Immediate Results of Percutaneous Mitral Balloon Valvuloplasty in Patients with Mitral Stenosis

Document Type : Original Article


1 International Cardiologist, Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran

2 International Cardiologist, Atherosclerosis Prevention Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


Introduction: Mitral stenosis is a prevalent valvular disease in developing countries. Percutaneous mitral balloon valvuloplasty (PMBV) is the gold standard treatment. The main objective of this study was to assess the initial results of PMBV in patients with mitral stenosis during 16 years (2002-2018) in Mashhad, Iran.
Materials and Methods: From April 2002 to March 2018, 770 patients underwent PMV in department of cardiology. PMV was performed by the antegrade transseptal method using the Inoue balloon.
Results: The obtained success rate was 97%. In this study, the valve area increased from 0.9±1.1 to 1.8±0.2 cm2 (P<0.0001). There was no case of peri-procedural death or cardiac tamponade. Additionally, 0.25% of the patients required mitral valve replacement. Severe mitral regurgitation occurred in 0.9% of the subjects. There was no case of cerebrovascular accident, transient ischemic attack, embolic myocardial infarction, or cardiac perforation. Supraventricular tachycardia occurred in 2.59% of the patients.
Conclusion: The PMBV by the Inoue technique is a feasible and easy procedure with a short crossing times and low complications.


  1. Marcus RH, Sareli P, Pocock WA, Barlow JB. The spectrum of severe rheumatic mitral valve disease in a developing country. Correlations among clinical presentation, surgical pathologic findings, and hemodynamic sequelae. Ann Intern Med 1994;120:177–83.
  2. Inoue K, Owaki T, Nakamura T, Kitamura F, Miyamoto N. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. The Journal of thoracic and cardiovascular surgery. 1984 Mar;87(3):394-402.
  3. McKay RG, Lock JE, Safian RD, Come PC, Diver DJ, Baim DS, Berman AD, Warren SE, Mandell VE, Royal HD, Grossman W. Balloon dilation of mitral stenosis in adult patients: Postmortem and percutaneous mitral valvuloplasty studies. Journal of the American College of Cardiology. 1987 Apr 1;9(4):723-31.
  4. Bakaeean B, Kabiri M, Iranfar H, Saberi MR, Chamani J. Binding effect of common ions to human serum albumin in the presence of norfloxacin: investigation with spectroscopic and zeta potential approaches. Journal of Solution Chemistry 2012; 41(10): 1777-1801.
  5. Patel JJ, Shama D, Mitha AS, Blyth D, Hassen F, Le Roux BT, Chetty S. Balloon valvuloplasty versus closed commissurotomy for pliable mitral stenosis: a prospective hemodynamic study. Journal of the American College of Cardiology. 1991 Nov 1;18(5):1318-22..
  6. Farhat MB, Ayari M, Maatouk F, Betbout F, Gamra H, Jarrar M, Tiss M, Hammami S, Thaalbi R, Addad F. Percutaneous balloon versus surgical closed and open mitral commissurotomy: seven-year follow-up results of a randomized trial. Circulation. 1998 Jan 27;97(3):245-50..
  7. Reyes VP, Raju BS, Wynne J, Stephenson LW, Raju R, Fromm BS, et al. Percutaneous balloon valvuloplasty compared with open surgical commissurotomy for mitral stenosis. N Engl J Med. 1994;331:961–7.
  8. Feldman T, Henmann HC, Inoue K Techniques of percutaneous transvenous mitral commissurotomy using the Inoue balloon catheter. Curhet Cardiowsc Diag 1994;28(suppl2):26-34.
  9. Vahanian A, Michel PL, Cormier B, Vitoux B, Michel X, Slama M, Sarano LE, Trabelsi S, Ismail MB, Acar J. Results of percutaneous mitral commissurotomy in 200 patients. American Journal of Cardiology. 1989 Apr 1;63(12):847-52.

10. Iung B, Cormier B, Ducimetiere P, Porte JM, Nallet O, Michel PL, Acar J, Vahanian A. Immediate results of percutaneous mitral commissurotomy: a predictive model on a series of 1514 patients. Circulation. 1996 Nov 1;94(9):2124-30..

11.Lembcke A, Durmus T, Westermann Y, Geigenmueller A, Claus B, Butler C, Thiele H. Assessment of mitral valve stenosis by helical MDCT: comparison with transthoracic Doppler echocardiography and cardiac catheterization. American Journal of Roentgenology. 2011 Sep;197(3):614-22.

12.Sohrabi T, Hosseinzadeh M, Beigoli S, Saberi MR, Chamani J. Probing the binding of lomefloxacin to a calf thymus DNA-histone H1 complex by multi-spectroscopic and molecular modeling techniques. Journal of Molecular Liquids. 2018; 256:127-138.

13.Ribeiro PA, Fawzy ME, Arafat MA, Dunn B, Sriram R, Mercer E, Duran CG. Comparison of mitral valve area results of balloon mitral valvotomy using the Inoue and double balloon techniques. Am J Cardiol 1991;68:687-688.

14.Bassand J-P, Schiele F, Bernard Y, Anguenot T, Payet M, Ba S-A, Daspet J-P, Maurat J-P. The double-balloon and Inoue techniques in percutaneous mitral valvuloplasty: comparative results in a series of 232 cases. J Am Coil Cardiol 1991;18:982-989.

15.Abdullah M, Halhn M, Rajendran V, Sawyer W, Zaibag MA. Comparison between single (Inoue) and double balloon mitral valvuloplasty: immediate and short-term results. Am Hearr J 1992;123:1581-1588.

16.Palacios IF, Sanchez PL, Harrell LC, Weyman AE, Block PC. Which patients benefit from percutaneous mitral balloon valvuloplasty. Prevalvuloplasty and postvalvuloplasty variables that predict long-term outcome. Circulation 2002;105:1465–71.

17.Herrmann HC, Ramaswamy K, Isner JM, Feldman TE, Carroll JD, Pichard AD, et al. Factors influencing immediate results, complications, and short-term follow-up status after Inoue balloon mitral valvotomy: a North American multicenter study. Am Heart J 1992;124:160–6.

18.Hamed-Akbari Tousi Sh, Saberi MR, Chamani J. Comparing the Interaction of cyclophosphamide monohydrate to human serum albumin as opposed to holo-transferrin by spectroscopic and molecular modeling methods: evidence for allocating the binding site. Protein and peptide Letters. 2010; 17(12): 1524-35.

19.Arora R, Nair M, Kalra GS, Nigam M, Khalilullah M. Immediate and long-term results of balloon and surgical closed mitral valvotomy: a randomized comparative study. American heart journal. 1993 Apr 1;125(4):1091-4.

20.Commerford PJ, Hastie T, Beck W. Closed mitral valvotomy: actuarial analysis of results in 654 patients over 12 years and analysis of preoperative predictors of long-term survival. The Annals of thoracic surgery. 1982 May 1;33(5):473-9.

21.Reid, C.L., Otto, C.M., Davis, K.B., Labovitz, A., Krislo, K.B., McCay, C.R. Influence of mitral valve morphology on mitral balloon commissurotomy: immediate and six-month results from the NHLBI balloon valvotomy registry. Am. Heart J 1992; 124, 657–665.

22.Jneid H, Cruz-Gonzalez I, Sanchez-Ledesma M, Maree AO, Cubeddu RJ, Leon ML, Rengifo-Moreno P, Otero JP, Inglessis I, Sanchez PL, Palacios IF. Impact of pre-and postprocedural mitral regurgitation on outcomes after percutaneous mitral valvuloplasty for mitral stenosis. The American journal of cardiology. 2009 Oct 15;104(8):1122-7.