thiết bị có thể được tái sử dụng nhiều lần mà không có bất kỳ tổn thất thực hiện sau khi resterilization thích hợp, do đó làm giảm chi phí thủ tục. Các mục tiêu khác để nâng cao hiệu quả và độ dung sai kỹ thuật từ tính chất cơ học | 524 Practical Handbook of Advanced Interventional Cardiology device that could be reused several times without any loss of performance after proper resterilization thus decreasing the procedural cost. Other goals were to improve the efficacy and tolerance of the technique resulting from the device s mechanical properties which are aimed at acting principally on the mitral commissures. The technical aspects of the procedure and the results of an international multicenter registry including 1087 patients will be presented here. DESCRIPTION OF THE DEVICE The device Medicorp Inc Nancy France consists of a metallic dilator screwed on the distal end of a disposable catheter. The entire system consists of four components Figs 25-1 and 25-2 The stainless steel metallic dilator is a cylinder 5 cm long and 5 mm wide with a slightly tapered tip Figure 25-1 . Its distal half comprises 2 bars 20 mm in length that can be opened in parallel up to a maximum length of 40 mm using a lever arms system Figure 25-2 . An internal lumen allows the passage of a guidewire and the recording of the distal pressures. The metallic head is screwed on the distal end of the catheter and is detachable. The catheter has a diameter of 13F mm and a length of 170 cm. Its proximal end has a connector for recording Figure 25-1 A Distal part of the guidewire. Note the metallic bead soldered at the junction of the stiff proximal and flexible and pigtail curved distal segments of the wire. B Distal end of the catheter and metallic dilator before connection. C The dilator screwed at the extremity of the catheter. D The dilator in the opened 40 mm position. Percutaneous Mechanical Mitral Commissurotomy 525 Figure 25-2 Proximal end of the catheter and activating pliers. the distal pressures and it enables the connection of the activating pliers. Its distal end enables the fastening of the dilator. The metallic guidewire has a length of 270 cm and a diameter of A metallic bead of 2 mm in .
