title: Aortic valve replacement with concomitant open mitral valvotomy--early results and long term followup in 72 consecutive patients.
abstract: Experience with 72 consecutive subjects, who underwent aortic valve replacement with open mitral valvotomy is presented. Mean age was 30 years and history of rheumatic fever was forthcoming in 80%. 91.7% patients had aortic regurgitation--with or without aortic stenosis. 45% patients had pulmonary hypertension. Starr Edwards (51.4% and Bjork Shiley valves (45.8%) were commonly used. There were no early deaths. All patients were followed up for 1 to 19 years (mean = 9 years). There were 4 (5.5%) late deaths. 4.1% patients developed mild restenosis of the mitral valve over a mean period of 8 years and 1.04% developed mitral regurgitation mandating mitral valve replacement. A notable feature of this series is the low incidence of thromboembolism-free lives at upto 10 years followup despite receiving only aspirin in place of coumarin anticoagulation. We believe aortic valve replacement and open mitral valvotomy is a worthy alternative to double valve replacement in view of its zero hospital mortality, low late mortality, low incidence of restenosis, low thromboembolic episodes and the avoidance of coumarin anticoagulation.
authors.affiliation: Department of Thoracic & Cardiovascular Surgery, Christian Medical College Hospital, Vellore.
authors.forename: P
authors.initials: P
authors.lastname: Kaul
authors.forename: S
authors.initials: S
authors.lastname: John
authors.forename: C N
authors.initials: CN
authors.lastname: John
authors.forename: V V
authors.initials: VV
authors.lastname: Bashi
authors.forename: E
authors.initials: E
authors.lastname: Ravikumar
authors.forename: U
authors.initials: U
authors.lastname: Choudhry
authors.forename: S
authors.initials: S
authors.lastname: Krishnaswamy
mesh_terms: D000293:Adolescent; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D002404:Catheterization; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications / Q000628:therapy*; D012008:Recurrence