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Long-Term Results of Open Mitral Commissurotomy : Effects of Pathologic Features and Surgical Techniques


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Title: Long-Term Results of Open Mitral Commissurotomy : Effects of Pathologic Features and Surgical Techniques
Authors: Narimatsu, Motoharu / Takagi, Masatake / Miyagawa, Naotaka / Shibata, Ryuichiro / Hashiyada, Hiroshi / Yamada, Takafumi / Kugimiya, Toshiyasu
Issue Date: 20-Jun-1997
Citation: Acta medica Nagasakiensia. 1997, 42(1-2), p.25-29
Abstract: Of the 174 patients with mitral stenosis (MS) who underwent open mitral commissurotomy (OMC) at Nagasaki University Hospital between 1971 and 1988, the cases of the 50 pure MS patients who underwent OMC alone as the first operation were retrospectively investigated, and the indications for OMC in these MS patients were evaluated. According to the pathological features of the mitral valve (Types I-III) and operative methods used (r: radical OMC, c : conservative OMC), the patients were classified into 4 groups, groups I, IIr, IIc, and III, and we compared the changes in the mitral valve area before and after the operation and the cardiac functions and clinical status in the late postoperative period in these groups. In all groups, the mitral valve area was significantly increased in the early postoperative period, then gradually decreased, but on average it remained larger in the late postoperative period than before the operation. However, significantly larger mitral valve areas were maintained in the late postoperative period than those before the operation only in groups I and IIr. Group IIr showed the highest % increase of the valve areas in the late postoperative period. Furthermore, group IIr maintained the best NYHA cardiac function classes and the highest percentage of normal sinus rhythm on electrocardiograms in the same period. These results suggested that OMC was effective in the Types I and II MS patients, and the complete removal of subvalvular fusions with debridement of calcified foci was considered to be particularly effective for Type II patients to maintain the favorable operative effects and high quality of life for a long period.
Keywords: Open mitral commissurotomy / Mitral stenosis / Mitral restenosis / Mitral valve
URI: http://hdl.handle.net/10069/16075
ISSN: 00016055
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 42, No. 1-2

Citable URI : http://hdl.handle.net/10069/16075

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