Eighty-four cases of mitral commissurotomy were done in this department between October 1958 and September 1970.
There were 54 males and 30 females. Six cases were under the age of 20 years.
Preoperative embolization occurred in 9.5 % of the cases, consisting of 8.3% cerebral and 1. 2% peripheral embolization.
Intraoperative and postoperative embolization occurred in 4.7% of the cases, with 1.2% cerebral and 15% peripheral embolism. Two out of three postopeative embolism cases expired, one of which was caused by septic cerebral embolism due to valve vegetation and the other by mesenteric embolism.
Atrial fibrillation was noted in 43% of the cases.
Seventy closed mitral commissurotomy was done by left appendegeal approach with finger fracture method or Bailey´s guillotine valvotome.
Fourteen open mitral commissurotomy cases were done either by right side approach or median sternotomy, three of which were reoperation case after blind mitral commissurotomy.
One out of 14 cases were operated oil with open mitral commissurotomy and concomitant open aortic valve bicuspidalization, This case expired due to severe serum hepatitis ten days after operation.
Thirty-two per cent of valve calcification was noted during operation and one of which had marked vegetation on the valve cusps too.
Operative mortality was 1.4% in blind mitral commissurotomy and 14% in open mitral commissurotomy. Over-all mortality in the entire series was 3.5%.
One case among the blind commissurotomy cases expired during operation due to left inferior pulmonary vein laceration and death was caused in two open mitral commissurotomy cases by coronary artery air-embolism.
Three hospital death occurred in blind operation group, one due to coronary embolism, and two by hepatic failures. Three hospital death among open heart surgery cases were caused by hepatic failure in two and cerebral embolism in one cases.
In most of the survivors improved functional capacity and exercise tolerance were noted.
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