Document Detail


Percutaneous transvenous mitral commissurotomy using an Inoue balloon in children with rheumatic mitral stenosis.
MedLine Citation:
PMID:  9363498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  62     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-12-19     Completed Date:  1997-12-19     Revised Date:  2010-12-01    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  19-22     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India.
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MeSH Terms
Descriptor/Qualifier:
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:
Int J Cardiol. 1998 Sep 1;66(1):97-8   [PMID:  9781796 ]

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


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