Open AccessPercutaneous balloon mitral valvuloplasty in rheumatic mitral stenosis: An experience of 50 patients in india
Author(s) -
Shrivastava S.,
Dev V.,
Das G.,
Rajani M.,
Mukhopadhyaya S.
Publication year - 1991
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960140312
Subject(s) - medicine , percutaneous , mitral valvuloplasty , stenosis , cardiology , balloon , mitral valve stenosis , balloon valvuloplasty , rheumatic fever
We attempted percutaneous balloon mitral valvuloplasty in 50 patients (27 female and 23 male, age 10–38 years) with rheumatic mitral stenosis. The procedure could be completed in 40 patients. The failures were caused by problems related to transseptal puncture in eight cases and inability to cross the mitral valve in two cases. Immediately after valvuloplasty there was a remarkable reduction in the mean pulmonary artery pressure, left atrial mean pressure, mean diastolic gradient across the mitral valve, and the calculated pulmonary vascular resistance. The calculated mitral valve area increased and the cardiac index increased marginally. Inadequate results with a post valvuloplasty mitral valve area of 0.9 cm 2 were seen in only one patient. Repeat hemodynamic evaluation in 25 patients within two weeks of valvuloplasty showed persistent benefit in all except one patient, who showed partial restenosis. Follow‐up cardiac catheterization at 3–6 months in 13 patients showed evidence of restenosis (mitral valve area <1.0 cm 2 and mean diastolic gradient of > 10 mmHg) in one patient, while all others maintained hemodynamic benefit. Repeat hemodynamic evaluation at 9–18 months after valvuloplasty in eight patients showed evidence of restenosis in an additional two cases. The patients in our series are young (28 patients <20 years), small body surface area (1.35–0.2 m 2 ), and have high left atrial and pulmonary arterial pressures.