Catheter Balloon Valvuloplasty Treatment of Adult Patients with Mitral Stenosis: Complications of Mitral CBV
Complications of Mitral CBV
As with all therapeutic catheter interventions, the mitral CBV carries risks of potential complications, not all of which have yet actually been encountered. Current experience shows that the most serious complications of death, embolism, cardiac perforation with tamponade, tears of diseased and normal valves, and infective endocarditis have been reported. The occurrence of important complications such as atrial septal defects, acute mitral regurgitation, inadequate dilation, or early restenosis may be related to several factors. These factors include the particular techniques and the equipment used, the patients selected for the procedure, and the operators experience with CBV Long-term studies with clinical and repeat hemodynamic determinations will be needed to evaluate these problems.
The Decision To Refer Patients for Mitral CBV
The decision to refer patients for mitral CBV, which is still an investigational procedure, may be made by patients and their physicians after they acquire and evaluate several categories of information. This information may be organized with regard to the patients mitral valve morphology, other cardiac problems, and the patients general medical condition. so
Information regarding valve morphology includes the degree of mitral valve stenosis and regurgitation, the amount of calcium and pliability of the valve, and the degree of subvalvular fibrosis. Other hemodynamic information to be obtained includes the presence and severity of other valve lesions, of left and right ventricular dysfunction, and of coronary artery disease. This information can usually be obtained by detailed Doppler echocardiography examinations and cardiac catheterization with angiography. It should then be determined whether a surgical or catheter intervention is warranted. The presence of left atrial thrombus diagnosed on echocardiography is a contraindication to mitral CBV.