[Surgical procedure in complicated mitral stenosis].

The experience with the surgical treatment of complicated forms of mitral stenosis in 110 patients with the III and IV classes of the disease according to the classification of the New York Heart Association was analyzed. Closed mitral commissurotomy was performed in 36 patients, opened commissurotomy--in 33 patients, prosthetics of the mitral valve was made in 41 patients. Closed mitral commissurotomy is believed to be the simplest method of correction of the duct in mild calcinosis and deformity of the mitral valve, and fixed thrombosis of the left auricle. Opened mitral commissurotomy was justified in case of thrombosis of the left auricle and mild calcinosis and deformity of the valve. Substitution of the valve is indicated in cases of massive calcinosis and rough deformity of the valve and subvalvular structures when valve-preserving operations are impossible.