THE INDIAN EXPERIENCE OF PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY - COMPARISON OF THE TRIPLE LUMEN (INOUE) AND DOUBLE-LUMEN (ACCURA) VARIABLE SIZED SINGLE BALLOON WITH REGARD TO PROCEDURAL OUTCOME AND COST SAVINGS

The efficacy, safety, and cost of percutaneous mitral commissurotomy ( PTMC), using variable volume dependent sized catheters, compared a tri ple lumen (Inoue) with a double lumen (Accura) catheter. PTMC was perf ormed using Accura balloons in 400 patients and Inoue balloons in 512 patients. The group demographics, increase in mitral valve area, and i ncidence of significant complications were similar. The catheters were similar with respect to maneuverability and procedure (fluoroscopy) t ime. The Accura balloons could be reutilized statistically more often (6.3 +/- 1.4 for Accura and 5.2 +/- 0.8 for Inoue, P < 0.05). Accura b alloons were more cost-effective, with 6.3 usages lowering the per pro cedural catheter cost to $214.00, while the Inoue balloons, with 5.2 u sages, had a final catheter cost of $395.00. The potential savings wou ld have been $155,340.00 if Accura balloons were utilized. Conclusions : Accura and Inoue mitral valvuloplasty balloons were comparable with regard to efficacy and safety, but the Accura balloon was significantl y less costly and is therefore more suitable for use in India and othe r nations where resources are limited.