Percutaneous mitral valvotomy with the Inoue balloon catheter in children and adults: Immediate results and early follow-up

Percutaneous mitral balloon valvotomy (PMV) using the Inoue balloon catheter was attempted in 60 consecutive patients with severe symptomatic mitral stenosis. There were 10 children (mean age 13 years) and 50 adults (mean age 31 years). Forty patients were females and 20 were males; 53 were in sinus rhythm. The procedure was technically successfully performed in 57 (95%) patients. There were no deaths or thromboembolic complications. Balloon valvotomy was done using a 22 to 30 mm diameter catheter with the echo/Doppler guided stepwise mitral dilatation technique. After PMV the mean left atrial pressure decreased from 23.0 ± 5.0 to 14.0 ± 4.0 mm Hg ( p < 0.001). The mean mitral valve gradient (MBG) decreased from 15.0 ± 4.0 to 6.0 ± 2.0 mm Hg ( p < 0.001). The mitral valve area (Gorlin formula) increased from 0.7 ± 0.2 to 1.6 ± 0.4 cm 2 ( p < 0.001). The mitral valve area as determined by echocardiography increased from 0.8 ± 0.1 to 1.9 ± 0.3 cm 2 ( p < 0.001). Mild mitral regurgitation (MR) developed in six patients (11%) and increased by one grade in another five patients (9%). No patient developed severe mitral regurgitation. Mitral valve area at mean follow-up of 4.8 months remained anchanged at 1.9 ± 0.3 cm 2. We conclude that PMV, using the Inoue balloon catheter, is safe and effective in the treatment of severe mitral stenosis in children and adults, without inducing significant mitral regurgitation.