There are two main methods for determining the appropriate balloon size for percutaneous balloon mitral valvuloplasty (BMV): 1) An empirical formula based on the patient's height or 2) Choosing size based on the maximal inter-commissural distance of the mitral valve as measured by echocardiography. While height-based formulas are commonly used, they have limitations since differences in body habitus are not accounted for. Measurement of the maximal inter-commissural distance via echocardiography is considered a more accurate method for determining balloon size and may provide better outcomes.

1. BALLOON SIZING FOR PBMV

2. INTRODUCTION
• Percutaneous balloon mitral valvuloplasty (BMV) is an important option
for the treatment of mitral valve stenosis. The crux of this process is
choosing the appropriate Inoue balloon size. There are two methods to
do this. One is an empirical formula based on the patient’s height, and
other is to choose according to the maximal inter-commissural distance
of the mitral valve provided by echocardiography

3. BASED ON HEIGHT
• Inflated balloon catheter diameter
based on the height of the patient
[size = 0.1 × height (cm) + 10]
• Lau KW, Hung JS. A simple balloon-
sizing method in Inoue-balloon
percutaneous transvenous mitral
commissurotomy. Cathet Cardiovasc
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balloon mitral commissurotomy:
impact of operator experience and
evolving technique. Am Heart J 1999;
138(1 Pt 1): 114–121.

4. LIMITATION OF FORMULA BASED ON HEIGHT
• Differences between body habitus, heart orientation and configuration
of the cardiac skeleton are combined to calculate balloon diameter
using a height-based formula. Therefore, different results can be
obtained, even in patients with the same height

5. BASED ON MITRAL COMMISSURE LENGTH
• Echo based
• The maximal inter-commissural
distance in the parasternal short-axis
view from the anterolateral to
posteromedial commissures in mid-
diastole
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valvuloplasty – a new method for balloon sizing based on
maximal commissural diameter to improve procedural
results. Am Heart Hosp J 2010; 8(1): 29–32
3. Ahmet Tastan, Ali Ozturk, Omer Senarslan, Erdem Ozel,
Samet Uyar, Emin Evren Ozcan, Omer Kozan. Comparison of
two different techniques for balloon sizing in percutaneous
mitral balloon valvuloplasty:which is preferable? DOI:
10.5830/CVJA-2015-062

6. THANK YOU
• An alternative path may be safer