Indian Journal of Thoracic and Cardiovascular Surgery 1985-86; 4 :77 -78

A Modified Ventriculotomy Dilator-cum-Probe for Transventricular Mitral Commissurotomy SOLOMON VICTOR*

ABSTRACT : A convenient one-pass ventriculotomy wound dilator-cum-probe for mitral commissurotomy is described.

KEY WOROS : equipment design, heart surgery, surgical equipment, mitral stenosis.

I N T R O D U C T I O N

Transventricular mitral commissurotomy is the commonest cardiac operation performed in India.

Usually a set of 3 or 4 double-ended uterine dilators of varying diameters (Fig. 1) is deployed to enlarge the ventriculotomy wound and probe the stenotic orifice prior to passage of the Tubbs dilator. A one- pass ventricuiotomy dilator-cum-probe device replacing the set of uterine dilators is described.

T H E I N S T R U M E N T

We have introduced a tapered dilator (Fig. 2) which simplifies the procedure. The narrow tip is

Fig. 1 Conventional set of dilators

"Additional Professor

From the Department of Cardiothoracic Surgery, Institute of Cardiology, Government General Hospital, Madras, India.

Address for correspondence : Dr. Solomon Victor, 15, East Street, Kilpauk Garden Colony, Madras 600 010, India.

Fig. 2 The modified tapered ventriculotomy dilator-cum- probe

78 Victor

easily introduced through the ventriculotomy and guided into the mitral orifice. During this manoeuvre, the progressively increasing diameterof the dilator enlarges the ventriculotomy wound and obviates the need for repeated introduction of varying sizes of dilators.

COMMENT

This one-pass dilator-cum-probe has been found useful in a few thousand cases. It is especially helpful during emergency mitral valvotomy. It also minimises blood loss through the ventriculotomy wound.