Inoue Balloon Mitral Commissurotomy Using Percutaneous Transvenous Approach inBabylon, Iraq

Abstract

Objective: Immediate outcomes of percutaneous transvenous approaches to inoue balloon mitral commissurotomy.

Study Design: A single-center observational study
Place and Duration of Study: This study was conducted at the Shaheed Almihrab Cardiac Center in Babylon‚ Iraq from 1st January 2021 to 31st December 2025.

Methods: 86 patients with severe rheumatic mitral stenosis (mitral valve area ≤1.5 cm2 and Wilkins score ≤8) who underwent inoue balloon mitral commissurotomy were included. Pre- and post-procedural transthoracic
echocardiography was performed on all patients. Mean mitral pressure gradient ‚ mean mitral valve area‚ pulmonary artery systolic pressure post-transcatheter pulmonary valve replacement‚ and mitral regurgitation (MR) severity were primary clinical end points. Procedural success was defined as mitral valve area >1.5 cm2 without severe mitral regurgitation (MR ≥3+).

Results: The mean age was 38.4 ± 11.2 years. The majority of the patients were females (74.4%). Procedural success was 94.2%. Baseline mitral valve area was 0.91±0.18 cm2 ‚ increasing to 1.79±0.24 cm2‚ P<0.001. Mitral
mean gradient decreased from 14.2±4.6 mmHg to 5.1±2.3 mmHg‚ P<0.001‚ and pulmonary artery systolic pressure decreased from 48.6±14.2 mmHg to 31.4±10.8 mmHg‚ P <0.001. Severe mitral regurgitation occurred in 3.5%‚
cardiac tamponade in 1.2%‚ but no deaths were procedure-related.

Conclusion: Inoue balloon mitral commissurotomy via the percutaneous transvenous approach for rheumatic mitral stenosis performed in Babylon‚ Iraq‚ achieves a hemodynamic improvement and procedural success rate similar to the global data.