Combined aortic and mitral stenosis.

While mitral stenosis is still frequently encountered despite the large decline in the incidence of acute rheumatism, combined mitral stenosis and aortic stenosis is less common. The recognition of the existence of aortic stenosis in association with mitral stenosis is important, as both can be dealt with successfully at one operation. If the aortic lesion goes undetected and mitral valvotomy alone is performed, the results may sometimes prove disastrous (Ross, 1959). Honey (1961) recently reviewed the clinical and hemodynamic features of 35 patients with this combination, 32 of whom were operated on. The present series comprises 15 patients seen at Mearnskirk Hospital between November 1957 and January 1962, all of whom underwent surgical treatment. The symptoms and clinical features ofcombined aortic and mitral stenosis are compared with. those of isolated aortic stenosis. A further five had mitral stenosis with an aortic systolic murmur but the aortic gradient at operation was regarded as insignificant.