Update on Percutaneous Mechanical Mitral Commissurotomy
Identifieur interne : 00B307 ( Main/Exploration ); précédent : 00B306; suivant : 00B308Update on Percutaneous Mechanical Mitral Commissurotomy
Auteurs : Alain Cribier [France] ; Hélène Eltchaninoff [France] ; René Koning [France] ; Pratap C. Rath [Inde] ; Ramesh Arora [Inde] ; Adel Iman [Égypte] ; Mustapha El-Sayed [Égypte] ; Sameer Dani [Inde, France] ; Geneviève Derumeaux [France] ; Satej Janorkar [France] ; Brice Letac [France]Source :
- Journal of Interventional Cardiology [ 0896-4327 ] ; 1998-10.
English descriptors
- Teeft :
- Atrial, Balloon catheter, Balloon catheters, Balloon valvotomy, Bead, Bilateral splitting, Cardiol, Cardiology, Cardiovasc, Cathet, Cathet cardiovasc diagn, Catheter, Clinical outcome, Commissurotomy, Cribier, Demographic data, Diagn, Dilator, Distal extremity, Echocardiographic, Echocardiography, Guidewire, Inoue, Inoue balloon, Inoue technique, International experience, Interventional, Interventional cardiology, Jacc, Metallic bead, Mitral, Mitral regurgitation, Mitral stenosis, Mitral valve, Mitral valve area, Percutaneous, Percutaneous balloon, Percutaneous transvenous, Pericardial tamponade, Pliers, Predictive factors, Regurgitation, Tamponade, Valve, Valve replacement, Valvotomy, Valvuloplasty.
Abstract
A reusable metallic valvotomy device has been developed with the goals of improving the results of percutaneous mitral valvotomy and increasing the cost‐effectiveness of the procedure. The device consists of a detachable and reusable metallic dilator with two articulated bars screwed at the distal end of a catheter. Using transseptal catheterization, the device is placed across the valve over a traction guidewire and then opened gradually by means of pliers up to a maximum of 40 mm. To date, the device was used in 168 patients with a broad spectrum of mitral valve disease. The procedure was successful in 95% of cases and resulted in an increase in mitral valve area from 1.01 ± 0.8 to 2.20 ± 0.7 cm2. No increase in mitral regurgitation was noted in 87% of cases. Bilateral splitting of the commissures was observed in 89%. Complications included the following: 2 severe mitral regurgitations (one requiring surgery), 1 pericardial tamponade, 1 transient cerebrovascular embolic event. The maximum number of consecutive patients treated with the same device was 35. The results obtained are at least comparable to those of current balloon techniques and confirm the possibility of safe multiple reuses of the device after sterilization.
Url:
DOI: 10.1111/j.1540-8183.1998.tb00193.x
Affiliations:
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Rath</name><affiliation wicri:level="1"><country xml:lang="fr">Inde</country><wicri:regionArea>Apollo Hospital, Hyderabad</wicri:regionArea><wicri:noRegion>Hyderabad</wicri:noRegion></affiliation></author><author><name sortKey="Arora, Ramesh" sort="Arora, Ramesh" uniqKey="Arora R" first="Ramesh" last="Arora">Ramesh Arora</name><affiliation wicri:level="1"><country xml:lang="fr">Inde</country><wicri:regionArea>G.B. Pant Hospital, New‐Delhi</wicri:regionArea><wicri:noRegion>New‐Delhi</wicri:noRegion></affiliation></author><author><name sortKey="Iman, Adel" sort="Iman, Adel" uniqKey="Iman A" first="Adel" last="Iman">Adel Iman</name><affiliation wicri:level="1"><country xml:lang="fr">Égypte</country><wicri:regionArea>National Heart Institute, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="El Ayed, Mustapha" sort="El Ayed, Mustapha" uniqKey="El Ayed M" first="Mustapha" last="El-Sayed">Mustapha El-Sayed</name><affiliation wicri:level="1"><country xml:lang="fr">Égypte</country><wicri:regionArea>Al‐Azhar University, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Dani, Sameer" sort="Dani, Sameer" uniqKey="Dani S" first="Sameer" last="Dani">Sameer Dani</name><affiliation wicri:level="1"><country xml:lang="fr">Inde</country><wicri:regionArea>Institute of Cardiology, Ahmedabad</wicri:regionArea><wicri:noRegion>Ahmedabad</wicri:noRegion></affiliation><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Charles Nicolle Hospital, Department of Cardiology, University of Rouen</wicri:regionArea><wicri:noRegion>University of Rouen</wicri:noRegion><wicri:noRegion>University of Rouen</wicri:noRegion></affiliation></author><author><name sortKey="Derumeaux, Genevieve" sort="Derumeaux, Genevieve" uniqKey="Derumeaux G" first="Geneviève" last="Derumeaux">Geneviève Derumeaux</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Charles Nicolle Hospital, Department of Cardiology, University of Rouen</wicri:regionArea><wicri:noRegion>University of Rouen</wicri:noRegion><wicri:noRegion>University of Rouen</wicri:noRegion></affiliation></author><author><name sortKey="Janorkar, Satej" sort="Janorkar, Satej" uniqKey="Janorkar S" first="Satej" last="Janorkar">Satej Janorkar</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Charles Nicolle Hospital, Department of Cardiology, University of Rouen</wicri:regionArea><wicri:noRegion>University of Rouen</wicri:noRegion><wicri:noRegion>University of Rouen</wicri:noRegion></affiliation></author><author><name sortKey="Letac, Brice" sort="Letac, Brice" uniqKey="Letac B" first="Brice" last="Letac">Brice Letac</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Charles Nicolle Hospital, Department of Cardiology, University of Rouen</wicri:regionArea><wicri:noRegion>University of Rouen</wicri:noRegion><wicri:noRegion>University of Rouen</wicri:noRegion></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">11</biblScope><biblScope unit="page" from="S73">S73</biblScope><biblScope unit="page" to="S76">S76</biblScope><biblScope unit="page-count">1</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1998-10">1998-10</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>Atrial</term><term>Balloon catheter</term><term>Balloon catheters</term><term>Balloon valvotomy</term><term>Bead</term><term>Bilateral splitting</term><term>Cardiol</term><term>Cardiology</term><term>Cardiovasc</term><term>Cathet</term><term>Cathet cardiovasc diagn</term><term>Catheter</term><term>Clinical outcome</term><term>Commissurotomy</term><term>Cribier</term><term>Demographic data</term><term>Diagn</term><term>Dilator</term><term>Distal extremity</term><term>Echocardiographic</term><term>Echocardiography</term><term>Guidewire</term><term>Inoue</term><term>Inoue balloon</term><term>Inoue technique</term><term>International experience</term><term>Interventional</term><term>Interventional cardiology</term><term>Jacc</term><term>Metallic bead</term><term>Mitral</term><term>Mitral regurgitation</term><term>Mitral stenosis</term><term>Mitral valve</term><term>Mitral valve area</term><term>Percutaneous</term><term>Percutaneous balloon</term><term>Percutaneous transvenous</term><term>Pericardial tamponade</term><term>Pliers</term><term>Predictive factors</term><term>Regurgitation</term><term>Tamponade</term><term>Valve</term><term>Valve replacement</term><term>Valvotomy</term><term>Valvuloplasty</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A reusable metallic valvotomy device has been developed with the goals of improving the results of percutaneous mitral valvotomy and increasing the cost‐effectiveness of the procedure. The device consists of a detachable and reusable metallic dilator with two articulated bars screwed at the distal end of a catheter. Using transseptal catheterization, the device is placed across the valve over a traction guidewire and then opened gradually by means of pliers up to a maximum of 40 mm. To date, the device was used in 168 patients with a broad spectrum of mitral valve disease. The procedure was successful in 95% of cases and resulted in an increase in mitral valve area from 1.01 ± 0.8 to 2.20 ± 0.7 cm2. No increase in mitral regurgitation was noted in 87% of cases. Bilateral splitting of the commissures was observed in 89%. Complications included the following: 2 severe mitral regurgitations (one requiring surgery), 1 pericardial tamponade, 1 transient cerebrovascular embolic event. The maximum number of consecutive patients treated with the same device was 35. The results obtained are at least comparable to those of current balloon techniques and confirm the possibility of safe multiple reuses of the device after sterilization.</div></front></TEI><affiliations><list><country><li>France</li><li>Inde</li><li>Égypte</li></country></list><tree><country name="France"><noRegion><name sortKey="Cribier, Alain" sort="Cribier, Alain" uniqKey="Cribier A" first="Alain" last="Cribier">Alain Cribier</name></noRegion><name sortKey="Cribier, Alain" sort="Cribier, Alain" uniqKey="Cribier A" first="Alain" last="Cribier">Alain Cribier</name><name sortKey="Dani, Sameer" sort="Dani, Sameer" uniqKey="Dani S" first="Sameer" last="Dani">Sameer Dani</name><name sortKey="Derumeaux, Genevieve" sort="Derumeaux, Genevieve" uniqKey="Derumeaux G" first="Geneviève" last="Derumeaux">Geneviève Derumeaux</name><name sortKey="Eltchaninoff, Helene" sort="Eltchaninoff, Helene" uniqKey="Eltchaninoff H" first="Hélène" last="Eltchaninoff">Hélène Eltchaninoff</name><name sortKey="Janorkar, Satej" sort="Janorkar, Satej" uniqKey="Janorkar S" first="Satej" last="Janorkar">Satej Janorkar</name><name sortKey="Koning, Rene" sort="Koning, Rene" uniqKey="Koning R" first="René" last="Koning">René Koning</name><name sortKey="Letac, Brice" sort="Letac, Brice" uniqKey="Letac B" first="Brice" last="Letac">Brice Letac</name></country><country name="Inde"><noRegion><name sortKey="Rath, Pratap C" sort="Rath, Pratap C" uniqKey="Rath P" first="Pratap C." last="Rath">Pratap C. Rath</name></noRegion><name sortKey="Arora, Ramesh" sort="Arora, Ramesh" uniqKey="Arora R" first="Ramesh" last="Arora">Ramesh Arora</name><name sortKey="Dani, Sameer" sort="Dani, Sameer" uniqKey="Dani S" first="Sameer" last="Dani">Sameer Dani</name></country><country name="Égypte"><noRegion><name sortKey="Iman, Adel" sort="Iman, Adel" uniqKey="Iman A" first="Adel" last="Iman">Adel Iman</name></noRegion><name sortKey="El Ayed, Mustapha" sort="El Ayed, Mustapha" uniqKey="El Ayed M" first="Mustapha" last="El-Sayed">Mustapha El-Sayed</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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