Percutaneous Balloon Valvuloplasty for Restenosis after Surgical Mitral Commissurotomy

Kim, Han Soo; Shim, Won Heum; Tahk, Seung Jea; Jang, Yang Soo; Cho, Seung Yun; Kim, Sung Soon; Lee, Woong Ku

Abstract

To evaluate the efficacy of percutaneous balloon valvuloplasty in patients with prior surgical mitral commissurotomy, balloon valvuloplasty was performed in 9 patients with restenosis 14.1+/-9.3 years(5-30) after the operation. There were 6 women and 3 men with a mean age of 43+/-8 years. Two patients were in NYHA class II, 6 in classIII and 1 in class IV. Six were in atrial fibrillation. Percutaneous balloon mitral valvuoplasty in 9 patients resulted in increase of mitral valve area(1.03+/-0.13 to 1.81+/-0.49cm2, P<0.05) by Gorlin's formula, and decrease of mean diastoic mitral pressure gradient(13+/-5 to 6+/-2 mmHg, P<0.05), and mean left atrial pressure(17+/-7 to 10+/-4 mmHg, P<0.05). And also cardiac output increased(4.2+/-0.8 to 4.6+/-1.0L/min, P<0.05) and mean pulmonary artery pressure and pulmonary vascular resistance decreased(25+/-6 to 19+/-5 mmHg, P<0.05, 316+/-103 to 239+/-101 dyne.s.cm(-5), P<0.05). Mitral regurgitation develop or increased in severity in 2 patients. No other complications occured. These results suggst that percutaneous balloon mitral valvuloplasty is safe and effective procedure in selected patients with restenosis after mitral commissurotomy and can postpone reoperation in many cases.