| Long-term results of mitral commissurotomy. | |
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MedLine Citation:
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PMID: 8468997 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Between January 1968 and December 1989, 280 patients underwent conservative surgical treatment for pure mitral stenosis. Closed commissurotomy was utilized in 134 patients, with a mean age of 38 +/- 11 years and a mean valve area of 1.0 +/- 0.29 cm2. Open commissurotomy was performed in 146 older patients (mean age 44 +/- 11 years) with a mean valve area of 0.9 +/- 0.3 cm2. The perioperative mortality was 3% in closed procedures and 3.4% in open procedures. Surviving patients were evaluated by questionnaires or phone interviews, and 129 patients were examined by two-dimensional echocardiography with the purpose of analyzing long-term results. Follow-up was 95% complete (Grunkemeier-Starr method), with a median of 18 years in patients with closed commissurotomy and 6.6 years in patients with open commissurotomy. The actuarial survival at 21 years was 60.8% (70% confidence limits 55% to 66%) in patients having closed commissurotomies and 60.6% (70% confidence limits 49% to 71%) at 22 years in patients having open commissurotomies. The "effective palliation" rate, defined by clinical and echocardiographic criteria, was 47% at 15 years and 15% at 20 years. We conclude that mitral commissurotomy is the procedure of choice in pure mitral valve stenosis and should be applied early. When performed in patients aged less than 40 years, a 78% (70% confidence limits 72% to 84%) survival at 18 years and 67% "effective palliation" at 15 years were observed. The closed valvotomy results of our study support the present trend toward use of percutaneous balloon valvotomy. |
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Authors:
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D Scalia; G Rizzoli; F Campanile; P Melacini; C Villanova; A Milano; G Fasoli; A Mazzucco; D Casarotto |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 105 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 1993 Apr |
Date Detail:
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Created Date: 1993-05-13 Completed Date: 1993-05-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 633-42 Citation Subset: AIM; IM |
Affiliation:
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Istituto di Chirurgia Cardiovascolare, Università di Padova, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age Factors Aged Cardiac Surgical Procedures / methods Echocardiography Echocardiography, Doppler Female Follow-Up Studies Humans Male Middle Aged Mitral Valve Stenosis / mortality*, surgery*, ultrasonography Multivariate Analysis Postoperative Complications / mortality*, surgery*, ultrasonography Reoperation Survival Rate Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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