Catheter Balloon Valvuloplasty Treatment of Adult Patients with Mitral Stenosis: Diagnosis of Mitral Stenosis
The ECG of patients who are in sinus rhythm may show left atrial enlargement. Atrial fibrillation and right ventricular hypertrophy are common. The chest x-ray film shows left atrial enlargement; pulmonary venous congestion and an increased cardiothoracic ratio may also be present. On echocardiography, the typical signs are a thickened mitral valve and restricted mitral valve motion. Doppler echocardiography can show the presence of a significant mitral valve gradient and a reduced mitral valve area. The presence and severity of other valve abnormalities, including mitral regurgitation and tricuspid and aortic valve disease, can also be demonstrated on Doppler echocardiography, which provides useful screening information in planning diagnostic cardiac catheterization and possible intervention. Supervision and interpretation of these procedures by experienced echocardiographers can yield excellent data that have a known correlation with direct hemodynamic determinations. More info
Current Techniques of Mitral CBV
The single-balloon technique of CBV was first reported by Inoue et al. They applied it first during open surgical commissurotomy and then percutaneously, using a special balloon design. The design incorporated a preshaped catheter shaft and a special latex balloon. The balloon was placed transseptally across the mitral valve under fluoroscopic control. At low inflation pressures, the distal portion of the balloon expanded, and the balloop that was resting in the left ventricle could be pulled fcack and “locked” into the stenotic mitral valve orifice. At high inflation pressures the proximal portion of the balloon expanded and split the fused mitral commissures.
Mitral CBV has been performed in children and adolescents using a single, commercially available balloon and subsequently applied to adult patients.