Aim: It has been reported that mitral surgery(MVS) along with antiarrhythmic surgery(AAH) decreases embolic events, and thus,is a better therapeutic option than percutaneous mitral commissurotomy(PMC) alone in patients with mitral stenosis (MS) and atrial fibrillation(AF). We compared the long term clinical outcomes between the 2 treatment strategies in these patients. Method and results: We reviewed the medical records of the patients with MS and AF who underwent PMC (GrI, n=117, male 31,45.6±9.8years) or MVS with AAH(GrII, n=71, male 28, 49.8±9.8years) between 1992 and 2000. Mean follow-up duration was 129±53 months. The incidences of clinical events; ischemic stroke, complications, readmission due to heart failure(HF), and death, were analyzed in each group at the time of 7 year-follow up. Event-free survival rates were also evaluated. Ischemic stroke occurred in 6 patients in GrI and 3 in GrII, but event-free interval showed no significant difference(p=0.85). In terms of HF, there were 10 patients in GrI and 3 in GrII during follow-up without a statistical significance(p=0.26). Likewise, there was no difference in complication rate between the 2 groups(10 in GrI vs. 5 in GrII, p=0.73). Two curves representing death rates for the 2 groups were not significantly different as shown in the figure(p=0.20). Conclusions: PMC is not an inferior therapeutic option compared to surgical treatments in patients with MS and AF. It seems that persistence of AF after successful correction of MS does not have a significant impact on the long term prognosis.
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