Document Detail


Evaluation of a simplified transseptal mitral valvuloplasty technique using over-the-wire single balloons and complementary femoral and jugular venous approaches in 1,407 consecutive patients.
MedLine Citation:
PMID:  15867439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The over-the-wire double balloon technique (DBT) of balloon mitral valvuloplasty (BMV) has been decreasingly used in recent years because of its relative complexity and potential for left ventricular perforation. We attempted to make over-the-wire BMV simpler and safer by developing: (a) a single balloon technique (SBT) using a rapidly inflating, over-the-wire, cylindrical balloon having abrupt distal taper and short blunt tip to prevent left ventricular perforation, and (b) an alternative jugular approach to reduce technical difficulty in patients with cardiac anatomic distortion. SBT-BMV was evaluated over seven years in 1,407 consecutive patients (femoral approach: 1,277 patients, jugular approach: 130 patients), and compared with 954 patients who underwent DBT-BMV earlier at the same center. Results of SBT-BMV were comparable to those of DBT-BMV: optimal outcomes (91.0% versus 87.8%), fluoroscopy time (12.4 +/- 6.8 minutes versus 17.6 +/- 7.2 minutes), significant right heart oxygen step-up (4.8% versus 10.7%), and major complication rates (3.7% versus 5.6%) were significantly better with SBT-BMV; whereas mean post-BMV mitral valve area (1.92 +/- 0.31 cm2 versus 2.03 +/- 0.42 cm2), and post-BMV hemodynamic parameters were inferior with SBT-BMV. Balloon-related left ventricular perforation did not occur in SBT-BMV. Fluoroscopy time in jugular approach SBT-BMV (9.0 +/- 4.2 minutes) was significantly lower than in the femoral approach SBT-BMV (12.4 +/- 6.8 minutes) despite cardiac anatomic distortion. SBT-BMV reduced procedural costs considerably. SBT-BMV was effective, safe, technically simple and economical; it was comparable to, and overcame several limitations of DBT-BMV.
Authors:
George Joseph; Sunil Chandy; Paul George; Oommen George; Bobby John; Purendra Pati; Jacob Jose
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  17     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-05-03     Completed Date:  2005-05-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  132-8     Citation Subset:  IM    
Affiliation:
Professor of Cardiology, Department of Cardiology, Christian Medical College, Vellore, 632 004, India. josephg@cmcvellore.ac.in
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Balloon Dilatation / instrumentation,  methods*
Child
Child, Preschool
Female
Femoral Vein / pathology,  surgery
Heart Septum / pathology,  surgery
Humans
India / epidemiology
Jugular Veins / pathology,  surgery
Male
Middle Aged
Mitral Valve / pathology,  surgery
Mitral Valve Stenosis / epidemiology,  pathology,  therapy*
Postoperative Complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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