الفهرس 
Introduction and Aim of WorkOnly 14 pages are availabe for public view
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Abstract
The aim of this work is to evaluating, immediate, short and intermediate term follow up results (3 and 6 month) after non surgical mitral commissurotomy done by metallic valvulotome verses that done by Inoue balloon.
The present study concludes the following:
1- Percutaneous mitral valvuloplasty by the two techniques (metal valvulotome and Inoue balloon) improved MVA and significantly reduced transmitral pressure gradient.
2- Inoue balloon technique gives higher success rate and larger final MVA than the metal valvulotome technique irrespective of the mitral valve score.
3- The success of dilatation was maintained with both techniques even in patients with high echcardiographic score over the short and intermediate term follow up.
4- Morphologic aspects are more favorable with the metal valvulotome. Bilateral commissural splitting was significantly higher with the valvulotome compared to Inoue balloon in the immediate and short term follow up but with no significant difference in the inter-mediate term flow up.
5- Inoue balloon has a tendency to produce partial rather than complete splitting of posterior commissure.
6- Inoue balloon has the advantage of self-alignment across the mitral orifice; better control of the balloon during manipulation and larger final MVA may be due to its effect on the subvalvular apparatus.
7- The iatrogenic ASD incidence was higher by metallic valvulotome but is was small and restrictive with no homodynamic consequences.
8- One case of mortality is recorded in our study that happened with the metallic valvulotome group.
8- The cost of the valvulotome is significantly less than the Inoue balloon because of the advantage of reuse several times without loss of efficiency.