Transarterial Retrograde Mitral Balloon Valvotomy

Since studies on mitral balloon valvotomy without septostomy have been rare, we are reporting our experience on 6 patients with valvotomy which was performed utilizing the way of left atrial catheterization. The mean mitral valve area was increased from 1.1 cm2 to 1.64 cm. The pressure gradient across the mitral valve was decreased from 9.3 mmHg to 3.3 mmHg. Minimal mitral insufficiency occurred in · one patient but in two cases there was ( +++) and ( ++++) mitral insufficiency because of rupture of the chordae. Valve replacement had to be performed in both cases, one immediately postoperatively and one later on. It is concluded that although the risks of septostomy is eliminated and the procedure shortened, transarterial retrograde valvotomy has a high possibility of causing severe mitral insufficiency by damaging the subvalvular apparatus and that this method should not constitute an alternative for the classical transseptal method.