RETROGRADE NONTRANSSEPTAL BALLOON MITRAL VALVULOPLASTY FOR RHEUMATIC MITRAL-STENOSIS

Retrograde nontransseptal balloon mitral valvuloplasty is a relatively new technique for dilating stenosed mitral valves, wherein a speciall y designed steerable catheter is used to enter the left atrium retrogr adely. Over a 1-yr period, 52 patients (34 M, 18 F; mean age 26.4 +/- 6.5 yr) with symptomatic noncalcific rheumatic mitral stenosis underwe nt balloon mitral valvuloplasty by this technique at our center. The p rocedure was completed in 51 out of the 52 patients and technically su ccessful dilatation was achieved in 47 (90.4%) patients. The mean valv e area increased from 0.8 +/- 0.2 cm(2) to 1.86 +/- 0.37 cm(2) and end diastolic gradients decreased from 21.2 +/- 9.4 mm Hg to 4.0 +/- 2.2 mm Hg. Significant mitral regurgitation (>2+) developed in two (3.9%) patients, and both remained stable on medical treatment. In two patien ts, there was a significant decrease in femoral pulse, which improved with thrombolytic therapy.Our study is the first report of this techni que from a center other than that of its origin. The results of this s tudy further establish that this new retrograde technique may be a use ful alternative to the conventional transseptal techniques for mitral valvuloplasty.(C) 1994 Wiley-Liss, Inc.