[Percutaneous transvenous mitral commissurotomy in elderly patients with mitral stenosis]

Sixteen elderly patients (age > or = 60 years, elderly group) with mitral stenosis and 20 young patients (age < or = 59 years, young group) underwent percutaneous transvenous mitral commissurotomy (PTMC) by the single balloon technique. Pulmonary arterial and mean left atrial pressures, mitral valvular pressure gradient and left atrial dimension were significantly decrease in both groups after PTMC. Mitral valve areas by Gorlin formula were significantly increased from 1.14 +/- 0.40 to 1.78 +/- 0.66 cm2 in the elderly group and from 1.25 +/- 0.50 to 2.04 +/- 0.81 cm2 in the young group after PTMC. Thirteen elderly and 19 young patients became in NYHA class I or II after PTMC, and three elderly patients with early gastric cancer had the lower risk of the gastrectomies by preoperative PTMC. But, two elderly patients remained in NYHA class III or IV due to increased mitral regurgitation and late tamponade, and one elderly patient died by heart failure after PTMC. PTMC has the advantages of shorter hospitalization and lower invasion for the patients compared with surgery, therefore PTMC is an effective treatment in both elderly and young groups. Elderly patients with severe mitral stenosis have higher risk of PTMC and are needed discrete strategy.