Closed Mitral Valvlotomy at Srinagarind Hospital

Abstract

In a series of 42 patients operated upon at our hospital between October 1982 and December 1985. Of these, 38 patients (o : o = 20 : 18) underwent as elective operation and 4 patients (o : o = 3 : 1) as emergency operation.

In elective group (youngest 13 years, oldest 55 years, mean 28 + 9.87 years), there were preoperative functional class (New York Heart Association, NYHA) II,III and IV in 7, 21, and 10 cases respectively. Atrial Fibrillation (AF) was found in 10/38 (26.32%) and 4/10 (40%) had clot in left atrium (L.A).Three patients had a history of embolism, but there were no clot in left atrium. Echocardiography were done in 33/38 patients. After closed mitral valvulotomy and follow up 2-36 months, post-operative class were I 28, II 9 and IV 1 (this patient had MR and AR) with low complications. The complocations were wound infection 2 patients, empyema thorasis 1 patient and MR 2 patients. Improvement of NYHA functional class was found in 37/38 (97.37%) with no mortality.

In emergency group, all patients were functional class IV, postoperative mortality was 4/4 (100%). Three patients died 1-3 days after the operation and another one died from digitalis intoxication 11 day after operation. The overall mortality was 9.52%.