TREATMENT OF MITRAL VALVE STENOSIS BY RESECTION AND REPLACEMENT OF VALVE UNDER DIRECT VISION

Abstract

THE IMPETUS to cardiac surgery, initiated chiefly by the work of Blalock,¹ has expanded beyond the work on great vessels so that the field now has spread to involve intracardiac procedures such as closure of septal defects,² repair of stenosed valves³ and resection of coronary infarcts.⁴ The early work of resection of portions of stenosed valves by Cutler⁵ and of dilation by Souttar⁶ gave promising results, but it was soon found that in the presence of deranged cardiac function with an enlarged auricle, the regurgitation which followed resection of valves sometimes precipitated a condition which was worse than that existing from the stenosis alone. While the stenosis could be relieved, the regurgitation precipitated a state of failure in most of the patients. The work of Samways,⁷ Brunton,⁸ Cushing and Branch,⁹ Bernheim,¹⁰ Schepelmann,¹¹ Allen and Graham,¹² Cutler, Levine and