A novel technique for multi-track percutaneous balloon mitral valvoplasty

Percutaneous balloon mitral valvoplasty (PBMV) has become the treatment of choice for severe pliable rheumatic mitral stenosis. The multi-track system is a recent variation of the double-balloon technique and is easier owing to the use of a monorail balloon and a simple, single-guidewire approach. In the present study, we used the double-coil Inoue metal wire with a multi-track balloon instead of the conventional multi-track wire. We studied 62 consecutive patients (55 females) with significant symptomatic rheumatic mitral valve stenosis who underwent multi-track PBMV. Patients were randomized into 2 groups: the first group included 32 patients treated with the novel multi-track technique using the double-coil Inoue metal wire, and the second group included 30 patients treated with the conventional multi-track technique using a balloon endhole catheter and multi-track 0.035 inch stiff wire. None of the patients had cardiac tamponade, systemic thromboembolism, or any groin complications. No statistically significant differences were found between the 2 groups regarding any of the studied variables. There were no in-hospital deaths or complications necessitating emergent cardiac surgery in either group. In conclusion, this new technique with the double-coil Inoue metal wire achieves the double benefit of being as safe as (and indeed easier than) the conventional technique, and it utilizes fewer materials, making the multi-track system more cost-effective.