[Mitral valvuloplasty. The double balloon technique compared with the "Nucleus" single balloon technique]

Mitral stenosis requires mechanical management once the area decreases to critical values. We began practicing mitral valvuloplasty in 1994 with the double balloon technique and, since 1996, we have been performing the procedure using a single balloon called "Nucleus". We compare the immediate results of both techniques. We included 31 patients divided in two similar groups: group A (double balloon) of 15 patients, average Wilkins score of 7.13 +/- .80, mitral valve area pre-valvuloplasty of .83 +/- .25 cm2 and transmitral gradient of 17.06 +/- 7.6 mmHg; group B (Nucleus balloon) of 16 patients, Wilkins score of 7.6 +/- .71, mitral valve area 1.05 +/- .33 cm2, transvalvular gradient of 14.26 +/- 5.00 mmHg. Post-valvuloplasty valvular area increased in group A and group B, respectively, to 1.99 +/- .49 cm2 and 2.67 +/- .63 cm2 (p < .001); gradient decreased to 5.55 +/- 2.50 mmHg, and 2.95 +/- 2.32 mmHg (p < .001). Increase of mitral insufficiency of one grade was present on one patient of each group; one patient of group A had significant interatrial shunt after the procedure. The mitral valvuloplasty yields better results and is more practical when performed with the Nucleus balloon than with the double balloon.