Restenosis of the Mitral Valve: Surgical Considerations and Results of Operation

John, Stanley; Perianayagam, W J; Abraham, K A; Jairaj, P. S.; Krishnaswami, S; Sukumar, I P; Cherian, G

doi:10.1016/s0003-4975(10)63548-5

Cited by 26 publications

(3 citation statements)

References 19 publications

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“…Halseth and Smith :9 , 23) reported OMC reoperation rate s above 10 % for the same period of time , i.e., twice as high as the rate s for our group with CMC (4.2 %). In agreement with other investigators ( 10,11), the reope rations in our group could be characterized as early reoperations. Our evaluation of patients with MVR showed that reoperations occurred on an average of 10 to II years after CMC, with peaks aft er 3 years (early reoperations) and after more than 13 years (late reoperation s).…”

Section: Discussionsupporting

confidence: 93%

Late Results after Tubbs Closed Mitral Commissurotomy

Huth¹,

Schmidt²,

Seboldt³

et al. 1983

Thorac cardiovasc Surg

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At present, the closed t ransventricular mit ral co mmiss uro tomy wit h th e Tubbs d ilat or is a controversial proce du re. Its critics charge unsatisfact ory result s and early reo peratlons. Th e risk assoc iated with op en mitral co mmissuro t omy. however. may we ll b e high er t ha n th at associated wit h th e clos ed pr oce du re ; mitr al valve replacement is also ofte n necessary. even in pure mit ral stenosis. One hun dre d sixty-eight pat ient s who underwen t a Tu bbs op eration bet ween 1970 and 1979 were surveyed at least one year. and an average of 4 .5 years, aft er surgery. Eight pat ients (4 .8%) were lost to follow-up beca use t hey co uld not be located. Early mortality was 3 .0 %; late mo rtalit y, 5.4 % (9 pat ien ts died after the fo llow-up st udy was co nclude d). The total reop eratlon rat e was 4 .1 %, l.e., 1.0 % per pat ient year. The survival rate was det ermined wit h the actuarial meth od of Berkson and Gage as mod ified by Anderson and co-wo rkers. The 7-year survival rate was 9 1 % and th e t n-veer surival rate 84 %. This rate diffe rs apout as much fro m a norm al popul atio n as th e early mortality rate, bu t it is co nsiderab ly higher than t hat for a group of conservati vely t reat ed patien ts. Th irty percent , or more , of t he patients , had improv ed at least one class acco rding to the New York Heart Associati on Classificat ion afte r 10 yea rs; 15 % slipped below t heir preoperative class. Forty-two percent of the pat ients repor ted th eir conditio n as st ill improved afte r 10 years; 26 % considere d their co ndition to have deteriorated.

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Section: Discussionsupporting

confidence: 93%

Late Results after Tubbs Closed Mitral Commissurotomy

Huth¹,

Schmidt²,

Seboldt³

et al. 1983

Thorac cardiovasc Surg

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“…It is estimated that about 10-30% of patients developed restenosis 5-10 years after an initial successful surgical commissurotomy. 2 The efficacy of Percutaneous balloon mitral valvuloplasty (BMV) in patients with unoperated mitral stenosis has been well documented though there exists less clear-cut data on its effectiveness in patients with mitral restenosis following closed mitral commissurotomy (CMC). Therefore, in this study, we analyzed our results obtained with balloon mitral valvuloplasty in patients with mitral restenosis after previous surgical commissurotomy.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous mitral balloon valvuloplasty in patients with previous surgical mitral commissurotomy

et al. 2009

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This prospective observational study was done in National Institute of Cardiovascular Diseases and hospital Dhaka, during the period April 2002 to July 2008. In this study the immediate results of balloon mitral valvuloplasty with mitral restenosis patients with previous surgical mitral commissurotomy was evaluated. We have done 50 cases of percutaneous balloon mitral valvuloplasty in patients who had the history of previous surgical commissurotomy. Out of these 50 patients 8 patients were male and 42 patients were female. The age range was 25-55 years with duration of surgical commissurotomy (SC) of 2-18 years past. The result of balloon mitral valvuloplasty (BMV) was successful in 48 cases and failed in 2 cases due to huge left atrium, balloon did not negotiate from LA to LV. Mitral valve area (MVA) before the procedure was 0.5-0.9 sq cm with mean 0.7± 2 sq cm. Following procedure the MVA was 1.6-2.04 cm2 with a mean of 1.8±0.2 cm2. Gradient across mitral valve (MV) before and after the procedure was 20-44 mm Hg with a mean of 32±-12 mm Hg and 8-12 mmHg with a mean of 10±2 mm Hg. MVA >1.8 cm2 was achieved in 41 cases &1.8-1.6 cm2 in 7 cases. Mitral regurgitation >1 grade occurred in 8 cases. So we conclude that BMV in patients with mitral restenosis following SC can be performed successfully with low risk of major cardiac complications. Key words: Surgical commissurotomy (SC), balloon mitral valvuloplasty (BMV) doi: 10.3329/uhj.v5i1.3433 University Heart Journal Vol. 5, No. 1, January 2009 9-12

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“…It is estimated that about 10% to 30% of patients have developed restenosis 5 -10 years after initial successful surgical commissurotomy [2].…”

Section: Introductionmentioning

confidence: 99%

Mitral Valve Commissurotomy: Which One between the Three Techniques Gives a Better Long-Team Outcome?

Aithoussa¹,

Atmani²,

Abetti³

et al. 2017

WJCD

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Objective: we sought to compare long-term results of three techniques: CMC, OMC and PMC in patients with rheumatic mitral stenosis. Patients and Method: Between January 1994 and December 2015, 183 patients underwent mitral valve surgery for rheumatic mitral restenosis. All patients were investigated by echocardiography-Doppler performed by a senior cardiologist. The patients were divided into 3 groups: patients who have previously closed mitral commissurotomy (CMC n = 101), patients with previously open mitral commissurotomy (OMC n = 28) and those treated by Balloon mitral valvuloplasty (PMC = 54). Results: The three groups were comparable in term of major demographic data. Mitral restenosis occurred precociously in groups treated by PMC (7 ± 4 years), followed by group with OMC 11.4 ± 4 years and CMC group but it occurred later CMC 16.8 ± 7.8 years (p < 0.01). No statistical difference was found in perioperative and postoperative data. Conclusion: CMC produces better long-term outcome than OMC and PMC. However, it would be premature to conclude to its superiority.

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Restenosis of the Mitral Valve: Surgical Considerations and Results of Operation

Cited by 26 publications

References 19 publications

Late Results after Tubbs Closed Mitral Commissurotomy

Late Results after Tubbs Closed Mitral Commissurotomy

Percutaneous mitral balloon valvuloplasty in patients with previous surgical mitral commissurotomy

Mitral Valve Commissurotomy: Which One between the Three Techniques Gives a Better Long-Team Outcome?

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