The Feasibility of Using Patent Foramen Ovale During Mitral Balloon Valvuloplasty.

This study was undertaken to examine the feasibility of searching and finding probe patency during mitral balloon valvuloplasty and whether the duration of procedure and/or the incidence and severity of iatrogenic atrial septal defect decreased in this patient population. Sixty consecutive patients treated with mitral balloon valvuloplasty (MBV) were studied; data from 55 patients were analyzed. Fifteen patients out of 55 (27.3%) had probe patency. The duration of the procedure was shorter (26.2 +/- 7.0 vs. 35.6 +/- 10.1 min; p < 0.01), incidence of atrial septal defect was lower (40% vs. 72.5%, p < 0.01), and the severity of atrial septal defect as measured by the jet area was smaller (1.68 +/- 0.23 vs 2.6 +/- 1.3 cm2; p < 0.01) in the probe patency group compared to patients without probe patency. At 6 month follow-up, all of the atrial septal defects present in the probe patency group disappeared, but 4 (10.2%) persisted in patients without probe patency. It was concluded that searching probe patency during mitral balloon valvuloplasty was feasible and worthwhile, would not unduly prolong the procedure, and would decrease the incidence and severity of complicating atrial septal defect.