Long-term results of percutaneous mitral valvuloplasty with the Inoue balloon catheter

Abstract

The initial 85 patients who successfully underwent percutaneous mitral valvutoplasty (PMV) with the Inoue balloon catheter at the Guangdong Cardiovascular Institute between November 1985 and November 1988 had a mean follow-up period of 5 ± 1 year (range 43 to 79 months). Before and after PMV and at follow-up, mean diastolic mitral gradients by the catheter method were 17.5 ± 6.2, 3.1 ± 3.3 and 3.3 ± 3.4 mm Hg, respectively (p < 0.001 before vs after PMV and before vs follow-up; and p > 0.05 after PMV vs follow-up). Mean diastolic mitral gradients by the Doppler method were 18 ± 6,8 ± 5 and 9 ± 5 mm Hg, respectively (p < 0.001 before vs after PMV and before vs follow-up; and p > 0.05 after PMV vs follow-up). Mitral valve areas by the echo-Doppler method were 1.1 ± 0.3, 2.0 ± 0.4 and 1.8 ± 0.5 cm 2, respectively (p < 0.001 before vs after PMV and before vs follow-up; and p > 0.05 after PMV vs follow-up). Phonocardiographic and vectorcardiographic studies, and cardiopulmonary exercise testing showed significant improvement after PMV and at follow-up. Functional status before PMV was New York Heart Association class IV in 2 patients, class III in 52, and class II in 31; at follow-up, the status was class I in 74, class II in 6, and class III in 5. All 5 patients (6.8%) in class III developed mitral restenosis; in all 5, severe mitral calcification and subvalvular fusion were found by 2-dimensional echocardiography. It is concluded that PMV with the Inoue balloon catheter can achieve excellent and sustained long-term results in relieving symptomatic, rheumatic mitral stenosis in patients without severe mitral calcification and subvalvular fusion.