[Mitral commissurotomy or mitral valve replacement. Comparison of results of closed and open operative procedures in acquired mitral valve stenoses and combined mitral valve defects, predominantly stenosis].

1012 closed operations for mitral stenoses, mitral restenoses and combined mitral and aortic stenoses were performed from 1963 to 1981. Moreover 888 operations were performed at the mitral valve from 1973 to October 1983 as open heart procedures: 676 cases of mitral valve replacement (MVR) including 7 cases of coronary artery operations; 4 cases both of mitral, aortic and tricuspidal valve replacement or mitral and tricuspidal valve replacement; 9 cases of valve reinsertion; 20 cases of open commissurotomy and 4 cases of annular plastic according to Wooler. The functional results after open operation are quite better than those after closed procedures. The rate of reoperations after MVR is only 3% but after closed operations more than 25%. In this way we believe the open operation to be the better way of treating acquired mitral stenosis. In our opinion the closed method may be used in cases of late pregnancy and in those centres having an insufficient capacity for open heart surgery to be performed.