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Ann Thorac Surg 1978;25:316-321
© 1978 The Society of Thoracic Surgeons

Articles

Restenosis of the Mitral Valve: Surgical Considerations and Results of Operation

Stanley John, M.D.*, W. John Perianayagam, M.Ch., K.A. Abraham, D.M., P.S. Jairaj, F.R.A.C.S., S. Krishnaswami, D.M., I.P. Sukumar, F.R.C.P., George Cherian, M.D.

Departments of Cardiothoracic Surgery and Cardiology, Christian Medical College Hospital, Vellore, India.

Accepted for publication September 23, 1977.

* Address reprint requests to Dr. John, Department of Cardiothoracic Surgery, Christian Medical College Hospital, Vellore, 632 004, India

Our experience over an eight-year period with 63 consecutive patients with mitral restenosis who underwent operation forms the basis for this report. Striking clinical disability was a notable finding. A majority of the patients were less than 30 years old. Embolic phenomena were rare. Closed transventricular valvotomy offers excellent low-risk palliation and good long-term results.

Follow-up showed excellent or good results in 90.5% of the patients and poor results in 9.5%. Hemodynamic study of 6 patients demonstrated a pronounced decrease in the pulmonary artery pressure. Open valvotomy was performed in 6 subjects. The presence of intracardiac calcification together with mild mitral incompetence in 2 patients made valve replacement mandatory. The problem of restenosis of the mitral valve is complex, and only after further long-term results are available will the superiority of any one method be demonstrated.




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