Inoue balloon deformity and rupture during percutaneous balloon valvuloplasty

In the management of mitral stenosis, similar long-term results can be obtained by using either an Inoue balloon catheter or a double-balloon technique for percutaneous balloon valvuloplasty. There have been few reports concerning any deformity of an Inoue balloon. From January 1988 to June 1995, 263 procedures of either mitral or tricuspid valvuloplasty have been performed in this center. The Inoue balloon catheter technique was used for 245 procedures. A deformity of the Inoue balloon catheter was noted in 4 (1.6%) and actual rupture of deformed balloon occurred in one (0.4%). All deformities were found at the distal portion of the Inoue balloon. Valvular insufficiency became more severe after valvuloplasty in two cases. Following rupture of the balloon, neither arterial embolization nor perforation of the cardiac chambers developed. In conclusion, a deformity of the Inoue balloon, although rare, can develop during percutaneous balloon valvuloplasty. The deformity may portend balloon rupture if additional maximal dilatations are undertaken.