JTCS KCI
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Suk Jung Choo
Hyun Song
Cheol Hyun Chung
Seung Whan Lee
Jae Won Lee
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Song, J.-K.
Right arrow Articles by Park, S.-J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Song, J.-K.
Right arrow Articles by Park, S.-J.
Related Collections
Right arrow Valve disease

J Thorac Cardiovasc Surg 2010;139:103-110
© 2010 The American Association for Thoracic Surgery

Acquired Cardiovascular Disease

Long-term outcomes of percutaneous mitral balloon valvuloplasty versus open cardiac surgery

Jae-Kwan Song, MDa,*, Mi-Jeong Kim, MDa, Sung-Cheol Yun, PhDb, Suk Jung Choo, MDc, Jong-Min Song, MDa, Hyun Song, MDc, Duk-Hyun Kang, MDa, Cheol Hyun Chung, MDc, Duk Woo Park, MDa, Seung Whan Lee, MDa, Young-Hak Kim, MDa, Cheol Whan Lee, MDa, Myeong-Ki Hong, MDa, Jae-Joong Kim, MDa, Jae Won Lee, MDc, Seong-Wook Park, MDa, Seung-Jung Park, MDa

a Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
b Division of Biostatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
c Division of Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Received for publication January 30, 2009; revisions received April 3, 2009; accepted for publication April 23, 2009.

* Address for reprints: Jae-Kwan Song, MD, Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong Songpa-ku, Seoul 138-736, South Korea. (Email: jksong{at}amc.seoul.kr).

Objectives: We sought to compare long-term outcomes between percutaneous mitral valvuloplasty and open heart surgery.

Methods: The study evaluated 402 patients who underwent percutaneous mitral valvuloplasty and 159 patients who underwent open heart surgery between January 1, 1995, and December 31, 2000. The rates of cardiovascular death or repeated intervention (redo percutaneous mitral valvuloplasty or open heart surgery) were determined over a median follow-up of 109 months (mean ± SD, 106 ± 27). The therapeutic effects on adverse outcomes were estimated by the Cox proportional hazards model adjusting differences in the severity of illness before intervention. The effects of the cardiac rhythm and echocardiographic score were also tested.

Results: The observed (unadjusted) event-free survival was similar for both groups, and the hazard ratio for the clinical events after percutaneous mitral valvuloplasty as compared with after open heart surgery was 1.510 (95% confidence interval, 0.914–2.496; P = .1079). However, the adjusted hazard ratio was 3.729 (95% confidence interval, 1.963–7.082; P < .0001), showing a higher event-free survival in the open heart surgery group. The adjusted hazard ratio after percutaneous mitral valvuloplasty as compared with after open heart surgery in patients with echocardiographic scores of 8 or more and atrial fibrillation were 5.348 (95% confidence interval, 2.504–11.422; P < .001) and 3.440 (95% confidence interval, 1.805–6.555; P = .0002), respectively, whereas the hazard ratio in patients with echocardiographic scores less than 8 and normal sinus rhythm did not show differences.

Conclusions: Open heart surgery was associated with a higher adjusted rate of long-term event-free survival than percutaneous mitral valvuloplasty. Patients with high echocardiographic scores or atrial fibrillation showed better outcomes after open heart surgery.

Abbreviations and Acronyms CI = confidence intervals; HR = hazard ratio; MS = mitral stenosis; MVR = mitral valve replacement; OHS = open heart surgery; OMC = open mitral commissurotomy; PMV = percutaneous mitral valvuloplasty




This article has been cited by other articles:


Home page
 Interact CardioVasc Thorac SurgHome page
H. A. Vohra, R. N. Whistance, A. Roubelakis, A. Burton, C. W. Barlow, G. M. K. Tsang, S. A. Livesey, and S. K. Ohri
Outcome after redo-mitral valve replacement in adult patients: a 10-year single-centre experience
Interact CardioVasc Thorac Surg, January 31, 2012; (2012) ivs005v1.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
S. H. Rahimtoola
The Year in Valvular Heart Disease
J. Am. Coll. Cardiol., September 13, 2011; 58(12): 1197 - 1207.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2010 by The American Association for Thoracic Surgery.