title: Preventive strategies to fight complications during percutaneous multitrack balloon valvotomy "refining the technique".
abstract: BACKGROUND
  Percutaneous mitral valvuloplasty (PMV) is still the treatment of choice in selected cases of mitral stenosis (MS). Multitrack balloon (MTB) catheter is one of the techniques used for PMV with optimal results. We describe a novel refinement of appropriate balloon sizing and wire placement to reduce mitral regurgitation (MR) and Left ventricular (LV) apical perforation, respectively.
  
  
  METHODS
  Ninety four consecutive patients with moderate to severe rheumatic mitral stenosis (MS) were selected for PMV with MTB catheter. Balloon sizing was done by effective balloon dilatation area (EBDA), using standard geometric formula. 0.35" PMV wire was placed in aortic arch /ascending aorta (AA) to avoid LV apical perforation.
  
  
  RESULTS
  Mild MR was present in 28(29.8%). Post-procedure MR was present in 50(53.2%). Out of 50 MR cases 44(88%) had mild and 6(12.0%) had moderate MR. No patient had severe MR. With placement of wire in AA and arch of aorta none of the patients developed complication of LV apical perforation.
  
  
  CONCLUSIONS
  EDBA as balloon sizing for multitrack system can be used to reduce severity of mitral regurgitation. Placement of PMV guide wire in Aortic arch/AA ascending aorta can eliminate/substantially reduce dreadful complication of LV perforation.
authors: Tariq
authors: T
authors: Asharf
authors: Muhammad Anis
authors: MA
authors: Memon
authors: Syed Ishtiaque
authors: SI
authors: Rasool
authors: Najma
authors: N
authors: Patel
authors: Ziauddin
authors: Z
authors: Panhwar
authors: Fawad
authors: F
authors: Farooq
authors: Tahir
authors: T
authors: Saghir
authors: Nadeem
authors: N
authors: Qamar
authors: Khan
authors: K
authors: Shah-e-Zaman
mesh_terms: D000328:Adult; D063126:Balloon Valvuloplasty / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006335:Heart Injuries / Q000517:prevention & control*; D006352:Heart Ventricles / Q000293:injuries; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000517:prevention & control*; D008946:Mitral Valve Stenosis / Q000628:therapy*; D055815:Young Adult