Why the study?
Does mitral commissurotomy improve valve function and survival in patients with advanced mitral stenosis?
Does mitral commissurotomy improve valve function and survival in patients with advanced mitral stenosis?
This early historical case series demonstrates the initial feasibility and learning curve mortality associated with surgical mitral commissurotomy for advanced mitral stenosis.
Initial mitral commissurotomy experience indicates feasibility despite early mortality; leaves open the impact of refinements on contemporary outcomes.
The term "mitral commissurotomy" has been suggested to designate a procedure in which the individual anatomic leaflets of the stenotic mitral valve are surgically separated. By incising the angles or commissures of the mitral slit ("fish-mouth") a considerable degree of valve function can be re-established without the production of additional significant regurgitation. Commissurotomy, as described below, was performed in 8 cases of advanced mitral stenosis. Results in 5 were most satisfactory. There were three deaths early in our experience during the period when our technic was being perfected. (Noted in addendum are 22 cases undergoing the operation since this article was submitted for publication, and bringing the total series to 30.)
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Glover et al. (1950) studied this question.