Percutaneous transvenous mitral commissurotomy using Inoue balloon in children less than 12 years

Catheterization and Cardiovascular Diagnosis
S S KothariB Airan

Abstract

Rheumatic mitral stenosis in some parts of the world afflicts even young children. Percutaneous transvenous mitral commissurotomy (PTMC) using Inoue balloon in these children is not well reported. Forty-five children (aged 7-12 years, mean 11.0 +/- 1.2 years) with severe rheumatic mitral stenosis (mitral valve area [MVA] 0.64 +/- 0.14 cm2) underwent PTMC. The pulmonary artery wedge pressure (PAW) decreased from 24.3 +/- 8.6 to 14.7 +/- 7.2 mmHg (P < 0.0001) and mean diastolic gradient decreased from 24.3 +/- 7.7 to 7.9 +/- 5.9 mmHg with the final MVA of 1.63 +/- 0.45 cm2 (P < 0.0001). Complications included significant mitral regurgitation (MR) in three children and atrial shunting in two patients. No procedural death, systemic embolism, and cardiac tamponade were encountered. Twenty-four children had maximum balloon size (MBS) same as recommended balloon size (RBS) derived according to the height (group I) and 21 children had MBS 1-3 mm less than RBS (group II). Despite the lesser maximum balloon size, the final results were comparable in both groups (MVA group 1.66 +/- 0.44 vs. group II 1.61 +/- 0.48 P = NS). The incidence of significant MR (2 and 1 in group I and group II, respectively) was similar. On follow-up of 20.4 +/- ...Continue Reading

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Citations

Jun 29, 2014·Heart, Lung & Circulation·Satish KarurManjunath C Nanjappa
Aug 9, 2011·Journal of Veterinary Cardiology : the Official Journal of the European Society of Veterinary Cardiology·Emilie Trehiou-SechiNicolas Borenstein
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Jan 10, 2001·Journal of Biomolecular Structure & Dynamics·S G KamzolovaR V Polozov
Mar 25, 2005·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Douglas S Moodie
Feb 21, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·S HarikrishnanS Sivasankaran
Jan 10, 2014·World Journal for Pediatric & Congenital Heart Surgery·Arkalgud Sampath Kumar
Mar 25, 2005·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Shyam S KothariRakesh Yadav
Apr 29, 1998·Catheterization and Cardiovascular Diagnosis·T O Cheng

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