[Prognosis for immediate results of mitral commissurotomy]

To reveal the symptoms characterizing the relative danger of a surgical intervention the preoperative data of 417 patients subjected to isolated mitral commissurotomy were analyzed. The immediate result of mitral commissurotomy was shown to depend not only on the severity of the preoperative state of the patient, but also by additional factors. These factors appeared to vary in patients with different severity of the disease. Thus, a negative result of the operation in the group of the most severely sick patients was attributed to the presence of 4 (or more) of the following 6 signs: severe oedema (internal one including), reduced diuresis, cachexia, increased sedimentation rate (over 8mm/hour), colour index over 0.9, pulmonary artery pressure over 100 mm Hg. With 4 or more signs present the incidence of mortality comprised 0.75. Among those with 3 signs or less, the mortality rate comprised about 0.06 (t approximately 5.1). Thus, patients with similar severity of the disease could be divided into two groups sharply distinguished in their surgical prognosis.