Comparison between the Inoue (IN) versus the double-balloon (DB) systems
		Inoue-Balloon System		Double-Balloon System		Practical Comments
		Easy to use, steeper		Harder to use, technically		IN advantageous where
		learning curve, technically less demanding. Short balloon, flexible tip, self-seating, no LV wiring. Steerable tip. Stepwise dilatation, allows LA hemodynamic measurements. 12F dilator to enlarge IAS, short balloon. Expensive.		demanding. Long balloon, stiff tip, not self-positioning, LV wiring mandatory. Non-steerable tip. "All or none" dilatation, cannot measure LA pressure. 5-8mm balloon to dilate IAS, long balloons. Much cheaper.		radiation exposure and speed are critical. DB has higher risk of LV perforation and failure. IN safer to use in presence of LAA thrombus and severe subvalvular disease. IN safer in presence of adverse valve anatomy and baseline moderate MR. Larger ASD with DB. DB advantageous when cost is a major factor.
* Coming Soon		ASD, atrial septal defect; IAS, interatrial septum; LA, left atrial; LAA, left atrial appendage; LV, left ventricle; MR, mitral regurgitation.
		© 2002-2003 Dr. Jui-Sung Hung. All Rights Reserved. Questions or Comments? Email shung@pipeline.com.