Percutaneous balloon mitral valvuloplasty...

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     Percutaneous balloon mitral valvuloplasty in patients with mitral restenosis after previous surgical commissurotomy

    Nguyen Quang Tuan,MD; Pham Manh Hung,MD; Nguyen Quoc Thai,MD; Nguyen Lan Viet,MD,PhD; Pham Gia Khai,MD,PhD.

    Vietnam National Heart Institute.

    Background: Although the efficacy of percutaneous balloon mitral valvuloplasty in patients with unoperated mitral stenosis has been well documented. Furthermore, in experienced hands, balloon mitral valvuloplasty is associated with an extremely low major complication rate. These salutary features ensure that balloon mitral valvuloplasty is a promising alternative for selected patients with mitral restenosis after previous surgical commissurotomy in whom a repeat surgical procrdure carries with it a significantly higher morbidity and mortality compared with the initial operation. Accordingly, the purpose of this study was to evaluate our immediate results of balloon mitral valvuloplasty in this subset of patients with previous mitral surgery.

    Methods Between October 1998 and October 2001, 82 consecutive patients with mitral restenosis after prior surgical commissurotomy (group 1) underwent Inoue balloon mitral valvuloplasty. They were matched on a patient-to-patient basis with regards to baseline mitral echocardiographic score, mitral valve area and severity of angiographic mitral regurgitation with 82 other patients with unoperated mitral stenosis (group 2) who underwent balloon mitral valvuloplasty during the same study period.

    Results Percutaneous mitral valvuloplasty resulted in significant improvement in hemodynamic values: the mean left atrial pressure fell from 26.20 ± 7.7 mmHg to 16.00 ± 5.76 mmHg (p

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