Inoue balloon deformity and rupture during percutaneous balloon valvuloplasty

Ho, Yi‐Lwun; Chen, Wen-Jone; Wu, Cho‐Kai; Chao, Chia-Lun; Kao, Hsien‐Li; Lee, Yuan‐Teh

doi:10.1002/(sici)1097-0304(199608)38:4<345::aid-ccd3>3.0.co;2-7

Cited by 5 publications

(5 citation statements)

References 16 publications

(2 reference statements)

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“…The rupture of the balloon may get complicated with air embolism, embolisation of torn latex and cardiac perforation 4. Fortunately, in our case, there was no complication.…”

Section: Discussionmentioning

confidence: 57%

“…The prevalence of balloon rupture was 0.4–4.5% with double-balloon technique 4. Although there are a few published reports of rupture (0.4%) of the Inoue balloon,3–6 there is no report of rupture of the Accura balloon in the literature.…”

Section: Discussionmentioning

confidence: 95%

“…A higher (20%) than usual incidence is reported when Inoue balloons are reused 8. Balloon rupture during interventional procedures could occur owing to accidental or intentional use of high inflation pressures, abrasive effect of calcified MV, avulsing effect to balloon while squeezing through narrowed orifice or it can be due to suboptimal quality or fatigue of the nylon-rubber mesh layer 4. The distal segment of Accura balloon being the most compliant inflates first, followed by the proximal and finally the middle segment.…”

Section: Discussionmentioning

confidence: 99%

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Accura balloon rupture during percutaneous trans-septal mitral commissurotomy: a rare and potentially fatal complication

et al. 2013

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Percutaneous transseptal mitral commissurotomy (PTMC) is the treatment of choice in rheumatic mitral stenosis. The reuse of sterilised PTMC balloon catheters is widely practised to bring down the procedure cost and have proven safety and efficacy. The reused balloons may deform and are prone to rupture causing fatal complications like embolism either of the torn balloon material or air. We report a first case of Accura balloon rupture during PTMC to the best of our knowledge. Fortunately, there was no complication in our patient. Thus, during the balloon preparation it should be examined for any deformity or tear and air should be removed completely to prevent fatal outcome. The repeated use of the hardware should be limited and an informed consent regarding the possible complications of the reused hardware should be taken.

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“…The rupture of the balloon may get complicated with air embolism, embolisation of torn latex and cardiac perforation 4. Fortunately, in our case, there was no complication.…”

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Accura balloon rupture during percutaneous trans-septal mitral commissurotomy: a rare and potentially fatal complication

et al. 2013

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“…Balloon rupture during interventional procedures could occur owing to accidental or intentional use of high inflation pressures, abrasive effect of calcified mitral valve, avulsing effect to balloon while squeezing through narrowed orifice or it can be due to quality or fatigue of the nylon-rubber mesh layer. A deformity of the Inoue balloon catheter was noted in 1.6% and actual rupture of deformed balloon occurred in 0.4% in a series reported by Ho et al [5] All deformities were found at the distal portion of balloon and none of the patient developed any complication. Chow et al reported two cases of proximal balloon tear during PTMC by Inoue balloon and they attributed to the suboptimal quality of rubber layer might be responsible.…”

Section: Discussionmentioning

confidence: 88%

Rupture of Accura balloon during percutaneous transvenous mitral commissurotomy

Pradhan

Sahoo

Mallick

et al. 2016

CRIM

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Percutaneous transvenous mitral commissurotomy (PTMC) is one of the treatment modality in the management of rheumatic mitral stenosis. Reuse of sterilized PTMC balloon catheters has been widely practiced in developing countries to bring down procedural cost. PTMC by reused balloons are prone to deform and rupture during procedure. This can cause fatal complications like embolism of air or balloon material. Herein, we report a case of Accura balloon rupture during PTMC without any fatal complication. Thus, during balloon preparation particularly of reused balloon, it should be examined for any deformity or tear and air should be removed completely to prevent the fatal outcome.

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“…9,10 In a study by Ho et al the incidence of Inoue balloon deformity was observed in 1.6% while rupture in 0.4% (1 out of 245 cases). 11 Abdominal distension during mechanical ventilation is a common occurrence due to insufflation of air in the course of positive pressure ventilation during ambulatory mask and bag unit (AMBU) ventilation or during endotracheal intubation if accidently the tube enters the oesophagus but having documented that on fluoroscopy during a percutaneous cardiac is an unusual finding. The importance of this sign is that the clinicians and the interventionists should be aware of this as a benign occurrence during mechanical ventilation and should not be viewed as a complication or otherwise when incidentally picked during fluoroscopy.…”

Section: Discussionmentioning

confidence: 99%

An unusual percutaneous transmitral commissurotomy: A collection of four rare occurrences!

Shankarappa

Agrawal

Karur

et al. 2013

Journal of Cardiovascular Disease Research

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a b s t r a c tWe are presenting an interesting case of a 30-year-old patient taken for percutaneous transvenous mitral commissurotomy (PTMC) for severe rheumatic mitral stenosis in which there was a collection of four unusual occurrences during the course of a procedure.She had recurrent generalized toniceclonic seizures immediately after femoral sheath insertion requiring the patient to be mechanically ventilated. Subsequently, the pressure tracings recorded with catheters in the aorta and the pulmonary artery showed transient unusually high supra-systemic pulmonary artery pressure. During inflation the Accura PTMC balloon which was used to dilate the mitral valve ruptured and the procedure subsequently had to be completed using another balloon catheter. During the procedure the presence of a distended stomach due to insufflations of air during positive pressure ventilation which subsided subsequently was another unusual documentation on fluoroscopy. The final outcome of the procedure was successful.This case presents an interesting collection of unusual occurrences during a PTMC procedure which started on an unusual note but ended on a successful one. Careful assessment and appropriate management of complications can lead to successful outcome of procedures as in our case.

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Inoue balloon deformity and rupture during percutaneous balloon valvuloplasty

Cited by 5 publications

References 16 publications

Accura balloon rupture during percutaneous trans-septal mitral commissurotomy: a rare and potentially fatal complication

Accura balloon rupture during percutaneous trans-septal mitral commissurotomy: a rare and potentially fatal complication

Rupture of Accura balloon during percutaneous transvenous mitral commissurotomy

An unusual percutaneous transmitral commissurotomy: A collection of four rare occurrences!

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