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A randomized clinical trial compared a novel wire-assisted method with the standard Inoue balloon technique in patients with Wilkins score ≤ 10. Twenty patients underwent optimized guidance with in-field and transesophageal echocardiography under general anesthesia. The wire-assisted method shortened time to first balloon inflation without increasing severe mitral 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anesthesia.",{"name":119,"@type":110,"acceptedAnswer":120},"What was the primary time outcome?",{"text":121,"@type":113},"Procedural time from interatrial septal puncture to balloon inflation was shorter with the wire-assisted method than with the Inoue balloon technique (14.4 ± 3.4 min vs 21.8 ± 8.3 min, p = 0.020).",{"name":123,"@type":110,"acceptedAnswer":124},"Did the wire-assisted method increase major safety problems?",{"text":125,"@type":113},"The trial reported no procedure complicated by severe mitral regurgitation, with no difference noted in that safety outcome between 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Time Compared to Inoue‐Balloon Technique of Treating Mitral Stenosis, Randomized Controlled Trial (CROSSVal)  \nChala Fekadu Oljira1  | Erik JS Packer2 | Håvard Dalen3,4,5 | Tom Roar Omdal2 | Rune Haaverstad2,6 | Adane Petros1 | Dejuma Yadeta1 | Eskindir Loha6 | Thomas Dolven7 | Hans Martin Flade3,8 | Arne Skagseth9 | Nigussie Bogale2,6  \n1Cardiology Department, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia | 2Department of Heart Disease, Haukeland University Hospital, Bergen, Norway | 3Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway | 4Clinic of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway | 5Department of Medicine, Levanger Hospital, Nord‐Trøndelag Hospital Trust, Levanger, Norway | 6University of Bergen, Bergen, Norway | 7Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway | 8Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim,  \nNorway | 9University Hospital of North Norway, Tromsø, Norway Correspondence: Chala Fekadu Oljira ([chalaf46@gmail.com](chalaf46@gmail.com))  \nReceived: 9 August 2025 | Revised: 14 October 2025 | Accepted: 10 November 2025  \nKeywords: interventional study | interventional ultrasound | percutaneous mitral commissurotomy | transesophageal echocardiography | valvular heart disease  \nABSTRACT  \nBackground: Percutaneous mitral commissurotomy (PMC) of mitral stenosis is routinely performed by the Inoue balloon technique (IBT) which may be challenging with respect to valvular crossing. Using a novel wire‐assisted method (WAM) may improve feasibility and time efficiency.  \nAims: In a randomized clinical trial, we compared the feasibility and time consumption by WAM and IBT.  \nMethods: Twenty mitral stenosis patients with a Wilkins score ≤10 were randomized 1:1 to IBT (n = 11) or WAM (n = 9) . All procedures were performed under general anesthesia and optimized by in‐field and transesophageal echocardiographic guiding. The IBT balloon catheter was inserted over the coiled wire, and the stylet was used to advance it to the mitral valve, while WAM was performed by advancing a commercially available balloon over a stiff coiled wire placed in the left ventricle. 1st endpoint was time from interatrial septal puncture to balloon inflation, and 2nd outcomes were failure to double mitral valve area or severe mitral regurgitation.  \nResults: Mean ± SD age was 28 ± 7 years (80% women) with all in NYHA class II or III. Symptom duration was median (IQR)  \n7 (4.8) years, Wilkins score was 8.8 ± 0.9, and mitral inflow gradient was 15.6 ± 4.6 mmHg. Procedural time (1st endpoint) was 14.4 ± 3.4 min and 21.8 ± 8.3 min in WAM and IBT, respectively (p = 0.020) . Three patients in each group did not double the valve area by PMC, and no procedure was complicated by severe mitral regurgitation.  \nConclusions: WAM significantly reduced the time from interatrial septal crossing to first balloon inflation during equally optimized PMC in severe mitral stenosis patients compared to IBT.  \n\n| Abbreviations: CROSSVal, trial for comparison of Wire‐Assisted Percutaneous Balloon Mitral Valvulotomy with Standard Inoue Balloon Valvulotomy; IBT, Inoue balloon technique; LA, left atrium; MS, mitral stenosis; MVA, mitral valve area; PMC, percutaneous mitral commissurotomy; TEE, transesophageal echocardiography; WAM, wire‐assisted method for percutaneous mitral commissurotomy.\u003Cbr>ClinicalTrials. gov ID NCT06150274 |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for com","cbCainxhssjGKfjD","https://ap.wps.com/l/cbCainxhssjGKfjD","pdf",2045191,"English","# Abstract\n## Background\n## Aims\n## Methods\n## Results\n## Conclusions\n# Introduction\n## Rheumatic heart disease burden\n## Evolution of percutaneous mitral commissurotomy\n## Limitations of Inoue balloon valve crossing","[{\"question\":\"What clinical question does the study address?\",\"answer\":\"The study compares feasibility and time consumption between a wire-assisted method and the Inoue balloon technique for percutaneous mitral commissurotomy in mitral stenosis.\"},{\"question\":\"How were patients and procedures organized in the trial?\",\"answer\":\"Twenty mitral stenosis patients with Wilkins score ≤ 10 were randomized 1:1 to Inoue balloon technique or wire-assisted method, with all procedures guided by in-field and transesophageal echocardiography under general anesthesia.\"},{\"question\":\"What was the primary time outcome?\",\"answer\":\"Procedural time from interatrial septal puncture to balloon inflation was shorter with the wire-assisted method than with the Inoue balloon technique (14.4 ± 3.4 min vs 21.8 ± 8.3 min, p = 0.020).\"},{\"question\":\"Did the wire-assisted method increase major safety problems?\",\"answer\":\"The trial reported no procedure complicated by severe mitral regurgitation, with no difference noted in that safety outcome between groups.\"}]","Novel Wire-Assisted Mitral Commissurotomy Reduces Valve Crossing Time Compared to Inoue-Balloon Technique - Clinical Science | PDF",1790724565,18]