Nov. 20, 2000 PITTSBURGH, Nov. 15 -- For patients with rheumatic mitral stenosis, balloon mitral valvotomy yields similar long-term results compared to a surgical procedure called commissurotomy, according to a University of Pittsburgh study presented today at the American Heart Association annual meeting in New Orleans.
Mitral stenosis is caused by childhood rheumatic fever, which damages the heart valve. The valve slowly wears out and becomes more scarred over time. The scarring prevents the valve from opening and closing properly.
"Open surgery is the traditional method of treatment of mitral stenosis," said Galal Ziady, M.D., professor of medicine at the University of Pittsburgh School of Medicine, director of Clinical Cardiology at the UPMC Health System Cardiovascular Institute, and principal investigator of the study. "In this study, we wanted to determine if outcomes for the balloon procedure would be comparable and sustained over the long term."
In the surgical procedure, a surgeon uses a scalpel to remove scar tissue from the mitral valves. In the balloon procedure, a deflated balloon is inserted through an artery to the heart and into the area between the mitral valves. When it is inflated, it breaks the scar tissue and frees up the two valves to work properly.
The study followed a group of 40 rheumatic mitral stenosis patients since 1988. They were randomized into two groups of 20 patients each. One group underwent the balloon procedure while the other underwent surgery. There were no differences in patient sex, age and heart rhythm or echo score. Mean age of the patients at the time of treatment was 26 years.
The study found that patients in both groups had their mitral valve opening almost doubled. In addition, the pulmonary artery pressures of both groups dropped comparably following the procedure. Restenosis was noted in three patients in the surgery group and four in the balloon group. New mitral regurgitation developed in two patients in each group.
"We conclude that the balloon procedure yields comparable results on immediate and long-term outcome," Dr. Ziady said. "In addition, the balloon procedure has several advantages over the surgical procedure. The cost of the balloon is less than the cost of surgery, patients leave the hospital the same day or the next day, there is no operative scar, and there is less surgical risk."
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