Percutaneous mitral balloon valvuloplasty—a comparative evaluation of two transatrial techniques

Abstract

The efficacy and safety of two different percutaneous transfemoral mitral balloon valvuloplasty procedures were evaluated in 45 patients. A double-balloon technique with Mansfield balloons was applied in the first 22 patients (group A), and an Inoue single-balloon technique was used in the subsequent 23 patients (group B). Mean diastolic gradient decreased from 17 ± 7 mm Hg to 8 ± 3 mm Hg ( p < 0.001) in group A and from 13 ± 4 mm Hg to 8 ± 3 mm Hg ( p < 0.001) in group B. The mitral orifice area increased from 1.1 ± 0.3 cm 2 to 2.2 ± 0.8 cm 2 ( p < 0.001) in group A and from 1.2 ± 0.4 cm 2 to 1.7 ± 0.7 cm 2 ( p < 0.001) in group B. The length of the total procedure and the total fluoroscopy time were considerably shorter in group B (86 ± 24 minutes and 18 ± 7 minutes) compared with group A (128 ± 38 minutes and 35 ± 14 minutes; p < 0.001). Mitral regurgitation (grade 3/4) was observed after the procedure in two patients in group A but in nine patients in group B. Cardiac tamponade occurred in two patients in group A, but no major complications were seen in group B. The Inoue single-balloon technique seemed to be safe, easier to perform, and equally effective.