| Percutaneous transvenous mitral commissurotomy using an Inoue balloon in children with rheumatic mitral stenosis. | |
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MedLine Citation:
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PMID: 9363498 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Percutaneous transvenous mitral commissurotomy (PTMC) using the Inoue technique was performed in 557 patients with rheumatic mitral stenosis. Of these, 107 were children aged 10-18 years (mean +/- SD 14.5 +/- 2.3). All patients were symptomatic New York Heart Association (NYHA) Class II (n = 78) and Class III (n = 29). All were in sinus rhythm. Following PTMC, the mitral valve area (MVA) increased from 0.73 +/- 0.18 to 1.7 +/- 0.53 cm2 (P < 0.001). There was a significant fall in mean transmitral gradient from 15.6 +/- 5.2 to 5.1 +/- 2.3 mmHg, and in mean pulmonary artery pressure from 41 +/- 15 to 28.4 +/- 10 (P < 0.001). Cardiac tamponade developed in one patient. One patient developed severe mitral regurgitation requiring emergency mitral valve replacement. Five patients (4.7%) developed moderate mitral regurgitation. There was no mortality or cerebral embolism in any of the children. Four patients (3.7%) had oximetry evidence of atrial septal defect. Mean mitral valve area and transmitral gradient at 14 months mean follow up was 1.68 +/- 0.4 cm2 and 6 +/- 3.5 mmHg, respectively, and were comparable to the immediate post-PTMC results. Two patients (1.8%) developed restenosis. The immediate haemodynamic results in children were compared to 450 adult patients who underwent PTMC in the same period. The outcome was similar in both groups. Children were found to have significantly higher pulmonary artery pressure compared to adults. We found that PTMC using an Inoue balloon is very effective and safe in children, and consider that it should be the procedure of choice for young patients with symptomatic rheumatic mitral stenosis. |
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Authors:
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P K Joseph; A Bhat; B Francis; S Sivasankaran; A Kumar; V R Pillai; T Titus; J M Tharakan; K G Balakrishnan |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article |
Journal Detail:
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Title: International journal of cardiology Volume: 62 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 1997 Oct |
Date Detail:
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Created Date: 1997-12-19 Completed Date: 1997-12-19 Revised Date: 2010-12-01 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: IRELAND |
Other Details:
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Languages: eng Pagination: 19-22 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Balloon Dilation / instrumentation*, methods Balloon Occlusion* Child Echocardiography Female Follow-Up Studies Hemodynamics / physiology Humans Male Mitral Valve Stenosis / surgery*, ultrasonography Prognosis Rheumatic Heart Disease / surgery* Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Int J Cardiol. 1998 Sep 1;66(1):97-8
[PMID:
9781796
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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