[Reoperation after open mitral commissurotomy for mitral stenosis].

Between 1975 and 1993, 16 of 95 patients who received open mitral commissurotomy for mitral stenosis required reoperation for recurrent mitral lesions with a mean duration of 11 years after the initial operation at Kawasaki Medical School Hospital. The mitral lesions necessitating reoperation involved restenosis in eight, stenoinsufficiency in six and regurgitation in two. In 13 patients, mitral commissure was well separated, and the mitral restenosis and regurgitation were caused by progressions of valvular and subvalvular lesions. Significant tricuspid valve regurgitation was also seen in nine patients, and in seven out of eight patients who were in NYHA functional class III or IV, tricuspid regurgitation of grade 3 was observed. The combined tricuspid regurgitation aggravated the patient's symptoms and became a major risk factor of the reoperation after open mitral commissurotomy.