{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:11:06Z","timestamp":1787501466219,"version":"build-2736575974"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1999,2,16]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    \u2014Percutaneous balloon valvotomy has become a common treatment of mitral stenosis, but the cost of the procedure remains a limitation in countries with restricted financial resources, leading to a frequent reuse of the disposable catheters. To overcome this limitation, a reusable metallic valvotomy device has been developed with the goals of both improving the mitral valvotomy results and decreasing the cost of the procedure.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods and Results<\/jats:italic>\n                    \u2014The device consists of a detachable metallic cylinder with 2 articulated bars screwed onto the distal end of a disposable catheter whose proximal end is connected to an activating pliers. By the transseptal route, the device is advanced across the valve over a traction guidewire. Squeezing the pliers opens the bars up to a maximum extent of 40 mm. The clinical experience consisted of 153 patients with a broad spectrum of mitral valve deformities. The procedure was successful in 92% of cases and resulted in a significant increase in mitral valve area, from 0.95\u00b10.2 to 2.16\u00b10.4 cm\n                    <jats:sup>2<\/jats:sup>\n                    . No increase in mitral regurgitation was noted in 80% of cases. Bilateral splitting of the commissures was observed in 87%. Complications were 2 cases of severe mitral regurgitation (1 requiring surgery), 1 pericardial tamponade, and 1 transient cerebrovascular embolic event. In this series, the maximum number of consecutive patients treated with the same device was 35.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    \u2014The results obtained with this new device are encouraging and at least comparable to those of current balloon techniques. Multiple uses after sterilization should markedly decrease the procedural cost, a major advantage in countries with limited resources and high incidence of mitral stenosis.\n                  <\/jats:p>","DOI":"10.1161\/01.cir.99.6.793","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:42:29Z","timestamp":1339447349000},"page":"793-799","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["Percutaneous Mechanical Mitral Commissurotomy With a Newly Designed Metallic Valvulotome"],"prefix":"10.1161","volume":"99","author":[{"given":"Alain","family":"Cribier","sequence":"first","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. Pant Hospital, New Delhi, India (R.A.); National Heart Institute (A.I.) and Al-Azhar University, Cairo, Egypt (M.E.-S.); and the Institute of Cardiology, Ahmedabad, India (S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He\u0301le\u0300ne","family":"Eltchaninoff","sequence":"additional","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. Pant Hospital, New Delhi, India (R.A.); National Heart Institute (A.I.) and Al-Azhar University, Cairo, Egypt (M.E.-S.); and the Institute of Cardiology, Ahmedabad, India (S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene\u0301","family":"Koning","sequence":"additional","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. Pant Hospital, New Delhi, India (R.A.); National Heart Institute (A.I.) and Al-Azhar University, Cairo, Egypt (M.E.-S.); and the Institute of Cardiology, Ahmedabad, India (S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratap C.","family":"Rath","sequence":"additional","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. Pant Hospital, New Delhi, India (R.A.); National Heart Institute (A.I.) and Al-Azhar University, Cairo, Egypt (M.E.-S.); and the Institute of Cardiology, Ahmedabad, India (S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Arora","sequence":"additional","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. Pant Hospital, New Delhi, India (R.A.); National Heart Institute (A.I.) and Al-Azhar University, Cairo, Egypt (M.E.-S.); and the Institute of Cardiology, Ahmedabad, India (S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel","family":"Imam","sequence":"additional","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. Pant Hospital, New Delhi, India (R.A.); National Heart Institute (A.I.) and Al-Azhar University, Cairo, Egypt (M.E.-S.); and the Institute of Cardiology, Ahmedabad, India (S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustapha","family":"El-Sayed","sequence":"additional","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. Pant Hospital, New Delhi, India (R.A.); National Heart Institute (A.I.) and Al-Azhar University, Cairo, Egypt (M.E.-S.); and the Institute of Cardiology, Ahmedabad, India (S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Dani","sequence":"additional","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. Pant Hospital, New Delhi, India (R.A.); National Heart Institute (A.I.) and Al-Azhar University, Cairo, Egypt (M.E.-S.); and the Institute of Cardiology, Ahmedabad, India (S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevie\u0300ve","family":"Derumeaux","sequence":"additional","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. Pant Hospital, New Delhi, India (R.A.); National Heart Institute (A.I.) and Al-Azhar University, Cairo, Egypt (M.E.-S.); and the Institute of Cardiology, Ahmedabad, India (S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Benichou","sequence":"additional","affiliation":[{"name":"From Charles Nicolle Hospital, Departments of Cardiology (A.C., H.E., R.K., G.D., C.T., S.J., G.P., B.L.) and Biostatistics (J.B.), University of Rouen, France; Apollo Hospital, Hyderabad, India (P.C.R.); G.B. 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