Sánchez CAR, Esquivel CM, Medel JO, García MLF, López GLM, Moreno RJ

Language: Spanish
References: 8
Page: 11-15
PDF size: 86.61 Kb.

ABSTRACT

Background. Currently percutaneous mitral valvuloplasty has become the first choice option for treatment of mitral stenosis; this procedure is less traumatic, lower cost, with shorter hospitalization; and long term results may be equivalent with those of surgical closed and open comissurotomy. Objective. To analyze the results of 10 years of valvuloplasty in Hospital Juarez de Mexico according to echocardiographic evaluation criteria. Material and methods. We collected our data from 78 patients using medical records, there were 20 patients excluded for missing data. The patient population includes 58 patients: 48 female and 11 male. The inclusion criteria: ecocardiographic score Wilkins, radiographic and electrocardiographic findings; in our study population Wilkins average ‹ 7, mitral valve area average ‹ 0.9 cm and transvalvular gradient range from 9-39 all of those before valvuloplasty. The procedure was performed with doble ballon technique in 15 patients (25.9%), Inhoue 25 patients (43.11%), nucleus in 17 (29.3%) and only one with Von Hauffer (1.7%), the follow up period was from 1-84 months. Results. Our global data have shown that 63.7% restenosis within four years of follow up. Mitral valve area post procedure were ‹ 1.2 cm in 23 patients (39.3%), 14 patients with mitral valve area range 1.3-1.4 cm (24%) and › 1-5 cm 21 patients (36.2%). Complications ocurred in 18 patients (29.3%). 16 patients required mitral valve replacement, and one refuse to have surgical procedure. Conclusions. The results in our series in percutaneous mitral valvuloplasty are suboptimal; at the end of the study 63.7% had restenosis at four years of follow up. The complications and the amount of patients requiring mitral surgery is high and these results in force us to re-evaluate conditions in which patients could benefit with this procedure.

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