Some Clinical and Physiologic Effects of Mitral Commissurotomy

Eighteen patients, selected for mitral commissurotomy on the basis of appreciable hemodynamic abnormalities as well as physical disability have been studied prior to and following surgery. The results suggest that well compensated patients with mitral stenosis, normal sinus rhythm and pulmonary hypertension are likely to benefit from operation. Patients with atrial fibrillation, good compensation and moderate pulmonary hypertension may benefit from mitral commissurotomy. In patients with atrial fibrillation, marked pulmonary hypertension and congestive heart failure, operation is hazardous and the likelihood of benefit is small. The importance of myocardial function in the production of these results is discussed.