Percutaneous mitral valvotomy using inoue and double balloon technique: Comparison of clinical and hemodynamic short term results in 350 cases

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Abstract
The results of percutaneous mitral valvotomy (PMV) by double balloon (N = 230, Group I) and Inoue single balloon (N = 120, Group II) technique were compared. The groups were similar with respect to baseline characteristics. Following PMV there were marked symptomatic and haemodynamic benefits in both the groups. There was significant increase in mitral valve area (MVA) estimated by Gorlin's equation (Group I: from 0.83 ± 0.18 cm2 to 2.10 ± 0.45 cm2, p < 0.001; Group II: from 0.83 ± 0.17 cm2 to 2.16 ± 0.39 cm2, p < 0.001) and by echoplanimetry (Group I: from 0.84 ± 0.18 cm2 to 1.91 ± 0.35 cm2, p < 0.001; Group II: from 0.88 ± 0.17 cm2 to 1.96 ± 0.30 cm2, p < 0.001). However, the percentage increase in MVA in the two groups by echoplanimetry (Group I: 136 ± 59; Group II: 130 ± 51; p = NS) and by Gorlin's equation (Group I: 164 ± 69; Group II: 168 ± 61; p = NS) were not statistically significant. Results were considered optimal when increase in MVA was ± 1.5 cm2, percentage increase was ± 50, and mitral regurgitation was < 2/4. Out of 216 patients in Group I where PMV could be performed, optimal results were achieved in 184 (85.2%) by Gorlin's equation and 178 (82.4%) by echoplanimetry. In Group II, out of 116 patients, optimal results were achieved in 107 (92.2%) by Gorlin's equation and 103 (89%) by echoplanimetry. Incidence of mitral regurgitation although higher in Group II (24.1% vs. 18.9%) was not statistically significant. The results of both the techniques are similar and the main advantage of Inoue technique is its short procedure (Group I: 120 ± 35 minutes; Group II: 90 ± 30, p < 0.01) and fluoroscopy time (Group I: 22 ± 4.5; Group II: 11 ± 3.3, p < 0.01).