Skagen K, Hansen J F, Olesen K H
Scand J Thorac Cardiovasc Surg. 1978;12(2):85-9. doi: 10.3109/14017437809100354.
This retrospective study is based upon a consecutive series of 90 patients with mitral stenosis who had their first closed mitral valvulotomy after the age of fifty. All patients were operated on during the period 1959--70 and were followed-up for at least 5 years until July 1, 1976. Calculated survival curves were compared with those of a group of 68 patients over fifty whose mitral stenosis was medically treated. The surgical mortality was 7.8%, largely due to the high mortality among patients in functional class IV. The late mortality rate after valvulotomy was significantly higher than in a matched population of the same age and sex, but significantly lower than in the medically treated patients. According to functional classification, the patients had improved markedly at the time of follow-up. High incidences of atrial fibrillation and late thromboembolic complications were noted. This study supports the view that closed mitral valvulotomy can be performed safely in patients over fifty with mitral stenosis without significant mitral regurgitation and heavy clacifications in functional classes II and III.
这项回顾性研究基于90例二尖瓣狭窄患者的连续病例系列，这些患者均在50岁之后首次接受闭式二尖瓣切开术。所有患者均于1959年至1970年期间接受手术，并随访至少5年直至1976年7月1日。将计算出的生存曲线与一组68例50岁以上接受药物治疗的二尖瓣狭窄患者的生存曲线进行比较。手术死亡率为7.8%，主要是由于IV级功能患者的高死亡率。二尖瓣切开术后的晚期死亡率明显高于年龄和性别匹配的人群，但明显低于接受药物治疗的患者。根据功能分级，患者在随访时明显改善。观察到房颤和晚期血栓栓塞并发症的高发生率。这项研究支持这样的观点，即对于50岁以上、无明显二尖瓣反流且功能分级为II级和III级、无严重钙化的二尖瓣狭窄患者，可以安全地进行闭式二尖瓣切开术。
