Ferrera E, Enríquez O, Santander C, Olmos A, Gyhra A
Rev Med Chil. 1989 Oct;117(10):1108-14.
We reviewed the clinical and hemodynamic findings in 52 patients undergoing open mitral commisurotomy. 85% were female and the mean age was 31 + 9 years. Before operation 21% were in functional class II, 73% in class III and 56% in class IV. Pure mitral stenosis was found in 61% and congestive heart failure in 42%. The mitral valve area was less than 1 cm2 in 61%, the wedge pressure over 25 mmHg in 59% and the pulmonary artery systolic pressure over 50 mmHg in 59%. There was no operative morbidity in 79% of cases. Operative mortality was 2% (1 patient). All survivors were followed for a mean of 40 + 26 months. At the final visit 79% were improved in their functional class and only 13% remained in heart failure. The mitral valve area increased from 0.98 + 0.26 to 1.5 + 0.48 cm2. Pulmonary wedge pressure was under 25 mmHg in 79% and pulmonary artery systolic pressure under 50 mmHg in 73%. We conclude that open mitral commisurotomy offers a low morbidity and mortality and good longterm results for the treatment of mitral stenosis.
我们回顾了52例接受开放式二尖瓣交界切开术患者的临床和血流动力学结果。其中85%为女性，平均年龄为31±9岁。术前，21%的心功能为II级，73%为III级，56%为IV级。61%的患者为单纯二尖瓣狭窄，42%的患者有充血性心力衰竭。61%的患者二尖瓣瓣口面积小于1平方厘米，59%的患者楔压超过25 mmHg，59%的患者肺动脉收缩压超过50 mmHg。79%的病例无手术并发症。手术死亡率为2%（1例患者）。所有幸存者平均随访40±26个月。在最后一次随访时，79%的患者心功能得到改善，只有13%的患者仍有心力衰竭。二尖瓣瓣口面积从0.98±0.26平方厘米增加到1.5±0.48平方厘米。79%的患者肺楔压低于25 mmHg，73%的患者肺动脉收缩压低于50 mmHg。我们得出结论，开放式二尖瓣交界切开术治疗二尖瓣狭窄的发病率和死亡率较低，且长期效果良好。
