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Clinical Investigations: CARDIOLOGY |

Feasibility of Simplifying Balloon Mitral Valvuloplasty by Obviating Left-Sided Cardiac Catheterization Using On-line Guidance With Transesophageal Echocardiography*

Cheng-Wen Chiang; Lung-An Hsu; Po-Hsien Chu; Wan-Jing Ho; Hung-Shun Lo; Chao-Chien Chang
Author and Funding Information

*From the Department of Internal Medicine (Drs. Chiang, Lo, and Chang), Cathay General Hospital, Taipei, Taiwan, Republic of China; and Department of Internal Medicine (Drs. Hsu, Chu, and Ho), Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.

Correspondence to: Cheng-Wen Chiang, MD, FCCP, Vice Superintendent, Cathay General Hospital, 280 Jen-Ai Rd, Section 4, Taipei, 106, Taiwan, Republic of China; e-mail: cwchiang@ms1.cgh.org.tw



Chest. 2003;123(6):1957-1963. doi:10.1378/chest.123.6.1957
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Published online

Study objectives: The purpose of this study was to evaluate the feasibility of simplifying balloon mitral valvuloplasty through the obviation of left-sided cardiac catheterization using on-line guidance with transesophageal echocardiography in patients with mitral stenosis.

Setting: A tertiary care medical center

Design: Patients who were eligible for balloon mitral valvuloplasty were enrolled into the study if they had no evidence of ischemic heart disease. Sixty-six patients (50 women and 16 men) met the criteria. Balloon mitral valvuloplasty was performed through right-sided cardiac catheterization using adjunctive on-line guidance with transesophageal echocardiography. Left-sided catheterization was obviated.

Measurement and results: Balloon mitral valvuloplasty was smoothly performed in all patients. Successful dilatation (postprocedural mitral orifice area, > 1.5 cm2; or increment in mitral orifice area, ≥ 50%) was achieved in 50 patients (75.8%). The mean (± SD) mitral orifice area increased from 1.08 ± 0.23 cm2 to 1.68 ± 0.39 cm2 (p = 0.0000). There were no in-hospital deaths, no patients with cardiac tamponade, or complications necessitating an emergency cardiac operation. The mean fluoroscopy time was 7.6 ± 3.9 min, and the total procedure time was 50.2 ± 15.0 min.

Conclusion: It is feasible and safe to simplify balloon mitral valvuloplasty by obviating left-sided cardiac catheterization in selected patients with mitral stenosis using adjunctive on-line guidance with transesophageal echocardiography.


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