Percutaneous Mitral Valvuloplasty—A New Method for Balloon Sizing Based on Maximal Commissural Diameter to Improve Procedural Results

Sanati, Hamid Reza; Kiavar, Majid; Salehi, Negar; Shakerian, Farshad; Firoozi, Ata; Parsa, Saeed; Behzadnia, Neda; Bakhshandeh, Hooman; Peighambari, Mohammad Mehdi; Maleki, Majid

doi:10.15420/ahhj.2010.8.1.29

Cited by 10 publications

(9 citation statements)

References 9 publications

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“…These hemodynamic benefits were mirrored by clinical improvements in patients' symptoms and significant downgrades in NYHA functional classification. Therefore, consistent with previous studies [6,7,10,11,12], our results show that PBMV produces immediate hemodynamic and clinical improvements in most patients.…”

Section: Discussionsupporting

confidence: 93%

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Percutaneous Balloon Mitral Valvuloplasty in Elderly

Mahmoud¹,

Abodahab²,

Bahaa³

2017

jshd

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introduction and aim of the work:-mitral stenosis still shows it self older population in developed countries.Percutaneous balloon mitral Valvuloplasty (PBMV) is the treatment of choice for severe and /or hemodynamically significant mitral stenosis. It has been developed as an alternative modality to surgical closed commissurotomy for mitral steno-sis5. Elderly patients with mitral stenosis are a special entity who suffered a severe form of the disease and in the same time at higher risk of surgical mitral valve replacement, the aim of the current study is to assess and analyze clinical and echocardiographic consequences after percutaneous balloon mitral Valvuloplasty in those patients. Study design Uncontrolled prospective longitudinal single center study performed in patients referred for percutaneous balloon mitral valvuloplasty. Patients :-The current study included 40 elderly consecutive patients who underwent PBMV in Sohag university hospital cathlab unit. results and conclusion:-There was no in hospital mortality , only one patient developed severe MR , technical failure was encountered in 2 patients, because of failure of the balloon ability to traverse tight valves.This study agreed that PBMV can be applied to those with less favorable valve morphology, PBMV is a safe and effective procedure and optimal results can be achieved in patients with higher wilkin's score if they are carefully selected and operated at experienced centers.

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Section: Discussionsupporting

confidence: 93%

“…Despite a dramatic decline in the incidence of rheumatic fever, the disease continues to affect many people [7]. Balloon mitral valvotomy, which was first performed in 1982 by Kanji Inoue in Japan, produces excellent results equivalent to those obtained with open or closed surgical valvotomy.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Balloon Mitral Valvuloplasty in Elderly

Mahmoud¹,

Abodahab²,

Bahaa³

2017

jshd

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“…Their final balloon sizes were similar between the two groups, and they achieved better valve areas with less MR 22. We believe that if calculated and final balloon sizes are similar, the success of MBV will be higher.…”

Section: Discussionmentioning

confidence: 65%

“…When maximal diastolic annulus diameter is used for balloon sizing, the balloon reference sizes are smaller than those obtained with the heightbased formula 22. In this way, balloons with a smaller diameter can be used to achieve sufficient mitral valve area, and with smaller balloons, procedures might be performed with less damage to the chordal structure and the leaflets.…”

Section: Discussionmentioning

confidence: 99%

Comparison of two different techniques for balloon sizing in percutaneous mitral balloon valvuloplasty: which is preferable?

Taştan

Öztürk

Şenarslan

et al. 2016

CVJA

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SummaryBackgroundPercutaneous balloon mitral valvuloplasty (BMV) is an important option for the treatment of mitral valve stenosis. The crux of this process is choosing the appropriate Inoue balloon size. There are two methods to do this. One is an empirical formula based on the patient’s height, and other is to choose according to the maximal inter-commissural distance of the mitral valve provided by echocardiography.MethodsThe study, performed between January 2006 and December 2011, included 128 patients who had moderate to severe mitral stenosis and whose valve morphology was suitable for BMV. Patients were randomised into two groups. One group was allocated to conventional height-based balloon reference sizing (the HBRS group) and the other was allocated to balloons sized by the echocardiographic measurement of the diastolic inter-commissural diameter (the EBRS group).ResultsBMV was assessed as successful in 60 (92.3%) patients in the HBRS group and in 61 (96.8%) in the EBRS group (p = 0.03). The mean of the calculated balloon reference sizes was significantly higher in the HBRS than in the EBRS group [26.3 ± 1.2 mm, 95% confidence interval (CI): 26.1–26.6 vs 25.2 ± 1.1, 95% CI: 25.0–25.4, respectively; p = 0.007). Final mitral valve areas (MVA) were larger and mitral regurgitation (MR) > 2+ was less in the EBRS group (p = 0.02 and p = 0.05, respectively).ConclusionsEBRS is a method that is independent of body structure. Choosing Inoue balloon size by measuring maximal diastolic annulus diameter by echocardiography for BMV may be an acceptable method for appropriate final MVA and to avoid risk of significant MR.

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“…Rheumatic heart disease has been shown to have a high prevalence in developing countries and is the major cause of mitral stenosis (MS) . According to the latest guideline, therapeutic modalities for MS, either medical or interventional, need to be approached with an accurate determination of the stage and cause of the MS .…”

Section: Introductionmentioning

confidence: 99%