Balloon mitral commissurotomy in patients with previous annuloplasty. Our experience

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• 作者：Zarauza ; Jesú ; s ; Hernando ; Juan P. ; Oliva ; Marí ; a J. ; Gutié ; rrez ; Benedicto ; et. al.
• 关键词：Balloon mitral commissurotomy ; Surgical mitral commissurotomy ; Annuloplasty ; Restenosis
• 刊名：International Journal of Cardiology
• 出版年：1995
• 出版时间：November 10, 1995
• 年：1995
• 卷：52
• 期：1
• 页码：5-10
• 全文大小：388 K

文摘

Balloon mitral commissurotomy is an alternative to surgical commissurotomy in the treatment of mitral stenosis and different studies have shown its usefulness for restenosis following surgical commissurotomy. We describe our experience in balloon mitral commissurotomy in five patients with previous commissurotomy and annuloplasty. Among 360 balloon commissurotomies performed in our hospital up to December 1993, 29 procedures were performed on patients with restenosis after surgical commissurotomy, five of whom also had an annuloplasty (flexible ring in four and rigid in one). The balloon commissurotomy was performed without complications using the Inoue single balloon technique. Mitral valve area increased from 0.9 ± 0.1 cm² to 1.0 ± 0.1 cm² by pressure half-time, and from 1.0 ± 0.2 cm² to 1.3 ± 0.1 cm² by Gorlin formula. Two patients in functional class III underwent mitral valve replacement, 32 and 11 months later; the other three patients were in class II 38, 10 and 7 months later. The presence of a mitral ring should not constitute a contraindication to balloon commissurotomy. However, the haemodynamic results are not favourable in our patients, probably due to the practical absence of commissural fusion and the ring's restrictive effect on valvular stretching.