Entrar/Registro  
HOME SPANISH
 
Archivos de Cardiología de México
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Archivos de Cardiología de México >Year 2006, Issue 1


Flores FJ, Ledesma VM, Palomo VJA, Montoya GS, Estrada GJ Astudillo SR, Abundes VA, González DB, Argüero SR, Farell CJ
Long-term results of mitral percutaneous valvuloplasty with Inoue technique. Seven-years experience at the Cardiology Hospital of the National Medical Center “Siglo XXI”, IMSS
Arch Cardiol Mex 2006; 76 (1)

Language: Español
References: 30
Page: 28-36
PDF: 94.04 Kb.


Full text




ABSTRACT

Since the last decade, percutaneous balloon mitral valvuloplasty with Inoue catheter is considered the treatment of choice for selected patients (mobile valve, no calcification and minimal subvalvular disease) with rheumatic mitral stenosis. Objective: We present the seven-year followup experience of 456 patients treated with this technique in the catheter laboratory of the Cardiology Hospital in National Medical Center SXXI. Material and methods: It is a retrospective, transversal and observational study performed with data obtained from January 1994 and December 2000, with a follow-up of 58.5 ± 26.6 months (range 12-96 mean 22). Results: We achieve an initial success of 82.8%, improvement of initial mitral valve area from 0.9 ± 0.1 to 1.8 ± 0.3 cm2, with a gain area from 88 to 106% (p ‹ 0.001). At the end of the follow-up, the mean valvular area was maintained in 1.7 ± 0.3 cm2 in 69.8% of the cases. We found a significant reduction of transmitral gradient and of the pulmonary artery systolic pressure immediately after the procedure; 93.1% of patients were in NYHA functional class II at the end of the follow-up, 11.6% presented complications (mitral regurgitation as the most important), in 15.9% of them, due to leaflet rupture, but only 9.1% corresponded to severe grade III-IV. Complications: Only one patient died due to septal perforation; 93.8% of the patients remained free of major cardiac events at the end of the study. Only 6.1% of the patients required surgery at the end of the follow-up; 5.5% were in functional class NYHA IIIIV and restenosis occurred in 14.6%. Conclusion: Percutaneous balloon mitral valvuloplasty with Inoue balloon catheter is a safe and effective technique for treating rheumatic mitral stenosis with Wilkins score ‹ 10, with minimal risk and complications and offers good life expectancy with absence of major cardiac events in › 90%. From these patients, 93.1% remained in NYHA-II or -I functional class and the incidence of restenosis decreased.


Key words: Percutaneous mitral valvuloplasty, Inoue balloon, Commissurotomy.


REFERENCIAS

  1. INOUE K, OWAKI T, NAKAMURA T, KITAMURA F, MIYAMOTO N: Clinical application of transvenous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg 1984; 87: 394-402.

  2. INOUE K, FELDMAN T: Percutaneous transvenous commissurotomy using the Inoue balloon. Catheter Catheterization Cardiovasc Diagn 1993; 28: 119-125.

  3. FELDMAN T, CARROLL D, ISNER M, CHISHOLM J, HOLMES R, MASUMI A, INOUE K, ET AL: Effects of valve deformity on results and mitral regurgitation after Inoue balloon commissurotomy. Circulation 1992; 85: 180-187.

  4. LOCK J, KHALILULLAH M, SHRIVASTAVA S, BAHL V, KEANE J: Percutaneous catheter commissurotomy in rheumatic mitral stenosis. N Engl J Med 1985; 313: 1515-1518.

  5. BABIC U, PEJCIC P, DJURISIC Z, VUCINIC M, GRUJICIC S: Percutaneous transarterial balloon valvuloplasty for mitral valve stenosis. Am J Cardiol 1986; 57: 1101-1104.

  6. AL ZAIBAG M, RIBEIRO A, AL KASAB S, AL FAGIH M: Percutaneous double balloon mitral valvotomy for rheumatic mitral valve stenosis. Lancet 1986; 1: 757-761.

  7. MARTÍNEZ-REDING J, CORDERO J, ROMERO A, BAN HAYASHI E, ALVARADO G, KURI J: Valvuloplastía mitral percutánea con balón de Inoue. Experiencia inicial y seguimiento clínico a 3 años en el Instituto Nal. de Cardiología “Ignacio Chávez”. Arch Cardiol Méx 1994; 64(6): 537-42.

  8. HERRMANN H, KLEAVELAND J, HILLJA M, MARGOLIS J, NICERO M: The M-Heart balloon mitral valvuloplasty registry: Initial results and early follow up. J Am Coll Cardiol 1990; 15: 1221-1226.

  9. Multicenter experience with balloon mitral commissurotomy. NHLBI balloon Valvuloplasty Registry report on immediate and 30 days follow up results. The National Heart, Lung and Blood Institute Balloon Valvuloplasty Registry Participants. Circulation 1992; 85: 448-461.

  10. GAMRA C, HABIB L, ZHANG CH, HEPING R: Factors determining normalization of pulmonary vascular resistance following successful balloon mitral valvuloplasty. Am J Cardiol 1999; 83(3): 392-95.

  11. VAHANIAN A: Balloon valvuloplasty. Heart 2001; 85(2): 223-228.

  12. MOHAMEDE E, LAYTH M, VAS S, JAYARAM L, ASHFAC P, KHAN B, ET AL: Immediate and long-term effect of mitral balloon valvotomy on severe pulmonary hypertension in patients with mitral stenosis. Am Heart J 1996; 131(1): 89-93.

  13. TREVIÑO J, IBARRA M, GARCÍA A, URIBE A, DE LA FUENTE F, BONFIL A, FELDMAN T: Immediate and long-term results of balloon mitral commissurotomy for rheumatic mitral stenosis: Comparison between Inoue and double-balloon techniques. Am Heart J 1996; 131(3): 530-536.

  14. OSA A, ALMENAR L, RINCÓN DE ARELLANO A, MARTÍ S, ROLDÁN I, MORA V: Resultados a largo plazo de la valvuloplastía mitral percutánea. Rev Esp Cardiol 1998; 51(6): 72-84.

  15. CHENG C, CHENG T: Long-term results of percutaneous balloon mitral valvuloplasty using the Inoue balloon catheter technique. Am Heart J 1995; 129: 1197-1204.

  16. PALACIOS I, TUZCU E, WEYMAN E, NEWELL B, BLOCK C: Clinical follow-up of patients undergoing percutaneous mitral balloon valvotomy. Circulation 1995; 95: 671-676.

  17. LEDESMA M, TREVIÑO A, DELGADO G, MARTÍNEZ A, MURILLO H, MUNAYER J, ET AL: Registro Nacional de Comisurotomía Mitral Percutánea. Experiencia de 8 años. Arch Cardiol Méx 1996; 66(3): 244-53.

  18. WILKINS T, WEYMAN E, ABASCAL M, BLOCK C, PALACIOS F: Percutaneous balloon dilatation of mitral valve; an analysis of echocardiography variables related to outcomes and the mechanism of dilatation. Br Heart J 1988; 60: 299-308.

  19. RUIZ C, ZHANG P, GAMRA H, ALLEN J, K LAU F: Late clinical and echocardiography follow up after percutaneous balloon dilatation of mitral valve. Br Heart J 1994; 71: 454-458.

  20. HATLE L, ANGLESEN J, TROMSDAL A: Noninvasive assessment of atrio-ventricular pressure half time by Doppler ultrasound. Circulation 1979; 60: 1094- 1104.

  21. ABASCAL R, WILKINS T, O’SHEA L: Prediction of successful outcome in 130 patients undergoing percutaneous balloon mitral valvuloplasty. Circulation 1990; 82: 448-56.

  22. SELLERS D, LEVY J, AMPLATZ K, ZELLEHE W: Left retrograde cardioangiography in acquired cardiac disease: technique, indications and interpretation of 700 cases. Am J Cardiol 1964; 14: 437- 447.

  23. HERNANDEZ R, MACAYA C, BAÑUELOS C, ALFONSO F, GOICOLEA J, IÑIGUES A: Predictors, mechanisms and outcomes of several mitral regurgitation complicating percutaneous mitral valvulotomy with the Inoue balloon. Am J Cardiol 1992; 70: 1169-1174.

  24. LUNG B, GARBAZ E, MICHAUD P, HELOU S, FARAH B, BERDAH P, ET AL: Late results of percutaneous mitral commissurotomy in a series of 1,024 patients. Circulation 1999; 99: 3272-78.

  25. HERNANDEZ R, MACAYA C, BAÑUELOS C, GOICOLEA J, IÑIGUES I: Long-term clinical and echocardiography follow up alter percutaneous mitral valvuloplasty with the Inoue balloon. Circulation 1999; 99: 1580-86.

  26. HARRISON K, WILSON S, HEARNE E, BASHORE M: Complications related to percutaneous transvenous mitral commissurotomy. Cathet Cardiovasc Diagn 1994; 33(Suppl 2): 52-60.

  27. CHEN R, CHENG O: Percutaneous balloon mitral valvuloplasty by the Inoue Technique: a multicenter study of 4,832 patients in China. Am Heart J 1995; 129: 1197-1203.

  28. BEN M, BETBOUT F, GAMRA H, MAATOUK F, AYARI M, CHERIF A, ET AL: Results of percutaneous doubleballoon mitral commissurotomy in one Medical Center in Tunisia. Am J Cardiol 1995; 76: 1266-70.

  29. RUIZ C, PING H, GAMRA H, ALLEN J, Y K LAU F: Late clinical and echocardiography follow up after percutaneous balloon dilatation of the mitral valve. Br Heart J 1994; 71: 454-58.

  30. PALACIOS I: Which patients benefit from percutaneous mitral balloon valvuloplasty? Pre Valvuloplasty and postvalvuloplasty variables that predict long-term outcome. Circulation 2002; 105: 1465-1072.






>Journals >Archivos de Cardiología de México >Year 2006, Issue 1
 

· Journal Index 
· Links 






       
Copyright 2019