Balloon mitral valvotomy: comparison between antegrade Inoue and retrograde non-transseptal techniques
Aims The results of percutaneous mitral valvotomy performed by the antegrade transseptal method using the Inoue balloon (n=1000; group 1) and by the retrograde non-transseptal technique using a polyethylene balloon (n=100; group 2) were compared in a retrospective, non-randomized study. Methods and...
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| Veröffentlicht in: | European heart journal 1997-11, Vol.18 (11), p.1765-1770 |
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| creator | Bahl, V. K. Chandra, S. Jhamb, D. K. Goswami, K. C. Juneja, R. Thatai, D. Talwar, K. K. Wasir, H. S. |
| description | Aims The results of percutaneous mitral valvotomy performed by the antegrade transseptal method using the Inoue balloon (n=1000; group 1) and by the retrograde non-transseptal technique using a polyethylene balloon (n=100; group 2) were compared in a retrospective, non-randomized study. Methods and results Both the groups were similar with respect to baseline characteristics. The success rate was 95% in group 1 and 93% in group 2. There was a significant increase in mitral valve area estimated by Gorlin's equation (Group 1: from 0·8 ± 0·5 to 2·1 ± 0·8 cm2; Group 2: from 0·8 ± 0·3 to 1·9 ± 0·8 cm2, both P |
| doi_str_mv | 10.1093/oxfordjournals.eurheartj.a015171 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_79471775</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>79471775</sourcerecordid><originalsourceid>FETCH-LOGICAL-c451t-9d71f56c2c4db2a96f123f2ad15dd9efee503972c7be4894b6d3fd85119c5e6a3</originalsourceid><addsrcrecordid>eNpVkF1rFDEUhoModa39CcJciHgzazKTj41X2q3tFgpe2ELpTcgkJ3bWmWSbZGr7703ZYcGrcPI-vOfwIPSZ4CXBsv0SnlyIdhum6PWQljDFe9Axb5caE0YEeYUWhDVNLTllr9ECE8lqzle3b9G7lLYY4xUn_AgdSYobysgCuVM9DCH4auxz1EP1qIfHkMP4_LUyYdzp2KcSdpD_AvhK-wy_o7ZQXfowQZltFSHHsP_0wdelxacEu1zKMph73z9MkN6jN64cDCfze4xuzn9crzf11c-Ly_X3q9qUa3ItrSCOcdMYartGS-5I07pGW8KsleAAGG6laIzogK4k7bhtnV0xQqRhwHV7jD7te3cxvOzNauyTgWHQHsKUlJBUECFYAb_tQRNDShGc2sV-1PFZEaxeVKv_VauDajWrLhUf5l1TN4I9FMxuS_5xznUyenBFjOnTAWswaxmlBav3WJ8yPB1iHf8oLlrB1Ob2Tl1vzs7Wv07vFG3_AWqSo4g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>79471775</pqid></control><display><type>article</type><title>Balloon mitral valvotomy: comparison between antegrade Inoue and retrograde non-transseptal techniques</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Bahl, V. K. ; Chandra, S. ; Jhamb, D. K. ; Goswami, K. C. ; Juneja, R. ; Thatai, D. ; Talwar, K. K. ; Wasir, H. S.</creator><creatorcontrib>Bahl, V. K. ; Chandra, S. ; Jhamb, D. K. ; Goswami, K. C. ; Juneja, R. ; Thatai, D. ; Talwar, K. K. ; Wasir, H. S.</creatorcontrib><description>Aims The results of percutaneous mitral valvotomy performed by the antegrade transseptal method using the Inoue balloon (n=1000; group 1) and by the retrograde non-transseptal technique using a polyethylene balloon (n=100; group 2) were compared in a retrospective, non-randomized study. Methods and results Both the groups were similar with respect to baseline characteristics. The success rate was 95% in group 1 and 93% in group 2. There was a significant increase in mitral valve area estimated by Gorlin's equation (Group 1: from 0·8 ± 0·5 to 2·1 ± 0·8 cm2; Group 2: from 0·8 ± 0·3 to 1·9 ± 0·8 cm2, both P<0·001) and by Doppler echocardiography using the pressure half-time method (Group 1: from 0·9 ± 0·4 to 2·2 ± 0·6 cm2; Group 2: from 0·9 ± 0·3 to 2·0 ± 0·7 cm2, both P<0·001). However, the calculated immediate post-valvotomy mitral valve area was larger with the Inoue technique (2·1 ± 0·8 vs 1·9 ± 0·8 cm2; P<0·02). Results were considered optimal when the mitral valve area increased to ≥ 1·5 cm2, the percentage increase was ≤50, and mitral regurgitation was ≤2/4. Out of the total successful procedures, optimal results were obtained in 95% patients in Group 1 and 94% in Group 2. Incidence of significant mitral regurgitation (≥grade 3/4) was similar in two groups (Group 1: 4% vs Group 2: 5%, P=ns). A significant left to right atrial shunt (Qp/Qs ≥ 1·5:1) in 2·5% and tamponade in 2% of cases occurred exclusively with the Inoue technique, while conduction disturbances, such as transient (<24 h) left bundle branch block (28%) and complete heart block (2%) were noted with the retrograde technique (Group 2). Local complications were significantly higher in Group 2 (3% vs 0·5%, P<0·01). The procedure time with the Inoue technique was shorter than with the retrograde (Group 1: 15 ± 8, range 10 to 35 min; Group 2: 22 ± 14, range 15 to 45 min, P=0·05). Echocardiographic follow-up at 1 year showed no significant difference in mitral valve area between the two groups (Group 1 (n=300): 1·8 ± 0·8 vs Group 2 (n=60): 1·9 ± 0·9 cm2; P=0·3). Conclusion Balloon mitral valvotomy using the Inoue balloon and the retrograde non-transseptal technique results in significant immediate haemodynamic and symptomatic improvement. The Inoue technique achieved a larger immediate post-valvotomy mitral valve area, but the difference was not apparent at 1 year follow-up. Incidence of significant mitral regurgitation was similar with both the techniques; however, local complications occurred more frequently with the retrograde technique. Both techniques may complement each other in technically difficult cases.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/oxfordjournals.eurheartj.a015171</identifier><identifier>PMID: 9402451</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Balloon mitral valvotomy ; Balloon Occlusion ; Biological and medical sciences ; Catheterization - adverse effects ; Catheterization - economics ; Catheterization - methods ; Diseases of the cardiovascular system ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Humans ; Inoue balloon ; Male ; Medical sciences ; Mitral Valve ; Mitral Valve Stenosis - therapy ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; retrograde non-transseptal balloon mitral valvotomy ; Retrospective Studies ; Treatment Outcome</subject><ispartof>European heart journal, 1997-11, Vol.18 (11), p.1765-1770</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-9d71f56c2c4db2a96f123f2ad15dd9efee503972c7be4894b6d3fd85119c5e6a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2053544$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9402451$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bahl, V. K.</creatorcontrib><creatorcontrib>Chandra, S.</creatorcontrib><creatorcontrib>Jhamb, D. K.</creatorcontrib><creatorcontrib>Goswami, K. C.</creatorcontrib><creatorcontrib>Juneja, R.</creatorcontrib><creatorcontrib>Thatai, D.</creatorcontrib><creatorcontrib>Talwar, K. K.</creatorcontrib><creatorcontrib>Wasir, H. S.</creatorcontrib><title>Balloon mitral valvotomy: comparison between antegrade Inoue and retrograde non-transseptal techniques</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Aims The results of percutaneous mitral valvotomy performed by the antegrade transseptal method using the Inoue balloon (n=1000; group 1) and by the retrograde non-transseptal technique using a polyethylene balloon (n=100; group 2) were compared in a retrospective, non-randomized study. Methods and results Both the groups were similar with respect to baseline characteristics. The success rate was 95% in group 1 and 93% in group 2. There was a significant increase in mitral valve area estimated by Gorlin's equation (Group 1: from 0·8 ± 0·5 to 2·1 ± 0·8 cm2; Group 2: from 0·8 ± 0·3 to 1·9 ± 0·8 cm2, both P<0·001) and by Doppler echocardiography using the pressure half-time method (Group 1: from 0·9 ± 0·4 to 2·2 ± 0·6 cm2; Group 2: from 0·9 ± 0·3 to 2·0 ± 0·7 cm2, both P<0·001). However, the calculated immediate post-valvotomy mitral valve area was larger with the Inoue technique (2·1 ± 0·8 vs 1·9 ± 0·8 cm2; P<0·02). Results were considered optimal when the mitral valve area increased to ≥ 1·5 cm2, the percentage increase was ≤50, and mitral regurgitation was ≤2/4. Out of the total successful procedures, optimal results were obtained in 95% patients in Group 1 and 94% in Group 2. Incidence of significant mitral regurgitation (≥grade 3/4) was similar in two groups (Group 1: 4% vs Group 2: 5%, P=ns). A significant left to right atrial shunt (Qp/Qs ≥ 1·5:1) in 2·5% and tamponade in 2% of cases occurred exclusively with the Inoue technique, while conduction disturbances, such as transient (<24 h) left bundle branch block (28%) and complete heart block (2%) were noted with the retrograde technique (Group 2). Local complications were significantly higher in Group 2 (3% vs 0·5%, P<0·01). The procedure time with the Inoue technique was shorter than with the retrograde (Group 1: 15 ± 8, range 10 to 35 min; Group 2: 22 ± 14, range 15 to 45 min, P=0·05). Echocardiographic follow-up at 1 year showed no significant difference in mitral valve area between the two groups (Group 1 (n=300): 1·8 ± 0·8 vs Group 2 (n=60): 1·9 ± 0·9 cm2; P=0·3). Conclusion Balloon mitral valvotomy using the Inoue balloon and the retrograde non-transseptal technique results in significant immediate haemodynamic and symptomatic improvement. The Inoue technique achieved a larger immediate post-valvotomy mitral valve area, but the difference was not apparent at 1 year follow-up. Incidence of significant mitral regurgitation was similar with both the techniques; however, local complications occurred more frequently with the retrograde technique. Both techniques may complement each other in technically difficult cases.</description><subject>Adult</subject><subject>Balloon mitral valvotomy</subject><subject>Balloon Occlusion</subject><subject>Biological and medical sciences</subject><subject>Catheterization - adverse effects</subject><subject>Catheterization - economics</subject><subject>Catheterization - methods</subject><subject>Diseases of the cardiovascular system</subject><subject>Echocardiography, Doppler</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Inoue balloon</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mitral Valve</subject><subject>Mitral Valve Stenosis - therapy</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>retrograde non-transseptal balloon mitral valvotomy</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkF1rFDEUhoModa39CcJciHgzazKTj41X2q3tFgpe2ELpTcgkJ3bWmWSbZGr7703ZYcGrcPI-vOfwIPSZ4CXBsv0SnlyIdhum6PWQljDFe9Axb5caE0YEeYUWhDVNLTllr9ECE8lqzle3b9G7lLYY4xUn_AgdSYobysgCuVM9DCH4auxz1EP1qIfHkMP4_LUyYdzp2KcSdpD_AvhK-wy_o7ZQXfowQZltFSHHsP_0wdelxacEu1zKMph73z9MkN6jN64cDCfze4xuzn9crzf11c-Ly_X3q9qUa3ItrSCOcdMYartGS-5I07pGW8KsleAAGG6laIzogK4k7bhtnV0xQqRhwHV7jD7te3cxvOzNauyTgWHQHsKUlJBUECFYAb_tQRNDShGc2sV-1PFZEaxeVKv_VauDajWrLhUf5l1TN4I9FMxuS_5xznUyenBFjOnTAWswaxmlBav3WJ8yPB1iHf8oLlrB1Ob2Tl1vzs7Wv07vFG3_AWqSo4g</recordid><startdate>19971101</startdate><enddate>19971101</enddate><creator>Bahl, V. K.</creator><creator>Chandra, S.</creator><creator>Jhamb, D. K.</creator><creator>Goswami, K. C.</creator><creator>Juneja, R.</creator><creator>Thatai, D.</creator><creator>Talwar, K. K.</creator><creator>Wasir, H. S.</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19971101</creationdate><title>Balloon mitral valvotomy: comparison between antegrade Inoue and retrograde non-transseptal techniques</title><author>Bahl, V. K. ; Chandra, S. ; Jhamb, D. K. ; Goswami, K. C. ; Juneja, R. ; Thatai, D. ; Talwar, K. K. ; Wasir, H. S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-9d71f56c2c4db2a96f123f2ad15dd9efee503972c7be4894b6d3fd85119c5e6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Balloon mitral valvotomy</topic><topic>Balloon Occlusion</topic><topic>Biological and medical sciences</topic><topic>Catheterization - adverse effects</topic><topic>Catheterization - economics</topic><topic>Catheterization - methods</topic><topic>Diseases of the cardiovascular system</topic><topic>Echocardiography, Doppler</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Inoue balloon</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mitral Valve</topic><topic>Mitral Valve Stenosis - therapy</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>retrograde non-transseptal balloon mitral valvotomy</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bahl, V. K.</creatorcontrib><creatorcontrib>Chandra, S.</creatorcontrib><creatorcontrib>Jhamb, D. K.</creatorcontrib><creatorcontrib>Goswami, K. C.</creatorcontrib><creatorcontrib>Juneja, R.</creatorcontrib><creatorcontrib>Thatai, D.</creatorcontrib><creatorcontrib>Talwar, K. K.</creatorcontrib><creatorcontrib>Wasir, H. S.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bahl, V. K.</au><au>Chandra, S.</au><au>Jhamb, D. K.</au><au>Goswami, K. C.</au><au>Juneja, R.</au><au>Thatai, D.</au><au>Talwar, K. K.</au><au>Wasir, H. S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Balloon mitral valvotomy: comparison between antegrade Inoue and retrograde non-transseptal techniques</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>1997-11-01</date><risdate>1997</risdate><volume>18</volume><issue>11</issue><spage>1765</spage><epage>1770</epage><pages>1765-1770</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Aims The results of percutaneous mitral valvotomy performed by the antegrade transseptal method using the Inoue balloon (n=1000; group 1) and by the retrograde non-transseptal technique using a polyethylene balloon (n=100; group 2) were compared in a retrospective, non-randomized study. Methods and results Both the groups were similar with respect to baseline characteristics. The success rate was 95% in group 1 and 93% in group 2. There was a significant increase in mitral valve area estimated by Gorlin's equation (Group 1: from 0·8 ± 0·5 to 2·1 ± 0·8 cm2; Group 2: from 0·8 ± 0·3 to 1·9 ± 0·8 cm2, both P<0·001) and by Doppler echocardiography using the pressure half-time method (Group 1: from 0·9 ± 0·4 to 2·2 ± 0·6 cm2; Group 2: from 0·9 ± 0·3 to 2·0 ± 0·7 cm2, both P<0·001). However, the calculated immediate post-valvotomy mitral valve area was larger with the Inoue technique (2·1 ± 0·8 vs 1·9 ± 0·8 cm2; P<0·02). Results were considered optimal when the mitral valve area increased to ≥ 1·5 cm2, the percentage increase was ≤50, and mitral regurgitation was ≤2/4. Out of the total successful procedures, optimal results were obtained in 95% patients in Group 1 and 94% in Group 2. Incidence of significant mitral regurgitation (≥grade 3/4) was similar in two groups (Group 1: 4% vs Group 2: 5%, P=ns). A significant left to right atrial shunt (Qp/Qs ≥ 1·5:1) in 2·5% and tamponade in 2% of cases occurred exclusively with the Inoue technique, while conduction disturbances, such as transient (<24 h) left bundle branch block (28%) and complete heart block (2%) were noted with the retrograde technique (Group 2). Local complications were significantly higher in Group 2 (3% vs 0·5%, P<0·01). The procedure time with the Inoue technique was shorter than with the retrograde (Group 1: 15 ± 8, range 10 to 35 min; Group 2: 22 ± 14, range 15 to 45 min, P=0·05). Echocardiographic follow-up at 1 year showed no significant difference in mitral valve area between the two groups (Group 1 (n=300): 1·8 ± 0·8 vs Group 2 (n=60): 1·9 ± 0·9 cm2; P=0·3). Conclusion Balloon mitral valvotomy using the Inoue balloon and the retrograde non-transseptal technique results in significant immediate haemodynamic and symptomatic improvement. The Inoue technique achieved a larger immediate post-valvotomy mitral valve area, but the difference was not apparent at 1 year follow-up. Incidence of significant mitral regurgitation was similar with both the techniques; however, local complications occurred more frequently with the retrograde technique. Both techniques may complement each other in technically difficult cases.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>9402451</pmid><doi>10.1093/oxfordjournals.eurheartj.a015171</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Balloon mitral valvotomy Balloon Occlusion Biological and medical sciences Catheterization - adverse effects Catheterization - economics Catheterization - methods Diseases of the cardiovascular system Echocardiography, Doppler Female Follow-Up Studies Humans Inoue balloon Male Medical sciences Mitral Valve Mitral Valve Stenosis - therapy Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) retrograde non-transseptal balloon mitral valvotomy Retrospective Studies Treatment Outcome |
| title | Balloon mitral valvotomy: comparison between antegrade Inoue and retrograde non-transseptal techniques |
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