Author + information
- Received July 16, 1987
- Revision received January 20, 1988
- Accepted February 3, 1988
- Published online June 1, 1988.
- Aaron D. Berman, MD,
- Joseph S. Weinstein, MD,
- Robert D. Safian, MD,
- Daniel J. Diver, MD,
- William Grossman, MD, FACC and
- Raymond G. McKay, MD∗
- ↵∗Address for reprints: Raymond G. McKay, MD, Cardiovascular Division, Beth Israel Hospital, 330 Brookline Avenue, Boston, Massachusetts 02215.
Six patients with severe combined aortic and mitral valve stenosis underwent double valve balloon dilation as an alternative to surgical valve replacement. Cardiac catheterization in all patients before valve dilation revealed heavily calcified aortic and mitral valves with severe stenosis and minimal regurgitation. Balloon aortic valvuloplasty was performed in each patient with a 20 mm balloon dilation catheter passed retrograde through the aortic valve whereas mitral valvuloplasty was performed transseptally with either a single or double balloon technique.
After dilation, the mean aortic and mitral gradients decreased in all patients, with the area of the aortic and the mitral valve increasing from 0.5 ± 0.3 to 0.9 ± 0.3 cm2and from 0.7 ± 0.1 to 1.5 ± 0.7 cm2, respectively. The procedures were well tolerated, with no embolic events and no significant increase in valvular regurgitation, and resulted in a reduction in symptoms of dyspnea on exertion and weakness in all patients that has persisted for an average of 5.7 months of follow-up in five of the six patients.
It is concluded that combined dilation of stenotic aortic and mitral valves can be accomplished percutaneously and may be considered for patients with combined valvular stenosis who refuse or are deferred from surgical intervention.
☆ This study was supported in part by Research Training Grant HL0739 from the United States Public Health Service, Washington, D.C.
- Received July 16, 1987.
- Revision received January 20, 1988.
- Accepted February 3, 1988.