A simple balloon‐sizing method in Inoue‐balloon percutaneous transvenous mitral commissurotomy

Abstract

This study was carried out to examine whether the previously determined balloon sizing method based on patient height was valid for percutaneous transvenous mitral commissurotomy using the current second-generation Inoue balloon catheter. The study consisted of 70 patients with pliable noncalcified mitral valves (group 1) and 85 patients with calcified mitral valves and/or severe subvalvular lesions (group 2). The mitral valve area was increased more in group 1 than in group 2 (1.0 +/- 0.3 to 1.9 +/- 0.5 cm2 versus 1.0 +/- 0.3 to 1.6 +/- 0.5 cm2, P = 0.002). Using the stepwise dilatation technique, none of the group 1 patients developed severe mitral regurgitation. Severe mitral regurgitation occurred in 4 patients (4.7%) in group 2. In conclusion, a simple balloon sizing method based on body height for selection of an appropriate-sized balloon catheter, as well as an initial inflated balloon diameter for the stepwise dilatation technique is useful for optimal acute outcomes in mitral commissurotomy.

Percutaneous transvenous mitral commissurotomy versus surgical commissurotomy in the treatment of mitral stenosis

“…Because of increased operator confidence and competence, and the nontraumatic nature of the procedure, PTMC has now been extended to those who would otherwise have been subjected to mitral valve replacement. This includes patients with grossly diseased mitral valve3, 33, 34, 42-5s, 57 and concomitant moderate mitral regurgitati~n.~~, s9 As expected, the results after PTMC in such patients are not as favorable as in those with optimal valve morphology; the former subset of patients has a higher restenosis rate and a greater need for mitral valve replacement on follow-up. Nonetheless, a substantial number of these patients continued to sustain functional benefits, even those with restenosis.…”

Percutaneous Balloon Mitral Valvuloplasty

“…A simple equation to obtain the reference size (height [cm]/10ϩ10) has been proposed. 28 The obvious point should be made, however, that the relationship of one's height to the diameter of the mitral valve orifice is not necessarily linear. Furthermore, the operator must remember that annular calcification will affect the size of the mitral valve orifice regardless of the patient's physical constitution.…”

Valvotomia mitral percutânea: experiência inicial com o novo balão único de dilatação "tipo Inoue"

“…O procedimento foi finalizado com novo registro pressórico em câma-ras cardíacas direita e esquerda, ventriculografia esquerda em projeção oblíqua anterior direita 35 graus para avaliação do plano valvar mitral e retirada dos introdutores valvulados. O cálculo para seleção do tamanho do balão foi baseado na seguinte fórmula 11 : [(altura em cm ÷ 10) + 10]. …”