A total of 140 patients with mitral stenosis were treated in the Department of Thoracic Surgery, Seoul National University Hospital during the 19-Year period from October 1958 to July 1977. There were 75 men and 65 women with sex ratio of 1.2 : 1 and slight male preponderance over female. The age of the patients varied widely from 17 years of the youngest to 54 years of the oldest. All had symptoms, and the mean duration of symptoms was 6.6 years, ranging from 5 months to 20 years. Preoperative functional levels according to NYHA-classification were Class Ⅱ in 24.7% of cases, Class Ⅲ in 63.0% and Class Ⅳ in 12.3%. Preoperative emborization occured in 9.3% of cases, consisting of 88% in cerebral location. Cardiomegaly was seen on chest films in 88% of the patients, and 40.2% of cases had electrocardiographic evidence of auricular fibrillation at admission. On the preoperative hemodynamic studies, 36.8% of cases revealed pulmonary hypertension of more than moderate degree with systolic pulmonary arterial pressure higher than 60mmHg.
One hundred and twenty four patients underwent 130 operations; 92 cases had closed mitral commissurotomy, 24 open mitral commissurotomy, 9 mitral valve replacement, and 5 had explorative thoracotomy. Other 16 patients did not undergo operation against medical advice mainly due to economic problems. Calcification was noticed in the valve in 44.4% of the cases and thrombi were found in the left atrium in 29.6%. Hospital mortality rate was 6.5% with cosed method, 20.8% with open commissurotomy, and it was as high as 44.4% with mitral valve replacement respectively. The most common causes of death were postoperative low output, peripheral emboism, hepatic failure in order.
Most of the survivors left hospital in a good and improved condition.
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