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2005, Número 3

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Arch Cardiol Mex 2005; 75 (3)


Valvuloplastía mitral percutánea

Ángeles-Valdés J, Uruchurtu CE

Idioma: Español
Referencias bibliográficas: 59
Paginas: 350-362
Archivo PDF: 184.51 Kb.


RESUMEN

La estenosis mitral pura (EMP) tiene mal pronóstico debido al estrechamiento progresivo de su orificio lo que hace necesario técnicas quirúrgicas para agrandarlo. Dentro de éstas figuran la cirugía abierta, y la intervencionista mediante la valvuloplastía mitral percutánea (VMP). Esta revisión de VMP actualiza las indicaciones, destaca al ecocardiograma para la selección de los pacientes, describe la punción transeptal, y analiza las ventajas y desventajas de las diferentes técnicas intervencionistas: Con un solo balón, en especial una técnica modificada por nosotros la del balón Nucleus, con balón de Inoue, la técnica de doble balón y la técnica de valvulotomía de Cribier que no se hace en nuestro país por no contar con el valvulótomo. Analiza los resultados cuyo porcentaje de éxito es hasta del 100% cuando se toma en cuenta el incremento del área valvular, y 61% en población desfavorable tomando como parámetros de éxito el incremento al 50% del área valvular en relación a la previa al procedimiento y una disminución del gradiente transvalvular mitral inferior a 10 mm Hg. Aborda las complicaciones como la insuficiencia mitral severa, cortocircuitos, tamponade. La mortalidad es 1% especialmente con área inferior a 0.7 cm2 o escala de Wilkins superior a 13.


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