novel technique of multi-track percutaneous balloon mitral commissurotomy [PBMC]

ABSTRACT

Percutaneous balloon mitral commissurotomy [PBMC] has become treatment of choice for severe pliable rheumatic mitral valve stenosis [RMVS]. The multi-track system is a recent variant of the double-balloon technique which is easier through the use of a monorail balloon and only a simple, single guide wire approach. In the present study, we sought to use the Inoue metallic wire with multi-track balloon instead of the conventional multi- track wire will make the procedure safer and faster. We studied 62 consecutive patients [55 females] with significant symptomatic RMVS who underwent multi-track PBMC. They were randomized into 2 groups the first group included 32 patients treated with the novel multi-track technique using the double coil Inoue metallic wire, and the second group includes 30 patients treated with the conventional multi-track technique. No statistically significant differences were found between both groups regarding any of the studied variables; apart from the pre-procedural MV area which was significantly lower in the novel-technique group compared to the conventional-technique group. None of the patients had cardiac tamponade, systemic thromboembolism or any groin complication. There were neither in-hospital deaths nor complications necessitating emergent cardiac surgery in both groups. This new technique achieves the double benefit of being safer and easier with Inoue wire and saving excess material with the multi-track system; which is more economic