Transesophageal Echocardiographic Guidance of Closed Mitral Commissurotomy

1993 ◽  
Vol 6 (3) ◽  
pp. 332-334 ◽  
Author(s):  
Gerald I. Cohen ◽  
Paul N. Casale ◽  
Bruce W. Lytle ◽  
James D. Thomas
Keyword(s):  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy

Role of Closed Mitral Commissurotomy for Mitral Stenosis: Mid- and Long-term Surgical Outcome of 36 Patients

2005 ◽  
Vol 8 (1) ◽  
pp. 55 ◽  
Author(s):  
Azman Ates ◽  
Yahya �nl� ◽  
Ibrahim Yekeler ◽  
Bilgehan Erkut ◽  
Yavuz Balci ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Stenosis ◽  
Operating Time ◽  
Term Survival ◽  
Long Term Outcome ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy

Purpose: To evaluate long-term survival and valve-related complications as well as prognostic factors for mid- and long-term outcome after closed mitral commissurotomy, covering a follow-up period of 14 years. Material and Methods: Between 1989 and 2003, 36 patients (28 women and 8 men, mean age 28.8 6.1 years) underwent closed mitral commissurotomy at our institution. The majority of patients were in New York Heart Association (NYHA) functional class IIB, III, or IV. Indication for closed mitral commissurotomy was mitral stenosis. Closed mitral commissurotomy was undertaken with a Tubbs dilator in all cases. Median operating time was 2.5 hours 30 minutes. Results: After closed mitral commissurotomy, the mitral valve areas of these patients were increased substantially, from 0.9 to 2.11 cm2. No further operation after initial closed mitral commissurotomy was required in 86% of the patients (n = 31), and NYHA functional classification was improved in 94% (n = 34). Postoperative complications and operative mortality were not seen. Follow-up revealed restenosis in 8.5% (n = 3) of the patients, minimal mitral regurgitation in 22.2% (n = 8), and grade 3 mitral regurgitation in 5.5% (n = 2) patients. No early mortality occurred in closed mitral commissurotomy patients. Reoperation was essential for 5 patients following closed mitral commissurotomy; 2 procedures were open mitral commissurotomies and 3 were mitral valve replacements. No mortality occurred in these patients. Conclusions: The mitral valve area was significantly increased and the mean mitral valve gradient was reduced in patients after closed mitral commissurotomy. Closed mitral commissurotomy is a safe alternative to open mitral commissurotomy and balloon mitral commissurotomy in selected patients.

scholarly journals Mitral valve restenosis after closed mitral commissurotomy: case discussion

2019 ◽  
Vol 11 (8) ◽  
pp. 3659-3671
Author(s):  
Anyi Xu ◽  
Jiang Jin ◽  
Xiaodong Li ◽  
Jian Xiao ◽  
Peng Zhu ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Case Discussion ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy

scholarly journals Closed Mitral Commissurotomy for Mitral Stenosis

1968 ◽  
Vol 167 (5) ◽  
pp. 796-800 ◽  
Author(s):  
C. Rollins Hanlon ◽  
George C. Kaiser ◽  
J. Gerard Mudd ◽  
Vallee L. Willman
Keyword(s):  
Mitral Stenosis ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy

scholarly journals A new instrument for closed mitral commissurotomy: 10 years' experience

Thorax ◽  
1971 ◽  
Vol 26 (4) ◽  
pp. 486-487 ◽  
Author(s):  
S. Sancho-Fornos ◽  
B. N. Arnau
Keyword(s):  
New Instrument ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy

scholarly journals Intraoperative Transesophageal Echocardiography in Nepal

2003 ◽  
Vol 2 (2) ◽  
pp. 20-25
Author(s):  
Arun Maskey ◽  
Deewakar Sharma ◽  
Man Bahadur KC ◽  
Sujeeb Rajbhandari ◽  
Jyotindra Sharma ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Transesophageal Echocardiography ◽  
Mitral Valve Repair ◽  
Open Repair ◽  
Valve Repair ◽  
Intraoperative Evaluation ◽  
Intraoperative Transesophageal Echocardiography ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy ◽  
Annular Tear

Intraoperative transesophageal echocardiography is an important tool for intraoperative evaluation of mitral valve repair. A total of 29 patients who underwent intraoperative transesophageal (TEE) between 25th June, 2001 to 30th Dec, 2002.at Shahid Gangalal National Heart Centre, Kathmandu were studied. The age ranged from 14 to 48 years with mean age of 30 years. There were 11 male and 18 female patients. Twenty three patiants had mitral valve repair for Severe mitral regurgitation, which was successful in 15 patients and rest underwent prosthetic valve replacement. Five patients had undergone closed mitral commissurotomy with 4 patients having successful dilatation and 1 patient had annular tear which was converted to open repair with mitral valve ring. One patient had huge aortic aneurysm which was successfully repaired. TEE has been proven to be extremely useful in intraoperative evaluation of mitral valve repair and may help to a timely raintervention, if needed. This is the first study of intraoperative transesophageal achocardiography in Nepal.

scholarly journals Comparison between Total Echo Score and Total Commissural Morphology Score for the Outcome and Complication of Balloon and Surgical Closed Mitral Commissurotomy

1970 ◽  
Vol 1 (1) ◽  
pp. 34-43
Author(s):  
AK Choudhury ◽  
S Alam ◽  
GM Faruque ◽  
M Ali ◽  
NAM Momenuzzaman ◽  
...  
Keyword(s):  
Mitral Stenosis ◽  
Statistical Significance ◽  
Nyha Class ◽  
Technical Failure ◽  
Significant Difference ◽  
Class 1 ◽  
Procedural Complications ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy ◽  
The Individual

Background: Now a days mitral balloon valvoplasty(PTMC) is an alternative to closed surgical mitral commissurotomy (CMC) for the treatment of selectcd patients with rheumatic mitral stenosis. To compare between the total echo score (Wilkin’s score) total echocardiographic commissural morphology score (TC) for outcome and as a predictors of complications of both procedures. Method: We carried out a prospective well matched comparative observational study on 123 patients of symptomatic mitral and three patients were rejected due to procedural complications and technical failure. Result: Age ranges were 12 55 years, mean (±SD) age was 28.83+9.33 years. Out of 120 patients, 41 (34.2%) were male and 79 (65.8%) were female. Before procedure, 29 (48.3 %) and 32 (53.3 %) patients were in NYHA class III.Total Wilkins score was in the range of 4 10. Mean (±SD) of total Wilkins score were 6.43+1.53 and 6.30+1.33. Good commissural morphology (score 0 1) were present in 38 (63.5%) and 36 (60%) and bad commissural morphology (score 2 3) were present in 22 (26.7 %) and. 24 (40 %) in both groups respectively. Mitral valve area increased from a mean (±SD) of 0.80±0.16 and 0.79±0.15 to 1.94 ±0.24 and 1.92 + 0.26cm2. in PTMC and CMC groups respectively. Transmitral mean and peak pressure gradient also decreased significantly in both the individual procedures but no statistically significant difference between the procedures. NYHA class improved by class 1 or more in most patients in both groups. There were 2 (3.33 %) cases of cardiac temponade due cardiac perforation in PTMC group, of which one need repair and CMC and another was managed conservatively. There were also 3 (5 %) patients in PTMC and I (1. 66 %) patient in CMC developed peripheral thromboembolism and one patient (1.66%) developed arteriovenous fistula in PTMC group. Mitral regurgitation grade III, developed in 3 (5%) patients and one patient (1.66%) in PTMC and CMC respectively having no statistical significance. Conclusion: Total Wilkin’s score and total commissural morphology score were found to be most important preprocedural variable associcated with the outcome and as a predictors of post procedural complications Keywords: PTMC, CMC, Mitral stenosis, Rheumatic heart diseaseDOI: http://dx.doi.org/10.3329/cardio.v1i1.8202 Cardiovasc. j. 2008; 1(1) : 34-43

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