Immediate and 18‐Month Outcome of Balloon Mitral Valvuloplasty: Comparison of Inoue and Multi‐Track System

Abstract

Aims: To compare the immediate and 18‐month clinical and echocardiographic outcome of Inoue and multi‐track system for balloon mitral valvuloplasty (BMV). Methods: We included 78 consecutive patients with moderate to severe rheumatic mitral stenosis (MS) [mitral valve area (MVA) < 1.5 cm2] and clinically indicated BMV. The first 42 consecutive patients were assigned to Inoue BMV (group I), and the following 36 consecutive patients were assigned to multi‐track system (group M). Clinical and echocardiographic assessment was performed before, immediately after, 3 months after, and 18 months after the procedure. Results: The successful immediate result [MVA > 1.5 cm2 and mitral regurgitation (MR) < II/IV] was achieved in 40 (95.23%) patients of group I and 34 (94.44%) patients of group M (P = 0.12). Immediately after BMV, MVA increased from 0.9 ± 0.4 to 1.7 ± 0.5 cm2 in group I and from 0.8 ± 0.2 to 1.9 ± 0.3 cm2 in group M (P < 0.01). Bilateral commissural splitting was significantly higher in group M (P < 0.01). This was associated with higher incidence of mild commissural mitral regurgitation. There were no significant differences of moderate to severe MR. Both procedure and fluoroscopy time were significantly shorter in group I (P < 0.001). Eighteen‐month clinical and echocardiographic evaluation was available for 66 (84.64%) patients with sustained immediate clinical and echocardiographic improvements. Conclusions: Both Inoue and the multi‐track balloon systems achieved successful immediate and 18‐month results. The multi‐track double balloon system produced significantly larger MVA, with better bilateral commissurotomy, yet with longer procedure and fluoroscopy times. (J Interven Cardiol 2012;25:47–52)

Additive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty

“…This could be explained by the ability of the double-balloon to fit and simultaneously press on both commissures, while Inoue balloon exerted its pressure mainly on the anterior one [31]. Meanwhile, Oraby and Youssef showed a better bilateral commissurotomy with multi-track balloon, with higher incidence of mild MR ( p = 0.003), while no significant differences regarding moderate to severe MR after BMV [32].…”

Severe Mitral Regurgitation After Pmbv? Comparison Between Inoue and Multi-Track Techniques

“…PMBV MV area of ≥ 1.8 cm 2 and commissural MR were reported to be important to optimize long term results of PMBV.Similarly, Oraby M et al15 reported successful immediate and 18 months outcome of multi-track and Inoue balloon technique with immediate successful results in 94.44% vs. 95.23% respectively. Various other investigations have revealed similar immediate-, short, and long-term hemodynamic and morphologic results of both methods [16][17][18].…”