Percutaneous balloon valvuloplasty of coexisting mitral and tricuspid stenosis: single-wire, double-balloon technique
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Tariq Ashraf1, Asad Pathan, Asadullah Kundi
1Incharge Cath Lab, National Institute of Cardiovascular Diseases, NICVD Karachi, Karachi, Pakistan. tariqash@cyber.net.pk
Background:
Percutaneous transmitral commissurotomy (PTMC) was first described by Inoue as an alternative to surgical closed mitral commissurotomy for severe rheumatic mitral stenosis. Two techniques - single- and double-balloon methods and percutaneous metallic devices - have been described for mitral dilatation. The Multi-Track system, a single-wire, double-balloon device was introduced by Bonhoeffer for mitral valve dilatation. We describe a case of mitral and tricuspid valve dilatation employing this double-balloon technique.
Methods:
A 25-year-old male with combined rheumatic mitral and tricuspid stenosis and severe pulmonary hypertension underwent simultaneous double-valve dilatation in a single setting using different sizes of the Multi-Track balloon catheter.
Results:
The patient's transmitral gradient decreased from 15 to 2 mmHg and his mitral valve area increased from 1 cm(2) to 2.2 cm(2). Similarly, his tricuspid valve gradient dropped from 7 to 3 mmHg and his tricuspid valve area increased from 0.9 cm(2) to 3.0 cm(2).
Conclusion:
Percutaneous balloon valvuloplasty using the Multi-Track system for combined mitral and tricuspid stenosis is cost effective and simple to use.
