Journal Article

Late evolution of mitral commissurotomy in patients with low echocardiographic score

Luciano Rapold Souza, Pablo Maria Alberto Pomerantzeff, Carlos Manuel de Almeida Brandão, Luiz Francisco Cardoso, Luis Ramón Virgen Carrillo, Luiz Felipe Pinho Moreira, Max Grinberg and Sérgio Almeida de Oliveira

in European Journal of Cardio-Thoracic Surgery

Published on behalf of European Association for Cardio-Thoracic Surgery

Volume 26, issue 3, pages 640-645
Published in print September 2004 | ISSN: 1010-7940
Published online September 2004 | e-ISSN: 1873-734X | DOI: https://dx.doi.org/10.1016/j.ejcts.2004.05.026
Late evolution of mitral commissurotomy in patients with low echocardiographic score

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Objective: The purpose of this study was to analyze the late results with open mitral commissurotomy in patients with low echocardiographic scores and to identify variables influencing these late results. Methods: We studied 50 patients who underwent open mitral commissurotomy due to rheumatic mitral stenosis at the Heart Institute University of São Paulo Medical School. Enrolled patients had a Wilkins echocardiographic score ≤9 and a mean mitral valve area (MVA) of 0.94±0.19 cm2. Patients underwent clinical, electrocardiographic, and echocardiographic evaluations preoperatively, immediate postoperatively, at 6 months, at 12 months, and then annually for 11 years. Results: There was no hospital mortality. During 383.58 patient/years of follow-up, there were two late deaths, one related to valve disease. Actuarial survival was 94.3±4.0% at 11 years. The linearized reoperation rate was 1.3% patient/year, and the linearized thromboembolism rate was 0.8% patient/year. No patients developed endocarditis. The mean MVA was 2.50±0.44 cm2 during the immediate postoperative period, decreasing to 1.74±0.4 cm2 over 60 months (P<0.01). Although it was 1.40±0.24 cm2 at 132 months, variations observed after 60 months were not significant. In regard to MVA, patients with higher echocardiographic scores had worse late results than patients with low scores (P=0.002). Neither the grade of subvalvular apparatus involvement nor MVAs during the preoperative and immediate postoperative periods significantly influenced the late evolution of MVAs. Conclusions: Open mitral commissurotomy produces satisfactory results in patients with low echocardiographic scores.

Keywords: Commissurotomy; Mitral stenosis; Late results; Echocardiographic score

Journal Article.  3227 words.  Illustrated.

Subjects: Cardiovascular Medicine

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