Percutaneous valvuloplasty using a balloon catheter in acquired mitral and aortic stenosis in adults

: Since 1984 to 1985, catheter dilation of mitral stenosis and aortic stenosis has been added to the arsenal of interventional cardiology. In mitral valvuloplasty the left atrium is approached by transseptal catheterization. Dilation is normally performed by two balloon catheters of 20 mm diameter. One or two dilations of 20 sec duration are usually sufficient to open the mitral valve by cracking one or two fused commissures. In our series of 61 patients the mitral valve area had more than doubled (from 1.03 +/- 0.27 cm2 to 2.17 +/- 0.71 cm2). The most suitable subjects for the technique are young patients in sinus rhythm with relatively elastic valve leaflets, few calcifications, little distortion of the subvalvular apparatus and no major regurgitations. However, mitral valvuloplasty can also be tried in less favourable conditions where there are surgical contraindications, particularly in elderly patients. The complications of the technique are in fact rare. The functional improvement is spectacular and control studies over two years show no tendency to restenosis. --In aortic valvuloplasty a retrograde arterial approach is used. Balloon catheters of increasing size are consecutively employed, starting from 15-20 and even 23 mm diameter. Forceful dilation is needed not only to overcome leaflet fusion but also to compress the valvular structures against the aortic wall to render them more pliable and break the calcifications. --Since September 1985 over 400 patients have undergone valvuloplasty at Rouen with satisfactory overall results.(ABSTRACT TRUNCATED AT 250 WORDS)