Abstract 2661: Long Term Results Of Percutaneous Mitral Commissurotomy Versus Mitral Valve Surgery Concomitant With Maze Operation For Patients With Mitral Stenosis And Atrial Fibrillation
Background: We sought to compare the long term outcomes of percutaneous mitral commissurotomy (PMC) versus mitral valve (MV) surgery along with MAZE operation in patients with mitral stenosis (MS) and atrial fibrillation (AF).
Methods and results: We reviewed the medical record of the patients with MS and AF who underwent PMC (GrI, n=117, male 31, age 45.6±9.8 years) or MV surgery along with MAZE operation (GrII, n=68, male 28; age 49.8±9.8 years) between 1992 and 1996 and completed at least 5 years of clinical follow-up. Mean follow-up duration was 129±53 months. The incidences of clinical events; periprocedural complications, ischemic stroke, readmission due to heart failure (HF), and death, were analyzed in each group. Event free survival rates were also evaluated. Ischemic stroke occurred in 14 patients of GrI vs. 6 of GrII, but event free interval showed no significant difference (p=0.89). In terms of HF, there were 14 patients in GrI and 2 in GrII during follow-up without a statistical significance (p=0.11). Likewise, there was no difference in complication rate between the 2 groups (17 in GrI vs. 4 in GrII, p=0.85). Two curves representing death rates for the 2 groups were not significantly different as shown in the figure⇓ (p=0.36).
Conclusions: PMC is not an inferior therapeutic option compared to MV surgery with combined MAZE operation in patients with MS and AF. Presence and persistence of AF after successful correction of MS may not have a significant impact on the long term prognosis.