Document Detail


Outcome probabilities and life history after surgical mitral commissurotomy: implications for balloon commissurotomy.
MedLine Citation:
PMID:  1987238     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From 1967 to 1988, 339 patients with mitral stenosis underwent surgical commissurotomy, 103 with a closed and 236 with an open technique. The 1 month and 1, 5, 10 and 20 year overall survival rate was 99.7%, 99%, 95%, 87% and 59%, respectively, and the technique (open versus closed) was not a risk factor. Technique was also not a risk factor for a second mitral commissurotomy, subsequent mitral valve replacement, thromboembolism or poor functional status. Risk factors were older age at commissurotomy, black race, higher pulmonary vascular resistance, mitral leaflet calcification, left ventricular enlargement and postcommissurotomy mitral incompetence. The closed technique was a risk factor for mitral incompetence immediately after commissurotomy, but important incompetence developed in only 2 of the 103 patients undergoing closed commissurotomy. Mitral valve replacement was not required within 10 years in 78% of patients and within 20 years in 47%. Despite some increased prevalence of postcommissurotomy mitral incompetence and particularly in view of the considerable long-term likelihood of mitral valve replacement, initial therapy for most patients with mitral stenosis should probably be surgical closed (or percutaneous balloon) mitral commissurotomy. The equations developed in the present study can be used to predict and compare outcome probability after percutaneous balloon commissurotomy with that after surgical commissurotomy and to compare these with outcome probability after mitral valve replacement.
Authors:
M S Hickey; E H Blackstone; J W Kirklin; L S Dean
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  17     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1991 Jan 
Date Detail:
Created Date:  1991-02-21     Completed Date:  1991-02-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  29-42     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Alabama, Birmingham School of Medicine 35294.
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MeSH Terms
Descriptor/Qualifier:
Balloon Dilatation*
Heart Valve Prosthesis
Humans
Mitral Valve / surgery*
Mitral Valve Insufficiency / epidemiology
Mitral Valve Stenosis / mortality,  surgery*
Postoperative Complications / epidemiology*
Reoperation
Risk Factors
Thromboembolism / epidemiology
Comments/Corrections
Comment In:
J Am Coll Cardiol. 1992 May;19(6):1369-70   [PMID:  1564244 ]

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


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