Percutaneous Mechanical Mitral Commissurotomy with the Metallic Valvulotome: Detailed Technical Aspects and Overview of the Results of the Multicenter Registry on 882 Patients
Identifieur interne : 003309 ( Istex/Curation ); précédent : 003308; suivant : 003310Percutaneous Mechanical Mitral Commissurotomy with the Metallic Valvulotome: Detailed Technical Aspects and Overview of the Results of the Multicenter Registry on 882 Patients
Auteurs : Alain Cribier [France] ; Hélène Eltchaninoff [France] ; Raphaëlle Carlot [France] ; Catherine Bizet [France] ; Carlos Giron [France] ; Stephan Chassaing [France] ; Genevieve Derumeaux [France]Source :
- Journal of Interventional Cardiology [ 0896-4327 ] ; 2000-08.
English descriptors
- Teeft :
- Aortic valve, Balloon catheter, Balloon catheters, Balloon techniques, Bars opening, Bead, Cardiology, Cathet cardiovasc diagn, Catheter, Clinical experience, Clinical outcome, Coll cardiol, Commissure, Commissurotome, Commissurotomy, Complete closure, Cribier, Dilatation maneuvers, Dilator, Distal pressures, Doppler, Guidewire, Heparinized saline, Inoue, Inoue balloon, Inoue technique, Interatrial septum, International registry, Interventional, Interventional cardiology, Metal head, Metal struts, Metallic bead, Metallic commissurotome, Metallic dilator, Metallic head, Metallic valvulotome, Mitral, Mitral commissurotomy, Mitral commissurotomy figure, Mitral orifice, Mitral stenosis, Mitral valve, Mitral valve area, Mullins sheath, Other patients, Percutaneous, Percutaneous balloon, Pericardial tamponade, Pericardial tamponades, Pigtail catheter, Pliers, Pmmc, Polyethylene dilator, Procedural cost, Puncture, Security latch, Septa1 puncture, Septum, Several times, Stenosis, Subvalvular apparatus, Technical aspects, Transeptal catheterization, Transesophageal color flow doppler, Transient stroke, Transmitral gradient, Transmitral pressure gradient, Transseptal puncture, Transseptal shunting, Transthoracic color flow doppler, Valve, Valve area, Valvotomy, Ventricular cavity, Vertical line.
Abstract
Percutaneous mechanical mitral commissurotomy (PMMC) is a new technique that has been developed over the last 3 years for the treatment of mitral stenosis. The device used opens the commissures by a direct action of two parallel bars located in a metallic head screwed at the distal end of a 13Fr catheter. Opening of the bars is obtained with the use of activating pliers attached at the proximal end of the catheter. The metallic dilator and the pliers can be safely reused after sterilization. The device and the direrent steps of the procedure are detailed in this article. The results of an international registry including 882 patients are reported here. PMMC could be achieved in 863 (98%) cases. Maximal opening of the bars was 40 mm in 90% of the cases. The technique resulted in an increase of the mitral valve area from 0.94 ± 0.2 cm2 to 2.12 ± 0.4 cm2. Bilateral splitting of the commissures was achieved in 85% of the cases. Complications occurred in 33 (3.7%) patients: pericardial tamponade in 1.4% (12 cases, one death), mitral regurgitation > grade 2 in 2.1% (18 cases, surgery required in 4), and transient stroke in 0.3% (3 patients). The role of the learning curve in the occurrence of complications has been clearly demonstrated. The cost of the procedure has been markedly decreased in developing countries due to multiple reuses of the device after sterilization.
Url:
DOI: 10.1111/j.1540-8183.2000.tb00300.x
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Rouen</wicri:regionArea></affiliation></author><author><name sortKey="Carlot, Raphaelle" sort="Carlot, Raphaelle" uniqKey="Carlot R" first="Raphaëlle" last="Carlot">Raphaëlle Carlot</name><affiliation wicri:level="1"><mods:affiliation>From the Hôpital Charles Nicolle, Rouen, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>From the Hôpital Charles Nicolle, Rouen</wicri:regionArea></affiliation></author><author><name sortKey="Bizet, Catherine" sort="Bizet, Catherine" uniqKey="Bizet C" first="Catherine" last="Bizet">Catherine Bizet</name><affiliation wicri:level="1"><mods:affiliation>From the Hôpital Charles Nicolle, Rouen, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>From the Hôpital Charles Nicolle, Rouen</wicri:regionArea></affiliation></author><author><name sortKey="Giron, Carlos" sort="Giron, Carlos" uniqKey="Giron C" first="Carlos" last="Giron">Carlos Giron</name><affiliation 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Rouen</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of Interventional Cardiology</title><title level="j" type="alt">JOURNAL OF INTERVENTIONAL CARDIOLOGY</title><idno type="ISSN">0896-4327</idno><idno type="eISSN">1540-8183</idno><imprint><biblScope unit="vol">13</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="255">255</biblScope><biblScope unit="page" to="262">262</biblScope><biblScope unit="page-count">8</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2000-08">2000-08</date></imprint><idno type="ISSN">0896-4327</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0896-4327</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Aortic valve</term><term>Balloon catheter</term><term>Balloon catheters</term><term>Balloon techniques</term><term>Bars opening</term><term>Bead</term><term>Cardiology</term><term>Cathet cardiovasc diagn</term><term>Catheter</term><term>Clinical experience</term><term>Clinical outcome</term><term>Coll cardiol</term><term>Commissure</term><term>Commissurotome</term><term>Commissurotomy</term><term>Complete closure</term><term>Cribier</term><term>Dilatation maneuvers</term><term>Dilator</term><term>Distal pressures</term><term>Doppler</term><term>Guidewire</term><term>Heparinized saline</term><term>Inoue</term><term>Inoue balloon</term><term>Inoue technique</term><term>Interatrial septum</term><term>International registry</term><term>Interventional</term><term>Interventional cardiology</term><term>Metal head</term><term>Metal struts</term><term>Metallic bead</term><term>Metallic commissurotome</term><term>Metallic dilator</term><term>Metallic head</term><term>Metallic valvulotome</term><term>Mitral</term><term>Mitral commissurotomy</term><term>Mitral commissurotomy figure</term><term>Mitral orifice</term><term>Mitral stenosis</term><term>Mitral valve</term><term>Mitral valve area</term><term>Mullins sheath</term><term>Other patients</term><term>Percutaneous</term><term>Percutaneous balloon</term><term>Pericardial tamponade</term><term>Pericardial tamponades</term><term>Pigtail catheter</term><term>Pliers</term><term>Pmmc</term><term>Polyethylene dilator</term><term>Procedural cost</term><term>Puncture</term><term>Security latch</term><term>Septa1 puncture</term><term>Septum</term><term>Several times</term><term>Stenosis</term><term>Subvalvular apparatus</term><term>Technical aspects</term><term>Transeptal catheterization</term><term>Transesophageal color flow doppler</term><term>Transient stroke</term><term>Transmitral gradient</term><term>Transmitral pressure gradient</term><term>Transseptal puncture</term><term>Transseptal shunting</term><term>Transthoracic color flow doppler</term><term>Valve</term><term>Valve area</term><term>Valvotomy</term><term>Ventricular cavity</term><term>Vertical line</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Percutaneous mechanical mitral commissurotomy (PMMC) is a new technique that has been developed over the last 3 years for the treatment of mitral stenosis. The device used opens the commissures by a direct action of two parallel bars located in a metallic head screwed at the distal end of a 13Fr catheter. Opening of the bars is obtained with the use of activating pliers attached at the proximal end of the catheter. The metallic dilator and the pliers can be safely reused after sterilization. The device and the direrent steps of the procedure are detailed in this article. The results of an international registry including 882 patients are reported here. PMMC could be achieved in 863 (98%) cases. Maximal opening of the bars was 40 mm in 90% of the cases. The technique resulted in an increase of the mitral valve area from 0.94 ± 0.2 cm2 to 2.12 ± 0.4 cm2. Bilateral splitting of the commissures was achieved in 85% of the cases. Complications occurred in 33 (3.7%) patients: pericardial tamponade in 1.4% (12 cases, one death), mitral regurgitation > grade 2 in 2.1% (18 cases, surgery required in 4), and transient stroke in 0.3% (3 patients). The role of the learning curve in the occurrence of complications has been clearly demonstrated. The cost of the procedure has been markedly decreased in developing countries due to multiple reuses of the device after sterilization.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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