Mitral valve rupture following percutaneous mitral commissurotomy: existence of predictive factors
| Autor: | Y Leclerc, J Creépeau, Tack-Ki Leung, Ihor Dyrda, Robert Petitclerc, M J Rey, A Serra, Raoul Bonan, C. Le Feuvre |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
medicine.medical_specialty Percutaneous medicine.medical_treatment Regurgitation (circulation) Balloon Catheterization Valve replacement Internal medicine Mitral valve medicine Humans Mitral Valve Stenosis cardiovascular diseases Aged Retrospective Studies Mitral regurgitation business.industry Mitral Valve Insufficiency Middle Aged medicine.disease Surgery medicine.anatomical_structure Heart Injuries Echocardiography cardiovascular system Cardiology Mitral Valve Female Cardiology and Cardiovascular Medicine Commissurotomy business Calcification |
| Zdroj: | European Heart Journal. 16:43-48 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/16.1.43 |
| Popis: | The purpose of this study was to describe the mechanism and determine predictive factors of mitral valve rupture requiring valve replacement following percutaneous mitral commissurotomy. Of the 350 consecutive patients treated by balloon mitral commissurotomy, the procedure was not completed in 16, and 11 developed acute severe mitral regurgitation requiring valve replacement: seven cases of anterior leaflet rupture, three cases of posterior leaflet rupture and one case of anterior chordal surface. These 27 group I patients were compared to the remaining 323 (group II) in whom the procedure was completed. The 11 excised valves were evaluated by an experienced pathologist. Eight of the 11 patients had an echocardiographic score < 8 (mean score 6.5 +/- 1), no valvular calcification at X-ray and double balloon percutaneous mitral commissurotomy. Microscopy in six patients showed focal fibrous thickening at the site of the rupture but no calcification. One patient developed severe mitral regurgitation due to chordal rupture with an Inoue balloon. The two remaining patients had an echo score of ten and valve calcification on X-ray. Microscopy revealed severe homogeneous chronic rheumatic mitral disease. In one of these two patients, leaflet rupture was related to an 'oversized balloon' (2 x 19 mm + 15 mm). Statistical analysis showed only echo score differences between the two groups (6.9 +/- 1.4 in group I vs 8.2 +/- 1.6 in group II, P < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|