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The Annals of Thoracic Surgery, Vol 55, 641-645, Copyright © 1993 by The Society of Thoracic Surgeons
JM Herrera, JL Vega, JM Bernal, JM Rabasa and JM Revuelta
From May 1974 to December 1978, 159 patients with mitral stenosis underwent
open mitral commissurotomy at our institution. Follow-up data were complete
in 96.8%, with a mean follow-up of 13.7 years (range, 14 to 18 years).
Preoperatively, most patients (n = 94) were in functional class III or IV.
Valve calcification was found in 18 patients (11.3%), left atrial
thrombosis was found in 21 (13.2%), and the subvalvular apparatus was
affected in 105 (66%). When a residual insufficiency was detected during
the operation, a mitral annuloplasty was performed (n = 43). There was one
hospital death (0.6%) and 15 late deaths (9.5%). Actuarial survival at
15-year and 18-year follow-up is 89.4% +/- 3% and 75.2% +/- 10.8%. Fifteen
patients (9.7%) had a thromboembolic episode 1 to 189 months after
operation (mean, 104.3 months). Eleven patients (7%) required reoperation 3
to 183 months after operation (mean, 110.1 months). Freedom from
reoperation at 18-year follow-up was 91.9% +/- 2.7%. Event-free actuarial
survival at 15-year and 18-year follow-up was 73.4% +/- 4.2% and 54.3% +/-
10.5%. Most patients (n = 131) are in class I or II. Open mitral
commissurotomy represents a safe surgical alternative for treating mitral
stenosis, allowing a complete removal of atrial thrombosis if present. This
long-term follow-up clinical study encourages us to persist in this
successful surgical repair of mitral stenosis.
ARTICLES
Open mitral commissurotomy: fourteen- to eighteen-year follow-up clinical study
Cardiovascular Surgery, Hospital Universitario Marques de Valdecilla, Universidad de Cantabria, Santander, Spain.
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