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document
Comparison of percutaneous transmitral commissurotomy with Inoue balloon technique and metallic commissurotomy : immediate and short-term follow-up results of a randomized study . 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 1 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 .
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Intervention_Surgical
percutaneous transmitral commissurotomy ( PTMC )
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Intervention_Surgical
means of the Inoue balloon technique ( IBMC
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Intervention_Surgical
metallic commissurotomy ( PMMC
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Intervention_Physical
, n = 51 )
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Intervention_Physical
technique
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Outcome_Other
Success of valvotomy
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Outcome_Adverse-effects
procedure-related complications
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Outcome_Physical
follow-up events
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Outcome_Physical
Basal echocardiographic
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Outcome_Physical
hemodynamic data
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Outcome_Adverse-effects
cardiac tamponade and mitral regurgitation
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Participant_Sample-size
One hundred
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Participant_Condition
severe mitral stenosis