Between January, 1993 and January, 1998, 59 patiens, had a second operation for rheumatic mitral disease. The average interval between their first and second operations was 10.8±2.9 years. At their first operation, closed mitral valvotomy in 35 patiens (59.3), open mitral valvotomy in 17(28.9), allcarbon tilting disc prosthesis valve implantation in mitral position in 5(8.5%) and bioprosthesis valve implantation in mitral position in 2 (3.3%) had been done.
All patiens were administered 560 mg of aprotinin to reduce blood transfusion besides autotransfusion during the operations. We expressly shortened the short aortic crossclamp duration. Within the postoperative 24 hours, while the average drainage volume was 252.4±66.1 ml, the average erytrocite suspansion volume to be tranfused indicated 1.2±0.6 units.
No mortality was registered during either early or late stages in patiens with class II, III preoperative functional capactiy and also in patients with acute bacterial endocarditis indication, whereas two patients (3.3%), in functional class IV, died postoperatively within the early period.
Blood conservation, total myocardial protection, good timing and a good preoperative efor capactiy are the factors which may reduce mortality and morbidity.