Zia ur Rehman, Abdul Rashid, Abdul Bari, Tariq Mufti, Mohammad Rehman.
Short Term Effect of Closed Mitral Commissurotomy on Mitral Valve Area.
J Ayub Med Coll Abottabad Jan ;12(2):12-4.

Background: Closed mitral commissurotomy is still an effective procedure for milral stenosis in the third world countries. We studied the short term effect of closed instrumental mitral commissurotomy on mitral valve area in 1-16 patients. Methods: Each patient had echocardiography preoperatively, one and six months postoperative for initial valve area determination by planimetry and pressure Half time. Results: 67.7% patients were females and 32.3% were males with age range of 8 to 60 rears and mean age of 24.3 years. 89% were having pure mural stenosis and 11% having associated other lesion like mild aortic regurgitation. mild mitral regurgitation or tricuspid regurgitation. Pre-operatively 72.6% patients were in functional, Class III and 27.4% were in FC-IV. Mitral valve area ranged from 0.55-1.0 cm2 with mean of 0.9 cm2 pre-operatively which increased from 1.2 cm2 to 2.8 cm2 with mean of 2.4 cm2. This remained same after six months except in two pulmonary artery pressure ranged from 35 to 110 mmHg with mean of 5040 mmHg which dropped to 30 to 55 mmHg with mean of 358 mmHg al one month and 22 to 39 mmHg with mean of 27.7 mmHg at 6 months. Two patients could not be dilated and two patients developed acute mitral regurgitation for which they were subjected to Initial valve replacement in emergency. One patient died giving a mortality of 0.6%. Conclusions: We conclude that closed instrumental mitral commissurotomy is an effective economical and safe procedure for mitral stenosis.

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