Publications of Faculty of Medicine:PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY VERSUS SURGICAL CLOSED MITRAL COMMISSUROTOMY FOR MITRAL STENOSIS : A RANDOMIZED COMPARATIVE STUDY USING ECHOCARDIOGRAGHY: Abstract

From November 1993 to October 1996.133 patients with rheumatic mitral stenosis (MS) scheduled for either percutarteous balloon mitral valvulop/ asty ( PBMV ) or closed mitral commissurotomy (CMC) were studied prospectively. 47 patients were excluded from the study. 55 patients underwent PBMV (group I) with a mean age of 29.3 ± 10.8 years. 63.6 % of this group were females .31 patients underwent CMC (group 11) with a mean age of 30.6 + 11.6 years 64.5% were females . Patients were evaluated by transthoracic echocardiography (77'E) and trartsesophageal echocardiography (TEE) before PBMV or CMC immediately after the procedure and after 6 months. No statistic-illy significant difference was found as regards the baseline data between the two groups . The immediate results after the procedures were comparable, with no statistically significant difference between them. The mitral valve area (MVA) difference was 1.01 + 0.32 in groupI and 0.91 + 0.3 in groupEL the mean pressure gradient (PG) difference was 10.65 ± 5.39 in group' and 9.29 + 4.17 in groupII. left atrial diameter (LAD) difference was 0.51 + 0.41 in groupl and 0.5 + 0.37 in group11. Left atrial spontaneous echo contrast (LASEC ) was 4 (7.3%) in groupl and 3 ( 9.7%) in grouplI. Pulmonary artery pressure (PAP) difference was 21.8 + 13.02 in groupl and 21.73 + 11.79 in group11. occurrence of new or worse mitral regurge (MR) was 29 (53%) in groupl and 15 (48.4%) in groupII. occurrence of significant MR was I / (2096) in group! and 24 ( 77.4%) in groupll and the incidence of suboptimal outcome was 8 ( 14.5%) in group!. and 5 (16.1%) in groupil . Short term follow up results of both groups were comparable with no statistically significant dtjference. Restenosis occurred in 8( 14.5%)in group!. and 5 (16..1%) in group11 and NYHA> II in 5( 9.1%) in group! and 3 ( 9.7%) in group&