Percutaneous transseptal balloon valvuloplasty for dilating mitral valve stenosis (report of 200 cases).

Two hundred cases with mitral valve stenosis were treated by percutaneous single balloon (Inoue balloon) valvuloplasty at our institute from May 1988 to July 1992. The subjects included 137 females and 63 males with a mean age of 36.5 +/- 8.8 years (15-58 years). Hemodynamic and left ventriculographic findings were evaluated immediately before and after the procedure, and the results showed that the mean left atrial pressure was reduced from 25.08 +/- 9.13 mmHg to 10.64 +/- 4.10 mmHg (P < 0.001), the pressure gradient across the mitral valve was reduced from 25.49 +/- 10.22 mmHg to 6.71 +/- 4.87 mmHg (P < 0.001), and systolic pulmonary pressure was reduced from 52.78 +/- 21.42 mmHg to 38.56 +/- 16.47 mmHg (P < 0.001). At the same time, cardiac output and mitral orifice area were increased from 3.84 +/- 0.11 L/min to 4.66 +/- 0.28 L/min (P < 0.001) and from 1.08 +/- 0.28 cm2 to 2.20 +/- 0.47 cm2 (P < 0.001) respectively. Follow-up of 6-48 months (median 24 months) in 50 nonselective patients showed a symptomatic improvement rate of 100%. Percutaneous transseptal balloon mitral valvuloplasty (PBMV) proved to be a highly effective and safe nonsurgical method that can yield very good results in relieving symptomatic rheumatic mitral stenosis, with minimal morbidity and no mortality in this group. PBMV works by splitting the adhered mitral commissures toward the mitral annulus.