Farewell to surgical mitral commissurotomy for many patients.

Percutaneous mitral balloon valvotomy (PMV) has been accepted as an alternative to surgical mitral commissurotomy in the treatment of patients with symptomatic rheumatic mitral stenosis. Previous studies have demonstrated that PMV produces good immediate and long-term follow-up results in a selected group of patients with mitral stenosis.1-4 Hemodynamic and clinical improvement is achieved in the majority of patients with rheumatic mitral stenosis. PMV resulted in a significant decrease in mitral gradient and an increase in mitral valve area with minimal morbidity and mortality. The majority of patients have a marked clinical improvement, and the hemodynamic and clinical improvement produced by PMV persist at long-term follow-up.2-4 On the other hand, surgical mitral commissurotomy has been used successfully for many years to treat patients with mitral stenosis. The results of closed or open surgical mitral commissurotomy have demonstrated favorable immediate and long-term hemodynamic and symptomatic improvement in selected patients with rheumatic mitral stenosis.