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Ann Thorac Surg 1975;19:654-658
© 1975 The Society of Thoracic Surgeons

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Articles

Advantages of Open Mitral Commissurotomy Using a Triple-Orifice Technique

From the Division of Thoracic and Cardiac Surgery, Medical College of Virginia Hospital, Richmond, Va.

^* Address reprint requests to Dr. Lower, Medical College of Virginia, 1200 E. Broad St., Richmond, Va. 23298.

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 occurred 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.

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