Factors of possible value in determining whether a patient was likely to benefit from mitral commissurotomy by the closed-heart technique were sought in a series of 92 consecutive cases. The patients were repeatedly observed by the same group of physicians for as long as eight years after operation. Deaths immediately after operation or occurring during the years of observation brought the total mortality to 28%. Improvement sufficient to promote the patient at least to the next higher functional classification occurred for at least one year in 76% of the patients but was sustained during the remainder of the observation period in only 47%. The two major factors adversely affecting prognosis were preexisting mitral insufficiency and production of an inadequate valve opening at operation. Criteria for operability by this procedure are defined. New techniques of operation may be helpful to patients not meeting these criteria.
Adatto IJ, Bliss HA. PROGNOSIS AFTER MITRAL COMMISSUROTOMY: FACTORS AFFECTING RESULTS IN NINETY-TWO PATIENTS. JAMA. 1959;170(9):1011–1018. doi:10.1001/jama.1959.03010090001001
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