Vietnam Heart Institute, Hanoi, Vietnam. Pham Gia Khai, Pham Manh Hung, Tran Quang Tuan,Tran Van Duong, Nguyen Lan Hieu, Nguyen Quang Thai, Do Doan Loi, Nguyen Lan Viet. 中国循环杂志 1999 0 14 0
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The University of Chicago Hospital and Clinics, USA Ted Feldman.
Objective: We here by report the immediate results of our first 50 attempts of Percutaneous Mitral Valvuloplasty (PMV) using Inoue balloon in Vietnam. The mean age was (35±15) years. The gender: 44 females and 6 males. 40 were in sinus rhythm and 10 presented with atrial fibrillation. The mean total echo score was 6.7±3.5 and the majority was in functional class (NYHA) Ⅲ/Ⅳ (85%).
Results: The procedure was technically successful in 47 patients (94%). PMV resulted in significant improvement in hemodynamic values: the mean left atrial pressure fell from (25±9) mmHg to (12±5) mmHg (p<0.001), the mean transmitral gradient from (20±8) mmHg to (4±3) mmHg (p<0.001), and the mean pulmonary pressure fell from (45±15) mmHg to (30±10) mmHg (p<0.001). The mitral valve area (MVA) on 2D echo-cardiogram increased significantly from (0.7±0.4) cm2 to (1.5±0.5) cm2 (p<0.001), and similar MVA was obtained on echo Doppler (0.75±0.3) cm2 to (1.55±0.4) cm2 . There was one case with failure to cross the mitral valve orifice with Inoue balloon. There were two tamponades. The first, in a patient to whom PMV was stopped. The patient underwent successful closed heart comissurotomy right after the pericardial tamponade subsided and his general status stabilized. The second case also had pericardial effusion drained and reperfused, and PMV was performed successfully in the catheterization laboratory when the tamponade had subsided and cardiovascular status normalized. We met one case with increasing MR post PMV (grade Ⅲ). Transient cerebral event occurred in one patient who fully recovered 2 days later.
Conclusion: The acute results of this series attest to the effectiveness and usefulness of PMV with Inoue balloon in Vietnam.
