Mn. Leon et al., Comparison of immediate and long-term results of mitral balloon valvotomy with the double-balloon versus Inoue techniques, AM J CARD, 83(9), 1999, pp. 1356-1363
Citations number
30
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
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.