Observations on the Surgical Treatment of Mitral Stenosis by Commissurotomy

The surgery of mitral stenosis has played the primary role in introducing the current principles of intracardiac surgery, and the success of this venture has served to establish it as a background for future developments. Since the first successful operation performed by us, June 10, 1948, there have been a succession of favorable results. These principles have been projected to apply to other defects, such as pulmonic and aortic abnormalities and the septal defects. Nevertheless, efforts in none of these other defects have been more gratifying than the original efforts in mitral stenosis. THE BASIC PROBLEMS The disease itself is an acquired one, mostly following attacks of rheumatic fever. The basic problem has always been a surgical one, leading out of the observation that the fault is a mechanical stricture. Heretofore, correction of this defect has been hampered not only by technical difficulties but also by needlessly perverse reasoning. These