Document Detail


Open mitral commissurotomy: fourteen- to eighteen-year follow-up clinical study.
MedLine Citation:
PMID:  8452426     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From May 1974 to December 1978, 159 patients with mitral stenosis underwent open mitral commissurotomy at our institution. Follow-up data were complete in 96.8%, with a mean follow-up of 13.7 years (range, 14 to 18 years). Preoperatively, most patients (n = 94) were in functional class III or IV. Valve calcification was found in 18 patients (11.3%), left atrial thrombosis was found in 21 (13.2%), and the subvalvular apparatus was affected in 105 (66%). When a residual insufficiency was detected during the operation, a mitral annuloplasty was performed (n = 43). There was one hospital death (0.6%) and 15 late deaths (9.5%). Actuarial survival at 15-year and 18-year follow-up is 89.4% +/- 3% and 75.2% +/- 10.8%. Fifteen patients (9.7%) had a thromboembolic episode 1 to 189 months after operation (mean, 104.3 months). Eleven patients (7%) required reoperation 3 to 183 months after operation (mean, 110.1 months). Freedom from reoperation at 18-year follow-up was 91.9% +/- 2.7%. Event-free actuarial survival at 15-year and 18-year follow-up was 73.4% +/- 4.2% and 54.3% +/- 10.5%. Most patients (n = 131) are in class I or II. Open mitral commissurotomy represents a safe surgical alternative for treating mitral stenosis, allowing a complete removal of atrial thrombosis if present. This long-term follow-up clinical study encourages us to persist in this successful surgical repair of mitral stenosis.
Authors:
J M Herrera; J L Vega; J M Bernal; J M Rabasa; J M Revuelta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  55     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-04-15     Completed Date:  1993-04-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  641-5     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Surgery, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Adolescent
Adult
Aged
Anticoagulants / adverse effects
Female
Follow-Up Studies
Hemorrhage / chemically induced
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Stenosis / mortality,  surgery*
Postoperative Complications
Retrospective Studies
Risk Factors
Thromboembolism / etiology
Chemical
Reg. No./Substance:
0/Anticoagulants

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


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