SIMULTANEOUS CORRECTION OF MULTIVALVULAR CARDIAC LESIONS.

Cardiac surgery, once confined to pure and isolated mitral stenosis, can now be carried out on all valvular lesions irrespective of their number or complexity. At the Montreal Heart Institute, simultaneous surgical correction of multivalvular lesions was carried out in 16 instances and 13 patients survived. All of the survivors have remained almost asymptomatic. However, if significant associated valvular lesions were not corrected at the same operation, the survival rate dropped to 28%. Moreover, such survivors have required constant medical therapy.This experience emphasizes the necessity of correcting completely and simultaneously all significant valvular malfunctions. Extrapleural median sternotomy appears to be the best single approach for all cases of valve replacement.