Mitral balloon valvuloplasty [MBV] by Inoue technique was performed in 85 patients with symptomatic rheumatic mitral stenosis [MS] . Twenty-eight patients were male and 57 patients were female.
The age range was nine to 59 years [mean 28] . All patients were subjected to echocardiographic and Doppler examinations before and one day after the procedure. The first 57 patients were subjected to exercise tolerance tests [ETT] a few days before and a few days after the procedure. An echocardiographic score was measured regarding valve thickening, leaflet mobility, degree of calcification and the severity of involvement of subvalvular apparatus. The mitral valve area [MVA] increased from 0.9 +/- 0.2 cm to 1.9 +/- 0.45 cm , [P<0.0001] . The mitral gradient [MG] decreased from 20 +/- 5.8 mm/Hg to 5.05 +/- 3.2 mm/Hg [P<0.0001] . Mean left atrial pressure [LAP] dropped from 25.85 +/- 8.4 mm/Hg to 11.05 +/- 5.4 mm/Hg [P<0.0001] . Exercise tolerance test [ETT] increased from 5.59 +/- 1.3 to 11.75 +/- 1.48 min. [P<0.0001] . Complications included severe mitral regurgitation [MR] in two patients [2.3%] . In the first 57 patients, mild left-to-right shunt measured by green dye dilution technique had occurred in 40% of patients. In conclusion, MBV by Inoue balloon is a good alternative to surgical commissurotomy and echocardiographic standby is very helpful when it is available. However, MBV can be safely performed if echocardiography is inaccessible
Yahya Kiwan ,
Mitral balloon valvuloplasty by Inoue technique without echocardiographic stand by,
Ann. Saudi Med. 1994;
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