Document Detail


Role of closed mitral commissurotomy for mitral stenosis: mid- and long-term surgical outcome of 36 patients.
MedLine Citation:
PMID:  15769718     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate long-term survival and valve-related complications as well as prognostic factors for mid- and long-term outcome after closed mitral commissurotomy, covering a follow-up period of 14 years. MATERIAL AND METHODS: Between 1989 and 2003, 36 patients (28 women and 8 men, mean age 28.8 +/- 6.1 years) underwent closed mitral commissurotomy at our institution. The majority of patients were in New York Heart Association (NYHA) functional class IIB, III, or IV. Indication for closed mitral commissurotomy was mitral stenosis. Closed mitral commissurotomy was undertaken with a Tubbs dilator in all cases. Median operating time was 2.5 hours +/- 30 minutes. RESULTS: After closed mitral commissurotomy, the mitral valve areas of these patients were increased substantially, from 0.9 to 2.11 cm(2). No further operation after initial closed mitral commissurotomy was required in 86% of the patients (n = 31), and NYHA functional classification was improved in 94% (n = 34). Postoperative complications and operative mortality were not seen. Follow-up revealed restenosis in 8.5% (n = 3) of the patients, minimal mitral regurgitation in 22.2% (n = 8), and grade >or=3 mitral regurgitation in 5.5% (n = 2) patients. No early mortality occurred in closed mitral commissurotomy patients. Reoperation was essential for 5 patients following closed mitral commissurotomy; 2 procedures were open mitral commissurotomies and 3 were mitral valve replacements. No mortality occurred in these patients. CONCLUSIONS: The mitral valve area was significantly increased and the mean mitral valve gradient was reduced in patients after closed mitral commissurotomy. Closed mitral commissurotomy is a safe alternative to open mitral commissurotomy and balloon mitral commissurotomy in selected patients.
Authors:
Azman Ates; Yahya Unlü; Ibrahim Yekeler; Bilgehan Erkut; Ahmet Yavuz Balci; Ahmet Ozyazicioglu; Hikmet Koçak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  8     ISSN:  1522-6662     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2005  
Date Detail:
Created Date:  2005-03-16     Completed Date:  2006-12-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E55-9     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Atatürk University School of Medicine, Erzurum, Turkey. azmanates@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiac Surgical Procedures*
Echocardiography
Female
Heart Valve Prosthesis Implantation
Humans
Longitudinal Studies
Male
Mitral Valve / physiopathology,  surgery*,  ultrasonography
Mitral Valve Stenosis / etiology,  physiopathology,  surgery*,  ultrasonography
Postoperative Period
Recurrence
Reoperation
Retrospective Studies
Rheumatic Diseases / complications
Survival Analysis
Treatment Outcome

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