MATERIALS AND METHODS: From November 2009 to March 2010, 100 consecutive patients with rheumatic non-calcific mitral stenosis were assigned either closed mitral valvotomy or balloon mitral valvoplasty procedure according to their will, after informed consent, and financial condition.
Fifty patients underwent balloon mitral valvoplasty by the Inoue balloon technique.
Patient undergoing balloon mitral valvoplasty were managed by cardiologist in the cardiac care unit and those undergoing closed mitral valvotomy were managed in the post-operative intensive care unit.
Two patients out of 50 patients of closed mitral valvotomy group and 2 patients out of 50 balloon mitral valvoplasty group lost to follow up after one week.
Cost: Procedure cost of closed mitral valvotomy was significantly lower than the procedure cost of balloon mitral valvoplasty. It was approximately Rs.25000/- for closed mitral valvotomy, compared to balloon mitral valvoplasty, which was approximately Rs.
Lowest age in balloon mitral valvoplasty group was 12 years and maximum was 64 years (Table no.1).
End diastolic gradient was 5.88 [+ or -] 2.64mm Hg before closed mitral valvotomy and 7.46 [+ or -] 3.7mmHg before balloon mitral valvoplasty. After closed mitral valvotomy and balloon mitral valvoplasty, they decreased significantly to 1.65 [+ or -] 1.22 mm Hg and 1.99 [+ or -] 1.2 mmHg respectively.
Mean diastolic gradient before closed mitral valvotomy was 16.38 [+ or -]4.3 mmHg and before balloon mitral valvoplasty it was 17.32 [+ or -] 5.63 mmHg.
Mean left atrial (LA) size before closed mitral valvotomy and balloon mitral valvoplasty were 45.21 [+ or -] 6.88 (mm) and 45.67 [+ or -] 6.58 (mm), decreased to 39.71 [+ or -] 5.92 (mm) and 40.02 [+ or -] 5.64 (mm) respectively.
Mean mitral valve area before closed mitral valvotomy and balloon mitral valvoplasty were 0.81 [+ or -] 1.5 ([cm.sup.2]) and 0.78 [+ or -] 0.15 ([cm.sup.2]), after procedure it increased to 1.97 [+ or -] 03.5 ([cm.sup.2]) and 1.57 [+ or -] 0.28 ([cm.sup.2]) respectively.