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Mitral balloon valvotomy in children with Inoue balloon technique: immediate and intermediate-term result.

Abstract
Percutaneous mitral balloon valvotomy (PMV) using the Inoue balloon technique was attempted in 170 patients. Of these, 30 patients were children aged 10 to 18 years (mean 15.9 +/- 2.7 years). There were 16 female and 14 male patients. All were in sinus rhythm. The procedure was successful in 28 patients (93%). PMV was performed using 20 to 28 mm (mean 25 mm) diameter balloon catheters with an echo-Doppler guided stepwise mitral dilation technique. After PMV, the mean left atrial pressure decreased from 25 +/- 5 to 14 +/- 4 mm Hg (p < 0.001). The mean mitral valve gradient (MVG) decreased from 16 +/- 4 to 6 +/- 3 mm Hg (p < 0.001). The mitral valve area (MVA) by catheter increased from 0.7 +/- 0.2 to 1.7 +/- 0.5 cm2 (p < 0.001), and MVA as determined by echocardiography (2DE) increased from 0.8 +/- 0.1 to 1.9 +/- 0.3 cm2 (p < 0.01). There were no deaths or thromboembolic complications; cardiac tamponade developed in one patient, mild mitral regurgitation (MR) developed in three patients (10%) and increased by one grade from (1+ to 2+) in another two patients (8%). A small atrial septal defect (ASD) assessed by color flow mapping developed in seven patients (25%); 90% were closed at 3 months. The Doppler and 2DE MVAs were maintained at 1.8 +/- 0.4 cm2 at 17 months' mean follow-up; one patient developed restenosis. We conclude the PMV using the Inoue balloon catheter is safe and effective in the treatment of severe mitral stenosis in children, with a low complication rate.
AuthorsM E Fawzy, L Mimish, M Awad, O Galal, F el-Deeb, B Khan
JournalAmerican heart journal (Am Heart J) Vol. 127 Issue 6 Pg. 1559-62 (Jun 1994) ISSN: 0002-8703 [Print] United States
PMID8197983 (Publication Type: Comparative Study, Journal Article)
Topics
  • Adolescent
  • Balloon Occlusion
  • Cardiac Catheterization
  • Catheterization (adverse effects, instrumentation, methods, statistics & numerical data)
  • Child
  • Female
  • Follow-Up Studies
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary (epidemiology, physiopathology, therapy)
  • Male
  • Mitral Valve
  • Mitral Valve Stenosis (epidemiology, physiopathology, therapy)
  • Time Factors

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