Advantages of open mind commissurotomy using a triple-orifice technique

Our experience over an eight-year period with the operative relief of mitral stenosis is reviewed and detailed. Of the 106 patients in the series, 80% had minimal or no calcification, 17% had moderate calcification, and 4% had severe calcium deposits in the valve. Four patients have required reoperation for recurrent stenosis, with valve replacement in 3 and a second commissurotomy in the fourth. Left atrial thrombus was encountered in 16%, and no patient with thrombus experienced embolization in the postoperative period. One postoperative death occurred within 30 days, and a single late death occured 35 days after operation. For the scarred, retracted mitral valve we have utilized a multiple-orifice technique that provides maximal flow without the risk of inducing significant mitral insufficiency.