COMPARISON OF IMMEDIATE RESULTS OF PERCUT ANEOUS BALLOON MITRAL VALVULOPLASTY AND OPEN MITRAL COMMISSUROTOMY

The aim of this study was to assess the real usefulness of percutaneou s mitral balloon valvuloplasty (PMV). Eighty patients aged less than 5 6 years old, with symptomatic pure mitral stenosis, with an hemodynami c and echocardiographic area < 1 5 cm2 without associated valvular or coronary lesions and without surgical contraindications were studied. These were randomized in two groups of similar age, sex, symptomatolog y, cardiac rhythm, severity of stenosis and valve anatomy, that were s ubjected to PMV (n = 38) using a double balloon technique or to mitral commissurotomy (n = 42) with extracorporeal circulation (MC). Mitral areas (calculated using modified Gorlin's formula) increased in 1, 15 +/- 0.28 and 1 72 +/- 0.34 cm2 in patients subjected to PMV and MC res pectively No patient died, there was one technical failure with PMV an d two patients subjected to MC had a surgical wound infection Mitral r egurgitation increased in more than one degree in two patients treated with PMV (5%) and in 6 patients treated with MC (15%) It is concluded that PMV and MC are highly effective and safe procedures for the trea tment of mitral stenosis Mitral areas obtained with MC are higher than with PMV, however a significant improvement of the disease is achieve d with both procedures and MC produces mitral regurgitation with a hig her frequency