© 2002 by Heart
EDITORIAL
Contemporary criteria for the selection of patients for percutaneous balloon mitral valvuloplasty
1 Department of Cardiology, Western General Hospital, Edinburgh, UK
2 Service de Cardiologie, Hopital Bichat, Paris, France
Correspondence to:
Correspondence to:
Dr BD Prendergast, North-West Regional Cardiothoracic Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK;
bernard.prendergast@smuht.nwest.nhs.uk
Percutaneous balloon mitral valvuloplasty is now the treatment of choice for many patients with symptomatic mitral stenosis Applications are expanding to include several categories of patients previously considered ineligible for the procedure.
Keywords: balloon valvuloplasty; echocardiography; mitral stenosis
Commissural fusion is now recognised as the principal pathology underlying mitral stenosis, and commissural splitting underlies successful interventional treatment. Although the technique of surgical commissurotomy was first described as early as 1948,1 percutaneous commissurotomy became a feasible option with the advent of the Inoue balloon in 1984.2 Percutaneous balloon mitral valvuloplasty (PBMV) is now the treatment of choice for many patients with symptomatic mitral stenosis. Numerous large series have reported excellent short, medium, and long term outcome3–7 with a low incidence of serious complications.8 Furthermore, randomised trials comparing balloon valvuloplasty with the surgical alternatives of open or closed commissurotomy have demonstrated equivalent outcome,9,10 although patients treated using the percutaneous approach enjoy the advantages of reduced procedural morbidity and mortality and a short hospital stay. Specific advantages of the Inoue balloon in comparison with other percutaneous techniques include a lower risk of complications (particularly left ventricular perforation which is more frequent
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