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(Circulation. 1972;46:298.)
© 1972 American Heart Association, Inc.

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Current Results of Operation for Mitral Stenosis

Clinical and Hemodynamic Assessments in 124 Consecutive Patients Treated by Closed Commissurotomy, Open Commissurotomy, or Valve Replacement

EDWARD M. MULLIN JR. M.D.¹; D. LUKE GLANCY M.D.¹; LAWRENCE M. HIGGS M.D.¹; STEPHEN E. EPSTEIN M.D.¹; ANDREW G. MORROW M.D.¹

¹ From the Cardiology Branch and the Clinic of Surgery, National Heart and Lung Institute, Bethesda, Maryland.

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.

Key Words: Prior mitral valvotomy • Left heart catheterization • Systemic emboli • Starr-Edwards prosthesis • Mitral calcium • NYHA functional class • Kay-Shiley prosthesis • Atrial fibrillation • Residual mitral stenosis

Submitted on February 3, 1972
Accepted on March 20, 1972

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