Percutaneous transvenous mitral commissurotomy versus surgical commissurotomy in the treatment of mitral stenosis

Kean Wah Lau*, Zee Pin Ding, Jui Sung Hung

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations

Abstract

There is no doubt that percutaneous transvenous mitral commissurotomy (PTMC) in experienced centers is associated with a low risk of major complications and yields excellent immediate and long-term outcome. Although previous observational studies on both PTMC and surgical commissurotomy have indicated similar outcome between the two treatment strategies in terms of valve area improvement and risk of major complication (death, thromboembolism and significant resultant mitral regurgitation), it was not until recently that several prospective randomized trials comparing the two procedures and involving >470 patients with favorable valve characteristics (pliable, noncalcified valve with mild sub-valvular disease and no or mild mitral regurgitation), have confirmed that PTMC is indeed just as, if not more, effective as surgical commissurotomy. The late restenosis rate at up to 3- year follow-up appears comparable. Furthermore, PTMC has other additional benefits. It is nontraumatic, may be repeated without additional risk, and has been shown to be an extremely useful and efficacious palliative tool in those with end-stage mitral stenosis or with unfavorable valve anatomy who refuse surgery, and in certain subset of patients at high surgical risk because of medical comorbidities.

Original languageEnglish
Pages (from-to)99-106
Number of pages8
JournalClinical Cardiology
Volume20
Issue number2
DOIs
StatePublished - 1997
Externally publishedYes

Keywords

  • balloon valvuloplasty
  • mitral regurgitation
  • mitral stenosis
  • restenosis

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