BALLOON VALVOTOMY FOR MITRAL RESTENOSIS AFTER OPEN OR CLOSED SURGICALCOMMISSUROTOMY

Balloon mitral valvotomy was performed in 48 patients (Group I) with m itral restenosis following prior surgical commissurotomy 3-21 years pr eviously. Their results were compared with those of balloon valvotomy in 302 patients without prior commissurotomy (Group II). The procedure was successful in 91.7% of Group I. The mitral valve area, cardiac ou tput, mitral valve gradient, mean left atrial and pulmonary arterial p ressures significantly improved following valvotomy (all P < 0.001) in Group I and similar results were obtained in Group II. A comparison o f the absolute and percentage change in the mitral valve area followin g valvotomy amongst the two groups revealed no significant difference (P = N.S.). The baseline clinical characteristics in both the groups w ere similar except for a higher echocardiographic score (8.64 +/- 1.5 vs. 7 +/- 1.7; P < 0.005) in Group I. Despite the high echo score, ach ievement of an 'optimal' result and occurrence of postprocedural mitra l regurgitation were similar in both groups. The complications include d systemic embolus in one patient and increase in mitral regurgitation to greater-than-or-equal-to 2+ in 2. There were no deaths. Balloon va lvotomy for mitral restenosis following surgical commissurotomy is saf e, effective and produces clinical and hemodynamic results comparable to those in unoperated cases.