Comparison of immediate and long-term results of mitral balloon valvotomy with the double-balloon versus Inoue techniques

There is controversy as to whether the double-balloon or Inoue technique of percutaneous mitral balloon valvotomy (PMBV) provides superior immediate a nd long-term results. This study compares the immediate procedural and long -term outcomes of patients undergoing PMBV using the double-balloon versus the Inoue techniques. Seven hundred thirty-four consecutive patients who un derwent PMBV using the double-balloon (n = 621) or Inoue technique (n = 113 ) were studied. There were no statistically significant differences in base line clinical and morphologic characteristics between the double-balloon an d Inoue patients. The double-balloon technique resulted in superior immedia te outcome, as reflected in a larger post-PMBV mitral valve area (1.9 +/- 0 .7 vs 1.7 +/- 0.6 cm(2); p = 0.005) and a lower incidence of 3+ mitral regu lation after PMBV (5.4% vs 10.6%; p = 0.05). This superior immediate outcom e of the double-balloon technique was observed only in the group of patient s with echocardiographic score less than or equal to 8 (post-PMBV mitral va lve areas 2.1 +/- 0.7 vs 1.8 +/- 0.6; p 0.004). Despite the difference in i mmediate outcome, there were no significant differences in event-free survi val at long-term follow-up between the 2 techniques, Our study demonstrates that compared with the Inoue technique, the double-balloon technique resul ts in a larger mitral value area and less degree of severe mitral regurgita tion after PMBV. Despite the difference in immediate outcome between both t echniques, there were no significant differences in event-free survival at long-term follow-up. (C) 1999 by Excerpta Medica, Inc.