Comparaçäo entre uso de duplo balão unifoil e baläo bifoil no sucesso da valvoplastia mitral por cateter balão / Comparison between the use of unifoil double balloon and bifoil balloon in successful mitral valvuloplasty by balloon catheter

ABSTRACT

PURPOSE--To compare immediate and long term results balloon mitral valvuloplasty (BMV) using double balloon or bifoil balloon. METHODS--One hundred and thirteen consecutive cases of BMV used aleatory double balloon (group DB--55 cases) or bifoil balloon (group BF--16 cases). Patients were similar regarding to age, sex, valvopaty etiology, functional class and echocardiographic score. Seventy one (63 per cent ) patients achieved 12 months follow-up. RESULTS--In group DB there were 2 (4 per cent ) insuccess, 2 (4 per cent ) cardiac tamponade and 2 (4 per cent ) deaths, 91 per cent patients had immediate criteria of success. Mitral valve area (MVA) increased from 0.8 to 1.69cm2 and mitral gradient (G) by echodopplercardiographic (ECHO) decreased from 17.9 to 4.8mmHg. Three (5 per cent ) patients developed severe mitral regurgitation (MR) and needed surgical intervention. At follow-up 2 (4 per cent ) developed mitral restenosis. MVA estimated by ECHO study after one year follow-up was inferior to 1.15cm2 in 15 (32 per cent ) cases, between 1.5 and 2.0cm2 in 17 (37 per cent ) and superior to 2.0cm2 in 14 (31 per cent ). In group BF there were 2 (12.5 per cent ) insuccess, 4 (25 per cent ) developed severe MR occurring 1 death immediate post-operative mitral valve replacement. Among 14 (87 per cent ) success cases, MVA increased from 0.8 to 1.89cm2 and G decreased from 18 to 6.4mmHg. Lately 2 (12.5 per cent ) needed surgical intervention because significative MR. At 12th month follow-up the ECHO study showed that in one (10 per cent ) case MVA was < 1.5cm2, and in 3 (27 per cent ) cases was between 1.5 and 2.0cm2. CONCLUSION--There were similar good results in both groups, however group DB had more restenosis, cardiac tamponade and vascular complications and group BF had more severe MR