[Mitral commisurotomy in extracorporeal circulation: long term follow-up with clinical and hemodynamic control]

We reviewed the clinical and hemodynamic findings in 52 patients undergoing open mitral commisurotomy. 85% were female and the mean age was 31 + 9 years. Before operation 21% were in functional class II, 73% in class III and 56% in class IV. Pure mitral stenosis was found in 61% and congestive heart failure in 42%. The mitral valve area was less than 1 cm2 in 61%, the wedge pressure over 25 mmHg in 59% and the pulmonary artery systolic pressure over 50 mmHg in 59%. There was no operative morbidity in 79% of cases. Operative mortality was 2% (1 patient). All survivors were followed for a mean of 40 + 26 months. At the final visit 79% were improved in their functional class and only 13% remained in heart failure. The mitral valve area increased from 0.98 + 0.26 to 1.5 + 0.48 cm2. Pulmonary wedge pressure was under 25 mmHg in 79% and pulmonary artery systolic pressure under 50 mmHg in 73%. We conclude that open mitral commisurotomy offers a low morbidity and mortality and good longterm results for the treatment of mitral stenosis.