Efficacy and Safety of Percutaneous Metallic Mitral
Valvuloplasty in Rheumatic Mitral Stenosis at Siriraj
Hospital
REWAT PHANKINGTHONGKUM, M.D.*, CHUNHAKASEM CHOTINAIWATTARAKUL, M.D.**,
PRADIT PANCHA VINNIN, M.D.*, DAMRAS TRESUKOSOL, M.D.*,
DECHO JAKRAPANICHAKUL, M.D.*, YONGYUTH SAHASAKUL, M.D.*,
SANYA KAEOKAM-AIM, Cert.PN.**
Affiliation : * Division of Cardiology, Department of Medicine,
** Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
AbstractMitral stenosis is an important problem that leads to heart failure and stroke in Thailand.
The options of treatment at present are either surgical or balloon mitral commissurotomy. However,
the cost of balloon is very expensive. To reduce the expense of the procedure, the authors prospec
tively did a study using a new device called the metallic valvulotome in symptomatic severe mitral
stenosis to assess the safety, feasibility and immediate outcomes.
Fifty-seven patients were included in the study. The successful outcome achieved by the
metallic valvulotome was 96.2 per cent in patients in whom the procedure was actually performed.
The mean transmitral gradient, left atrial pressure and pulmonary artery pressure were significantly
decreased and the mitral valve area was also significantly increased. Three cases failed the procedure
due to inappropriate position of the septal puncture. No death occurred in the study and complica
tions of the procedure included only two cases of hemopericardium.
In the future, it is believed that this new innovative device will provide improvement and
reduce the cost of the procedure in patients with severe mitral stenosis.
Keywords : Mitral Valve, Valvuloplasty, Catheters
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