The hemodynamic results of instrumental and digital valvotomy in patients with mitral stenosis

In order to evaluate the postoperative results from mitral valvotomy when patients were selected according to age, sex, cardiac rhythm, and mode of operation, the mitral valve area (MVA) was determined by cardiac catheterization in 32 patients before and 1 year following closed mitral valvotomy. There was a significantly greater increase in MVA in female patients, younger patients, and patients with sinus rhythm than in males, patients over 45 years of age, and patients with atrial fibrillation. Patients who had an instrumental valvotomy (20 patients) did not have a greater postoperative increase in MVA than patients who had a digital valvotomy (12 patients); however, patients with the largest postoperative MVA had instrumental valvotomy. The incidence of postoperative mitral insufficiency was similar in patients with digital and instrumental valvotomy. Small flecks of mitral valve calcification, as determined by preoperative image-intensification fluoroscopy, did not influence the postoperative MVA.