Percutaneous balloon mitral valvuloplasty in patients with severe mistral stenosis and low transmitral diastolic pressure gradient

Yoav Turgeman, Shaul Atar, Khalid Suleiman, Lev Bloch, Tiberio Rosenfeld

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

An elevated left atrial pressure and high diastolic pressure gradient (DPG) across the mitral valve are the major hemodynamic abnormalities in mitral stenosis (MS). However, a subgroup of patients with severe MS is characterized by low initial DPG. The authors reviewed the clinical, echocardiographic and hemodynamic data as well as procedural results in 180 patients who underwent percutaneous balloon mitral valvuloplasty (PBMV). An initial mean DPG > 10 mmHg was found in 144 patients (80%) (group A) and mean DPG ≤ 10 mmHg in 36 patients (20%) (group B). Patients in group A had higher left ventricular ejection fraction (LVEF) than in group B (61 ± 5% versus 42 ± 6%, respectively) and higher cardiac index (2.8 ± 0.4 versus 2.0 ± 0. 3 l/min/m2). In group B 12 patients (33%) had normal LVEF, whereas 24/36 (67%) had reduced LVEF. All the latter had wall motion abnormalities on ventriculography. Unlike group A, intraprocedural echocardiography was essential for monitoring and evaluating immediate results of PBMV in group B. On follow-up of three years, 75% of group A patients and 55% in group B were in functional class I (p < 0.05). PBMV did not significantly improve symptoms in patients in group B who had preprocedure LVEF ≤ 35%.

Original languageEnglish
Pages (from-to)200-205
Number of pages6
JournalInternational Journal of Cardiovascular Interventions
Volume5
Issue number4
DOIs
StatePublished - 2003
Externally publishedYes

Keywords

  • Balloon
  • Gradient
  • Mitral stenosis
  • Valvuloplasty

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