Percutaneous transarterial balloon dilatation of the mitral valve: five year experience.

Babic, Uros U.; Grujicic, Sreten; Popovic, Zoran; Djurisic, Zoran; Pejcic, Petar; Vučinić, Marijana

doi:10.1136/hrt.67.2.185

Cited by 22 publications

(6 citation statements)

References 16 publications

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“…Although PMBV and MVR are accepted gold standard therapy for mitral stenosis, both of them have some important complications. Babic et al 24 found a 2% rate of embolic stroke after PMBV; similarly, in our study, five patients (1.8%) had embolic stroke. Four of them had embolic stroke on long-term follow-up.…”

Section: Discussionsupporting

confidence: 87%

Comparison of early and long-term follow-up results of percutaneous mitral balloon valvuloplasty and mitral valve replacement

Usta

Erdim

Görmez

et al. 2021

Rev. Assoc. Med. Bras.

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BACKGROUND: Percutaneous mitral balloon valvuloplasty and mitral valve replacement have been the treatment options for mitral stenosis for several years, however, studies that compare these two modalities are very rare in the literature.ObjectIve: In this article, we aim to investigate the comparison of clinical results of percutaneous mitral balloon valvuloplasty and mitral valve replacement.Methods: 527 patients with rheumatic mitral stenosis, treated with percutaneous mitral balloon valvuloplasty or mitral valve replacement (276 patients with percutaneous mitral balloon valvuloplasty and 251 patients with mitral valve replacement) from 1991 to 2012 were evaluated.The demographic characteristics, clinical, echocardiographic and catheterization data of patients were evaluated retrospectively. The results of early and late clinical follow-up of patients after percutaneous mitral balloon valvuloplasty and mitral valve replacement were also evaluated.Results: The mean follow-up time of the percutaneous mitral balloon valvuloplasty group was 4.7 years and, for the mitral valve replacement-group, it was 5.45 years. The hospital stay of the percutaneous mitral balloon valvuloplasty group was shorter than that of the mitral valve replacement group (2.02 days vs 10.62 days, p<0.001). The hospital mortality rate of percutaneous mitral balloon valvuloplasty and mitral valve replacement were 0% and 2% respectively (p=0.024). In the percutaneous mitral balloon valvuloplasty group, early postprocedural success rate was 92.1%. The event-free survival of percutaneous mitral balloon valvuloplasty and mitral valve replacement was found to be similar. While reintervention was higher in percutaneous mitral balloon valvuloplasty-group (p<0.001), mortality rate was higher in mitral valve replacement-group (p<0.001).ConclusIon: Percutaneous mitral balloon valvuloplasty seems to be more advantageous than mitral valve replacement due to low mortality rates, easy application of the procedure and no need for general anesthesia.

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Section: Discussionsupporting

confidence: 87%

Comparison of early and long-term follow-up results of percutaneous mitral balloon valvuloplasty and mitral valve replacement

Usta

Erdim

Görmez

et al. 2021

Rev. Assoc. Med. Bras.

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“…PTMC is considered the mainstay of treatment in patients with MS ( 13 - 15 ). It is a time-tested, safe, and effective treatment ( 15 - 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…PTMC is considered the mainstay of treatment in patients with MS ( 13 - 15 ). It is a time-tested, safe, and effective treatment ( 15 - 17 ). Despite the careful selection of patients using Wilkins score and selecting patients with a Wilkins score of <8, PTMC carries a considerable failure rate ( 18 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

Predictors of successful percutaneous transvenous mitral commissurotomy using the Bonhoeffer Multi-Track system in patients with moderate to severe mitral stenosis: Can we see beyond the Wilkins score?

Farman¹,

Khan²,

Sial³

et al. 2015

Anatol J Cardiol

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ObjectiveTo know the predictors of a successful outcome of percutaneous transvenous mitral commissurotomy (PTMC) other than described in the Wilkins scoring system.MethodsTwo hundred fifty-eight consecutive patients were enrolled for this observational study in a tertiary care heart center of Pakistan who had a Wilkins score of ≤8. Patients with more than mild mitral regurgitation (MR) or having a clot in the left atrium were excluded. The Bonhoeffer multi-track system was used as a default technique. Successful PTMC was defined as achieving a mitral valve area (MVA) of ≥1.5 cm2 with no more than mild MR.ResultsOut of 258 PTMC procedures, 197 were successful. The Bonhoeffer multi-track system was used in ~94% cases. Among unsuccessful procedures, 41 patients did not achieve the required valve area, and 21 patients developed more than mild MR, including those 8 patients who did not achieve the required valve area and had more than mild MR. Bigger mean annulus size (33.5±2.6 versus 32.8±2.1 mm; p=0.02) and pre-procedure MVA (0.93±0.1 versus 0.87±0.1 cm2; p=0.002) had a significant effect on successful PTMC. Lower mean preprocedure systolic right ventricular pressure on echo (65.4±19.4 versus 75.3±18 mm Hg; p=0.000) and on cath (74±21.5 versus 81.5±24.6 mm Hg; p=0.002), lower grade of left ventricular dysfunction (p=0.04), and tricuspid regurgitation on echo (p=0.003) also had positive effects on the outcome.ConclusionBigger preprocedure mitral valve annulus size and mitral valve area, and better left and right ventricular hemodynamics are correlated with successful PTMC.

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“…The double‐balloon technique is claimed to produce larger mitral valve area (MVA). Also, there is no agreement whether different dilating shapes in the two techniques might produce difference in extent of commissurotomy and whether this difference might result in different incidences of restenosis and cardiac events 4 . More than 15 years ago, Bonhoeffer et al modified the conventional double balloon each on a separate guidewire, to the multi‐track system where two balloons are applied on a single wire.…”

Section: Introductionmentioning

confidence: 99%

“…Also, there is no agreement whether different dilating shapes in the two techniques might produce difference in extent of commissurotomy and whether this difference might result in different incidences of restenosis and cardiac events. 4 More than 15 years ago, Bonhoeffer et al modified the conventional double balloon each on a separate guidewire, to the multi-track system where two balloons are applied on a single wire. He hypothesized that the multi-track system approach should make the procedure easier and needs shorter procedure time with the advantages of the double-balloon technique.…”

Section: Introductionmentioning

confidence: 99%

Immediate and 18‐Month Outcome of Balloon Mitral Valvuloplasty: Comparison of Inoue and Multi‐Track System

Oraby

Youssef

2011

J Interven Cardiology

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Aims: To compare the immediate and 18‐month clinical and echocardiographic outcome of Inoue and multi‐track system for balloon mitral valvuloplasty (BMV). Methods: We included 78 consecutive patients with moderate to severe rheumatic mitral stenosis (MS) [mitral valve area (MVA) < 1.5 cm2] and clinically indicated BMV. The first 42 consecutive patients were assigned to Inoue BMV (group I), and the following 36 consecutive patients were assigned to multi‐track system (group M). Clinical and echocardiographic assessment was performed before, immediately after, 3 months after, and 18 months after the procedure. Results: The successful immediate result [MVA > 1.5 cm2 and mitral regurgitation (MR) < II/IV] was achieved in 40 (95.23%) patients of group I and 34 (94.44%) patients of group M (P = 0.12). Immediately after BMV, MVA increased from 0.9 ± 0.4 to 1.7 ± 0.5 cm2 in group I and from 0.8 ± 0.2 to 1.9 ± 0.3 cm2 in group M (P < 0.01). Bilateral commissural splitting was significantly higher in group M (P < 0.01). This was associated with higher incidence of mild commissural mitral regurgitation. There were no significant differences of moderate to severe MR. Both procedure and fluoroscopy time were significantly shorter in group I (P < 0.001). Eighteen‐month clinical and echocardiographic evaluation was available for 66 (84.64%) patients with sustained immediate clinical and echocardiographic improvements. Conclusions: Both Inoue and the multi‐track balloon systems achieved successful immediate and 18‐month results. The multi‐track double balloon system produced significantly larger MVA, with better bilateral commissurotomy, yet with longer procedure and fluoroscopy times. (J Interven Cardiol 2012;25:47–52)

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Percutaneous transarterial balloon dilatation of the mitral valve: five year experience.

Abstract: Objective-To examine the value of transarterial balloon dilatation of the mitral valve for treatment of patients with mitral stenosis over a period of five years.

Cited by 22 publications

References 16 publications

Comparison of early and long-term follow-up results of percutaneous mitral balloon valvuloplasty and mitral valve replacement

Comparison of early and long-term follow-up results of percutaneous mitral balloon valvuloplasty and mitral valve replacement

Predictors of successful percutaneous transvenous mitral commissurotomy using the Bonhoeffer Multi-Track system in patients with moderate to severe mitral stenosis: Can we see beyond the Wilkins score?

Immediate and 18‐Month Outcome of Balloon Mitral Valvuloplasty: Comparison of Inoue and Multi‐Track System

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