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Percutaneous Balloon Valvuloplasty for Mitral Stenosis

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Catheter Based Valve and Aortic Surgery

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Abstract

Rheumatic mitral stenosis (MS) remains a significant health problem in developing nations. Medical therapy forms the initial treatment strategy for most asymptomatic patients and for those with mild MS. Patients with severe (valve area < 1.5 cm2), symptomatic MS may be considered for percutaneous mitral balloon valvuloplasty (PMBV), a catheter-based therapy that works by cleaving the commissural fusion associated with rheumatic MS. Echocardiography is extremely helpful in identifying appropriate patients for this procedure and for excluding patients with contraindications (i.e., those with left atrial thrombus and significant mitral regurgitation). The Inoue balloon technique is the standard method used; the procedure may be technically challenging. The procedure is successful in more than 80 % of cases and results in roughly a doubling of the valve area and an immediate drop in left atrial and pulmonary artery pressures. The results of PMBV are comparable to those achieved with open surgical commissurotomy. The hemodynamic effects typically endure with a low event rate for the first 5 years following the procedure; however, by 10 years, about half the patients experience restenosis and require additional PMBV or surgical valve replacement.

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Authors and Affiliations

  1. Cardiovascular Division, Cardiac Catheterization Laboratory, University of Virginia Health System, Lee Street, 800158, Charlottesville, VA, 22909, USA

    Michael Ragosta MD

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  1. Michael Ragosta MD
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Correspondence to Michael Ragosta MD .

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Editors and Affiliations

  1. Department of Surgery, Advanced Cardiac Valve Center, Universit, Charlottesville, Virginia, USA

    Gorav Ailawadi

  2. Department of Surgery, University of Virginia, Charlottesville, Virginia, USA

    Irving L. Kron

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Ragosta, M. (2016). Percutaneous Balloon Valvuloplasty for Mitral Stenosis. In: Ailawadi, G., Kron, I. (eds) Catheter Based Valve and Aortic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3432-4_11

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  • DOI: https://doi.org/10.1007/978-1-4939-3432-4_11

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