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Open mitral commissurotomy. A modern re-evaluation

W L Halseth, D P Elliott, E L Walker

    The Journal of Thoracic and Cardiovascular Surgery
    |December 1, 1980
    PubMed
    Summary
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    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.

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    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.