Clinical application of transvenous mitral commissurotomy by a new balloon catheter

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Clinical application of transvenous mitral commissurotomy by a new balloon catheter

K Inoue, T Owaki, T Nakamura, F Kitamura and N Miyamoto

A new balloon catheter was developed which allows mitral commissurotomy without thoracotomy. The procedure has been successful in five of the six patients with mitral stenosis so treated. In the remaining patient, the procedure could not be performed because of technical difficulties. The balloon is reinforced with a nylon micromesh and its shape changes in three stages, depending on the extent of inflation. It is inserted from the saphenous vein into the mitral orifice transseptally, fixed across the mitral orifice with partial inflation, and finally inflated to full its extent, separating the fused commissures by its expansile force. After the procedure, catheterization revealed a significant reduction in the mean diastolic pressure gradient across the mitral valve without resultant mitral regurgitation in each patient. Two- dimensional echocardiograms showed a marked to moderate degree of dilatation of the mitral orifice in each patient. All five patients are well with remarkable clinical improvements 2 to 16 months after the procedure.

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				O. Ozdemir, O. Alyan, M. Soylu, F. Metin, F. Kacmaz, A. D. Demir, B. Geyik, D. Aras, H. Sasmaz, and S. Korkmaz Improvement in sympatho-vagal imbalance and heart rate variability in patients with mitral stenosis after percutaneous balloon commissurotomy Europace, January 1, 2005; 7(3): 204 - 210. [Abstract] [Full Text] [PDF]

				R. D. Fish Percutaneous Heart Valve Replacement: Enthusiasm Tempered Circulation, October 5, 2004; 110(14): 1876 - 1878. [Full Text] [PDF]

				L. R. Souza, P. M. A. Pomerantzeff, C. M. de Almeida Brandao, L. F. Cardoso, L. R. V. Carrillo, L. F. P. Moreira, M. Grinberg, and S. A. de Oliveira Late evolution of mitral commissurotomy in patients with low echocardiographic score Eur. J. Cardiothorac. Surg., September 1, 2004; 26(3): 640 - 645. [Abstract] [Full Text] [PDF]

				A. Vahanian and I. F. Palacios Percutaneous Approaches to Valvular Disease Circulation, April 6, 2004; 109(13): 1572 - 1579. [Full Text] [PDF]

				C.-W. Chiang, L.-A. Hsu, P.-H. Chu, W.-J. Ho, H.-S. Lo, and C.-C. Chang Feasibility of Simplifying Balloon Mitral Valvuloplasty by Obviating Left-Sided Cardiac Catheterization Using On-line Guidance With Transesophageal Echocardiography Chest, June 1, 2003; 123(6): 1957 - 1963. [Abstract] [Full Text] [PDF]

ARTICLES

Clinical application of transvenous mitral commissurotomy by a new balloon catheter

				J. Langerveld, N. M. van Hemel, J. C. Kelder, J. M. P. G. Ernst, H. W. M. Plokker, and W. Jaarsma Long-term follow-up of cardiac rhythm after percutaneous mitral balloon valvotomy: Does atrial fibrillation persist? Europace, January 1, 2003; 5(1): 47 - 53. [Abstract] [PDF]

				K. Fan, K. L. Lee, W.-H. Chow, E. Chau, and C.-P. Lau Internal Cardioversion of Chronic Atrial Fibrillation During Percutaneous Mitral Commissurotomy: Insight Into Reversal of Chronic Stretch-Induced Atrial Remodeling Circulation, June 11, 2002; 105(23): 2746 - 2752. [Abstract] [Full Text] [PDF]

				B D Prendergast, T R D Shaw, B Iung, A Vahanian, and D B Northridge Contemporary criteria for the selection of patients for percutaneous balloon mitral valvuloplasty Heart, May 1, 2002; 87(5): 401 - 404. [Full Text] [PDF]

				S. Silaruks, B. Thinkhamrop, W. Tantikosum, C. Wongvipaporn, P. Tatsanavivat, and V. Klungboonkrong A prognostic model for predicting the disappearance of left atrial thrombi among candidates for percutaneous transvenous mitral commissurotomy J. Am. Coll. Cardiol., March 6, 2002; 39(5): 886 - 891. [Abstract] [Full Text] [PDF]

				A. Wang, R. A. Krasuski, J. J. Warner, K. Pieper, K. B. Kisslo, T. M. Bashore, and J. K. Harrison Serial echocardiographic evaluation of restenosis after successful percutaneous mitral commissurotomy J. Am. Coll. Cardiol., January 16, 2002; 39(2): 328 - 334. [Abstract] [Full Text] [PDF]

				J. A. M. de Souza, E. E. Martinez Jr, J. A. Ambrose, C. M. R. Alves, D. Born, E. Buffolo, and A. C. C. Carvalho Percutaneous balloon mitral valvuloplasty in comparison with open mitral valve commissurotomy for mitral stenosis during pregnancy J. Am. Coll. Cardiol., March 1, 2001; 37(3): 900 - 903. [Abstract] [Full Text] [PDF]

				A. M. Abouzied, M. Al Abbady, M. F. Al Gendy, A. Magdy, H. Soliman, F. Faheem, T. Ramadan, and A. Yehia Percutaneous Balloon Mitral Commissurotomy During Pregnancy Angiology, March 1, 2001; 52(3): 205 - 209. [Abstract] [PDF]

				A. Vahanian VALVE DISEASE: Balloon valvuloplasty Heart, February 1, 2001; 85(2): 223 - 228. [Full Text]

				U. Zeymer and K.-L. Neuhaus Percutaneous balloon valvuloplasty--the first line treatment for mitral stenosis and restenosis Eur. Heart J., October 2, 2000; 21(20): 1643 - 1644. [PDF]

				A. Vahanian and B. Iung Percutaneous mitral balloon commissurotomy: a useful and necessary treatment for the western population Eur. Heart J., October 2, 2000; 21(20): 1651 - 1652. [PDF]