Clinical outcomes of percutaneous balloon valvuloplasty in patients with critical mitral stenosis

<strong>Background</strong>: Clinical outcomes after percutaneous balloon valvuloplasty in patients with critical mitral stenosis is challenging and widely discussed. <strong>Aim</strong> of the study was to analyze the results of balloon mitral valvuloplasty (BMV) using the Inoue technique in patients with critical mitral valve stenosis. <strong>Material and Methods:</strong> From January 2020 to 2022, balloon mitral valvuloplasty was performed in 31 patients with critical mitral valve stenosis using the Inoue technique. There were 14 men (45.2%), women - 17 (54.8%). The patients were aged from 19 to 59 years, on average 42.4±6.1 years. All patients data were analyzed to evaluate the possible outcomes. <strong>Results</strong>: In 30 (96.4%) patients, a successful BMV was performed. In 1 (3.2%) patients, PMV failed, including puncture was unsuccessful, and it was not possible to pass a balloon catheter from the LA to the LV through the critically narrowed mitral valve opening. These failures took place at the initial stages of mastering the technique. A lethal outcome was noted in 0 (0.0%) case. In all 30 (96.8%) patients after BMV, positive results were obtained: the area of the mitral orifice increased by an average of 2.5 times, from 0.85±0.17 to 2.16±0.76 cm2 (p&lt; 0.001), the maximum gradient at the level of the mitral valve decreased by 60.5%, on average from 26.9±2.95 to 8.9±0.6 mm Hg. (p&lt;0.0001). The maximum pressure in the LA statistically significantly decreased from 40.29±6.01 mm Hg. Art. up to 21.43±3.83 mm Hg (p&lt;0.05), in LA - from 49.7±10.9 to 29.7±8.2 mm Hg. (p&lt;0.05). According to EchoCG data, regurgitation on the mitral valve after BMV appeared in 6 (24.1%) patients up to I degree, in 1 (3.2%) - up to II, and in 1 (3.2%) - up to III. In 16 (61.5%) of 26 patients with initial mitral insufficiency after BMV, the degree of regurgitation remained at the same level, in 8 (30.7%) the latter increased to II, in 2 (7.7%) - to III degree. <strong>Conclusion</strong>: BMV using the INOUE technique is a highly effective minimally invasive treatment method, accompanied by a low morbidity and mortality rate.

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