Balloon valvuloplasty for mild mitral stenosis

Abstract

Of a total number of 288 patients with mitral stenosis treated by percutaneous balloon valvuloplasty, 21 patients had a basal mitral area equal to or greater than 1.5 cm2, as measured hemodynamically. The immediate hemodynamic results of this particular group of patients with mild mitral stenosis are described, as well as the clinical and echo doppler findings at follow-up (22 +/- 12 mo). Patients with mild mitral stenosis (group I) had more pliable valves (p < 0.01), as assessed by echo, and higher incidence of sinus rhythm (p < 0.02) than that observed in the remaining 267 patients (group II). After valvuloplasty the valve area incresed in group I from 1.7 +/- 0.2 to 3.1 +/- 0.7 cm2 (p < 0.0001). This mean final area was significantly different (p < 0.0001) than that observed in group II (1.98 +/- 0.6 cm2). No patients with mild mitral stenosis developed progression of mitral regurgitation, and none had any other major complications. Most of them reached a grade I final functional status. At echo doppler follow-up studies we did not observe significant changes in the mean mitral gradient as compared with the immediate hemodynamic results.These findings suggest that early mitral balloon valvuloplasty could be an alternative in trying to favorably influence the natural course of the rheumatic mitral disease in selected patients.