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The role of the surgeon in percutaneous valvuloplasty

Since August 1987, at the Instituto Dante Pazzanese de Cardiologia (IDPC) percutaneous mitral and aortic valvuloplasty was performed in 27 patients. In 26 for mitral and in 1 for aortic valve disease. In 26 patients mitral valvuloplasties success was accomplished in 14 patients. From those we had some complications in 4. The success was not total in 3 patients. One patient with mitral insufficiency refused surgery; the second one underwent surgery, and the third one is assymptomatic but without increase in valve area or drop in the gradient and will be reviewed. The last 9 patients underwent surgery. Six underwent commissurotomy and papilotomy and 3, valve replacement. The surgical indications were: cardiac tamponade in one, papilary muscle rupture in another one, low cardie output in 1 and puncture of the aorta in 4 cases. The catheter did not reach the left atrium in the last 2 cases and the hypothesis of cardiac tamponade was suspected, but not confirmed. The patient who underwent aortic valvuloplasty had the gradient dropped, but died one month later, in heart failure. Percutaneous valvuloplasty is an alternative treatment for patients with mitral or aortic valve stenosis without calcification or alterations of the subvalvar apparatus, mainly in those cases in which the surgery is of high risk like the elderly, in patient with renal and chronic lung diseases.

percutaneous valvuloplasty; heart valves


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