short term clinical outcome of percutaneous balloon mitral valvuloplasty versus surgical closed mitral commissurotomy

bailon mitral valvuloplasty and closed mitral valve conunissurotomy were performed in 450 and 127 patients, respectively. also, 254 patients with severe mitral stenosis were enrolled in a prospective randomized trial comparing the two procedures. immediately after balloon mitral valvuloplasty, mean left atrial pressure was 11.38±3.54 mmhg, transmitral valve gradient was 1.8±2 mmhg, and mitral valve area was 204± 004 cm2 (allp< 0.0001). at one week follow up after surgical mitral commissurotomy, transmitral valve gradient was 604±2o4 mmhg and mitral valve area was 1.85±oo45 cm2. two cases of severe mitral regurgitation occurred in each group. there was one case of death due to infection in the surgical commissurotomy group. mild to moderate mitral regurgitation occurred in 36 patients (28.3%) in the surgical commissurotomy group whereas 11 patients (8.7%) developed only mild mitral regurgitation in the balloon commissurotomy group. the success rate was 96.8% in each group. we conclude that immediate hemodynamic results of balloon mitral commissurotomy, if not superior, is as favorable as surgical commissurotomy and is the treatment of choice in selected cases.