Balloon valvoplasty of mitral bioprosthesis

Babic, Uros U.; Grujicic, Sreten; Vučinić, Marijana

doi:10.1016/0167-5273(91)90102-u

Cited by 12 publications

(4 citation statements)

References 4 publications

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“…However, the reports regarding balloon valvuloplasty for bioprosthetic valve failure in adult patients are extremely limited. A literature search identified 26 cases of balloon valvuloplasty for degenerated bioprosthetic valve; 14 cases in mitral position [6][7][8][9][10][11][12][13][14][15][16], 6 cases in aortic position [17,18,16,19,20], 4 cases in tricuspid position [21][22][23][24], and 2 case in pulmonary position (Table 2) [27]. We cannot draw any concrete conclusions from these limited experiences, more case reports are needed to establish a base for future expert recommendation of balloon valvuloplasty of prosthetic mitral valve.…”

Section: Percutaneous Transcatheter Balloon Valvuloplasty Was First Pmentioning

confidence: 99%

Percutaneous balloon valvuloplasty for bioprosthetic mitral valve stenosis

et al. 2012

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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.

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Section: Percutaneous Transcatheter Balloon Valvuloplasty Was First Pmentioning

confidence: 99%

Percutaneous balloon valvuloplasty for bioprosthetic mitral valve stenosis

et al. 2012

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“…Balloon dilatation of left sided bioprosthetic valves poses an additional problem; potential for dislodgment and systemic embolization of calcific debris and fractured valve cusps. A custom-made embolic-protecting device to capture embolic material has been used successfully [6]. This device, made up of nylon netting, connected to six stainless steel wires can be positioned and opened in the aortic root during valvuloplasty to capture the embolic material [6].…”

Section: Stenotic Bioprosthetic Valvesmentioning

confidence: 99%

“…A custom-made embolic-protecting device to capture embolic material has been used successfully [6]. This device, made up of nylon netting, connected to six stainless steel wires can be positioned and opened in the aortic root during valvuloplasty to capture the embolic material [6]. While this is an ingenious approach and may be useful in adults and older adolescents, the device-carrying catheter may be too bulky for routine use in younger children.…”

Section: Stenotic Bioprosthetic Valvesmentioning

confidence: 99%

Interventional Pediatric Cardiology: State of the Art and Future Directions

Rao

1998

Pediatr Cardiol

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Although the interventional pediatric cardiology began in the early 1950s, it was not until the mid-1980s that a full spectrum of transcatheter interventions in children could be undertaken including balloon atrial septostomy which has been in usage since 1966. Enormous developments have occurred even from the mid-1980s to date. In this review, current state-of-the-art for each broad area of therapeutic catheterization is presented. A large variety of lesions could be opened-up or closed, as the case may be and the results of these interventions were either similar to or better than those reported for the alternative surgical therapy. Indeed, therapeutic catheterization techniques have replaced the conventional surgery for many lesions and are threatening to do so for others. However, long-term follow-up results are scanty and are needed. Further miniaturization of catheters/sheaths used in interventional pediatric cardiology and development of new technology for the lesions which are not amenable to currently available transcatheter methods are awaited. The future seems to be bright for interventional pediatric cardiology.

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“…Of the available follow-up information, the only reported complications have been trace mitral regurgitation and a small left-to-right atrial shunt (Table II). There is no mention of clinically apparent embolic complications, although Babic et al [8] demonstrated several small particles (2-4 mm) of clot material with the use of an emboli-protecting umbrella downstream from the procedure.…”

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confidence: 99%

Prosthetic mitral valvuloplasty

Hurst

Caravalho

Wisenbaugh

2004

Cathet Cardio Intervent

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A 78-year-old man underwent mitral valve replacement with a no. 33 Hancock porcine bioprosthesis for severe mitral regurgitation. Postoperatively, a transthoracic echocardiogram (TTE) revealed a mean mitral valve gradient (MVG) of 4 mm Hg, a calculated mitral valve area (MVA) of 2.8 cm(2), and no mitral regurgitation. Eighteen months later, he presented to the emergency room with progressive dyspnea. Repeat TTE demonstrated severe mitral stenosis (MVG, 16 mm Hg; MVA, 0.9 cm(2)). The patient was deemed high risk for a repeat valve replacement, and percutaneous valvuloplasty was performed with an Inoue balloon catheter inflated to 26 mm. The patient's symptoms dramatically improved, as did his hemodynamics (MVG, 5 mm Hg; MVA, 1.6 cm(2)). There was no evidence of mitral regurgitation and the successful results were maintained after 10 months of follow-up. Since its introduction in 1987, there have been only nine cases reporting successful balloon valvulotomy in prosthetic mitral valves. While percutaneous valvulotomy is the intervention of choice for native mitral stenosis, it is rarely performed in prosthetic valves, with surgical valve replacement being the treatment of choice. Our case was successful and may suggest a niche to reconsider using the procedure in certain clinical circumstances.

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Balloon valvoplasty of mitral bioprosthesis

Cited by 12 publications

References 4 publications

Percutaneous balloon valvuloplasty for bioprosthetic mitral valve stenosis

Percutaneous balloon valvuloplasty for bioprosthetic mitral valve stenosis

Interventional Pediatric Cardiology: State of the Art and Future Directions

Prosthetic mitral valvuloplasty

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