Percutaneous mitral commissurotomy report of a new simplified method

ABSTRACT

We report a new simplified method of mitral dilatation done on 146 patients. The technique use the lnoue balloon with progressive diameters under ultrasonographic control, avoiding the arterial part of the dilatation. The population include 9 pregnant women, 13 children, 13 with restenosis and closed heart and 12 restenosis after dilatation. Mean age is 32 +/- 16 years [9 to 72] and sex ratio 3.7 [114 F/32 M]. Three groups are individualized according to histopathologic exam of metal struclure, group [26 percent] concern good indication and III [32 percent] bad indication for this technique, group II [42 percent] contain intermediate indications. Commissurolomy increase the mean mitral square for 0.2 to 1.9 +/- cm'. We observe 3 cases of chirurgical mitral insufficiency needing remplacement recuited for 2 patients from the group III. Mean fluoroscopic exposition time is 5.2 +/- 3.3 mn and procedure duration 18 +/- 11 mn. Hospitalisation duration is one day for 95 percent of the patients. This method remaining simple, efficient and safe permit a gain in time of 70 percent with a good confort for patient and a return to work on the 4th day