Mitral or aortic commissurotomy; criteria for selection of patients

Abstract

IN THE SELECTION OF PATIENTS FOR MITRAL COMMISSUROTOMY, FIVE SEPARATE CATEGORIES ARE TO BE CONSIDERED: (1) true mitral block with small heart and high pulmonary artery pressure, (2) mitral stenosis without mitral block, (3) mitral stenosis with subacute carditis, (4) mitral stenosis with marked cardiac hypertrophy, and (5) mitral stenosis with embolism. Surgical results are good to excellent provided adequate preoperative evaluation has eliminated the groups with subacute carditis, and those without mitral block. Cardiac catheterization is a valuable adjunct in difficult problems.