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Author Bhat, A. ♦ Harikrishnan, Sivadasan Pillai ♦ Tharakan, Jaganmohan Achuthan ♦ Titus, T. ♦ Kumar, V. K. ♦ Sivasankaran, S. ♦ Bimal, F. ♦ Krishnamoorthy, K. M.
Source Sree Chitra Tirunal Institute for Medical Sciences & Technology
Content type Text
Publisher American Heart Journal
File Format PDF
Language English
Subject Domain (in DDC) Technology ♦ Medicine & health ♦ Diseases
Subject Domain (in MeSH) Cardiovascular Diseases ♦ Diseases ♦ Surgical Procedures, Operative ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment
Subject Keyword Cardiology
Abstract Background The Inoue balloon technique for mitral commissurotomy is well established and carried out worldwide. Metallic commissurotomy is reported to be a cheaper and effective alternative to balloon mitral commissurotomy.Methods One hundred patients were randomized into 2 groups to undergo percutaneous transmitral commissurotomy (PTMC) by means of the Inoue balloon technique (IBMC, n = 49) or metallic commissurotomy (PMMC, n = 51). Patients were crossed over to the other technique when the initial technique was a failure. Success of valvotomy, procedure-related complications, and follow-up events of the 2 techniques were compared.Results Basal echocardiographic and hemodynamic data were similar in both groups. Procedural success was similar in both groups: 45 of 49 procedures (91.8%) in the IBMC group, compared with 46 of 51 procedures (90.18%) in the PMMC group (P = 1.0). Crossover was also comparable, with I occurring in the IBMC group, compared with 3 in the PMMC group. Complications such as cardiac tamponade and mitral regurgitation (requiring or not requiring mitral valve replacement) were similar in both groups, with 3 complications in the IBMC group, compared with 4 complications in the PMMC group (P =.29). After a follow-up period of approximately 4 months, both groups had similar event rates and comparable hemodynamic parameters (P = not significant).Conclusions Both IBMC and PMMC are successful means of providing relief from severe mitral stenosis with a gain in valve area and reduction in transmitral gradient. Both techniques have similar procedural success, complication rates, and follow-up events.
Education Level UG and PG
Learning Resource Type Article
Educational Framework Medical Council of India (MCI)
Volume Number 144
Issue Number 6
Page Count 7
Starting Page 1074
Ending Page 1080