Long-term results after closed mitral valvotomy

This paper is an analysis of the experiences of the author with patients under-going closed mitral valvotomy between 1948 and December 1963, and thus represents a follow-up of at least 10 years. Five hundred and seventy-one of 618 patients survived operation; the mortality rate of 7.6% is much higher than pertains at present. It includes the early pioneer days when many very ill patients were operated on. There were only five deaths in the most recent 400 consecutive cases. The mortality should be low today. A detailed follow-up shows that many patients are completely cured of their mitral stenosis: of 168 patients alive longer than 11 years, 41 survived for 11 to 15 years, 67 for 16 to 20 years and 60 for over 20 years. Restenosis was diagnosed in 128 patients (22.4%) and 93 of them had a second operation. When the valve is severely damaged, especially when it is regurgitant, the results are not as good and valve excision and replacement are often needed, but valvotomy for pure mitral stenosis can give excellent and lasting results.