Late results of chordotomy and/or papillotomy combined with open mitral commissurotomy
Konishi, Y.; Muraguchi, T.; Tatsuta, N.; Minami, K.; Matsuda, K.; Hirata, K.; Nishiwaki, N.; Ishihara, H.; Yamazato, A.; Chiba, Y.; Shiraishi, Y.; Murata, S.; Hikasa, Y.
Nihon Kyobu Geka Gakkai 30(8): 1399-1405
1982
ISSN/ISBN: 0369-4739 PMID: 7142770 Document Number: 186888
The pathology of the mitral valve is an important contributor to the prognosis of open mitral commissurotomy (OMC). In addition to simple valvotomy, separation of fused chordae tendenae and/or papillary muscles are usually performed in the cases with subvalvular stenosis. The late results of these procedures were evaluated in a total of 61 patients who survived for at least 1 yr after isolated OMC. Of the 61 patients, 24 (39%) had significant subvalvular stenosis (Sellors type II or III) and 17 of them were treated by separation of chordae and/or papillary muscles. Pre- and postoperative condition were followed by cardiac catheterization, echocardiography and radiocardiography. The division of fused chordae and/or papillary muscles yield benefits in the early postoperative period. Late deteriorations in cardiac index by radiocardiography and diastolic descent rate of the mitral valve by echocardiography occurred within 5 yr after surgery. Severe subvalvular stenosis with the involvement of both of the anterior and posterior papillary muscles was only incompletely relieved even if these papillary muscles were split. Thus, valve replacement is recommended for cases with this type of stenosis.