PMID- 7626356
OWN - NLM
STAT- MEDLINE
DCOM- 19950905
LR  - 20190503
IS  - 0007-0769 (Print)
IS  - 0007-0769 (Linking)
VI  - 73
IP  - 6
DP  - 1995 Jun
TI  - Percutaneous balloon dilatation of the mitral valve in critically ill young 
      patients with intractable heart failure.
PG  - 555-8
AB  - OBJECTIVE: To assess the outcome of percutaneous balloon dilatation of the mitral 
      valve in critically ill young patients with intractable heart failure. DESIGN: 
      Retrospective analysis of all such patients presenting over a period of 4 years. 
      PATIENTS: Of 432 consecutive patients undergoing percutaneous balloon dilatation 
      of the mitral valve, 12 (mean age 29 years) with intractable heart failure were 
      identified. Nine had severe pulmonary oedema and three had pulmonary oedema with 
      severe right heart failure and hypotension. Three patients were pregnant and 
      three required mechanical; ventilatory support. PROCEDURE: Percutaneous balloon 
      dilatation of the mitral valve was performed using the Inoue balloon technique. 
      The procedure was shortened by excluding full right study, cardiac output 
      measurement, and left ventriculography. The mitral valve morphology and mitral 
      valve area were determined before and after percutaneous balloon dilatation using 
      cross sectional Doppler echocardiography. RESULTS: The procedure was technically 
      successful in all patients. The mean (SD) echocardiographic value of the mitral 
      valve area increased from 0.7 (0.1) to 1.4 (0.2) cm2 with a concomitant reduction 
      in pulmonary artery systolic pressure (Doppler) from 81 (17) to 50 (7) mm Hg. 
      There was a significant clinical improvement in all patients. The mean (range) 
      fluoroscopy time for the procedure was 6.9 (1.7-14.1) min. During follow up (mean 
      10 months) nine patients were in New York Heart Association (NYHA) functional 
      class I, one was in class II, one under NYHA elective mitral valve replacement, 
      and one, who refused elective surgery, died suddenly at home. CONCLUSION: 
      Percutaneous balloon dilatation of the mitral valve can be performed as a life 
      saving procedure in critically ill patients with mitral stenosis, as even a 
      modest increase in valve area in these patients produces gratifying clinical 
      improvement.
FAU - Patel, J J
AU  - Patel JJ
AD  - Department of Cardiology, University of Natal/Wentworth Hopsital, Durban, South 
      Africa.
FAU - Munclinger, M J
AU  - Munclinger MJ
FAU - Mitha, A S
AU  - Mitha AS
FAU - Patel, N
AU  - Patel N
LA  - eng
PT  - Journal Article
PL  - England
TA  - Br Heart J
JT  - British heart journal
JID - 0370634
SB  - IM
CIN - Br Heart J. 1995 Dec;74(6):702-3. PMID: 8541187
MH  - Adult
MH  - *Catheterization
MH  - Critical Illness
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Mitral Valve Stenosis/diagnostic imaging/*therapy
MH  - Pregnancy
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC483919
EDAT- 1995/06/01 00:00
MHDA- 1995/06/01 00:01
PMCR- 1995/06/01
CRDT- 1995/06/01 00:00
PHST- 1995/06/01 00:00 [pubmed]
PHST- 1995/06/01 00:01 [medline]
PHST- 1995/06/01 00:00 [entrez]
PHST- 1995/06/01 00:00 [pmc-release]
AID - 10.1136/hrt.73.6.555 [doi]
PST - ppublish
SO  - Br Heart J. 1995 Jun;73(6):555-8. doi: 10.1136/hrt.73.6.555.