Closed Mitral Valvotomy Versus Balloon Valvoplasty: A Prospective Comparative Study of 100 Cases

Introduction: A prospective study to compare the result of closed mitral valvotomy with percutaneous balloon valvoplasty in 100 cases (50 patients in each group) of rheumatic non calcific mitral stenosis.

Methods and Result: From November 2009 to March 2010, 50 patient underwent closed mitral valvotomy and another 50 had percutaneous balloon mitral valvoplasty. Balloon mitral valvoplasty was performed by Inoue technique and closed mitral valvotomy was carried out through standard anterolateral thoracotomy with transventricular gradual Tubbs dilatation.Functional status, left atrial size, transmitral end diastolic gradient, mean diastolic gradient and mitral valve area were recorded. The results at the 4-day post procedure and the results at the 6-month follow-up were compared. Residual atrial septal defect(ASD) was present in 6 patient at 6 month follow-up after balloon mitral valvoplasty . Severe mitral regurgitation occurred in 3 cases of closed mitral valvotomy group as compared to 7 cases of balloon mitral valvoplasty group. Urgent mitral valve replacement was needed in 2 patient of balloon mitral valvoplasty group. There was one mortality in both groups.

Conclusion: No statistical significant difference between the result of closed mitral valvotomy and balloon mitral valvoplasty but better outcome obtained by closed mitral valvotomy . Hemodynamic and functional improvement was sustained through 6- month of follow-up. Procedural cost of closed mitral valvotomy is significantly lower than the procedural cost of balloon mitral valvoplasty.

Author(s):

Krishnakant Sahu

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