Long-term (≤50 years) results of patients after mitral valve commissurotomy—a single-center experience
| Autor: | Ralf Sodian, Klinner W, Daniel T. Reichart, Bruno Reichart, Christoph Schmitz, Rudolf Zenker |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors Kaplan-Meier Estimate Balloon Single Center Recurrence Mitral valve Germany Medicine Humans Mitral Valve Stenosis Cardiac Surgical Procedures Survival rate Retrospective Studies Heart Valve Prosthesis Implantation business.industry Retrospective cohort study Middle Aged New York Heart Association Functional Classification Surgery Survival Rate Catheter medicine.anatomical_structure Treatment Outcome Mitral Valve Female business Commissurotomy Cardiology and Cardiovascular Medicine human activities |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 143(4):S96-S98 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2011.09.064 |
| Popis: | Objective Currently, in Middle Europe, closed and open mitral valve commissurotomy (MVC) is rarely done and has been replaced by catheter-based balloon procedures. Especially under these circumstances, data on the long-term outcomes after surgical interventions are important. Methods From 1955 to 1989, 268 patients (75 male and 193 female patients) with mostly rheumatic or infectious mitral stenoses underwent closed (n = 151) or open (n = 117) surgical procedures. The mean age at surgery was 41.2 ± 11.1 years; 19 patients (7.1%) died within the first 30 days after surgery. Results The 50-year follow-up was complete for 215 patients (80.2%). The survival rate at 10, 20, and 30 years after surgery was 80.2%, 58.6%, and 41.8%, respectively. The differences after closed and open MVC were nonsignificant. At the latest follow-up, 32 patients were alive and had a mean New York Heart Association functional classification of 2.7. The 10-, 20-, and 30-year freedom from reoperation rate was 93.2%, 82.9%, and 76.0% for the closed intervention group and 88.5%, 80.3%, and 78.7% for the open intervention groups. Again, the differences were nonsignificant. The main cause for reoperation was recurrent fibrosis of the mitral valve. Most patients (n = 51) received mechanical valves, 5 a bioprothesis, and 8 repeat MVC. Four patients required a third intervention. Conclusions In Middle Europe, closed and open MVCs are now rarely performed, but the ultra-long-term results are excellent and serve as a standard for the now-established balloon valvuloplasty. MVCs remain an option for pregnant women. In third world clinical conditions, closed MVC remains a less expensive alternative. |
| Databáze: | OpenAIRE |
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