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Chirurgia 2006 February;19(1):7-11

language: English

Mitral valve replacament following closed mitral valvotomy

Tulga Ulus A., Tütün U., Aksöyek A., Çiçekçioglu F., Budak B., Seren M., Fehmi Katrcoglu S.

Department of Cardiovascular Surgery Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey


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Aim. Closed mitral valvotomy (CMV) has been accepted as a surgical method to treat the mitral valve stenosis. However after the development of the percutaneous mitral valvotomy techniques, CMV has been abandoned. Baloon valvotomy techniques have recently been used for mitral stensosis. In this report we present the results of mitral valve replacament (MVR) procedures that were performed after CMV.
Methods. A total of 496 patients who had undergone MVR following CMV was recruited in our study. The analysis was carried out retrospectively from hospital records, with follow up examinations being conducted mainly at the outpatient clinic. The period between closed and open procedures was 139.7 months. Serial echocardiographical measurements were performed before and after CMV and MVR.
Results. Hospital mortality rate for MVR after CMV was% 4. Cardiac failure was the main cause of early death. Ninety months actuarial survival rate was 93.2%. Thromboembolism occured 2.1% / patient year (py), hemorrhagic complications occured 1.5% / py during the follow-up. During a mean period of 139.7 months, mitral valves progressed to restenosis following the CMV until MVR. Pulmonary artery pressure decreased both after CMV and MVR. No statistically significant difference was observed in left ventricular and left atrial diameters during the follow-up.
Conclusion. We conclude that CMV may still be considered as a usufull technique that delays the valve replacement time and offers the patients relatively well preserved myocardial function. This technique does not create any additional risk during MVR and can be accomplished with good functional outcome.

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