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(Circulation. 2000;101:e91.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Long-Term Results of Percutaneous Balloon Mitral Valvuloplasty Using the Inoue Balloon Catheter Technique

Tsung O. Cheng, MD

Professor of Medicine The George Washington University, Washington, DC

	Introduction

 
To the Editor:

I read with interest the article on long-term follow-up after percutaneous mitral valvuloplasty with the Inoue balloon catheter by Hernandez et al.¹ They reported a restenosis rate of 39% at 7 years.

My colleagues from China and I recently reported our experience with the same technique in a follow-up study up to 11 years in the first 202 patients² among the original 4832 patients treated in China.³ The restenosis rate was 8%, which is very respectable and actually better than that after surgical closed commissurotomy (25% to 28%).² Why the restenosis rate in the Chinese patients is much lower than that in the Spanish patients is unclear.

Our experience as well as a series of recent reports of excellent long-term results have strengthened the previous conclusion that percutaneous mitral valvuloplasty using the Inoue balloon technique should be the procedure of first choice in most patients with mitral stenosis worldwide.⁴

	References

 
1. Hernandez R, Bañuelos C, Alfonso F, Goicolea J, Fernández-Ortiz A, Escaned J, Azcona L, Almeria C, Macaya C. Long-term clinical and echocardiographic follow-up after percutaneous mitral valvuloplasty with the Inoue balloon. Circulation. 1999;99:1580–1586.[Abstract/Free Full Text]

2. Chen C-R, Cheng TO, Chen J-Y, Huang Y-G, Huang T, Zhang B. Long-term results of percutaneous balloon mitral valvuloplasty for mitral stenosis: a follow-up study to 11 years in 202 patients. Cathet Cardiovasc Diagn. 1998;43:132–139.[Medline] [Order article via Infotrieve]

3. Chen C, Cheng TO, for the Multicenter Study Group. Percutaneous balloon mitral valvuloplasty using Inoue technique: a multicenter study of 4832 patients in China. Am Heart J. 1995;129:1197–1204.[Medline] [Order article via Infotrieve]

4. Cheng TO, Holmes DR Jr. Percutaneous balloon mitral valvuloplasty by the Inoue balloon technique: the procedure of choice for treatment of mitral stenosis. Am J Cardiol. 1998;81:624–628.[Medline] [Order article via Infotrieve]

Response

Rosa Hernandez, MD; Camino Bañuelos, MD; Fernando Alfonso, MD; Javier Goicolea, MD; Antonio Fernández-Ortiz; Javier Escaned, MD; Luis Azcona, MD; Carlos Almeria, MD; Carlos Macaya

Hospital Universitario San Carlos, Madrid, Spain

	Introduction

 
Dr Cheng remarks on the discrepancy between the restenosis rate reported in our article^R1 (39% at 7 years) and that reported by him and his colleagues^R2 (8%) after percutaneous valvuloplasty with the Inoue balloon. They speculate whether or not baseline differences in Spanish and Chinese populations may account for such a striking difference.

We believe that this difference is more apparent that real. Our restenosis rate after a mean follow-up of 39±23 months was 10%, rather similar to that reported by them (8% after 3.7±2.1 years). A different methodology may account for these differences: (1) Our analysis took . . . [Full Text of this Article]