Document Detail

Closed mitral valvotomy: early results and long-term follow-up of 3724 consecutive patients.
MedLine Citation:
PMID:  6616794     Owner:  NLM     Status:  MEDLINE    
Between 1956 and 1980 closed mitral valvotomies were performed in 3724 consecutive patients (male:female ratio 1.1:1) with mitral stenoses. Their ages ranged from 6 to 69 years, with a mean (SD) of 27.3 (9.3). Mitral stenosis in the younger age group is a unique condition and a great majority of these patients rapidly develop significant pulmonary hypertension and congestive cardiac failure. In this study a large number of subjects belonged to functional class IV (41.5%). Hospital mortality was 1.5% over the last 5 years. After valvotomy, 11 patients (0.3%) developed severe mitral regurgitation that made valve replacement necessary in the immediate postoperative period. Early postoperative embolism occurred in 0.4% of those who were in atrial fibrillation and had preoperative anticoagulation whereas it occurred in 0.95% of those in sinus rhythm who had no anticoagulation. Late postoperative embolism occurred at a rate of 0.3 to 1.6 per 1000 patients per year over a 20 year period. Rheumatic reactivity occurred at a rate of 1.3 to 2.2 per 1000 patients per year during the same period. Rate of occurrence of restenosis varied from 4.2 to 11.4 per 1000 patients per year between the fifth and fifteenth year of follow-up. Closed transventricular revalvotomy for restenosis was accomplished in 130 subjects with a 6.7% mortality. Excellent symptomatic improvement was evident in 86% of long-term survivors at the end of 15 years. Actuarial survival was 95%, 93.1%, 89.5%, and 84.2% at 6, 12, 18, and 24 years, respectively, after closed mitral valvotomy.(ABSTRACT TRUNCATED AT 250 WORDS)
S John; V V Bashi; P S Jairaj; S Muralidharan; E Ravikumar; T Rajarajeswari; S Krishnaswami; I P Sukumar; P S Rao
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  68     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1983 Nov 
Date Detail:
Created Date:  1983-11-23     Completed Date:  1983-11-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  891-6     Citation Subset:  AIM; IM    
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MeSH Terms
Actuarial Analysis
Follow-Up Studies
Middle Aged
Mitral Valve / surgery
Mitral Valve Insufficiency / etiology
Mitral Valve Stenosis / mortality,  surgery*
Postoperative Complications / mortality
Pulmonary Embolism / etiology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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