Anticoagulants and Mitral Valvotomy

Prophylactic anticoagulant treatment prior to mitral valvotomy was first recommended by Storm and Hansen (1955). Several authors have since confirmed that this measure significantly reduces the incidence of operative and post-operative embolism. But this dreaded complication was entirely abolished only in Storm and Hansen's series and in the first series reported by Miscall et al. (1962). In all other series (Table This failure has resulted in reluctance to introduce anticoagulant prophylaxis. The question arises as to whether anticoagulants inevitably fail to prevent embolism in some patients The detailed management of those patients in whom prophylaxis failed is not reported except in the series of Uglov and Potashov (1962) and Miscall et al. (1962), when insufficient reduction of the prothrombin time is mentioned.