Mitral stenosis with pulmonary hypertension. Long-term results after mitral valvotomy

Ten patients suffering from tight mitral stenosis with severe pulmonary hypertension were operated on and followed up for one to nine years after operation. There was no operative or postoperative mortality. Postoperative hemodynamic studies were performed on seven of the 10 patients. One patient was evaluated twice--one month and seven months after surgery. The condition of all patients improved after operation and regression of severe to extreme pulmonary hypertension was documented in the seven patients on whom the hemodynamic studies were repeated. Hemodynamic and clinical improvement was greatest in young patients with a shorter duration of disease and a normal sinus rhythm prior to operation. The results indicate that a severe degree of pulmonary vascular resistance in mitral stenosis is largely reversible, provided that the obstruction is adequately relieved.