Montoya A, Mulet J, Pifarré R, Moran J M, Sullivan H J
Chest. 1979 Feb;75(2):131-5. doi: 10.1378/chest.75.2.131.
Mitral commissurotomy is the treatment of choice for mitral stenosis. If this is not feasible, replacement of the valve becomes necessary. Open commissurotomy has been performed at Loyola University Medical Center, Maywood, Ill, in 105 patients since 1970. The mean age was 45 years. The indication for surgery was heart failure in 92 of the cases. Sixty of the patients were in class 3 of the New York Heart Association (NYHA) classification. Eighty-five underwent open mitral commissurotomy alone. This was not feasible in 42 patients scheduled for it who required valvular replacement. Twenty-five patients had a left atrial thrombus. Two patients died, one from aortic dissection and the other from acute infarction in the perioperative period. Ninety-eight patients are NYHA class 1 or 2 at present. Two patients required valvular replacement following the commissurotomy. The low mobidity and mortality with excellent long-term results support our contention that open mitral commissurotomy is the treatment of choice for mitral stenosis.
二尖瓣交界切开术是二尖瓣狭窄的首选治疗方法。若不可行，则需进行瓣膜置换。自1970年以来，伊利诺伊州梅伍德的洛约拉大学医学中心已为105例患者实施了开放性交界切开术。平均年龄为45岁。手术指征为92例患者存在心力衰竭。其中60例患者属于纽约心脏协会（NYHA）分级的3级。85例患者仅接受了开放性二尖瓣交界切开术。计划接受该手术的42例患者因需要瓣膜置换而无法进行此手术。25例患者有左心房血栓。2例患者死亡，1例死于主动脉夹层，另1例死于围手术期急性梗死。目前98例患者为NYHA 1级或2级。2例患者在交界切开术后需要瓣膜置换。低发病率和死亡率以及出色的长期效果支持了我们的观点，即开放性二尖瓣交界切开术是二尖瓣狭窄的首选治疗方法。
