Mitral regurgitation after double balloon or Inoue balloon mitral valvuloplasty

We performed serial color Doppler echocardiographic studies prospectively before and after double balloon or Inoue balloon mitral valvuloplasty in 44 patients (mean age 45 +/- 13, range 20-74) with pure rheumatic mitral stenosis (by angiography) selected in a case-control manner to compare the incidence and severity of mitral regurgitation. After balloon dilation, mitral valve area increased from 0.9 +/- 0.2 to 1.5 +/- 0.4 cm2 (p < 0.001) in the double balloon group and from 0.9 +/- 0.3 to 1.5 +/- 0.3 cm2 (p < 0.001) in the Inoue balloon group. Twenty-four hours after balloon dilation, 3 patients in the double balloon group and 12 patients in the Inoue balloon group developed moderate to severe mitral regurgitation (p < 0.05). The severity of mitral regurgitation tended to persist or progress during follow-up in both groups, although improvement could also be observed. Two patients with severe mitral regurgitation in the Inoue balloon group underwent mitral valve replacement during follow-up. In conclusion, double balloon and Inoue balloon techniques are both effective in relieving significant mitral stenosis. However, Inoue balloon technique may be associated with slightly higher frequency of mitral regurgitation.