The authors examined 28 patients with mitral stenosis aged 60 years or older, incl. 20 (71%) with atrial fibrillation and 14 (50%) who had moreover signs of heart failure. None of them suffered from severe mitral stenosis with an area of the mitral orifice smaller than 1 sq. cm. Statistical comparison of groups of patients with sinus rhythm and atrial fibrillation and groups with symptoms of heart failure or without it revealed a significant difference only between the areas of the mitral orifice (P less than 0.005). In the other echocardiographic indicators (dimensions of the left atrium and volume ratio of its evacuation, left ventricular ejection fraction) there was no significant difference. According to criteria published by Okamura et al. in 1986 for patients above 60 years with mitral stenosis and incipient cardiac failure cardiosurgery should be an opportunity to prolong life.
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