MITRAL BALLOON VALVULOPLASTY AS AN OUTPATIENT PROCEDURE USING INOUE BALLOON TECHNIQUE

Objective: To evaluate the safety and feasibility of mitral balloon va lvuloplasty (MBV) as an outpatient procedure. Background: MBV is usual ly done as an inpatient procedure, requiring 3-4 days of hospital admi ssion. Only one report is available about MBV as a day case procedure in the English literature. Methods: Between October 1994 and December 1996, 128 patients underwent MBV using an Inoue balloon. Of those, 31 patients (Group I) had the procedure as outpatients and 97 patients (G roup II) as inpatients. Their mean age in Group I was 29 +/- 9 years a nd in Group II 32 +/- 10 years (P < 0.3). Atrial fibrillation was pres ent in 4 patients in Group I and in 13 patients in Group II (P < 0.99) . Results: Hemodynamic study revealed that mitral valve area increased from 0.9 +/- 0.2 to 1.9 +/- 0.5 cm(2) in Group I and from 0.8 +/- 0. 2 to 1.7 +/- 0.5 cm(2) in Group II. Left atrial pressure decreased fr om 24 +/- 5 to 15 +/- 6 mm Hg in Group I and 24 +/- 6 to 16 +/- 5 mmH g in Group II. Mitral valve gradient decreased from 15 + 5 to 5 + 2 m mHg in Group I and 15 + 5 to 6 + 3 mmHg in Group II (*P < 0.001). Pat ients in Group I stayed in the Preadmission Unit for a mean period of 9.5 +/- 2.5 hours. Patients in Group II stayed for a mean of 2.5 days in the hospital. Severe mitral regurgitation developed in one patient in each Group and needed semiurgent mitral valve replacement without s equela. No death, convulsions, or thromboembolism were encountered and three patients in both Groups developed minor hematoma and needed no additional treatment. Conclusion: MBV as art outpatient procedure is f easible and safe and could significantly decrease the cost of medical care.