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Closed mitral commissurotomy via the transventricular instrumental approach was performed successfully in 137 patients with mitral stenosis. Valve calcifications were present in 38 patients. A close correlation between functional class and cardiac index at rest could be demonstrated. Early mortality was 1.5 percent; late, 3.7 percent. Late results show 73 percent of the patients still improving, 9 percent about the same, and 1 percent deteriorated. Calcifications or slight to moderate mitral insufficiency in patients with predominant mitral stenosis do not preclude success of closed mitral commissurotomy, but careful and staged dilatation is mandatory in these cases. Results were slightly better in patients with noncalcified mitral stenosis than in those with a calcified mitral valve. The advantage of closed mitral commissurotomy over the open technique is a significantly lower rate of prosthetic replacement of the mitral valve.
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Accepted: June 5, 1972
© 1972 Published by Elsevier Inc.