Late results of combined percutaneous balloon valvuloplasty of mitral and tricuspid valves

Although combined mitral and tricuspid stenosis are rarely seen in patients with rheumatic heart disease, when both exist together, combined percutaneous balloon valvuloplasty can be an alternative to surgical treatment in suitable cases. We present the immediate and late follow up results of 12 patients with rheumatic tricuspid and mitral stenosis treated with combined percutaneous balloon valvuloplasty. Twelve patients (11 female, 91.7%; 1 male, 8.3%) with a mean age of 35.3 +/- 6.4 years were enrolled in the study. The patients were followed up for 38.8 +/- 12.6 months. The mitral valve area increased from 1.2 +/- 0.2 cm2 to 2.3 +/- 0.2 cm2 (P < 0.01) and on follow up the mitral valve area did not differ significantly (2.2 +/- 0.2 cm2; P > 0.05). The tricuspid valve area increased from 1.6 +/- 0.3 cm2 to 3.2 +/- 0.2 cm2 (P < 0.01) and on follow up the tricuspid valve area did not differ significantly (3.1 +/- 0.2 cm2; P > 0.05). Two patients (16.6%) had tricuspid restenosis and tricuspid re-valvuloplasty. One other patient (8.3%) was referred to surgery 14 months after the procedure secondary to severe tricuspid regurgitation. In conclusion, this study demonstrates a sustained benefit on late follow up after combined percutaneous balloon valvuloplasty of mitral and tricuspid valves and confirms the efficacy and safety of the procedure as an alternative to surgery in selected cases of combined mitral and tricuspid stenosis.