Studies on non-operative cases of acquired valvular heart disease

Of the 652 cases with acquired valvular heart disease, 153 patients did not receive surgical therapies following cardiac catheterization studies. There were three types of reasons: mild symptoms, complications or high operative risks, and refusal. One hundred cases were not operated on immediately because of their mild symptoms, but 24 cases of them were aggravated during the follow-up periods and 15 underwent operations later. Twenty five cases were not operated on because of their complications or high operative risks. Eight of them died, 5 cardiac and 3 non-cardiac deaths. One was operated on later and another was aggravated with congestive heart failure. Twenty eight were refusal cases. Two of them died, 6 were aggravated and 7 were operated on later with one operative death. In this paper, several criteria were proposed for indications of surgery for the mild cases, and the limitations of the surgical therapies in the severe or complicated cases and the management of the refusal cases were discussed.