1982 年 Kanji Inoue 首創 Inoue balloon 擴張心臟風濕、性二尖瓣狹窄(percutaneous mitral valvuloplasty, PTMV)，洪瑞松教授當時由台灣長庚醫院開始，全國推廣此新技術，並到全世界各大心臟學會演講並臨 床示範教學，宣揚成功經驗。洪教授早期219位心臟風濕性二尖瓣狹窄(PTMV)病患，年齡平均43歲。 133位(61°/〇)呈現心房顫動，59位(27°/〇)同時併有1 +〜2 + Mitral regurgitation。只有在初期經驗有三位擴 張失敗，完全沒有心包膜填塞或緊急開刀，只有一例因造成3 +二尖瓣閉鎖不全(mitral regurgitation, MR) 住院中死亡。心臟風濕、性二尖瓣狹窄(PTMV)後最主要血行力學數據變化為Mean肺動脈(pulmonary artery, PA) Pressure 39.7 士 13.0 降到 30.6 士 0.9mmHg，MV gradient 從 13.0 士 5.0 降到 5.7 士 2.6mmHg，二尖瓣開口 面積(mitral valve area, MVA)由1.0 士 0.3增到2.0 士 0.7cm2。追踪3-4年，91%(205位)仍存活且無重大事件 變化。統計文獻長期觀察心臟風濕性二尖瓣狹窄(PTMV)後10-15年，無任何重大事件變化之存活率高達 40-70%，但術後造成重度二尖瓣閉鎖不全(MR)之預後較差。一般3-10年後，有10-30%病患二尖瓣膜會 再狹窄，需再度進行心臟風濕性二尖瓣狹窄(PTMV)或開刀治療。過去25年風濕性二尖瓣狹窄，使用Inoue balloon進行氣球擴張是一種相當安全有效的全球性治療方式。台灣早期經驗證實，有經驗之技術熟練團 隊，慎選病人作心臟風濕性二尖瓣狹窄(PTMV)，低風險且能保持長短期臨床療效。

Percutaneous transvenous mitral valvuloplasty (PTMV)with Inoue balloon, introduced in 1982 by K. Inoue, has created a new dimension in the treatment of patients with mitral stenosis. Extensive clinical data have demonstrated this minimally invasive, non-surgical procedure to be a safe and effective therapy in patients with mitral stenosis and is equivalent to or even better than surgical commissurotomy. Wilkin echo score is important for selecting the suitable patients with a mobile, pliable, non-calcified and non-thickened valve, and for prediction of excellent acute results. Taiwan is one of the pioneer country in this field. Since 1987, Professor Hung JS has performed a lot of live demonstrations here and worldwide. Following his standard technique and strategy, many centers (including Chang Gung & Shin Kong teams) have proved PTMV to be a treatment of choice with high success (>99%) and low complication rate (< 1%). In our experience with successful balloon dilatation, there is generally a twofold increased in the mitral valve are (MVA) > 2cm2 and an associated dramatic fall in MV gradient ( < 5mmHg) and pulmonary artery pressure (less than 30%). Over the past 25 years, PTMV has shown good immediate and long-term (70% event-free survival after 10 years) clinical results, when performed by fixed, experienced teams.