The Results of Mitral Commissurotomy One to Three Years After Surgery

¹ The University of Southern California School of Medicine, Department of Medicine (Cardiology), and the Los Angeles County Hospital.

The large majority of carefully selected cases of mitral stenosis with functional impairment submitted to commissurotomy benefit from the procedure and in many cases this benefit persists for at least one to three years.

A greater degree of benefit can be anticipated in otherwise satisfactory cases when the right ventricular pressure is markedly elevated. Such elevation can usually be predicted when evidence of right ventricular strain is present on the electrocardiogram.

In addition to evidence of improvement in respect to functional capacity, hemoptysis, and paroxysmal dyspnea, a large proportion of cases had objectively demonstrable improvement. This is evident in reduction of right ventricular pressure and decrease of right ventricular force on the electrocardiogram. Decrease in heart size by x-ray is an exceptional finding.

Mitral commissurotomy with auricular appendectomy is an effective method for controlling peripheral emboli in patients with mitral stenosis.

The presence of a calcified valve may not necessarily prevent lasting or significant benefit from the procedure.