Original communication| Volume 72, ISSUE 5, P812-818, November 1972

Closed mitral commissurotomy: Operative results and late follow-up in 137 patients

      This paper is only available as a PDF. To read, Please Download here.


      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ankeney J.L.
        Indications for closed- or open-heart surgery for mitral stenosis: Review of 152 operated cases.
        Ann. Thorac. Surg. 1967; 3: 389
        • Bailey C.P.
        The surgical treatment of mitral stenosis (mitral commissurotomy).
        Dis. Chest. 1949; 15: 377
        • Brock R.C.
        Surgery of the heart and great vessels.
        in: Proc. R. Soc. Med. 44. 1951: 995
        • Brunton L.
        Preliminary note on the possibility of treating mitral stenosis by surgical methods.
        Lancet. 1902; 1: 352
        • Bryant L.R.
        • Trinkle J.K.
        Mitral valvulotomy in the valve replacement era.
        Ann. Surg. 1971; 173: 1024
        • Cutler E.C.
        • Levine S.A.
        • Beck C.S.
        Surgical treatment of mitral stenosis.
        Arch. Surg. 1924; 9: 689
        • Ellis L.B.
        • Harken D.E.
        Closed valvuloplasty for mitral stenosis. A twelve year follow-up study of 1571 patients.
        N. Engl. J. Med. 1964; 270: 643
        • Gerami S.
        • Messmer B.J.
        • Hallman G.L.
        • Cooley D.A.
        Open mitral commissurotomy: Results of 100 consecutive cases.
        J. Thorac. Cardiovasc. Surg. 1971; 62: 366
        • Glenn W.W.L.
        • Calabrese C.
        • Goodyear A.V.N.
        • Hume M.
        • Stansel Jr., H.C.
        Mitral valvulotomy. II. Operative results after closed valvulotomy: A report of 500 cases.
        Am. J. Surg. 1969; 117: 493
        • Harken D.E.
        • Ellis L.B.
        • Wave P.F.
        • Norman L.R.
        Surgical treatment of mitral stenosis. I. Valvuloplasty.
        N. Engl. J. Med. 1948; 239: 801
        • Kay E.B.
        • Zimmerman H.A.
        Surgical treatment of mitral stenosis. Open versus closed techniques.
        Am. J. Cardiol. 1962; 10: 1
        • Moccetti T.
        • Albert H.
        • Lichtlen P.
        • Senning Å.
        Hämodynamische Untersuchungen nach Mitralkommissurotomie: Analyse anhand von 54 Patienten.
        Schweiz. Med. Wochenschr. 1970; 100: 2189
        • Nichols H.T.
        • Blanco G.
        • Mors D.P.
        • Adam A.
        • Baltazar N.
        Open mitral commissurotomy. Experience with 200 consecutive cases.
        J. A. M. A. 1962; 182: 268
        • Souttar P.W.
        The surgical treatment of mitral stenosis.
        Br. Med. J. 1925; 2: 603
        • Storch H.-H.
        • Trede M.
        • Schmitz W.
        Früh- und Spätergebnisse nach operativer Behandlung der Mitralstenose (Bericht über 700 operierte Patienten).
        Bruns Beitr. Klin. Chir. 1968; 216: 587