Comparação entre comissurotomia e valvoplastia por cateter-balão na estenose mitral: cinco anos de acompanhamento

Background: Despite the high prevalence of mitral stenosis in Brazil, there is a significant underreporting of percutaneous procedures in the treatment of this disease in the national literature. This study is aimed at reporting the results and course of patients with rheumatic mitral stenosis treated with the Inoue balloon. Methods: Clinical, echocardiographic and procedure-related parameters of patients treated from 1997 to 2009 who were followed-up for at least a month were evaluated. Results: One hundred and two patients were evaluated, most of them females (89.2%), with mean age of 38.1 + 11.1 years, 80.4% were in functional class II-III. Mean mitral valve area obtained by echocardiography (ECHO) was 1.01 + 0.19 cm² and 0.87 + 0.2 cm² by hemodynamic measurements (HEMO). Wilkins & Block score ranged from 5 to 8 in about 90% of the patients and 88.2% of them were in sinus rhythm. The procedure was successful in 76.5% patients with mean mitral valve area increasing to 1.9 + 0.5 cm² as measured by ECHO (P < 0.001) and to 2 + 0.5 cm² as calculated by HEMO (P < 0.001). Mean left atrial-left ventricular gradient was reduced from 16.6 mmHg to 4.2 mmHg (P < 0.001). Cardiac output increased from 3.75 L/min to 4.67 L/min (P < 0.001) and this change was a predictor of success. Of 79.4% patients who were followedup for 1 year, 87.6% were in functional class I and only 2 cases required surgical treatment. During the 5-year follow-up there were no cases of stroke or death due to cardiac causes. Conclusions: Mitral valvuloplasty with the Inoue balloon is effective for the treatment of rheumatic mitral stenosis in the medium term and has a low complication rate.

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Systematic comparison of the effectiveness of percutaneous mitral balloon valvotomy with surgical mitral commissurotomy

Hu¹,

Zhao²

2011

Swiss Med Wkly

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Comparação entre comissurotomia e valvoplastia por cateter-balão na estenose mitral: cinco anos de acompanhamento

Abstract: The rate of success in open mitral commissurotomy and balloon mitral valvuloplasty was 100%, and the rate of complications was low. During follow-up, a mild elevation in mitral gradient and a drop in mitral valve area were observed in both groups.

Cited by 4 publications

References 24 publications

Rheumatic Mitral Valve Disease

Rheumatic Mitral Valve Disease

Valvoplastia mitral pela técnica de inoue: registro do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo

Systematic comparison of the effectiveness of percutaneous mitral balloon valvotomy with surgical mitral commissurotomy

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