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(Circulation. 2000;102:e18.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Late Results of Percutaneous Balloon Mitral Valvuloplasty: The Chinese Experience

Tsung O. Cheng, MD

Professor of Medicine George Washington University, Washington, DC

Chuan Rong Chen, MD

President, Guangdong Society of Interventional Cardiology Guangzhou, People’s Republic of China

	Introduction

 
To the Editor:

We are writing in support of the conclusions reached by Iung et al¹ concerning the late results of percutaneous balloon mitral valvuloplasty (PBMV).

The French experience confirmed the Chinese experience that was reported earlier with a larger number of patients, namely, a PBMV can be performed with good late results in a variety of patient subsets.^{2 3} The Inoue balloon technique, which the Chinese investigators have used since November 1985⁴ and the French investigators began using more recently, is the procedure of choice for the treatment of mitral stenosis.⁵

We also found that a hemodynamic evaluation did not provide any information additional to that from clinical and echocardiographic examinations. For this reason and to simplify the procedure to make its use more widespread, the Chinese physicians have not performed systematic hemodynamic measurements before or after PBMV for the last several years. In China, >18 000 PBMVs have been performed to date.

	References

 
1. Iung B, Garbarz E, Michaud P, et al. Late results of percutaneous mitral commissurotomy in a series of 1024 patients: analysis of late clinical deterioration: frequency, anatomic findings, and predictive factors. Circulation. 1999;99:3272–3278.[Abstract/Free Full Text]

2. 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;129:1187–1204.

3. Chen C-R, Cheng TO, Chen J-Y, et al. 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]

4. Chen C, Lo Z, Huang Z, et al. Percutaneous transseptal balloon mitral valvuloplasty: the Chinese experience in 30 patients. Am Heart J. 1988;115:937–947.[Medline] [Order article via Infotrieve]

5. 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

Bernard Iung, MD; Eric Garbarz, MD; Pierre Michaud, MD; Steeven Helou, MD; Bruno Farah, MD; Patricia Berdah, MD; Pierre-Louis Michel, MD; Bertrand Cormier, MD; Alec Vahanian, MD

Cardiology Department, Tenon Hospital, Paris, France

	Introduction

 
We thank Drs Cheng and Chen for their comments concerning our article, "Late Results of Percutaneous Mitral Commissurotomy in a Series of 1024 Patients. Analysis of Late Clinical Deterioration: Frequency, Anatomical Findings, and Predictive Factors."^R1

Despite the absence of large randomized trials comparing the Inoue and double-balloon techniques, the Inoue technique is now the most widely used technique worldwide, mostly because of its ease of use and safety. A low rate of events can be accurately assessed only in reports based on large populations, and the consistency between the experiences in China, the United States, and Europe . . . [Full Text of this Article]