Effect of percutaneous balloon valvuloplasty on pulmonary hypertension in mitral stenosis

Abstract Percutaneous mitral balloon valvuloplasty (PMBV) has been useful in decreasing mitral valve obstruction in mitral stenosis; however, the long-term effects of valvuloplasty on pulmonary artery pressure have not been extensively studied. Thirty-three patients underwent PMBV in our institution between January 1988 and December 1991. There were significant reductions in peak (19 ± 1 to 12 ± 1 mm Hg) and mean (10 ± 0.7 to 6 ± 0.4 mm Hg) mitral valve gradients estimated by Doppler techniques immediately after PMBV. The mitral valve area, as assessed by the pressure half-time method, increased from 1.06 ± 0.05 to 1.98 ± 0.08 cm 2 ( p 2 ) at 17 ± 2 months. Right ventricular systolic pressure (RVSP) was estimated in patients with tricuspid regurgitation (TR) using the modified Bernoulli equation. There was a good correlation between Doppler and catheterization for RVSP ( r = 0.83 pre valvuloplasty; r = 0.87 post valvuloplasty). Right ventricular systolic pressure by Doppler was 56 ± 4 mm Hg before valvuloplasty and 48 ± 4 mm Hg immediately afterwards ( p p = NS compared with pre- and postvalvuloplasty values). Six of these nine patients had moderate or severe mitral regurgitation (MR), compared with one patient without TR at follow-up ( p