Περίληψη:
Background. Percutaneous retrograde nontransseptal balloon mitral
valvuloplasty is a new technique developed in our institution for
opening a stenotic mitral valve. This technique is based on a new,
externally steerable cardiac catheter that enters the left atrium
retrogradely via the left ventricle.
Methods and Results. The technique was used in 86 consecutive patients
(18 men and 68 women; mean age, 51 +/- 11 years). Dilatation of the
stenotic mitral valve was achieved in 85 of the 86 patients. After the
procedure, mitral valve area increased from 0.92 +/- 0.22 to 2.14 +/-
0.54 cm2 and transmitral gradient decreased from 16 +/- 6 to 5 +/- 2 mm
Hg. Major complications, such as cardiac perforation, embolic events,
or death, were not encountered. Severe mitral regurgitation (> 2+)
developed in three patients (3.5%). In two patients (2.4%), there was
major injury of the femoral artery. The maintenance of the initial
improvement was similar to that found in studies that used transseptal
techniques. The restenosis rate during the 2-year follow-up was 15.4%.
Conclusions. The immediate and long-term findings of this study
indicate that retrograde percutaneous nontransseptal balloon mitral
valvuloplasty is an effective and safe procedure with an acceptable
major complication rate. Moreover, this new technique has the advantage
that it does not involve puncture and dilatation of the interatrial
septum, although it may occasionally lead to arterial damage. Further
studies will show whether it may really be considered as an alternative
method or method of choice for percutaneous balloon mitral
valvuloplasty.
Συγγραφείς:
STEFANADIS, C
STRATOS, C
PITSAVOS, C
KALLIKAZAROS, I and
TRIPOSKIADIS, F
TRIKAS, A
VLACHOPOULOS, C
GAVALIATSIS, I and
TOUTOUZAS, P
