Anesthesia and Supportive Therapy During Mitral Commissurotomy

This communication is concerned with the experience at the Mayo Clinic in the anesthetic and supportive management of patients undergoing operations on the mitral valve prior to and through the year 1954. From 1951 to 1954 inclusive 187 operations were performed on 185 patients. Two patients had symptoms of recurrence of mitral stenosis following apparently successful valvotomy and underwent second operations, respectively 15 and 41 months after the original operations. The degree of functionalimpairment was determined before every operation according to the classification of the New York Heart Association.1This can be condensed as follows: impairment, Class I, none; Class II, slight; Class III, marked; Class IV, extreme (Table). Of our 185 patients, 56 were male and 129 were female. They ranged in age from 14 to 59 years. Three patients suffered from multiple cardiac lesions, one of which was mitral stenosis in each case. Following mitral commissurotomy,