Percutaneous balloon versus surgical closed commissurotomy for mitral stenosis. A prospective, randomized trial.

Turi, Zoltan G.; Reyes, Vincent P.; Raju, Bindu; Raju, A R; Kumar, D.N.; Rajagopal, P; Sathyanarayana, Ponangi Venkata; Rao, Dattatreya P.V.; Srinath, K M; Peters, Priscilla J.

doi:10.1161/01.cir.83.4.1179

Cited by 249 publications

(102 citation statements)

References 19 publications

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“…1) When there is favorable mitral valve anatomy, percutaneous balloon mitral valvoplasty (PBMV) has become the treatment of choice for severe pliable rheumatic mitral stenosis.…”

Section: R Heumatic Mitral Valve Stenosis Remains An Importantmentioning

confidence: 99%

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A Novel Technique for Multi-Track Percutaneous Balloon Mitral Valvoplasty

Sakr

Ramadan

Osama³

2013

Int. Heart J.

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SummaryPercutaneous balloon mitral valvoplasty (PBMV) has become the treatment of choice for severe pliable rheumatic mitral stenosis. The multi-track system is a recent variation of the double-balloon technique and is easier owing to the use of a monorail balloon and a simple, single-guidewire approach. In the present study, we used the double-coil Inoue metal wire with a multi-track balloon instead of the conventional multi-track wire. We studied 62 consecutive patients (55 females) with significant symptomatic rheumatic mitral valve stenosis who underwent multi-track PBMV. Patients were randomized into 2 groups: the first group included 32 patients treated with the novel multi-track technique using the double-coil Inoue metal wire, and the second group included 30 patients treated with the conventional multi-track technique using a balloon endhole catheter and multi-track 0.035 inch stiff wire. None of the patients had cardiac tamponade, systemic thromboembolism, or any groin complications. No statistically significant differences were found between the 2 groups regarding any of the studied variables. There were no in-hospital deaths or complications necessitating emergent cardiac surgery in either group. In conclusion, this new technique with the double-coil Inoue metal wire achieves the double benefit of being as safe as (and indeed easier than) the conventional technique, and it utilizes fewer materials, making the multi-track system more cost-effective. (Int Heart J 2013; 54: 196-201) Key words: Inoue, Endhole, Rheumatic, Stenosis R heumatic mitral valve stenosis remains an important public health concern in developed countries. 1) When there is favorable mitral valve anatomy, percutaneous balloon mitral valvoplasty (PBMV) has become the treatment of choice for severe pliable rheumatic mitral stenosis.2) With increasing experience and better selection of patients, the immediate results of the procedure have improved, and the rate of complications has declined.2) Several randomized trials reported similar hemodynamic results with PBMV and surgical commissurotomy.1, [3][4][5][6] There are currently 2 main techniques for PBMV: balloon commissurotomy and metallic commissurotomy. In balloon commissurotomy, the 2 main modalities are the double-balloon technique and the Inoue technique. The double-balloon technique is effective but demanding and carries a risk of left ventricular perforation by the guidewires or the tips of the balloons. 7)The multi-track operator-friendly system is a recent variation of the double-balloon technique. This system has the advantages of the double-balloon technique and is also an easier procedure because of the use of a monorail balloon and a simple, single-guidewire approach. 7,8) The procedure time is similar to that of single-balloon techniques while achieving consistently higher mitral valve area postdilatation.7) The mismatch between the round shape of a single balloon and the oval mitral valve orifice probably explains the better results that have been reported with double...

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“…1) When there is favorable mitral valve anatomy, percutaneous balloon mitral valvoplasty (PBMV) has become the treatment of choice for severe pliable rheumatic mitral stenosis.…”

Section: R Heumatic Mitral Valve Stenosis Remains An Importantmentioning

confidence: 99%

“…1,[3][4][5][6] There are currently 2 main techniques for PBMV: balloon commissurotomy and metallic commissurotomy. In balloon commissurotomy, the 2 main modalities are the double-balloon technique and the Inoue technique.…”

Section: R Heumatic Mitral Valve Stenosis Remains An Importantmentioning

confidence: 99%

A Novel Technique for Multi-Track Percutaneous Balloon Mitral Valvoplasty

Sakr

Ramadan

Osama³

2013

Int. Heart J.

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“…1 However, balloon mitral valvuloplasty (BMV) has been established as an effective method for treating mitral stenosis with result comparable to surgical commissurotomy(CMC). 2,3 Since its introduction in the early 1980s, BMV have lead to its world wide adoption. 4 Two BMV techniques have been extremely used; the Inoue balloon technique and the trans septal over the wire balloon technique.…”

Section: Introductionmentioning

confidence: 99%

Balloon Mitral Valvuloplaty (BMV): An early experience in Chitwan Medical College

2017

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Balloon Mitral Valvotomy (BMV) is one the preferred modality of treatment for Rheumatic mitral stenosis. This is usually performed with onsite surgical backup to tackle the complications like cardiac tamponade needing surgical drainage and severe mitral regurgitation which requires emergency Mitral Valve Replacement. Our aim is to evaluate the pre and post procedural outcomes of the BMV, without onsite surgical backup. Total patients were 88 who underwent BMV in Chitwan Medical College, from Feb 2014 to Jan. 2016. All symptomatic patients (NYHA class II-IV) with their mitral valve area (MVA ) <1.5cm2 were enrolled. Detail clinical evaluation and Echocardiography was done before and after the procedure. The procedure was performed under local anesthesia, using the step-wise Inoue balloon dilation with the ante grade transvenous approach. The successful procedure was 87 (98.8 %). The mean age was 38+13 yrs, mean pre BMV MVA= 0.85+0.18 cm2, mean Post BMV MVA =1.76+0.23 cm2, by plannimetry. Pre BMV mean left atrium pressure=23.10+6.79 mmHg and post BMV mean left atrium pressure=12.48+4.86mmHg.Minor complication like puncture site hematoma in 3 (3.44%) patients, vasovagal attack in 5 (5.74%) patients after intra atrial septal puncture, Ventricular arrhythmia in 3(3.44%) patients and supraventricular arrhythmia in 8 (9.19%) patients. Severe mitral regurgitation occurred in 4 (4.59%) patients and managed medically. Cardiac tamponade developed in 1(1.2%) patient, pericardiocentesis done. Balloon Mitral Valvotomy is safe and effective procedure for patient with severe and symptomatic patient with Rheumatic MS. It can be formed without onsite surgical backup with experience hand.

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“…7 It was proven that, it is as effective as open valvotomy and more effective than closed valvotomy. 8,9,10 As there are very few contraindications for the procedure, so it has greatly decreased the need for surgery. 11 It has established itself as the procedure of choice for symptomatic MS patients.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Transluminal Mitral Commisuriotomy for Mitral Stenosis in Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Adhikari

2016

Nepalese Heart J.

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Mitral stenosis (MS) is almost invariably the result of long term complication of rheumatic fever. Based upon the nature and severity of MS, patients can be managed with medical treatment, percutaneous transvenous mitral commissurotomy (PTMC) or surgery. PTMC is proven to be simple, effective and safe; it is considered as treatment of choice in the management of MS. In Shahid Gangalal National Heart Centre, PTMC service started in 2001. First PTMC in the centre was done on 14th April 2001. Till June2016, 6023 PTMCs were done in the centre. Multiple studies evaluated the safety and efficacy of PTMC in different groups of patients. These studies clearly demonstrated the safety and effectiveness of PTMC in our centre. This article summarizes the historical development, current status and future perspectives of PTMC procedure at Shahid Gangalal National Heart Centre, a teritary care cardiac centre in Nepal.Nepalese Heart Journal 2016; 13(2): 15-17

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Percutaneous balloon versus surgical closed commissurotomy for mitral stenosis. A prospective, randomized trial.

Cited by 249 publications

References 19 publications

A Novel Technique for Multi-Track Percutaneous Balloon Mitral Valvoplasty

A Novel Technique for Multi-Track Percutaneous Balloon Mitral Valvoplasty

Balloon Mitral Valvuloplaty (BMV): An early experience in Chitwan Medical College

Percutaneous Transluminal Mitral Commisuriotomy for Mitral Stenosis in Shahid Gangalal National Heart Centre, Kathmandu, Nepal

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