Closed mitral valvotomy in patients with rheumatic mitral stenosis and associated aortic regurge

This work comprised 300 patients with tight mitral stenosis [MS] who underwent closed mitral valvotomy [CMV] operation and subdivided into two main subgroups: Subgroup A with MS and without associated aortic regurge [AR] [MS group] and comprised 100 patients and subgroup B with MS and associated AR [MS-AR group] and comprised 200 patients [130 patients had AR grade up to I/IV and 70 had AR grade ranged from >1/IV to II/IV; 180 patients had normal preoperative left ventricular, LV, dimensions and 20 patients had mild increased LV dimensions] [end systolic diameter, ESD, up to 4.2 cm and end diastolic diameter, EDD, up to 6.2 cm]. All patients were subjected to CMV operation, preoperatively and postoperatively [within three months, one year and three years]; clinical and Doppler echocardiographs evaluation. The study concluded that CMV operative can be done safely for patients with tight MS and associated AR up to grade II/IV and even among those patients having mild increased LV dimensions [ESD up to 4.2 cm and EDD up to 6.2 cm]. A longer follow up period [up to ten years] was recommended for these patients to evaluate the rate of the progression of AR and the need of AV replacement among them