INFLUENCE OF INTRABALLOON PRESSURE ON DEVELOPMENT OF SEVERE MITRAL REGURGITATION AFTER PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY

To evaluate the influence of intra-balloon pressure on the development of severe mitral regurgitation (greater-than-or-equal-to grade 3+), w e measured intraballoon pressure during percutaneous transvenous mitra l commissurotomy (PTMC) in 62 patients using the Inoue balloon cathete r. The peak intraballoon pressure was 2.29 +/- 0.55 kg/cm2. Severe mit ral regurgitation as a result of leaflet tear occurred in 7 patients ( 11%). Patients were divided into two groups those with (n = 7) and tho se without (n = 55) severe mitral regurgitation. Intraballoon pressure had been significantly higher in those with vs. those without severe mitral regurgitation (2.76 +/- 0.31 kg/cm2 vs. 2.23 +/- 0.55 kg/cm2, P < 0.01). Multiple logistic regression analysis revealed that the occu rrence of severe mitral regurgitation was related to only the peak int raballoon pressure. These data suggest that a high intraballoon pressu re is a risk factor for severe mitral regurgitation as a result of lea flet tear. (C) 1994 Wiley-Liss, Inc.