Circulation, Vol 75, 778-784, Copyright © 1987 by American Heart Association
I Palacios, PC Block, S Brandi, P Blanco, H Casal, JI Pulido, S Munoz, G D'Empaire, MA Ortega and M Jacobs
Thirty-five patients with severe mitral stenosis underwent percutaneous
mitral valvotomy (PMV). There were 29 female and six male patients (mean
age 49 +/- 3 years, range 13 to 87). After transseptal left heart
catheterization, PMV was performed with either a single- (20 patients) or
double- (14 patients) balloon dilating catheter. Hemodynamic and left
ventriculographic findings were evaluated before and after PMV. There was
one death. Mitral regurgitation developed or increased in severity in 15
patients (43%). One patient developed complete heart block requiring a
permanent pacemaker. PMV resulted in a significant decrease in mitral
gradient from 18 +/- 1 to 7 +/- 1 mm Hg (p less than .0001) and a
significant increase in both cardiac output from 3.9 +/- 0.2 to 4.6 +/- 0.2
liters/min (p less than .001) and in mitral valve area from 0.8 +/- 0.1 to
1.7 +/- 0.2 cm2 (p less than .0001) Effective balloon dilating diameter per
square meter of body surface area correlated significantly with the
decrease in mitral gradient but did not correlate with the degree of mitral
regurgitation. There was no correlation of age, prior mitral commissurotomy
or mitral calcification with hemodynamic results. PMV is an effective
nonsurgical procedure for patients with mitral stenosis, including those
with pliable valves, those with previous commissurotomy, and even those
with mitral calcification.
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Percutaneous balloon valvotomy for patients with severe mitral stenosis
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