Ann Thorac Surg 1993;56:0003497593906622
© 1993 The Society of Thoracic Surgeons
Comparison of balloon valvuloplasty with operative treatment for mitral stenosis
Jeffrey M. Cohen, MHS,
Donald D. Glower, MD*,
J.Kevin Harrison, MD,
Thomas M. Bashore, MD,
William D. White, MPH,
L.Richard Smith, PHD,
J.Scott Rankin, MD,
David C. Sabiston, Jr, MD
Departments of Surgery, Medicine, and Community and Family Medicine, Duke University Medical Center, Durham, North Carolina USA
* Address reprint rcquests to Dr Glower, Department of Surgery, Duke University Medical Center, Box 3051, Durham, NC 27710.
To determine the optimal role for percutaneous balloon mitral valvuloplasty or open mitral commissurotomy, the outcome of 164 consecutive patients undergoing either percutaneous balloon mitral valvuloplasty, open mitral commissurtomy, or mitral valve replacement for mitral stenosis was reviewed. No preoperative differences existed between percutaneous balloon mitral valvuloplasty and open mitral commissurotomy in age, symptoms, or mitral valve characteristics. Symptoms improved similarly in all groups, and median hospital stays after procedures were 2, 9, and 10 days for percutaneous balloon mitral vaivuloplasty, open mitral commissurotomy, and mitrai valve replacement (p < 0.005). Actuarial survivals at 36 months did not differ significantly (83% ± 6%, 94% ± 4%, and 90% ± 4%). Actuarial freedoms from subsequent mitral valve procedures at 36 months were 66% ± 7%, 87% ± 6%, and 100% ± 13% (p < 0.005), with the linearized rate of subsequent mitral valve procedures being 12% ± 3%, 4% ± 2%, and 1.2% ± 0.8%/patient-year for percutaneous balloon mitral valvuloplasty, open mitral commissurotomy, and mitral valve replacement (p < 0.01). Prior mitral commissurotomy increased the likelihood of subsequent mitral procedures after percutaneous balloon mitral valvuloplasty from 10% ± 3% to 20% ± 7%/patient-year.
Presented in part at the Poster Session of the Twenty-ninth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, Jan 25–27, 1993.
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