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Clinical Investigations: CARDIOLOGY |

Partial Improvement in Pulmonary Function After Successful Percutaneous Balloon Mitral Valvotomy*

Joan A. Gómez-Hospital, MD; Angel Cequier, MD; Pablo V. Romero, MD; Concepción Cañete, MD; Carmen Ugartemendia, MD; Josepa Mauri, MD; Enrique Esplugas, MD
Author and Funding Information

*From the Division of Cardiology (Drs. Gómez-Hospital, Cequier, Ugartemendia, Mauri, and Esplugas) and Division of Pulmonary Diseases (Drs. Romero and Cañete), Hospital de Bellvitge, University of Barcelona, Barcelona, Spain.

Correspondence to: Angel Cequier, MD, Cardiac Catheterization Laboratory, Hospital de Bellvitge, C. Feixa Llarga s/n, Hospitalet del Llobregat, 08907 Barcelona, Spain; e-mail: acequier@csub.scs.es



Chest. 2000;117(3):643-648. doi:10.1378/chest.117.3.643
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Study objectives: This study was performed to assess the changes in pulmonary function after a successful percutaneous balloon mitral valvotomy (PBMV) in 23 consecutive patients with symptomatic mitral stenosis.

Methods and results: Lung function preprocedure and postprocedure were evaluated by spirometric flow, static pulmonary volumes, and diffusion capacity of the lung for carbon monoxide (Dlco). At baseline, a reduction in small airways flow (maximal expiratory flow at 50% of vital capacity, 70 ± 29% of predicted value; maximal expiratory flow at 25% of vital capacity, 55 ± 26% of predicted value) and an increase in Dlco (118 ± 29%) and Krough Index (KCO; 123 ± 29% of predicted value) were observed. PBMV caused an improvement in hemodynamic parameters with an increase in mitral valve area (from 1.0 ± 0.3 to 1.9 ± 0.5 cm2; p < 0.001) and a decrease in left atrial pressure (from 17 ± 3 to 12 ± 5 mm Hg; p < 0.001). These changes were associated with a significant increase in FVC (from 2.8 ± 0.84 to 2.9 ± 0.80 L; p < 0.05) and in FEV1 (from 2.2 ± 0.72 to 2.3 ± 0.68 L; p < 0.05). A decrease in Dlco was observed after PBMV (from 26.7 ± 7 to 22.5 ± 5.4 mL/min/mm Hg; p < 0.001; and KCO, from 6.2 ± 1.4 to 5.2 ± 1.2 mL/min/mm Hg/L; p < 0.001). No significant changes in small airways flow were detected, suggesting only a partial improvement in pulmonary congestion.

Conclusion: We conclude that the initial impairment of lung function in patients with symptomatic mitral stenosis is only partially ameliorated by PBMV.

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