Percutaneous Mitral Balloon Valvotomy and the New Demographics of Mitral Stenosis

Carroll, John D.; Feldman, Ted

doi:10.1001/jama.1993.03510140091035

Cited by 82 publications

(18 citation statements)

References 48 publications

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“…Valve replacement is therefore the optimal choice for patients who have marked mitral valve degenerative change. In Western countries patients now presenting with severe mitral stenosis are not infrequently of advanced age, as acute rheumatic fever has almost disappeared16 and these elderly patients often have more marked valvar and subvalvar degenerative change and would normally require valve replacement. They are frequently, however, high risk candidates for cardiac surgery.…”

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confidence: 99%

Long term outcome of percutaneous mitral balloon valvotomy in patients aged 70 and over

Sutaria

Elder²,

Shaw³

2000

Heart

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Objective-To assess the immediate haemodynamic improvement and long term symptomatic benefit of percutaneous mitral balloon valvotomy in patients aged over 70 years. Design-Pre-and postprocedure haemodynamic data and follow up for 1 to 10 years by clinic visit or telephone contact. Setting-Tertiary referral centre in Scotland. Subjects-80 patients age 70 and over who had mitral balloon dilatation: 55 were considered unsuitable for surgical treatment because of frailty or associated disease. In an additional four patients mitral dilatation was not achieved. Main outcome measures-Increase in valve area after balloon dilatation and survival, freedom from valve replacement, and symptom class at follow up. Results-Mean (SD) valve area increased by 89% from 0.84 (0.28) to 1.59 (0.67) cm 2 . There was a low rate of serious complications, with only two patients having long term major sequelae. Of 55 patients unsuitable for surgical treatment, 28 (51%) were alive without valve replacement and with improvement by at least one symptom class at one year, and 14 (25%) at five years. In the 25 patients considered suitable for surgical treatment, 16 (64%) achieved this outcome at one year and nine (36%) at five years. Conclusions-Percutaneous mitral balloon valvotomy is a safe and useful palliative procedure in elderly patients who are unsuitable for surgery. Balloon dilatation should also be used for elderly patients whose valve appears suitable for improvement by commissurotomy, but echo score is an imperfect predictor of haemodynamic improvement. (Heart 2000;83:433-438)

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confidence: 99%

Long term outcome of percutaneous mitral balloon valvotomy in patients aged 70 and over

Sutaria

Elder²,

Shaw³

2000

Heart

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“…Not surprisingly, the median age of PTMC and ASD/PFO closure patients ranged between 23 and 42 years of age compared with routine CA and CA+LV (49–69 years), while coronary artery disease has a higher incidence with advanced age, symptomatic rheumatic mitral stenosis and congenital heart defects usually affecting the younger population. For patients with rheumatic mitral valve stenosis, those in developing countries may become symptomatic in their late teens or early twenties, whereas patients in more developed countries have a mean age of presentation in the fifth or sixth decade of life 13 14. Since the patient age distribution is considerably lower in these therapeutic procedures, it is very important to investigate them in more detail.…”

Section: Resultsmentioning

confidence: 99%

Status of radiation protection in various interventional cardiology procedures in the Asia Pacific region

et al. 2011

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“…PTMC is an important therapeutic option for patients with rheumatic MS. Since its first description in 1984,1 PTMC has emerged as the treatment of choice in suitably selected patients 2 3. The expanding balloon splits fused commissures in the same manner as a surgical commissurotomy 4 5.…”

Section: Discussionmentioning

confidence: 99%

Application of a novel percutaneous transluminal mitral commissurotomy technique in deformed mitral valve

Thomas

Ananthakrishna²,

Chikkabasavaiah³

et al. 2011

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A 40-year-old woman, known to suffer from rheumatic heart disease, presented with New York Heart Association class III breathlessness of 6 months duration. Transthoracic echocardiogram revealed severe mitral stenosis with deformed double orifice-like mitral valve and severe interatrial septal bulge. Considering the unfavourable anatomy, a high-risk percutaneous transluminal mitral commissurotomy (PTMC) was planned. Initial septal puncture resulted in pericardial effusion with tamponade, which was effectively managed by pericardiocentesis. After haemodynamic stabilisation and a fresh septal puncture, repeated efforts were made to negotiate the balloon across the deformed valve using the conventional Inoue technique. As the attempts were unsuccessful, the authors planned for over-the-wire (OTW) technique, with which the procedure was accomplished successfully. A technically challenging case of PTMC in the presence of adverse factors is presented herein. OTW technique is a useful alternative in the presence of deformed mitral valve.

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Percutaneous Mitral Balloon Valvotomy and the New Demographics of Mitral Stenosis

Cited by 82 publications

References 48 publications

Long term outcome of percutaneous mitral balloon valvotomy in patients aged 70 and over

Long term outcome of percutaneous mitral balloon valvotomy in patients aged 70 and over

Status of radiation protection in various interventional cardiology procedures in the Asia Pacific region

Application of a novel percutaneous transluminal mitral commissurotomy technique in deformed mitral valve

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