Closed Commissurotomy Versus Balloon Valvuloplasty for Rheumatic Mitral Stenosis
Hilmi Tokmakoglu MD, Kerem M. Vural MD, Mehmet Ali Özatik MD, Sengül Cehreli MD, Erol Sener MD, Oguz Tasdemir MD

Closed mitral commissurotomy (CMC) and percutaneous mitral balloon valvuloplasty (PMBV) were compared by their initial results and Doppler echocardiographic data obtained at one week and one year after the procedure. Mortality was 0.7% after CMC, and 0.3% after PMBV. The primary success rate was 98.3% for CMC, and 89% for PMBV (p <0.0001). A significant reduction was seen in mean transmitral gradient (TMG), left atrial diameter and pulmonary artery pressure in both groups after one week and one year. The results of CMC were significantly better (p <0.0001) with regard to TMG and mitral valve area (p <0.0001). It is concluded that although both techniques provide satisfactory results, CMC offers a better primary success rate, greater mitral valve area augmentation, and better technical control. However, PMBV is less invasive and is preferred when surgical intervention is contraindicated due to associated problems; radiation exposure may be of concern in pregnant patients.