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Comparison of early results of percutaneous metallic mitral commissurotome with Inoue balloon technique in patients with high mitral echocardiographic scores
Author(s) -
Zaki Adel M.,
Kasem Hussien H.,
Bakhoum Sameh,
Mokhtar Magdy,
Nagar Wael El,
White Christopher J.,
Guindy Mohamed El
Publication year - 2002
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.10312
Subject(s) - medicine , percutaneous , mitral regurgitation , cardiology , balloon , mitral valve , mitral valvuloplasty , stenosis , calcification , mitral valve stenosis , surgery
We compared the safety, efficacy, and cost of the newly introduced percutaneous metallic commissurotome (PMC) with the results of Inoue balloon mitral valvuloplasty (BMV) in 80 patients with mitral stenosis (MS). The mean increase in mitral valve area (MVA) was 0.95 ± 0.19 to 1.7 ± 0.35 cm 2 for PMC and 0.97 ± 0.15 to 1.81 ± 0.36 cm 2 for BMV ( P = NS). The Wilkins echocardiographic scores before dilatation did not correlate with any difference in MVA after dilatation. Bilateral commissural splitting was significantly more common with PMC than with BMV (30/39 patients, 76.9%, vs. 21/40 patients, 52.5%; P = 0.02). Postprocedural severe mitral regurgitation occurred in 1/39 (2.6%) in the PMC group and in 4/41 (9.8%) in the BMV group. Because the PMC device is resterilizable, we estimated the cost to be one‐fourth the cost of BMV with the Inoue balloon. The estimated device cost ratio of PMC to BMV for each patient was 1 to 4.25. The early results of PMC on the MVA are comparable to BMV. However, PMC had better results not only in patients with high echocardiographic scores, but the PMC device splits commissural calcification better than BMV. Cathet Cardiovasc Intervent 2002;57:312–317. © 2002 Wiley‐Liss, Inc.