PERCUTANEOUS INOUE-BALLOON VALVULOPLASTY IN PATIENTS WITH MITRAL-STENOSIS AND ASSOCIATED MODERATE MITRAL REGURGITATION

The present study compares the outcome of percutaneous inoue-balloon m itral valvuloplasty performed in 21 patients with (group A) and 83 pat ients without (group B) preexisting moderate mitral regurgitation, usi ng our height-derived balloon-siring method. All procedures were succe ssfully completed without untoward complications. The immediate increm ents in mitral valve area measured by echocardiographic methods and op timal valvuloplasty results were significantly higher in group a compa red with group A (0.9 cm(2) vs. 0.7 cm(2), P = 0.01, and 99% vs. 90%, P = 0.007, respectively). No patients in either group sustained a fina l grade greater than or equal to 3/4 angiographic mitral regurgitation . A mild increase in mitral regurgitation was encountered more commonl y in group B than in group A patients (22% vs. 0%, P = 0.03). At a mea n follow-up of 19-20 months, the substantial majority of patients (gre ater than or equal to 90%) in both groups continued to experience main tained symptomatic benefits. In conclusion, our preliminary data seem to indicate that percutaneous Inoue-balloon mitral valvuloplasty using our height-derived balloon-siring method in the stepwise dilatation a pproach in selected patients with significant mitral stenosis and conc omitant moderate mitral regurgitation is associated with a low risk of developing severe mitral regurgitation, with effective mitral valve e nlargement, and with sustained midterm symptomatic benefits. (C) 1996 Wiley-Liss, Inc.