Percutaneous balloon mitral valvuloplasty by retrograde left atrial catheterization

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

“…Hoje está comprovado que se pode obter AVM pós-VMPB semelhante com qualquer das técnicas em uso, quer seja do duplo balão, do BI ou do balão monofoil de baixo Valvoplastia mitral percutânea Arq Bras Cardiol volume 71, (nº 1), 1998 perfil (BU), desde que as áreas efetivas de dilatação dos balões sejam comparáveis 16,19,22,25 . A técnica de VMPB via arterial retrógrada ficou restrita aos relatos iniciais e seria de uso excepcional, como alternativa, a via transeptal 8,9,35 . Comparamos os resultados que obtivemos com a técni-ca do BI e do BU, que foram os mais utilizados na nossa experiência, sendo 337 procedimentos com o BU e 29 com o BI.…”

Balloon mitral valvotomy—a modified technique

“…Percutaneous balloon mitral valvotomy (BMV) can be done by transvenms [ 1,2] or transarterial [3,4] techniques. The transvenous technique described by Locket al requires dilatation of the atrial septum by 6-8 mm size balloon, which can significantly interfere with the hemodynamic assessment of the interventional procedure [5].…”

“…There is sufficient in vitro data to show that stagnant blood is able to clot more readily in nonionic contrast media than in ionic contrast media [1,2,3]. To date, with proper catheterization laboratory technique, this in vitro finding has had little clinical impact, although Grollman, et al recently reported catheter related clots in three patients undergoing coronary angiography with nonionic contrast agents [4].…”

Retrograde nontransseptal balloon mitral valvuloplasty by the brachial artery approach

“…The welldocumented safety of the approach in experienced hands notwithstanding, this procedural step has been associated with a small risk of potentially serious complications [5][6][7][8]. In an effort to obviate the need for transseptal catheterization, an alternative, purely transarterial technique (retrograde nontransseptal balloon mitral valvuloplasty, or RNBMV), based on the use of a specially designed externally steerable left atrial guiding catheter, was developed at the University of Athens, Greece [9,10]. Since its introduction, RNBMV has produced good immediate and long-term results with a satisfactory safety record in properly selected patients [11][12][13].…”