Open mitral commissurotomy: long-term results with echocardiographic correlation

Area of Science:

• Cardiology
• Cardiac Surgery
• Echocardiography

Background:

• Mitral stenosis is a significant valvular heart disease.
• Open mitral commissurotomy is a primary surgical treatment option.
• Long-term outcomes and predictors of success require further investigation.

Purpose of the Study:

• To evaluate the long-term outcomes of open mitral commissurotomy for isolated mitral stenosis.
• To identify factors influencing survival and functional status post-procedure.
• To assess the correlation between echocardiographic mitral valve area and clinical outcomes.

Main Methods:

• Retrospective analysis of 91 patients undergoing open mitral commissurotomy over 11 years.
• Follow-up ranging from one to nine years (average: five years).
• Assessment of perioperative mortality, actuarial survival, functional class (NYHA FC), embolic events, reoperations, and complication-free status.
• Echocardiographic measurements of mitral orifice area in a subset of patients.

Main Results:

• Perioperative mortality was 4.4%.
• Actuarial survival was 94% at 5 years.
• 79% of patients achieved NYHA FC I or II at follow-up.
• 76% were complication-free at 5 years.
• Mitral orifice area ≥ 2 cm² on echocardiography correlated with good functional outcomes (FC I).

Conclusions:

• Open mitral commissurotomy offers favorable long-term survival and functional improvement in isolated mitral stenosis.
• Age, sex, prior commissurotomy, and surgical technique did not significantly impact outcomes.
• Echocardiographic mitral valve area is a reliable predictor of successful surgical results.