Balloon dilatation of the mitral valve by a single bifoil (2 x 19 mm) or trefoil (3 x 15 mm) catheter.

Abstract

The efficacy of balloon dilatation of the mitral valve by a bifoil (2 x 19 mm) or trefoil (3 x 15 mm) catheter (single catheter technique) was assessed in 53 patients (mean age 28) with mitral stenosis, most of whom were women. The procedure was unsuccessful in three patients. After balloon dilatation the left atrial pressure decreased from 22 mm Hg to 13 mm Hg and the mitral valve gradient from 12 mm Hg to 4 mm Hg. The mitral valve area increased from 0.7 cm2 to 2.1 cm2. Exercise time on the standard Bruce protocol increased from 3.9 minutes to 7.2 minutes. In 22 (44%) patients mitral regurgitation developed or the grade of regurgitation increased. Left to right shunts with pulmonary to systemic flow ratios greater than 1:5 were detected in four patients. Transient cerebrovascular episodes developed in two patients. One patient died after emergency valve replacement for severe mitral regurgitation. Balloon dilatation of the mitral valve by the single catheter technique with the bifoil or trefoil catheters is an effective treatment for patients with mitral stenosis. Mild mitral regurgitation is a frequent complication of the procedure.

Influence of the echocardiographic score and not of the previous surgical mitral commissurotomy on the outcome of percutaneous mitral balloon valvuloplasty

“…We use the double balloon technique less frequently. The literature shows in general similar results with these techniques [3][4][5][6][7][8] .…”

Resultados da valvoplastia por balão do grupo submetido a plastia mitral percutânea ou cirúrgica prévias com o tratado pela primeira vez: evolução do grupo com plastia prévia

“…Generally speaking, the studies documented in medical literature report similar results with the techniques mentioned [8][9][10][11][12][13][24][25][26] . In our case, the results attained in patients who had previously undergone commissurotomy surgery depended on the state of the mitral valve (Wilkins score) 27 and not on the previous surgical treatment; however, despite the positive immediate results 28,29 , and satisfactory evolution, the fi rsttime group presented a better evolution [30][31][32] .…”

Balão único versus balão de Inoue na valvoplastia mitral percutânea por balão. Resultados imediatos e complicações

“…Na literatura há trabalhos de comparação do BI com o duplo balão e do duplo balão com o BU convencional [23][24][25] , como o que utilizamos no início da nossa experiência 10 mas não há comparações com o BU de grande diâmetro e baixo perfil a não ser as nossas 22 .…”

“…Evidenciou-se de início que a área mitral pós-VMPB era maior quando utilizava-se a técnica do duplo balão, em vez da do BU convencional 6,23,30 . A seguir, mostrou-se que com balão bifoil e trifoil obtinha-se também AVM pós-VMPB semelhante à obtida com a técnica do duplo balão 24 . Foram demonstrados, também, a eficiência e baixo nível de complicações com o BI 31,32 .…”

“…O aparecimento de IM ou seu aumento é relatado na literatura, podendo chegar até a metade dos casos 1,24,[36][37][38]45 , sendo em geral discreto. Relato de IM de significado (3 ou 4+) é menor ainda 41,[45][46][47][48][49] .…”