Abstract
Objectives: To compare the frequency of severe mitral regurgitation after percutaneous mitral balloon valvuloplasty (PMBV) via Inoue balloon and multi-track balloon technique in our population. Methodology: In this retrospective observational study which was conducted at a tertiary care cardiac center of Karachi, Pakistan between 2015 and 2020 on Hospital registry of PMBV patients. Data were categorized in to two groups, Inoue balloon or multi-track balloon technique. Post procedure echocardiographic and catheterization parameters and in-hospital outcomes and complications, including severe MR, were compared between two groups. Results: Out of 470 PMBV procedures, 286 (60.9%) were performed with multi-track and 184 (39.1%) with Inoue balloon. Improvement in mitral value area was significantly higher with multi-track as compared to Inoue balloon (0.66±0.31 cm2 vs. 0.56±0.29 cm2; p<0.001). Severe MR was not significant, 3.5% (10/286) vs. 4.3% (8/184); p=0.639 for multi-track and Inoue balloon. One patient in Inoue balloon group and two patients in multi-track group required emergency valve surgery. Stroke was observed in two patients of multi-track group and two patients from the same group developed tamponade. No in-hospital mortality was observed. Conclusion: Post-procedure severe MR is a significant and frequent complication. Rate of post procedure severe MR are similar for PMBV via Inoue balloon and multi-track balloon. Both methods are equally effective with equal success rate.
Highlights
Prevalence of rheumatic heart disease (RHD) is slim to none in developed nations as a result of effective preventive measures such as reduction in exposure to the group-A streptococcus (GAS) bacterial infection and use of primary prophylaxis.[1]
Clinical and procedure related data of consecutive percutaneous mitral balloon valvuloplasty (PMBV) procedures performed for the patients of either gender with severe Mitral stenosis (MS) via Inoue balloon or multitrack double balloon were extracted from prospectively maintained institutional database
Data of total of 470 PMBV procedures performed by selected operators in defined period were evaluated in this study, 286 (60.9%) of these procedure were performed with multi-track balloon technique and remaining 184 (39.1%) of the procedures were performed via Inoue balloon technique
Summary
Prevalence of rheumatic heart disease (RHD) is slim to none in developed nations as a result of effective preventive measures such as reduction in exposure to the group-A streptococcus (GAS) bacterial infection and use of primary prophylaxis.[1] it remains a major challenge in low- and -middle income, underdeveloped and developing nations. It remains one of the leading cardiovascular disorder in young population, and major cause of significant premature mortality and morbidity.[1,2,3] Valvular damage in early years of life due to abnormal immune response to GAS infection remains the major cause of RHD. Various environmental and socioeconomic factors are known to contribute to the increased incidence of RHD in LMCs, such as lack of access and inadequate healthcare facilities, poverty, malnutrition, overcrowdings, and poor living conditions.[6]
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