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Open mitral commissurotomy. A modern re-evaluation
The Journal of Thoracic and Cardiovascular Surgery
|December 1, 1980
Summary
Open mitral commissurotomy (OMC) remains a valuable treatment for mitral stenosis, offering significant long-term survival and improved patient outcomes. This review highlights OMC
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Mitral valve replacement (MVR) with prosthetic or tissue valves is common.
- Awareness of open mitral commissurotomy (OMC) usefulness has diminished.
- This study reviews a decade of OMC experience.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of open mitral commissurotomy (OMC) for pure mitral stenosis.
- To compare OMC outcomes with the prevailing practice of mitral valve replacement (MVR).
Main Methods:
- Review of 222 consecutive patients with pure mitral stenosis operated on between 1969 and 1978.
- Focus on 197 patients who underwent OMC; MVR was performed in 25 patients.
- Follow-up data collected on 191 (97%) of OMC patients.
Main Results:
- Low operative mortality (1.52%) for OMC, with 81% 10-year survival.
- 76% of OMC patients improved by at least one New York Heart Association class.
- 14 patients (7%) required subsequent MVR, with a mean follow-up of 41.6 months.
Conclusions:
- Open mitral commissurotomy is the preferred initial treatment for most patients with mitral stenosis.
- OMC offers favorable long-term survival and functional improvement.
- MVR is reserved for cases with severe valvular deformity.