Abstract
Percutaneous mitral balloon valvotomy (PMV) using the Inoue balloon technique was attempted in 170 patients. Of these, 30 patients were children aged 10 to 18 years (mean 15.9 ± 2.7 years). There were 16 female and 14 male patients. All were in sinus rhythmn. The procedure was successful in 28 patients (93%). PMV was performed using 20 to 28 mm (mean 25 mm) diameter balloon catheters with an echo-Doppler guided stepwise mitral dilation technique. After PMV, the mean left atrial pressure decreased from 25 ± 5 to 14 ± 4 mm Hg (
p < 0.001). The mean mitral valve gradient (MVG) decreased from 16 ± 4 to 6 ± 3 mm Hg (
p < 0.001). The mitral valve area (MVA) by catheter increased from 0.7 ± 0.2 to 1.7 ± 0.5 cm
2 (
p < 0.001), and MVA as determined by echocardiography (2DE) increased from 0.8 ± 0.1 to 1.9 ± 0.3 cm
2 (
p < 001). There were no deaths or thromboembolic complications; cardiac tamponade developed in one patient, mild mitral regurgitation (MR) developed in three patients (10%) and increased by one grade from (1+ to 2+) in another two patients (8%). A small atrial septal defect (ASD) assessed by color flow mapping developed in seven patients (25%); 90% were closed at 3 months. The Doppler and 2DE MVAs were maintained at 1.8 ± 0.4 cm
2 at 17 months' mean follow-up; one patient developed restenosis. We conclude the PMV using the Inoue balloon catheter is safe and effective in the treatment of severe mitral stenosis in children, with a low complication rate.