MITRAL BALLOON VALVOTOMY IN CHILDREN WITH INOUE BALLOON TECHNIQUE - IMMEDIATE AND INTERMEDIATE-TERM RESULT

Percutaneous mitral balloon valvotomy (PMV) using the Inoue balloon te chnique was attempted in 170 patients. Of these, 30 patients were chil dren aged 10 to 18 years (mean 15.9 +/- 2.7 years). There were 16 fema le and 14 male patients. All were in sinus rhythmn. The procedure was successful in 28 patients (93%). PMV was performed using 20 to 28 mm ( mean 25 mm) diameter balloon catheters with an echo-Doppler guided ste pwise mitral dilation technique. After PMV, the mean left atrial press ure decreased from 25 +/- 5 to 14 +/- 4 mm Hg (p < 0.001). The mean mi tral valve gradient (MVG) decreased from 16 +/- 4 to 6 +/- 3 mm Hg (p < 0.001). The mitral valve area (MVA) by catheter increased from 0.7 /- 0.2 to 1.7 +/- 0.5 cm(2) (p < 0.001), and MVA as determined by echo cardiography (2DE) increased from 0.8 +/- 0.1 to 1.9 +/- 0.3 cm(2) (p < 001). There were no deaths or thromboembolic complications; cardiac tamponade developed in one patient, mild mitral regurgitation (MR) dev eloped in three patients (10%) and increased by one grade from (1+ to 2+) in another two patients (8%). A small atrial septal defect (ASD) a ssessed by color flow mapping developed in seven patients (25%); 90% w ere closed at 3 months, The Doppler and 2DE MVAs were maintained at 1. 8 +/- 0.4 cm(2) at 17 months' mean follow-up; one patient developed re stenosis. We conclude the PMV using the Inoue balloon catheter is safe and effective in the treatment of severe mitral stenosis in children, with a low complication rate.