Percutaneous mitral valvotomy with a metal dilatator

Cribier, Alain; Rath, Pratap Chandra; Letac, B

doi:10.1016/s0140-6736(97)24023-7

Cited by 30 publications

(12 citation statements)

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“…To solve this issue, Cribier, et al 12) and Arora, et al 13) have developed a percutaneous metallic device for mitral valve dilatation that can be autoclaved and reused. In fact, the cost of the multi-track system is reduced owing to the simplicity of the system.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

A Novel Technique for Multi-Track Percutaneous Balloon Mitral Valvoplasty

Sakr

Ramadan

Osama³

2013

Int. Heart J.

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“…During an eighteen-month period, 35 patients with MVS and indication for percutaneous treatment underwent PMV as per the Cribier method [7][8][9] . Chart 1 displays the characteristics of the study population.…”

Section: Methodsmentioning

confidence: 99%

Área valvar mitral através de medidas de meia-pressão em átrio esquerdo e capilar pulmonar

Osterne¹,

Haddad²,

Motta³

et al. 2006

Arq. Bras. Cardiol.

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Objective: To confirm the validity of the calculation in MVA applying the method of Doppler pressure half-time directly in left atrial (LA) and pulmonary capillary pressure curve. Methods:Thirty-five patients with mitral valve stenosis underwent percutaneous mitral valvotomy (PMV) using the Cribier method with MVA measurement made using the traditional methods (Gorlin and echo-Doppler) and this propose. MVA values obtained were compared and a linear regression model was used to obtain formula for reciprocal calculations of the mitral valve area.Results: A statistically correlation was found between the calculated values by all methods. The proposed method showed a strong correlation (p< 0.05) with the others mainly before valve opening. Simple reciprocal calculation formulas were found for mitral valve area assessment. Conclusions:The proposed method for the calculation of mitral valve area using LA or Cap proved to be highly accurate and simple making it possible to safely monitor valvotomy procedures.Key words: Pressure half-time, mitral valve area by half-pressure, left atrium of the half-pressure.

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“…Using an exchange guidewire, a balloon catheter is passed into the left atrium and manipulated across the mitral valve. The only device approved for this use in the United States is the Inoue-Balloon Catheter, though a variety of other devices are used in the United States and abroad [12][13][14][15]. Serial inflations…”

Section: Balloon Commissurotomymentioning

confidence: 99%

Rheumatic mitral stenosis

Feldman

2000

Curr Treat Options Cardio Med

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Patients with symptomatic mitral stenosis should undergo evaluation with transthoracic and transesophageal echocardiography (Table 1). Those patients with suitable valve morphology should be treated with percutaneous transvenous mitral commissurotomy (PTMC). Randomized trials of catheter commissurotomy have shown no differences in long-term outcome compared with surgical commissurotomy; there is therefore no role for surgical commissurotomy in patients who are suitable candidates for balloon commissurotomy. Mitral valve replacement should be recommended for those patients with valve deformity too severe to undergo catheter therapy. Some older patients who are less-than-ideal candidates for catheter therapy nonetheless may benefit from it as a palliative alternative to otherwise high-risk valve surgery. Asymptomatic patients should be screened for the presence of pulmonary artery hypertension. Those who have pulmonary artery systolic pressure at rest of greater than 50 mm Hg or who develop pulmonary artery systolic pressure of greater than 60 mm Hg with exercise should be considered for PTMC.

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Percutaneous mitral valvotomy with a metal dilatator

Cited by 30 publications

References 1 publication

A Novel Technique for Multi-Track Percutaneous Balloon Mitral Valvoplasty

A Novel Technique for Multi-Track Percutaneous Balloon Mitral Valvoplasty

Área valvar mitral através de medidas de meia-pressão em átrio esquerdo e capilar pulmonar

Rheumatic mitral stenosis

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