IMMEDIATE RESULTS OF PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY AND OPEN MITRAL VALVOT0MY: A RANDOMIZED COMPARATIVE STUDY

Abstract

Rheumatic mitral stenosis is a common disease in our country. Surgical closed and open mitral valvotomy were the only options available before the advent of percutaneous balloon valvuloplasty by Inoue in 1984.

Many studies were done before to compare the outcome ofPBMV and closed mitral valvotomy. The superiority of open mitral valvotomy over PBMV or the ability of the later to offer comparable outcome like that of open mitral valvotomy, is still controversial.

The aim of our study was to compare the PBMV with OMV as regards efficacy, complications, outcome and its predictors to find out which of them will be the treatment of choice and to identify the best candidates for each procedure.

This study included 80 patients who presented to our cardiology department and were suffering from rheumatic mitral stenosis. The study included those patients with symptomatic mitral stenosis (NYHA Class II) with Doppler mitral valve area (<1.5 cm2). Associated mitral incompetence (not more than angiographic grade I) was accepted. Echocardiographic score of all patients was < 11. They were randomized to PBMV and OMV. Echocardiographic study was done before and after the procedure in all patients. • TEE was performed for all patients who underwent PBMV prior to the procedure and it was done intraoperatively for all patients of surgery groups

after offing the extracorporeal circulation. Right and left cardiac catheterization