Mitral Valve Replacement After Closed Mitral Commissurotomy

Between November 1979 and July 1989 58 patients proviously operated with closed mitral commissurotomy (CMC) at the Center of Cardiovascular and Thoracic Surgery in Istanbul underwent open cardiac reoperations for mitral and/or other valvular lesions. Major cause of reoperation was mitral restenosis (19 cases). There were 37 female and 21 male patients whose ages ranged from 18 to 52 years (mean 38). Preoperatively, 72% were in NYHA functional class III and IV. There were 7 early (12%) and 4 late deaths (7%). Postoperative functional class showed 72% of these patients to be in class I and II. The patients were reoperated 5-20 years after the first operation. Associated valvular lesions, infections and pulmonary hypertension are the leading factors which determine the functional state, reoperation period and survival patients with previous CMC.