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April 1955

Rheumatic Restenosis of Mitral Value: Report of a Case with Death Almost Five Years After Mitral Valvulotomy

Author Affiliations


From the Department of Medicine, Johns Hopkins University School of Medicine and Johns Hopkins Hospital; Assistant Professor of Medicine, Johns Hopkins University School of Medicine; Physician, Johns Hopkins Hospital.

AMA Arch Intern Med. 1955;95(4):557-562. doi:10.1001/archinte.1955.00250100063006

Certain rheumatic restenosis of the mitral valve, although much feared, has been adequately documented in very few cases. In the patient of Donzelot and his collaborators 1 rheumatic activity was thought to have been present at the time of operation. Auscultatory signs of mitral obstruction and respiratory distress reappeared, and the patient died less than one month after mitral valvulotomy. Autopsy revealed "reconstitution of the mitral stenosis." Brock 2 referred to a patient in whom restenosis had occurred by two years after operation. In two patients, who died three weeks and seven months after operation, Muller 3 found no sign of restenosis. Wood 4 stated, without detailed amplification, that in an extensive experience restenosis occurred in 5% of patients. However, he pointed out that in the first 20 patients operated on 3 instances (15%) of restenosis occurred. The last finding had at least two alternative explanations. It may indicate that