procedure, ICE catheter was inserted into the right atrium from the right femoral vein, and the septal puncture was monitored by ICE, as well as positioning of the balloon in the mitral valve. Comparisons were made between ICE, transthoracic echocardiography (TTE), and catheterization derived hemodynamic measurements (cath).
  
  
  RESULTS
  Seventeen patients with mitral stenosis underwent the procedure. The mean age was 44.4 ± 21 years. The mean MV area increased from 0.9 ± 0.1 cm(2) to 1.7 ± 0.2 cm(2), P < 0.0001 and the mean gradient decreased from 12.6 ± 5.8 mmHg to 4.9 ± 1.8 mmHg, P < 0.001. Atrial septum puncture and guidance of the balloon into the MV apparatus were obtained in all patients under ICE guidance. Severe MR developed in one patient and was readily detected by ICE. ICE derived gradient measurements were comparable to those obtained by TTE, and cath.
  
  
  CONCLUSIONS
  ICE guidance of BMV is feasible, and useful in monitoring safe septal puncture, optimizing balloon positioning, and in detecting complications. The hemodynamic measurements obtained were comparable to those obtained by TTE, and cath.
authors: Adult Cardiology Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
authors: Saeed Al
authors: SA
authors: Ahmari
authors: Ahmed
authors: A
authors: Amro
authors: Mohammed Al
authors: MA
authors: Otabi
authors: Moheeb Al
authors: MA
authors: Abdullah
authors: Saad Al
authors: SA
authors: Kasab
authors: Husien Al
authors: HA
authors: Amri
keywords: Balloon valvuloplasty; Echocardiography; Mitral stenosis
references: Cardiol Clin. 1993 Aug;11(3):409-25
references: 8402770
references: J Am Soc Echocardiogr. 1989 Nov-Dec;2(6):380-5
references: 2627440
references: Circulation. 1994 Mar;89(3):1301-5
references: 8124819
references: J Am Coll Cardiol. 2002 Jun 19;39(12):1964-72
references: 12084595
references: Cathet Cardiovasc Diagn. 1998 Feb;43(2):132-9
references: 9488542
references: Circulation. 1998 Jan 27;97(3):245-50
references: 9462525
references: Am J Cardiol. 1998 Feb 15;81(4):515-8
references: 9485150
references: Cathet Cardiovasc Diagn. 1994;Suppl 2:69-75
references: 7994744
references: J Thorac Cardiovasc Surg. 1984 Mar;87(3):394-402
references: 6700245
references: J Heart Valve Dis. 1994 Mar;3(2):136-48
references: 8012630
references: N Engl J Med. 1994 Oct 13;331(15):961-7
references: 8084354
references: Cathet Cardiovasc Diagn. 1994;Suppl 2:52-60
references: 7994742
references: Prog Cardiovasc Dis. 1997 Jul-Aug;40(1):5-26
references: 9247552