Transseptal methods for percutaneous balloon valvoplasty simultaneously with radiofrequency catheter ablation

Percutaneous balloon mitral valvoplasty (PBMV) and radiofrequency catheter ablation (RFCA) have been used in the treatment of mitral stenosis (MS) and supraventricular tachycardia. The techniques of PBMV and RFCA yield better results with the development of interventional cardiology, but there is no report about PBMV performed simultaneously with RFCA in the same patient. Seven patients with mitral stenosis and Wollf-Parkinson-White (W-P-W) Syndrome were successfully treated with PBMV and RFCA by transseptal methods. LA, LAP, mPG and mPA were decreased from 43.4 +/- 4.6mm, 21.8 +/- 6.8mmHg, 21 +/- 7.7mmHg and 45.7 +/- 16.5mmHg to 39.2 +/- 3.7mm (P < 0.05), 12.7 +/- 4.5mmHg, 12 +/- 3.7mmHg and 32.3 +/- 9mmHg (P < 0.01). MVA was increased from 0.96 +/- 0.33cm2 to 1.7 +/- 0.80cm2 (P < 0.01). delta wave disappeared in 12-lead surface EKG and SVT could not be induced in electrophysiological study after the treatment. The overall time of the procedure for this series was 93 +/- 34 minutes and fluoroscopy time was 23 +/- 7 minutes on the average. Radiofrequency energy applications were 3 +/- 2 times each procedure. PBMV and RFCA are safe and highly effective in the treatment of MS and W-P-W syndrome. The results in the present study proved the feasibility of the combined use of PBMV and RFCA. We prefer a first choice of PBMV and then RFCA in order to avoid aggravation of the hemodynamics due to mitral stenosis. The results also showed that of overall procedure and fluoroscopy only took a short time for this series. We suggest that it could be used as a routine method for the treatment of mitral stenosis complicated by W-P-W syndrome.