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Closed mitral valvotomy for mitral restenosis: experience in 113 consecutive cases
R K Suri1, R Pathania, N K Jha
1Department of Cardiovascular & Thoracic Surgery, Postgraduate Institute of Medical Education and Research Chandigarh, India.
The Journal of Thoracic and Cardiovascular Surgery
|September 1, 1996
Summary
Closed mitral revalvotomy is an economical, simple, and safe procedure for treating mitral restenosis in patients with rheumatic heart disease, offering good long-term results and symptomatic improvement.
Area of Science:
- Cardiology
- Cardiac Surgery
- Rheumatic Heart Disease
Background:
- Mitral stenosis in nonindustrialized countries is often caused by rheumatic heart disease.
- High costs and anticoagulation issues limit prosthetic valve replacement options.
- Young patient age necessitates native valve preservation, making closed mitral valvotomy a preferred approach.
Purpose of the Study:
- To evaluate the 10-year experience with closed transventricular revalvotomy for mitral restenosis.
- To assess the safety, efficacy, and long-term outcomes of this palliative procedure.
Main Methods:
- A consecutive series of 113 patients with mitral restenosis underwent closed transventricular revalvotomy using a Tubbs dilator.
- Patient demographics, functional status (New York Heart Association classes), procedural details, and outcomes were recorded.
Main Results:
- The mean age was 34 years; 74.3% and 19.4% were in NYHA functional classes III and IV.
- Hospital mortality was 2.8%, with 16.1% experiencing trivial and 1.9% moderate-to-severe mitral regurgitation.
- Early systemic embolism occurred in 3.8%, while 89.4% showed moderate to excellent symptomatic improvement.
Conclusions:
- Closed mitral revalvotomy is an economical, simple, and safe palliative procedure for mitral restenosis.
- The procedure offers good long-term symptomatic relief and functional improvement, with acceptable complication rates.