Scientific paper| Volume 106, ISSUE 1, P38-42, July 1963

The challenge of mitral stenosis in men

A three to ten year follow-up study
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      • 1.
        1. Fifty-one patients operated upon for mitral stenosis at the West Roxbury Veterans Administration Hospital, and followed for a period of three to ten years, have been analyzed for the incidence of restenosis.
      • 2.
        2. In twenty-six patients (51 per cent) restenosis developed. Eight died of valvular disease, ten were reoperated upon and eight patients with clinical restenosis were not operated upon.
      • 3.
        3. Forty-nine of fifty-one patients were men. The valves were calcified in 66 per cent of fifty-one.
      • 4.
        4. The valves of the patients in this series were classified according to the anatomic features described by the surgeon at operation, and to the quality of the commissural fracture (split) accomplished.
      • 5.
        5. The eight valves with no calcium and complete mobility of the leaflet surfaces and chordae tendineae all had satisfactory splits and none recurred.
      • 6.
        6. The remaining forty-three valves showed an incidence of inadequate split and recurrence ascending from 33 per cent to 77 per cent in direct relation to the severity of valve damage by calcification.
      • 7.
        7. The incidence of calcification in this predominantly male series was 66 per cent as contrasted to 15 per cent reported by others in women with mitral stenosis.
      • 8.
        8. The mean interval between operation and severe disability from recurrent disease was about five years. The importance of prompt reoperation is emphasized by eight deaths probably due to restenosis in patients whose long-term postoperative care had not been supervised.
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