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Long-term evolution of mitral commissurotomy in rheumatic patients with low echocardiographic score

Luciano Rapold Souza1, Carlos Manuel de Almeida Brandão, Pablo Maria Alberto Pomerantzeff

  • 1Faculdade de Medicina da Universidade de São Paulo, Cirurgia Cardiovascular do Hospital Português de Salvador, Salvador, BA, Brasil. uciano.rapold@ig.com.br

Revista Brasileira De Cirurgia Cardiovascular : Orgao Oficial Da Sociedade Brasileira De Cirurgia Cardiovascular
|November 17, 2011
PubMed

Insights

Open mitral commissurotomy shows excellent long-term survival and freedom from major adverse events in selected rheumatic mitral stenosis patients. Echocardiographic score selection is key for optimal outcomes in this procedure.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Rheumatic Heart Disease Management

Background:

  • Open mitral commissurotomy (OMC) is a known treatment for rheumatic mitral stenosis.
  • Echocardiographic scoring may identify patients who benefit most from OMC.

Purpose of the Study:

  • To evaluate the long-term outcomes of OMC in patients selected by echocardiographic score.
  • To identify factors influencing these outcomes.

Main Methods:

  • Fifty patients with rheumatic mitral stenosis underwent OMC between 1990 and 1994.
  • Inclusion criteria included age < 60 years, NYHA functional class II-IV, and echocardiographic score ≤ 9.
  • Follow-up extended to 18 years.

Main Results:

  • No hospital mortality was observed.
  • Actuarial survival was 95.5%, with 62.3% freedom from reoperation and 88.2% freedom from thromboembolism at 18 years.
  • Echocardiographic score grade did not significantly impact reoperation rates.

Conclusions:

  • OMC yields excellent long-term results in carefully selected rheumatic mitral stenosis patients.
  • Low echocardiographic scores are associated with favorable long-term outcomes after OMC.
Abstract

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