Retrograde nontransseptal balloon mitral valvuloplasty. Immediate results and long-term follow-up.

Stefanadis, Christodoulos; Stratos, Costas; Pitsavos, Christos; Kallikazaros, Ioannis; Triposkiadis, Filippos; Trikas, Athanasios; Vlachopoulos, C; Gavaliatsis, Isidoros P.; Toutouzas, Pavlos

doi:10.1161/01.cir.85.5.1760

Cited by 79 publications

(35 citation statements)

References 33 publications

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“…Em nossos testes, observaram-se elevações significantes no tempo de endurance em fases precoces e tardias após VTM. Elevações tardias do tempo de endurance têm sido descritas 2,19,9 . Tendências não significativas de elevação do tempo de endurance foram verificadas logo após a VTM 8,9 .…”

Section: Discussionunclassified

Adaptações fisiológicas precoces e tardias após valvotomia mitral por cateter balão

Filho¹,

Regazzini²,

Filho³

et al. 1998

Arq. Bras. Cardiol.

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Purpose - Resultados -Os pacientes evoluíram para tipo funcional II (44%) ou I (56%), na fase tardia. Houve redução da freqüência cardíaca de repouso (87±11bpm vs 85±7bpm vs 75±9bpm) e elevação do número de estágios (4±1 estágios vs 5±2 estágios vs 6±1 estágios); a capacidade aeróbia máxima aumentou apenas na fase tardia (16±3mL/kg/min vs 18±4mL/kg/min vs 22±7mL/kg/min Adaptações Fisiológicas Precoces e Tardias após Valvotomia Mitral por Cateter Balão Artigo OriginalA valvotomia mitral por cateter balão (VTM) é um tratamento eficaz e alternativo à cirurgia da valva mitral. O alí-vio dos sintomas, o aumento da duração do exercício e a melhora das variáveis hemodinâmicas e cardiorrespiratórias têm sido descritos nos primeiros meses após valvotomia [1][2][3][4][5][6][7] .

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Section: Discussionunclassified

Adaptações fisiológicas precoces e tardias após valvotomia mitral por cateter balão

Filho¹,

Regazzini²,

Filho³

et al. 1998

Arq. Bras. Cardiol.

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“…Mitral valve dilatation was performed using an appropriate sized bifoil balloon catheter (Mansfield, Boston Scientific Corp. Boston, MA, U.S.A.) inserted through a 12 French arterial sheath. Optimal balloon size was chosen to keep the ratio of effective balloon dilating area and body surface area (EBDA/BSA) between 3 and 4 [14] . Transmitral gradients were re-checked with the guidewire across the mitral valve before and after dilatation.…”

Section: Methodsmentioning

confidence: 99%

Balloon mitral valvotomy: comparison between antegrade Inoue and retrograde non-transseptal techniques

Bahl

Chandra

Jhamb

et al. 1997

European Heart Journal

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AimsThe results of percutaneous mitral valvotomy performed by the antegrade transseptal method using the Inoue balloon (n=1000; group 1) and by the retrograde non-transseptal technique using a polyethylene balloon (n=100; group 2) were compared in a retrospective, non-randomized study. Methods and resultsBoth the groups were similar with respect to baseline characteristics. The success rate was 95% in group 1 and 93% in group 2. There was a significant increase in mitral valve area estimated by Gorlin's equation (Group 1: from 08 ± 05 to 21 ± 0-8 cm 2 ; Group 2: from 0-8 ±0-3 to 1-9 ±0-8 cm 2 , both P<0001) and by Doppler echocardiography using the pressure half-time method (Group 1: from 0-9 ±0-4 to 2-2 ±0-6 cm 2 ; Group 2: from 0-9 ±0-3 to 20 ±0-7 cm 2 , both P<0001). However, the calculated immediate post-valvotomy mitral valve area was larger with the Inoue technique (21 ± 0-8 vs 1-9 ± 0-8 cm 2 ; /><0-02). Results were considered optimal when the mitral valve area increased to > 1-5 cm 2 , the percentage increase was > 50, and mitral regurgitation was < 2/4. Out of the total successful procedures, optimal results were obtained in 95% patients in Group 1 and 94% in Group 2. Incidence of significant mitral regurgitation (> grade 3/4) was similar in two groups (Group 1: 4% vs Group 2: 5%, P=ns). A significant left to right atrial shunt (Qp/Qs> 1-5:1) in 2-5% and tamponade in 2% of cases occurred exclusively with the Inoue technique, while conduction disturbances, such as transient (<24 h) left bundle branch block (28%) and complete heart block (2%) were noted with the retrograde technique (Group 2). Local complications were significantly higher in Group 2 (3% vs 0-5%, / > <001). The procedure time with the Inoue technique was shorter than with the retrograde (Group 1: 15 ± 8, range 10 to 35 min; Group 2: 22 ± 14, range 15 to 45 min, P=005). Echocardiographic follow-up at 1 year showed no significant difference in mitral valve area between the two groups (Group 1 (n = 300): 1-8 ±0-8 vs Group 2 (n = 60): 1-9 ±0-9 cm 2 ; Conclusions Balloon mitral valvotomy using the Inoue balloon and the retrograde non-transseptal technique results in significant immediate haemodynamic and symptomatic improvement. The Inoue technique achieved a larger immediate post-valvotomy mitral valve area, but the difference was not apparent at 1 year follow-up. Incidence of significant mitral regurgitation was similar with both the techniques; however, local complications occurred more frequently with the retrograde technique. Both techniques may complement each other in technically difficult cases.

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“…To facilitate passage of the guidewire through the latter hemostatic valve and not through the central one in which the steering arm is situated, the proximal end of the guidewire is slightly bent before threading the device onto it. Based on the same concept as other steerable catheters developed in our institution [ 16,171, external manipulation of the steering arm enables the diameter of the spiral stent to be altered by remote control. When the steering arm is completely retracted, the spiral stent collapses and makes contact with the catheter wall, thus facilitating insertion of the device and positioning within the coronary artery over a 0.014-or 0.018-in.…”

Section: Methodsmentioning

confidence: 99%

A new adjustable temporary stent catheter for management of acute dissection during balloon angioplasty

Stefanadis

Kallikazaros

Vlachopoulos

et al. 1996

Cathet. Cardiovasc. Diagn.

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Retrograde nontransseptal balloon mitral valvuloplasty. Immediate results and long-term follow-up.

Cited by 79 publications

References 33 publications

Adaptações fisiológicas precoces e tardias após valvotomia mitral por cateter balão

Adaptações fisiológicas precoces e tardias após valvotomia mitral por cateter balão

Balloon mitral valvotomy: comparison between antegrade Inoue and retrograde non-transseptal techniques

A new adjustable temporary stent catheter for management of acute dissection during balloon angioplasty

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