TRANSJUGULAR APPROACH TO TRANSSEPTAL BALLOON MITRAL VALVULOPLASTY

The feasibility of a transjugular approach to septal puncture and Inou e-balloon mitral valvuloplasty (BMV) was studied in 20 patients with s evere mitral stenosis and varying degrees of anatomic atrial distortio n, Left atrial entry by transjugular septal puncture was achieved with out difficulty and BMV completed in all patients. In all of 16 patient s who had high septal punctures, crossing the mitral valve with the In oue-balloon was consistently simple and quick, In one patient, septal dilation after very high septal puncture led to a tear extending to th e atrial free wall, resulting in cardiac tamponade requiring surgery. Another patient developed severe mitral regurgitation after BMV and re quired mitral valve replacement. Excellent results were obtained in 16 patients, The transjugular approach simplifies BMV procedure signific antly in patients with distorted atrial anatomy and allows rapid patie nt mobilization. Its safety and efficacy need to be established in lar ger studies. (C) 1997 Wiley-Liss, Inc.