2003, Número 1
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Arch Cardiol Mex 2003; 73 (1)
Resultados a largo plazo de la valvuloplastía mitral percutánea con balón de Inoue. Experiencia del CMN 20 de Noviembre ISSSTE
Flores FJ, Sánchez PJL, Vargas CA, Jiménez VA, Zaragoza RG, Díaz CAC, Robledo NR, Blanco CM
Idioma: Español
Referencias bibliográficas: 31
Paginas: 18-23
Archivo PDF: 65.95 Kb.
RESUMEN
La valvuloplastía mitral con balón de Inoue se ha convertido en los últimos 15
años en el procedimiento intervencionista de elección en pacientes con estenosis
mitral con valvas flexibles y no calcificadas. En este artículo nosotros
reportamos la experiencia a largo plazo de 100 pacientes a quienes se les
realizó este procedimiento en nuestro hospital (CMN 20 de Noviembre ISSSTE).
El promedio de seguimiento fue de 38.72 ± 22.4 meses. Se logró éxito en el
83.3% de los pacientes. El área valvular mitral aumento de 0.95 ± 0.16 a
1.62± 0.24 cm
2 (P < 0.001) después del procedimiento y al final del seguimiento
el área fue de 1.57 ± 0.29 cm
2. El gradiente trans-valvular medio disminuyo de
8.80 ± 3.67 mm Hg a 4.74 ± 1.90 mm Hg (P < 0.001). Se presentaron complicaciones
en el 7.0% de los pacientes, la más frecuente fue la insuficiencia mitral
debido a ruptura de una de las valvas. No hubo decesos.
Conclusiones: La
valvuloplastía mitral con balón es un procedimiento efectivo en pacientes
con score de Wilkins < 8, con un mínimo riesgo de complicaciones y un resultado
duradero a largo plazo, con el 90% de los pacientes en clase funcional I NYHA al final del seguimiento.
REFERENCIAS (EN ESTE ARTÍCULO)
Braunwald E: Valvular Heart Disease. En Braunwald E, Zipes D, Libby P, Heart Disease A Text Book of Cardiovascular Medicine Sexta Edición. Philadelphia , Pennsylvania . WB Saunders 2001; 1643-1714
Ommen SR, Nishimura RA, Grill DE, Holmes DR, Rihal CS: Long-Term Results of Percutaneous Mitral Balloon Valvulotomy with Closed Transventricular Mitral Commissurotomy at a Single North American Institution. Am J Cardiol 1999; 84(5): 575-577.
Abascal VM, Wilkins GT, O’Shea JP: Prediction of Successful Outcome in 130 Patients Undergoing Percutaneous Balloon Mitral Valvulotomy. Circulation 1990; 82: 448-456.
Wilkins GT, Weyman AE, Abascal VM: Percutaneus Balloon Dilatation of the Mitral Valve: an Analysis of Echocardiographic Variables Related to Outcome and the Mechanism of Dilatation. Heart 1998; 60: 299-308.
Hernandez R, Bañuelos C, Alfonso F, Goicolea J, Fernandez OA, Escaned J, Azcona L, Macaya C: Long-Term Clinical and Echocardiographic Follow Up After Percutaneous Mitral Valvuloplasty with the Inoue Balloon. Circulation 1999; 99(12): 1580-1586.
Cheng T, Tsung O, Holmes D: Percutaneous Mitral Valvuloplasty By the Inoue Balloon Tecnique: the Procedure of Choice for Treatment of Mitral Stenosis. Am J Cardiol 1999; 84(5): 624-628.
Ha JW, Chung N, Jang Y, Kang WC, Kang SM, Rim SJ, Shim WH, Cho SY, Kim SS: Is the left atrial V Wave the Determinant of Peak Pulmonary Artery Pressure in Patients with Pure Mitral Stenosis? Am J Cardiol 2000; 85(8): 986-91.
Hildick–Smith DJ, Walsh JT, Shapiro LM: Pulmonary Capillary Wedge Pressure in Mitral Stenosis Accurately Reflects Mean Left Atrial Pressure But Overestimates Transmitral Gradient. Am J Cardiol 2000; 85(4): 512-515.
Padial LR, Abascal VM, Moreno PR, Weyman AE, Levine RA, Palacios IF: Echocardiography Can Predict the Development of Severe Mitral Regurgitation After Percutaneous Mitral Valvuloplasty By the Inoue Technique. Am J Cardiol 1999; 83(8): 1210-1213.
Multicenter Experience With Balloon Mitral Commissurotomy. NHLBI Balloon Valvuloplasty Registry Report on Immediate and 30 Days Follow Up Results. The National Heart Lung and Blood Institute Balloon Valvuloplasty Participants. Circulation 1992; 85: 448-461.
Inoue K, Owaki T, Nakamura T: Application of Transvenous Mitral Commissurotomy By a New Balloon Catheter. J Thorac Cardiovasc Surg 1984; 87: 394-402.
Cheng T, Tsung O, Holmes D: Percutaneous Mitral Valvuloplasty By the Inoue Balloon Technique: the Procedure of Choice for Treatment of Mitral Stenosis. Am J Cardiol 1999; 84(5): 624-628.
Mazur W, Parilak LD, Kaluza G, DeFelice C, Raizner AE: Balloon Valvuloplasty for Mitral Stenosis. Curren Opinion In Cardiology 1999; 14(2): 95-105.
ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease. JACC 1998; 32(5): 1486-1582.
Gamra H, Zhang HP, Allen JW, Lou FY, Ruiz CE: Factors Determining Normalization of Pulmonary Vascular Resistence Following Successful Balloon Mitral Valvulotomy. Am J Cardiol 1999; 83(3): 392-395.
Chen CR, Cheng TO: Percutaneous Balloon Mitral Valvuloplasty by the Inoue Technique: A Multicenter Study of 4832 Patients in China. Am Heart J 1995; 129: 1197-1204.
Vahanian A, Groupe Hospitalier Bichat. Balloon Valvuloplasty. Heart 2001; 85(2): 223-228.
Lung B, Garbarz E, Michaud P, Helou S, Farah B, Berdah P, Michel PL: Late Results of Percutaneous Mitral Commissurotomy in a Series of 1024 Patients. Analysis of Late Clinical Deterioration: Frequency, Anatamic Findings and Predictive Factors. Circulation 1999; 99: 3272-3278.
Sutaria N, Northridge DB, Shaw TR: Significance of Commissural Calcification on Outcome of Mitral Balloon Valvulotomy. Heart 2000; 84(4): 398-402.
Shavelle DM, Otto CM, Tavel ME: Recurrent Mitral Stenosis: Problems of Management. Chest 2001; 119(3): 958-960.
Zanchetta M, Onorato E, Rigatelli G, Dimopoulos K: Use of Amplatzer SeptalOccluder in a Case of Residual Atrial Septal Defect Bidirectional Shunting After Percutaneous Inoue Mitral Balloon Valvuloplasty. Journal of Invasive Cardiology 2001; 134(3): 223-226.
Petre R, Turina MI: Cardiac Valve Surgery in the Octogenarian. Heart 2000; 83(1): 116-121.
Hildick-Smith DJ, Shapiro LM: Balloon Mitral Valvuloplasty in the Elderly. Heart 2000; 83(4): 374-375.
Hildick S, Taylor G, Shapiro L: Inoue Balloon Valvuloplasty : Long Term Clinical and Echocardiographic Follow-up of a Predominantly Unfavourable Population. Eur Heart J 2000; 21(20): 1690-1697.
Sutaria N, Elder A, Shaw T: Long Term Outcome of Percutaneous Mitral Balloon Valvuloplasty in Patients Aged 70 and Over. Heart 2000; 83(4): 433-438.
Abouzied AM, Abbady M, Al Gendy MF, Magdy A, Soliman H, Faheem F: Percutaneus Balloon Mitral Commissurotomy During Pregnancy. Angiology 2001; 52(3): 205-209.
Zeymer U, Neuhaus K: Percutaneous Balloon Valvuloplasty , the First Line Treatment of Mitral Stenosis and Restenosis. Eur Heart J 2000; 21(20): 1643-1644.
Lung B, Garbarz E, Michaud P, Fondard O, Helou S, Kamblock J: Immediate and Mid-Term Results og Repeat Percutaneous Mitral Commissurotomy for Restenosis Following Earlier Percutaneous Mitral Commissurotomy. Eur Heart J 2000; 21: 1683-1689.
Post J, Feldman T, Isner J, Herrmann H: Inoue Balloon Mitral Valvulotomy in Patients with Severe Valvular and Subvalvular Deformity. J Am Coll Cardiol 1995; 25: 1129-1136.
Chen C, Cheng T, Chen J, Zhou Y, Mei J, MA T: Long Term Results of Percutaneous Mitral Valvuloplasty with Inoue Balloon Catheter. Am J Cardiol 1992; 70: 1445-1448.
Cheng T, Tsung O: Long Term Results of Percutaneous Balloon Mitral Valvuloplastia Using The Inoue Balloon Catheter Technique ( Letter Comment). Circulation 2000; 101(8): E91.