Retrograde non-transseptal balloon mitral valvuloplasty--an initial experience

Eleven patients with symptomatic isolated non-calcific mitral stenosis were treated with retrograde nontransseptal balloon mitral valvuloplasty. This new technique utilizes a specifically designed steerable catheter to enter the left atrium retrogradely via the left ventricle thus avoiding transseptal puncture, an essential step in other methods of balloon mitral valvuloplasty. Technical success was obtained in ten (91%) patients. Mitral valve area increased from 0.8 +/- 0.2 to 1.8 +/- 0.4 cm2 and the transmitral gradient decreased from 23.9 +/- 7.7 to 8.2 +/- 2.8 mmHg. There were no major complications such as cardiac perforation, embolic events, cardiac tamponade or severe mitral regurgitation. This early experience, the first outside Greece (centre of origin) indicates that retrograde nontransseptal balloon mitral valvuloplasty is a simple, effective and safe technique with results comparable with other techniques of mitral balloon dilatation which require transseptal catheterisation. Further experience involving multicenteric trials, is required to determine the overall efficacy of this technique for percutaneous balloon mitral valvuloplasty.