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December 1959

Emergency Mitral Valvular Commissurotomy Preceding a Second Aortic Embolectomy

Author Affiliations

New York
From the Surgical and Medical Divisions, The Montefiore Hospital.

AMA Arch Surg. 1959;79(6):1009-1012. doi:10.1001/archsurg.1959.04320120151019

Embolization to the bifurcation of the abdominal aorta represents one of the more serious complications that may develop in a patient with rheumatic mitral stenosis. Unless prompt embolectomy is accomplished, the mortality rate is extremely high. The three survivals in the series of 11 consecutive operative cases of saddle embolus of aorta previously reported from this hospital1 all were subjected to surgery within seven hours of the onset of embolization. With the widespread performance of surgical procedures for the mechanical relief of the obstructed mitral valve, one may now evaluate the management of saddle embolization with reference to one of three time categories: occurring prior to, during, or after mitral valvular commissurotomy. Each of the three survivals previously reported fell into a different one of these categories.

When aortic embolization occurs during the course of surgery on the mitral valve, prompt embolectomy is associated with a high degree of

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