Percutaneous mitral balloon valvuloplasty with the assistance of the femoral arterio-venous circuit
10.3969/j.issn.1004-8812.2025.08.005
- VernacularTitle:导丝轨道辅助下经皮二尖瓣球囊成形术的安全性和可行性探讨
- Author:
Ang LIU
1
;
Lin-yuan WAN
;
Yun-dan PINGCUO
;
Jing-lin JIN
;
Ke WANG
;
Wei-chun WU
;
Zhen-hui ZHU
;
Chao-wu YAN
Author Information
1. 国家心血管病中心 北京协和医学院 中国医学科学院阜外医院结构性心脏病中心,北京 100037
- Publication Type:Journal Article
- Keywords:
Arterio-venous circuit;
Rheumatic heart disease;
Mitral stenosis;
Transseptal puncture;
Balloon valvuloplasty
- From:
Chinese Journal of Interventional Cardiology
2025;33(8):454-458
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and feasibility of percutaneous mitral balloon valvuloplasty with the assistance of arterio-venous circuit.Methods From January 2015 to October 2022,a total 25 patients[19 females,6 males;age(61.60±9.00)years]were included,who were diagnosed with rheumatic heart disease and severe mitral stenosis.A transseptal puncture was performed to establish a femoral arterio-venous circuit,followed by graded dilation with Inoue balloon(diameters:22.00 mm to 28.00 mm).The target was a mitral valve area≥1.50 cm2 with mild or less regurgitation.Results The arterio-venous circuit was established,and mitral balloon valvuloplasty was successfully completed in all 25 patients.Among them,20 patients experienced difficulty with transvalvular crossing using the balloon catheter with conventional methods,16 patients had valvular severe calcification,and 3 patients presented with a left atrial appendage thrombus despite of more than 6-month anticoagulation therapy with warfarin.The mean balloon diameter was(25.00±1.40)mm.The mitral valve area increased from(0.91±0.15)cm2 preoperatively to(1.70±0.14)cm2 postoperatively(P＜0.001).Mean left atrial pressure decreased from(27.00±7.50)mmHg to(16.36±4.07)mmHg(P＜0.001),and mean pulmonary artery pressure decreased from(40.84±13.81)mmHg to(25.00±7.12)mmHg(P＜0.001).All patients showed significant symptom improvement with no complications.Conclusions Arterio-venous circuit for percutaneous mitral balloon valvuloplasty is safe and feasible.This technique can serve as an alternative to standard technique for patients with complex mitral stenosis.
