Percutaneous balloon mitral valvuloplasty by retrograde left atrial catheterization.

A new technique was developed for percutaneous mitral valve balloon valvuloplasty, using a retrograde approach to the left atrium via the left ventricle. A newly designed externally steerable guiding catheter is used for the introduction of 1 or 2 guidewires to the left atrium and the balloon catheters are advanced along these guidewires into the mitral orifice. The technique was used successfully in 10 adult patients with rheumatic mitral stenosis. After the procedure there was a significant reduction in mitral valve pressure gradient and an increase in the mitral valve area in all cases. There were no serious complications during or after the procedure. This technique should prove to be a useful nonsurgical treatment for mitral stenosis and could provide an alternative to the transseptal method.