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Retrograde nontransseptal balloon mitral valvuloplasty: immediate results and intermediate long-term outcome in 441 cases—a multicenter experience

Christodoulos I. Stefanadis, MD, FACC^*, Costas G. Stratos, MD^*, Spyros G. Lambrou, MD^*, Vinay Kumar Bahl, MD, Dennis V. Cokkinos, MD, FACC, Vassilios A. Voudris, MD, FACC, Stefanos G. Foussas, MD, FACC, Costas P. Tsioufis, MD^* and Pavlos K. Toutouzas, MD, FACC^*

^* Department of Cardiology of Athens University, Hippocration Hospital, Athens, Greece
All India Institute of Medical Sciences, New Delhi, India
Onassis Cardiac Surgery Center, Athens, Greece
Tzannio Hospital, Pireus, Greece

View larger version (122K): [in a new window]   Figure 1 Ventriculographic frames of a single valvuloplasty balloon dilated across the stenotic mitral valve in the right anterior oblique (A) and left anterior oblique (B) projections. (C): schematic representation of the steerable left atrial guiding catheter (GC) in the right anterior oblique (left) and left lateral projection (right). By external manipulations of the steering arm (SA), the catheter’s distal tip is curved so as to point directly at the mitral orifice. The guidewire (GW) is stabilized within the left atrium by the formation of spirals.

View larger version (11K): [in a new window]   Figure 2 Kaplan-Meier event-free survival curve for the entire follow-up population. The number of patients available for observation at the end of each year of follow-up is depicted under the horizontal axis.

View larger version (16K): [in a new window]   Figure 3 Kaplan-Meier event-free survival curves for patients with echocardiographic score 8 versus > 8. Format as in Figure 2.

View larger version (16K): [in a new window]   Figure 4 Kaplan-Meier event-free survival curves for patients with postprocedural mitral valve area (MVA) 2cm2 versus < 2cm2. Format as in Figure 2.

View larger version (19K): [in a new window]   Figure 5 Kaplan-Meier event-free survival curves according to baseline symptom severity. Format as in Figure 2. NYHA = New York Heart Association.