Background: Rheumatic heart disease is the most common cause of mitral valve stenosis. About 20 million people are believed to be affected with rheumatic heart fever in underdeveloped countries, and 40% of these patients have only mitral valve disease. The characteristic features of mitral stenosis are leaflet / chordal thickening and retraction. All current operations for the condition are palliative.

Aims of the study: To know the results of closed mitral valvotomy in patients undergoing surgery for mitral valve stenosis.

Material and Methods: The study was conducted on all the patients who underwent closed mitral valvotomy.

Results: 97 patients, mostly in 3^rd decade of life, irrespective of age, sex, surgical results were included in the study. Majority, 60.82% were in New York Heart Association Functional class III, 55.67% were fibrillating. Closed mitral valvotomy was done in 90 (90.78%) of  patients.

Conclusion: In pure mitral stenosis, closed mitral valvotomy gives good results, and is still relevant even in current minimally invasive era.

Keywords: Mitral valve, Mitral stenosis, Closed mitral valvotomy.

1.      Woods P. An appreciation of mitral stenosis. Part I. Clinical features. Br Med J 1954; 1: 1051.

2.      Woods P. An appreciation of mitral stenosis. Part II. Br Med J 1954; 1: 1113.

3.      Welch KJ, johonson J, Zinsser H. The significance of pulmonary vascular lesions in the selection of patients for mitral valve surgery. Ann Surg 1950; 132: 1027.

4.      Cutler EC, Levine SA. Cardiotomy and Valvotomy for mitral stenosis. Experimental observation and clinical notes concerning an operated case with recovery. Bastobon Med Surg J 1923; 188:1024.

5.      Souttar HS. The surgical treatment of mitral stenosis. Br Med J 1925; 2: 258.

6.      Bailey Cp. The surgical treatment of mitral stenosis (mitral commissurotomy). Dis Chest 1949; 15; 377.

7.      Blasé A carabello. Contemporary Reviews in cardiovascular medicine. Circulation 2005; 112: 432-437.

8.      Krasuski RA, Bush A, Kay JE, Mayes CE, Wang A, Fleming J et al. C-reactive protein elevation independently influences the procedural success of percutaneous balloon mitral valve commissurotomy. Am Heart J 2003; 146: 1099-1104.

9.      Waheed G Attman, Salah EL Tahan. Minimally invasive closed mitral commissurotomy. Texas Heart Institute Journal 1999; 26(4): 269-274.

10.  Wilkins GT, Weyman AE, Abascal VM, Block PC, Palacious IF. Percutaneous balloon dilatation of the mitral valve: an analysis of the echocardiographic variables related to out come and the mechanism of dilatation. Br Heart J 1988; 60: 299-308.

11.  Spencer FC. A plea for early, open mitral commissurotomy. Am Heart J 1978; 95: 668. 

12.  Ellis LB, Singh JB, Morales DD, Harken DE. Fifteen to twenty years study of one thousand patients undergoing closed mitral valvuloplasty. Circulation 1973; 48: 357-64.

13.  John S, Bashi VV, Jairaj PS, Muralidharan S, ravikumar E, rajarajeshwari T, et. al. Closed mitral valvotomy: early results and long-term follow-up of 3724 patients. Circulation 1983; 68: 891-96.

14.  Brewer LA, Discussion of Finnegan JO, Gray DC, Macwagh H, Joyner CR, Johnson J. The open approach to mitral commissurotomy. J Thorac Cardiovasc Surg 1974; 67: 75-80, p 81-2.

15.  Obeid AL, Marvasti M, Parker F, Rosenberg J. Comparison of transthoracic and transesophageal echocardiography in diagnosis of left atrial myxoma. Am J Cardiol 1989; 63: 1006-8.

16.  Aschenberg w, Schluter m, kremer P, Schroder e, Siglow V, Bleifeld W. Transesophageal two-dimensional echocardiography for detectection of left atrial appendage thrombus. J Am Coll Cardiol 11986; 7: 163-6.

17.  Gross RL, Cunningham J N, Snively SL et al. Long term results of open radical mitral commissurotomy: Ten year follow-up study of 202 patients. Am J cardiol 1981; 47: 655.

18.  Austen WJ, Wooler GH. Surgical treatment of mitral stenosis, by the transventricular approach with a mechanical dilator. N Engl J Med 1960; 263: 661.

19.  Frazer, K., Turner, M. A., and Sugden, B. A. Closed mitral valvotomy. British Medical Journal 1976; 2: 352-353.

20.  Kenneth Frazer and Brian A Sugden. Second closed mitral valvotomy for recurrent mitral stenosis. Thorax 1977; 32: 759-762.

21.  C. Rollins Hanlon, Georce C. Kaisor, J. Gerard Mudd, Vallee L. Willman. Closed Mitral Commissurotomy for Mitral Stenosis. Annals of Surgery 1968; 167(5): 796-800.