Page 15 - Journal of Structural Heart Disease Volume 3, Issue 2

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Original Scienti c Article
studies using the same protocol with a larger number of patients are needed. Because all of our patients under- went PBMV with the Inoue balloon technique, it is un- known whether our data can be safely extrapolated to patients undergoing double-balloon PBMV or percuta- neous metallic valvotomy. Furthermore, we depended only on Wilkin’s score to assess mitral stenosis, which has several limitations, including a limited ability to di eren- tiate nodular brosis from calci cation, an inability to account for uneven distribution of pathological abnor- malities, an inability to assess commissural involvement, and frequent underestimation of subvalvular disease.
Conclusions
Elderly patients with rheumatic heart disease and mitral stenosis show a tendency toward a higher de- gree of calci cation and brosis of the mitral valve. This may be attributed to a greater likelihood of repeated episodes of active rheumatic disease, which highlights
the importance of administering rheumatic fever pro- phylaxis to younger patients undergoing PBMV pro- cedures. Our study con rmed that PBMV is a safe and e ective procedure that can be used for those with less favorable valve morphology. Without questioning the value of Wilkin’s score or its cut-o point, our study shows that successful PBMV can be accomplished in patients with a Wilkin’s score between 9 and 10. In con- clusion, PBMV and redo PBMV can be employed as a palliative technique in patients with mitral regurgita- tion at a high risk of morbidity and mortality due to the presence of signi cant comorbid disease.
Con ict of Interest
The authors have no con ict of interest relevant to this publication.
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Percutaneous Balloon Mitral Valvuloplasty