Does the mitral valve recoil after percutaneous balloon valvotomy?

Abstract

Aim: The significance of passive stretching of the mitral valve as a contributor to valve opening, after percutaneous transvenous mitral commissurotomy (PTMC), is not known. Our objective was to determine whether any acute reduction in valve area occurs due to recoil of stretched valve structures. Methods and Results: In a prospective observational study, we evaluated nine patients (age 30.1±8.0 years; median valve score 7) who underwent PTMC. We calculated mitral valve area (MVA) before, immediately after, and at 10 and 30 min after valvotomy. There was no acute reduction in MVA after successful PTMC. But there was a significant increase in MVA at 30 min, from that measured immediately after the procedure (1.8±0.4 to 2.0±0.4 cm²; P=.048). This was attributable to the continuing fall in pulmonary artery wedge (PAW) pressures (17±3 to 15±3 mmHg; P=.003) and transmitral gradients (8±3 to 7±2 mmHg; P=.037). Conclusion: Passive stretching of the valve apparatus does not play an important role in valve opening after PTMC in young patients with favorable valve morphology.