Why the study?
Does mitral commissurotomy improve clinical and physiologic outcomes in patients with mitral stenosis and hemodynamic abnormalities?
Does mitral commissurotomy improve clinical and physiologic outcomes in patients with mitral stenosis and hemodynamic abnormalities?
Mitral commissurotomy provides clinical benefit primarily in well-compensated patients with mitral stenosis, while posing significant hazards to those with advanced heart failure and marked pulmonary hypertension.
May inform commissurotomy selection in mitral stenosis; case-report data leave modern applicability open.
Eighteen patients, selected for mitral commissurotomy on the basis of appreciable hemodynamic abnormalities as well as physical disability have been studied prior to and following surgery. The results suggest that well compensated patients with mitral stenosis, normal sinus rhythm and pulmonary hypertension are likely to benefit from operation. Patients with atrial fibrillation, good compensation and moderate pulmonary hypertension may benefit from mitral commissurotomy. In patients with atrial fibrillation, marked pulmonary hypertension and congestive heart failure, operation is hazardous and the likelihood of benefit is small. The importance of myocardial function in the production of these results is discussed.
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Wood et al. (1956) studied this question.
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