Catheter balloon valvuloplasty of aortic and mitral stenosis in adults : 1987

THERAPEUTIC catheter intervention probably started with Dotter and Judkins performance of transluminal treatment of arteriosclerotic obstruction of peripheral vessels.' Rashkind extended the therapeutic use of the catheter to intracardiac work with the performance of balloon atrial septostomy for transposition of the great arteries.2 Over the next 20 years, the field has blossomed, with removal of fragments of other catheters and intravenous lines that had become accidentally sheered off and left in the right heart or pulmonary artery3; closure of atrial septal defect and patent ductus arteriosus, blockage of vena cava for prevention of recurrent pulmonary emboli and fragmentation of massive pulmonary emboli, closure of arterial and venous malformations with the use of coils, glues, and other substances; dilatation of systemic and pulmonary arterial and venous stenoses, of coarctation of the aorta, and of coronary arteries and bypass grafts; intracoronary thrombolysis; and ablation of conducting and accessory tissues and of tachyarrhythmias (table 1).`-3 It was natural that an attempt should be made to dilate stenotic cardiac valves. The technique is best called catheter balloon valvuloplasty (CBV) because the catheter may be introduced by cutdown; valvotomy and commissurotomy have been used to describe surgical dilatation of stenotic valves for over three decades and balloon dilatation of coronary arteries is called angioplasty. A variety of balloon catheters (single, modified sin-