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Repeat mitral commissurotomy: long-term results.

W A Peper, B W Lytle, D M Cosgrove

    Circulation
    |September 1, 1987
    PubMed
    Summary
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    Repeat open mitral commissurotomy (OMC) offers excellent long-term survival for eligible patients. This reoperation provides good freedom from further mitral valve surgery, demonstrating its long-term efficacy.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Thoracic Surgery

    Background:

    • Mitral stenosis often requires surgical intervention.
    • Repeat open mitral commissurotomy (OMC) is an option for patients with recurrent or persistent mitral stenosis.
    • Long-term outcomes of repeat OMC are not well-established.

    Purpose of the Study:

    • To evaluate the long-term survival and reoperation-free survival after repeat open mitral commissurotomy (OMC).
    • To assess the feasibility and outcomes of repeat OMC in patients with prior mitral valve surgery.

    Main Methods:

    • Retrospective analysis of 53 patients undergoing repeat OMC.
    • Data collection included in-hospital outcomes, late mortality, and subsequent mitral valve interventions.
    • Kaplan-Meier survival analysis was used to determine survival and reoperation-free survival rates.

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    Main Results:

    • One in-hospital death (1.9%) occurred among 53 patients.
    • Long-term survival rates at 5, 10, and 15 years were 96%, 83%, and 63%, respectively.
    • Reoperation-free survival rates at 5, 10, and 15 years were 94%, 74%, and 52%, respectively. Sixteen patients required subsequent mitral valve surgery.

    Conclusions:

    • Repeat OMC is a viable option for selected patients with mitral stenosis, offering excellent long-term survival.
    • Repeat OMC can provide significant freedom from prosthetic valve replacement.
    • Patient age, functional class, and rhythm did not correlate with survival or reoperation-free survival in this cohort.