Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;98(4):E610-E616.
doi: 10.1002/ccd.29664. Epub 2021 Mar 31.

A new over-the-wire percutaneous mitral balloon valvuloplasty technique

Hellmuth Weich  1 , Lize-Mari van Veyeren  1
Affiliations

A new over-the-wire percutaneous mitral balloon valvuloplasty technique

Hellmuth Weich et al. Catheter Cardiovasc Interv. 2021 Oct.

Abstract

Objectives: To develop and evaluate a new over-the-wire technique for mitral valvuloplasty that is both technically easier and less costly.

Background: Rheumatic heart disease (RHD) and resultant mitral stenosis (MS) carries a significant burden of disease worldwide. The prevalence is however concentrated in lower income countries where the current gold standard for percutaneous mitral valvuloplasty (PMBV)-the Inoue technique, is not always available due to cost and technical complexity.

Methods: The development of an over-the-wire technique involving a steerable catheter to aid crossing of the valve and a dedicated TAVI wire is described. The procedure evolved over the initial eight cases and the final standardized procedure was performed in 16 cases. Clinical, echocardiographic and procedural outcomes are described in 16 consecutive cases performed at a single center.

Results: The procedure was performed with 88% procedural success and only one technical failure during the development phase. 2/24 patients had moderate mitral regurgitation (MR) afterwards but one had unfavorable anatomy and the other had pre-procedural moderate MR. The average procedural duration was 66 min, which was shortened significantly over time. No procedural deaths or conversion to open surgery at 1 year. Procedural cost was 44% lower than the Inoue technique.

Conclusion: We present favorable results of a new PMBV technique that is cheaper and technically easier in our opinion.

Keywords: mitral stenosis; rheumatic heart disease; transseptal.

PubMed Disclaimer

References

REFERENCES

    1. Horstkotte D, Niehues R, Strauer BE. Pathomorphological aspects, aetiology and natural history of acquired mitral valve stenosis. Eur Heart J. 1991;12(suppl B):55-60.
    1. Harken DE, Ellis LB. The surgical treatment of mitral stenosis; valvuloplasty. N Engl J Med. 1948;239(22):801-809.
    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(3):394-402.
    1. Al Zaibag M, Al Kasab S, Ribeiro PA, Al Fagih MR. Percutaneous double-balloon mitral valvotomy for rheumatic mitral-valve stenosis. Lancet. 1986;327(8484):757-761.
    1. Rihal CS, Nishimura RA, Reeder GS, Holmes DR. Percutaneous balloon mitral valvuloplasty: comparison of double and single (Inoue) balloon techniques. Cathet Cardiovasc Diagn. 1993;29(3):183-190.

MeSH terms

LinkOut - more resources