J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1903KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 93(9): 1016-1019, 1992

Report on the annual meeting

PERCUTANEOUS TRANSVENOUS, MITRAL COMMISSUROTOMY VERSUS OPEN MITRAL COMMISSUROTOMY

1) The Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan
2) Department of Cardiovascular Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan

Shin-ichi Momomura1), Katsu Takenaka1), Takashi Serizawa1), Masahide Chikada2), Hiroshi Kotsuka2), Hitoshi Matsunaga2), Akira Furuse2)

Effects of PTMC (percutaneous transvenous mitral commissurotomy) were evaluated retrospectively in 34 patients with mitral stenosis and compared with those of OMC (open mitral commissurotomy) in 28 patients. PTMC resulted in a decrease in transmitral pressure gradientf rom 11±6 to 6±4mmHg (p＜0.001) and an increase in cardiac index from (2.4±0.4 to 2.7±0.5L/min・m2 and mitral valve area from 1.0±0.3 to 1.7±0.4cm2 (p＜0.001). Mitral valve area remained increased (1.6±0.4cm2) after a mean follow-up period of 19±11months. Death, cerebro-vascular accident, or sever mitral regurgitation (＞III°) did not occur. NYHA class improved from 2.28±0.63 to 1.44±0.50 (p＜0.001). OMC resulted in a greater increase in mitral valve area (from 1.1±1.4 to 2.0±0.5cm2＜0.001) and greater improvement of NYHA class (2.25±0.65 to 1.11±0.34, p＜0.001). Thus OMC surpasses PTMC in hemodynamic effects and symptomatic improvement. However, PTMC may still be the first choice for the treatment of mitral stenosis because of its excellent safety and efficacy.

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