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. 1994 Nov;72(5):486–491. doi: 10.1136/hrt.72.5.486

A comparison of cylindrical and Inoue balloon techniques for mitral valvotomy in patients in the United Kingdom.

T R Shaw 1, C M Turnbull 1, P Currie 1, A D Flapan 1, S Pringle 1, B C Lee 1
PMCID: PMC1025621  PMID: 7818970

Abstract

OBJECTIVES--To compare the use of cylindrical balloons and the Inoue balloon for percutaneous mitral valvotomy in patients in the United Kingdom. DESIGN--Comparison of the haemodynamic results, complications, and symptomatic outcome of balloon dilatation for mitral stenosis in consecutive patients treated by cylindrical balloons and a second consecutive series of patients treated by the Inoue balloon. SETTING--A tertiary cardiac referral centre in Scotland. PATIENTS--70 patients (mean age 60.6 years) treated by the single or double cylindrical balloon technique and 70 patients (mean age 58.9 years) treated with the Inoue balloon method. MAIN OUTCOME MEASURES--Success in obtaining dilatation at the mitral orifice, procedure and screening times, increase in valve area, complications, and early symptomatic outcome. RESULTS--Dilatation of the mitral valve was obtained in 91% of patients when cylindrical balloons were used and in 99% of patients treated with the Inoue balloon. Use of the Inoue balloon gave significantly shorter procedure and screening times. Technical problems in obtaining and maintaining the position at the mitral orifice were more common with cylindrical balloons. Improvements in valve area and symptoms were not significantly different with use of the two types of balloon. The Inoue balloon avoided cardiac tamponade and the creation of larger atrial septal defects, but had a higher incidence of increase in mitral reflux. CONCLUSIONS--In these elderly patients, the Inoue balloon method was safer and faster for percutaneous mitral valvotomy, with a higher success rate for dilatation within the valve orifice. Haemodynamic and symptomatic improvement was similar with the two techniques.

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Selected References

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  1. Abdullah M., Halim M., Rajendran V., Sawyer W., al Zaibag M. Comparison between single (Inoue) and double balloon mitral valvuloplasty: immediate and short-term results. Am Heart J. 1992 Jun;123(6):1581–1588. doi: 10.1016/0002-8703(92)90813-b. [DOI] [PubMed] [Google Scholar]
  2. Al Zaibag M., Ribeiro P. A., Al Kasab S., Al Fagih M. R. Percutaneous double-balloon mitral valvotomy for rheumatic mitral-valve stenosis. Lancet. 1986 Apr 5;1(8484):757–761. doi: 10.1016/s0140-6736(86)91780-0. [DOI] [PubMed] [Google Scholar]
  3. Chen C. R., Huang Z. D., Lo Z. X., Cheng T. O. Comparison of single rubber-nylon balloon and double polyethylene balloon valvuloplasty in 94 patients with rheumatic mitral stenosis. Am Heart J. 1990 Jan;119(1):102–111. doi: 10.1016/s0002-8703(05)80089-4. [DOI] [PubMed] [Google Scholar]
  4. Cohen M. V., Gorlin R. Modified orifice equation for the calculation of mitral valve area. Am Heart J. 1972 Dec;84(6):839–840. doi: 10.1016/0002-8703(72)90080-4. [DOI] [PubMed] [Google Scholar]
  5. Inoue K., Owaki T., Nakamura T., Kitamura F., Miyamoto N. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg. 1984 Mar;87(3):394–402. [PubMed] [Google Scholar]
  6. Inoue K. Percutaneous transvenous mitral commissurotomy using the Inoue balloon. Eur Heart J. 1991 Jul;12 (Suppl B):99–108. doi: 10.1093/eurheartj/12.suppl_b.99. [DOI] [PubMed] [Google Scholar]
  7. Kasper W., Wollschläger H., Geibel A., Meinertz T., Just H. Percutaneous mitral balloon valvuloplasty--a comparative evaluation of two transatrial techniques. Am Heart J. 1992 Dec;124(6):1562–1566. doi: 10.1016/0002-8703(92)90073-5. [DOI] [PubMed] [Google Scholar]
  8. Lefèvre T., Bonan R., Serra A., Barraud P., Crépeau J., Vanderperren O., Muller T., Dyrda I. Résultats immédiats et suivi à moyen terme après valvuloplastie mitrale percutanée. Arch Mal Coeur Vaiss. 1991 Sep;84(9):1311–1319. [PubMed] [Google Scholar]
  9. Lefèvre T., Bonan R., Serra A., Crépeau J., Dyrda I., Petitclerc R., Leclerc Y., Vanderperren O., Waters D. Percutaneous mitral valvuloplasty in surgical high risk patients. J Am Coll Cardiol. 1991 Feb;17(2):348–354. doi: 10.1016/s0735-1097(10)80098-1. [DOI] [PubMed] [Google Scholar]
  10. Lock J. E., Khalilullah M., Shrivastava S., Bahl V., Keane J. F. Percutaneous catheter commissurotomy in rheumatic mitral stenosis. N Engl J Med. 1985 Dec 12;313(24):1515–1518. doi: 10.1056/NEJM198512123132405. [DOI] [PubMed] [Google Scholar]
  11. Palacios I., Block P. C., Brandi S., Blanco P., Casal H., Pulido J. I., Munoz S., D'Empaire G., Ortega M. A., Jacobs M. Percutaneous balloon valvotomy for patients with severe mitral stenosis. Circulation. 1987 Apr;75(4):778–784. doi: 10.1161/01.cir.75.4.778. [DOI] [PubMed] [Google Scholar]
  12. Patel J., Vythilingum S., Mitha A. S. Balloon dilatation of the mitral valve by a single bifoil (2 x 19 mm) or trefoil (3 x 15 mm) catheter. Br Heart J. 1990 Nov;64(5):342–346. doi: 10.1136/hrt.64.5.342. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Ribeiro P. A., Fawzy M. E., Arafat M. A., Dunn B., Sriram R., Mercer E., Duran C. G. Comparison of mitral valve area results of balloon mitral valvotomy using the Inoue and double balloon techniques. Am J Cardiol. 1991 Sep 1;68(6):687–688. doi: 10.1016/0002-9149(91)90369-v. [DOI] [PubMed] [Google Scholar]
  14. Ruiz C. E., Allen J. W., Lau F. Y. Percutaneous double balloon valvotomy for severe rheumatic mitral stenosis. Am J Cardiol. 1990 Feb 15;65(7):473–477. doi: 10.1016/0002-9149(90)90813-g. [DOI] [PubMed] [Google Scholar]
  15. Ruiz C. E., Zhang H. P., Macaya C., Aleman E. H., Allen J. W., Lau F. Y. Comparison of Inoue single-balloon versus double-balloon technique for percutaneous mitral valvotomy. Am Heart J. 1992 Apr;123(4 Pt 1):942–947. doi: 10.1016/0002-8703(92)90700-6. [DOI] [PubMed] [Google Scholar]
  16. Shaw T. R., McAreavey D., Essop A. R., Flapan A. D., Elder A. T. Percutaneous balloon dilatation of the mitral valve in patients who were unsuitable for surgical treatment. Br Heart J. 1992 Jun;67(6):454–459. doi: 10.1136/hrt.67.6.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Stefanadis C., Stratos C., Pitsavos C., Kallikazaros I., Triposkiadis F., Trikas A., Vlachopoulos C., Gavaliatsis I., Toutouzas P. Retrograde nontransseptal balloon mitral valvuloplasty. Immediate results and long-term follow-up. Circulation. 1992 May;85(5):1760–1767. doi: 10.1161/01.cir.85.5.1760. [DOI] [PubMed] [Google Scholar]
  18. Vahanian A., Michel P. L., Cormier B., Ghanem G., Vitoux B., Maroni J. P., Cazaux P., Acar J. Immediate and mid-term results of percutaneous mitral commissurotomy. Eur Heart J. 1991 Jul;12 (Suppl B):84–89. doi: 10.1093/eurheartj/12.suppl_b.84. [DOI] [PubMed] [Google Scholar]

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