Mechanism of mitral valve area increase by in vitro single and double balloon mitral valvotomy

Ribeiro, Paulo A.; Zaibag, Muayed Al; Rajendran, Vijay; Ashmeg, Abdullah; Kasab, Saad Al; Faraidi, Yahya Al; Halim, Murtada; Idris, Mohamed; Fagih, Mohamed R. Al

doi:10.1016/0002-9149(88)90223-8

Cited by 71 publications

(19 citation statements)

References 10 publications

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“…Because the mechanism of PBMV is the same as closed mitral commissurotomy [38,39], their rates of success should be comparable [40]. That this is indeed the case has been well demonstrated in several wellcontrolled prospective studies in recent years [41-451, with comparable restenosis rate [45].…”

Section: Tsung 0 Cheng MD Fscaimentioning

confidence: 99%

“…WIth more experience, the interventionalists can broaden the criteria to include patients with mildly to moderately calcified mitral valves or moderate to severe subvalvular deformities, or both. The in vitro studies [38] revealed that the inflated balloon splits preferentially through calcified mitral commissures. Therefore, mitral calcification is not a contraindication, but rather an indication for PBMV.…”

Section: Tsung 0 Cheng MD Fscaimentioning

confidence: 99%

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Percutaneous balloon mitral valvuloplasty: Are chinese and western experiences comparable?

Cheng

1994

Cathet. Cardiovasc. Diagn.

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Section: Tsung 0 Cheng MD Fscaimentioning

confidence: 99%

Section: Tsung 0 Cheng MD Fscaimentioning

confidence: 99%

Percutaneous balloon mitral valvuloplasty: Are chinese and western experiences comparable?

Cheng

1994

Cathet. Cardiovasc. Diagn.

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“…Regurgitation was located on one open commis sure in 61 patients and on both in 26 patients. This fact, along with the observation of commissural splitting vi sualized by two-dimensional echocardiography in suc cessful percutaneous mitral valvotomy [2,6,7] and the results of anatomical studies carried out during openheart surgery or postmortem on cadaver hearts [12,[16][17][18] confirm that percutaneous mitral valvuloplasty acts similarly to closed-heart surgical commissurotomy in…”

Section: Mitral Regurgitationmentioning

confidence: 64%

Advantage of Color Doppler Flow Imaging in the Assessment of Mitral Regurgitation and Atrial Septal Defect after Percutaneou Mitral Valvotomy

Bernard¹,

Schiele²,

Anguenot³

et al. 1992

Am J Noninvas Cardiol

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Doppler echocardiography and color Doppler flow imaging were used to assess the results of percutaneous mitral valvotomy in 293 consecutive patients aged 16-86 years (mean age 52.4 ± 13.5). Doppler examinations were performed the day before as well as within 2 days and 3 months after valvotomy. The first 161 procedures were carried out using the double-balloon technique and the last 132 using the Inoue technique. Mitral valve area, calculated according to the Gorlin formula, increased on average from 1.0 ± 0.3 to 2.0 ± 0.5 cm^2 (p < 0.0001) and the mean gradient dropped on average from 12.5 ± 4 to 5 ± 2 mm Hg (p < 0.0001). Grade 1+ mitral regurgitation was present in 85 patients (29%) before valvotomy when estimated from left ventricular angiography. After valvotomy, it worsened to grade 2+ in 19 patients (6%) and to grade 3+ or 4+ in 5 cases (1.7%). Grade 1+, 2+ and 3+ mitral regurgitation appeared in 28 (9.5%), 5 (1.7%) and 6 patients (2%), respectively. Grade 1+ mitral regurgitation was detected by color Doppler in 159 patients (54%) before valvotomy. After the procedure, it worsened to grade 2+ in 16 patients (5%) and to grade 3+ or 4+ in 5 patients (1.7%). Grade 1+, 2+ and 3+ mitral regurgitation appeared in 30 (10%), 6 (2%) and 2 (0.7%) patients, respectively. Mitral regurgitation disappeared after valvotomy in 21 patients (7.2%). The specificity of color Doppler in the detection of mitral regurgitation was questionable when compared to contrast angiography (44%), perhaps because color Doppler may be more sensitive than left ventriculography in the diagnosis of mild mitral regurgitation. All in all, mitral regurgitation quantification determined by color Doppler correlated well with contrast angiography data, with a discrepancy of more than 1 grade in only 6 patients. The location and mechanism of mitral regurgitation were determined using color Doppler. Regurgitation was central in most cases; it was sometimes located on one commissure or on both in 26 cases. Color Doppler visualized an atrial septal defect in 115 patients (39%) on day 2, which persisted in 36 of 96 patients reexamined 3 months later. A shunt inversion was present during deep inhalation in 1 case. No correlation was found between the persistence or disappearance of the shunt and the results of mitral valvotomy.

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“…It has been suggested that because the stenotic mitral orifice is oval and not circular, double balloons selforient [6] and exert maximal force laterally toward the fused commissures, resulting in superior valve opening [32,33]. This suggestion is supported by results from in vitro studies [34,35].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous balloon mitral valvuloplasty: Comparison of double and single (Inoue) balloon techniques

Rihal

Nishimura

Reeder

et al. 1993

Cathet. Cardiovasc. Diagn.

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To assess relative merits of the double and single (Inoue) balloon techniques of percutaneous balloon mitral valvuloplasty for treating symptomatic mitral stenosis, 33 patients who underwent dilatation with the double balloon were compared retrospectively with 28 who underwent dilatation with the Inoue balloon. There were no baseline differences in mean left atrial pressure, mean mitral gradient, or calculated mitral valve area between the two groups. The procedure was successful in 89% of patients in the double balloon group and in 93% in the Inoue balloon group. Final mitral valve area and absolute increase in mitral valve area were significantly greater in the double balloon group, in which there was a nonsignificant trend toward greater incidence of acute complications. Final left atrial pressure and mitral gradient were not different. Both techniques are useful and safe.

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Mechanism of mitral valve area increase by in vitro single and double balloon mitral valvotomy

Cited by 71 publications

References 10 publications

Percutaneous balloon mitral valvuloplasty: Are chinese and western experiences comparable?

Percutaneous balloon mitral valvuloplasty: Are chinese and western experiences comparable?

Advantage of Color Doppler Flow Imaging in the Assessment of Mitral Regurgitation and Atrial Septal Defect after Percutaneou Mitral Valvotomy

Percutaneous balloon mitral valvuloplasty: Comparison of double and single (Inoue) balloon techniques

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