[Percutaneous mitral valvuloplasty with the Inoue balloon. The initial experience and 3-year clinical follow-up at the Instituto Nacional de Cardiología Ignacio Chávez].

In 113 patients with mitral stenosis a balloon mitral valvuloplasty (VMPB) was performed. There were 97 female and 16 male patients. Mean age was 40 +/- 11 with range of 18 and 70 years. 95 patients had sinus rhythm and 18 were on atrial fibrillation. Previous mitral commissurotomy was reported in 13 patients and 5 were pregnant at the moment of the procedure. Patients were carefully selected using both clinical and echocardiographic studies as well as the Wilkins score (SW). Transesophageal echocardiography (ETE) was performed when transthoracic echocardiography was not satisfactory. After right and left catheterization, VMPB was performed. In 106 patients (93.8%) a significant increase of the area mitral valve (AVM) was obtained. Echocardiographic results showed an AVM increase from 0.95 +/- 0.19 to 1.61 +/- 0.34 cm2 (p < 0.0001). Mean mitral gradient (GTM) decreased from 16.18 +/- 4.69 to 9.14 +/- 3.2 mmHg (p < 0.0001). Functional class improved in all patients in the long term. As complications there was severe mitral regurgitation (IM) reported in 6 patients who subsequently underwent mitral valve exchange, 2 of then died during surgery (one of them by bleeding and the other by non reparable rags on the atrium). A patient had cerebrovascular event (EVC) one week after the VMPB. In 3 of them non-significant interatrial communication (CIA) was produced. One patient died two months after the procedure due to bacterial endocarditis (EBSA). VMPB can be considered as a safe and effective treatment to patients with mitral stenosis.