Valvoplastia mitral percutânea por balão. Resultados imediatos, complicaçoes e evolução hospitalar / Percutaneous balloon mitral valvoplasty. Immediate results, complications and hospital outcome

ABSTRACT

PURPOSE--To study the short-term results, complications and in-hospital follow-up of 223 percutaneous mitral balloon valvuloplasty (PMBV) procedures (proc)in 219 patients. METHODS--It was used a single 20mm balloon diameter in 4 proc, double balloon in 7, Inoue balloon in 4 and low profile balloon in 196. The mean-age group was 37.19 years. One hundred eighty three (82.1) procedures were performed in women (mean age, 36.99 years) and 40 (17.9) in men (mean age, 38.10 years) (p = 0.63). Patients were in functional class II, (NYHA) in 25 (11.2) procedures, class III in 165 (74.0) and class IV in 33 (14.8). Patients were in sinus rhythm in 182 procedures (81.6) and in atrial fibrillation in 41 (18.4). The echocardiographic score range from 4 to 14 (7.4 +/- 1.7). Among 4 and 11 were 98.2 of patients. RESULTS--We had 203 complete proc and success, mitral valve area (MVA) > or = 1.5cm2 after PMBV in 194 proc. Echocardiographic MVA before PMBV was 0.9 +/- 0.2cm2 and after 1.8 +/- 0.3cm2 (p < 0.01). Hemodynamic measures MVA before PMBV was 0.9 +/- 0.2cm2 and after was 1.9 +/- 0.3cm2 (p < 0.01). Mean pulmonary artery pressure decreased from 39 +/- 14mmHg to 27 +/- 11mmHg (p < 0.01) and mitral mean gradient from 20 +/- 9mmHg to 6 +/- 5mmHg (p < 0.01). In the 203 proc, mitral valve (MV) was competent in 176 and there were 1+ mitral regurgitation (MR) in 27. After PMBV, MV was competent in 126, and there were 1+ MR in 60, 2+ in 10.3+ in 6 and 4+ MR in 1. There was complication in 15 proc, severe MR in 7 (3 or 4+), stroke in 3 and cardiac tamponade in 5. Two patients died during emergency cardiac surgery after left ventricular perforation and one by stroke. CONCLUSION--PMBV was an effective procedure with a high grade of success and low rate of complication.