Key result
Open-ring mitral valvuloplasty yields excellent 30-day valve function in ~84% of patients.
Why the study?
Does mitral valvuloplasty with a new open prosthetic ring improve valve function and clinical status in patients with mitral insufficiency?
Observational (n=105)
Does mitral valvuloplasty with a new open prosthetic ring improve valve function and clinical status in patients with mitral insufficiency?
Mitral valvuloplasty using a new open prosthetic ring demonstrated excellent early and mid-term functional and echocardiographic outcomes in a predominantly young, rheumatic population.
May support open-ring feasibility in rheumatic mitral disease; leaves open randomized trials versus alternatives.
From October 1987 to March 1993, 105 patients were studied who have undergone valvuloplasty with an open ring. They ranged from 5 to 79 years (mean 30); 33 (31.4%) were under 16. All patients had mitral insufficiency, alone in 62 (59.0%) and associated with mitral stenosis (double mitral lesion) in 43 (41.0%). In the majority of the cases, the aetiology was rheumatic (78.1%); active in 10 (9.5%) patients. Three patients (2.9%) were in class II, 42 (40.0%) in class III, 57 (54.3%) in class IV and 3 (2.9%) in class V. Ten patients (9.5%) had isolated ring implantation while the remaining underwent associated procedures on the leaflets, chordae and papillary muscles. There were two (1.9%) hospital deaths, and six patients (5.7%) had to be reoperated. On the 30th (mean) postoperative day, 75 (71.4%) patients were reevaluated by catheterization, echo Doppler or both to confirm the effectiveness of the techniques employed. The mitral valve was functioning normally or with mitral regurgitation + in 63 (84.0%) patients, mitral regurgitation + + in 2 (2.7%), mitral regurgitation + + + in 5 (6.7%), mitral stenosis + in 4 (5.3%), and mitral stenosis + + in 1 (1.3%) patient. The results were therefore considered excellent in 63 (84.0%) patients with either normal mitral valve or mitral regurgitation +, good in 6 (8.0%) patients with mitral regurgitation + + and/or mitral stenosis +, and poor in 6 (8.0%) patients with mitral regurgitation + + + and/or mitral stenosis + +. Two deaths (1.9%) occurred within the first 7 months of follow-up. Patients were evaluated clinically 1-67 months postoperatively (mean 27):90 (85.7%) were in class I, 4 (3.8%) in class II, 4 (3.8%) in class III and 1 (1.0%) in class IV.(ABSTRACT TRUNCATED AT 250 WORDS)
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Gregori et al. (1994) conducted an observational in Mitral insufficiency (n=105). Mitral valvuloplasty with an open ring was evaluated on Excellent valve function (normal or mitral regurgitation +) at 30 days. Mitral valvuloplasty with an open ring yielded excellent valve function in 84.0% of patients at 30 days, with 85.7% in NYHA class I at a mean follow-up of 27 months.
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