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Percutaneous balloon valvuloplasty for bioprosthetic mitral valve stenosis

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Abstract

Percutaneous transcatheter mitral valvuloplasty is the indicated treatment of choice for symptomatic native mitral valve stenosis, but there have been limited reports of successful procedures of balloon valvuloplasty for bioprosthetic mitral valve stenosis. We present the case of a 62-year-old woman suffering from progressive dyspnea due to bioprosthetic mitral valve stenosis. The measured mean pressure gradient across the mitral valve was 30 mmHg and the mitral valve area was 0.73 cm2. Redoing mitral replacement was considered high risk and was refused by the patient. Percutaneous balloon valvuloplasty was performed with an Inoue balloon catheter inflated to 20 mm. The patient’s symptoms immediately improved after the procedure, with no procedure-related complications. The mean pressure gradient across the valve decreased to 19 mmHg, and the mitral valve area increased to 1.21 cm2 in postprocedural echocardiography. We conducted a literature search and identified 26 cases of balloon valvuloplasty for degenerated bioprosthetic valves. Of these, 14 cases were bioprosthetic mitral valves, and the results were favorable. However, more case reports are required to establish an evidence base for future expert recommendation of balloon valvuloplasty of prosthetic mitral valve. Meanwhile, balloon valvuloplasty will serve a niche role in highly selected patients with prosthetic mitral valve stenosis.

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Conflict of interest

K. Inoue holds all patents of the Inoue balloon. The Inoue balloon was developed and made by K. Inoue. All the other authors report no financial relationships or conflicts of interest regarding the content herein.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Yasuhiro Hamatani, Naritatsu Saito, Junichi Tazaki, Masahiro Natsuaki, Kentaro Nakai, Takeru Makiyama, Yasuhiro Sasaki, Masao Imai, Shin Watanabe, Tetsuo Shioi & Takeshi Kimura

  2. PTMC Institute, Kyoto, Japan

    Kanji Inoue

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  1. Yasuhiro Hamatani
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  2. Naritatsu Saito
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  3. Junichi Tazaki
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  4. Masahiro Natsuaki
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  5. Kentaro Nakai
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  6. Takeru Makiyama
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  7. Yasuhiro Sasaki
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  8. Masao Imai
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  9. Shin Watanabe
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  10. Tetsuo Shioi
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  11. Takeshi Kimura
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  12. Kanji Inoue
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Correspondence to Naritatsu Saito.

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Hamatani, Y., Saito, N., Tazaki, J. et al. Percutaneous balloon valvuloplasty for bioprosthetic mitral valve stenosis. Heart Vessels 28, 667–671 (2013). https://doi.org/10.1007/s00380-012-0309-7

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  • DOI: https://doi.org/10.1007/s00380-012-0309-7

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