Q. Explain Percutaneous Interventions

Over the last two decades, significant strides have been made in the field of Balloon Valvuloplasties both in terms of technique as well as equipment.

Percutaneous Balloon Mitral Valvuloplasty

Percutaneous balloon mitral valvuloplasty has emerged as the treatment of choice in patients with Rheumatic mitral stenosis which is rampant in developing countries.

Mechanism of PBMV

Mitral valvuloplasty works by the principle of "commisurotomy" - by increasing the mitral orifice area by splitting the fused commisures. The expanding balloon splits fused commisures akin to surgical commisurotomy.

Patient Selection

The patients who are suitable for balloon mitral valvuloplasty are:

1) Patients who are symptomatic with a mitral orifice area as determined by echocardiography and haemodynamics studies to be <1.5cm²

2) Patients with pulmonary hypertension, severe mitral stenosis and variable LV function with anatomically suitable valve

3) Patients with mitral Restenosis after previous surgical commisurotomy in anatomically suitable valves

4) Younger the patient, better the results as older patients have fibrotic valves

5) Suitable procedure for pregnant women with mitral stenosis