**Acknowledgements**

**6.4. Inoperable patients**

112 Interventional Cardiology

**7. Results**

**7.1. Immediate results**

are also determining [43, 44].

**7.2. Long-term results**

< 1.5 cm2

**8. Conclusions**

severe MR and the difficulty in its management.

A good immediate result is defined as an MVA > 1.5 cm<sup>2</sup>

lotomy and better than closed mitral valvulotomy [5].

mitral valve surgery should be selected according to the guidelines.

competent technique are the key factors for achieving an excellent result.

BMV might be an option in patients who are old and have significant comorbidities. Given the suboptimal results and the higher incidence of complications arising from unfavorable morphologic characteristics of the mitral valve and poor condition of patients, BMV should be only used in highly symptomatic patients. In these patients, a more conservative BMV strategy is suggested. The Inoue technique is more appropriate because it is less demanding and provides a faster and smoother procedure. A balloon 1 size smaller than the RS is chosen, followed by a further stepwise dilatation of 0.5 mm. The final result should be judged on an individualized basis. Definitely, a smaller MVA is sufficient in most patients in exchange for

and is most probably achieved in patients with favorable morphologic features; nonetheless, other factors including age, history of previous commissurotomy, smaller baseline MVA, preexisting MR, pulmonary artery pressure, sinus rhythm, functional status, and technical issues

When BMV has a good acute result, the long-term survival rate is high and the need for reintervention is infrequent. Anatomical characteristics and age are important predictors of long-term outcomes. Midterm outcomes (3–7 y) are favorable and comparable with open mitral valvu-

Restenosis can occur after successful BMV, but its incidence is difficult to determine due to the absence of a uniform definition and different follow-up periods in the studies. An MVA

anisms include suboptimal initial results, recurrent rheumatic attacks, and a hemodynamicrelated degenerative process. In patients with symptomatic severe restenosis, repeat BMV or

MS as the long-standing sequel of RHD is rare in developed countries, whereas it is still seen frequently in many areas of the world. BMV as a minimally invasive transcatheter technique is the method of choice in the treatment of these patients. In successful cases, BMV results in a very high survival rate and freedom from symptoms. Appropriate patient selection and a

or a 50% loss in the initial MVA is generally defined as restenosis. The possible mech-

without MR more than moderate

The authors like to thank Farshad Amouzadeh for his great assistance in the linguistic editing of this chapter.
