Current Results of Operation for Mitral Stenosis

Abstract

Among 124 consecutive patients undergoing operation for pure or predominant mitral stenosis between 1964 and 1969, closed commissurotomy was carried out in 53 (43%). There were no early or late deaths, and the hemodynamic and symptomatic results of operation were excellent. In 51 (41%) of the patients, valvular anatomy was such that valve replacement proved necessary. As a group, these patients were more severely symptomatic preoperatively and had worse hemodynamics than patients in the closed-commissurotomy group. With replacement, operative (24%) and late (12%) mortality were high, but surviving patients enjoyed hemodynamic and symptomatic benefits comparable to those of the patients undergoing closed commissurotomy. In 20 patients whose preoperative clinical and hemodynamic characteristics were intermediate between those of the closed-commissurotomy and valve-replacement groups, open commissurotomy was performed. Early (10%) and late (5%) mortality were less than with mitral replacement, but in general hemodynamic and symptomatic benefits were modest.