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Before the beneficial results of mitral valvotomy were established, it was customary to follow MacKenzie's teaching and invoke myocardial weakness as the major factor in causing the heart to fail in its functions in the presence of mitral valve disease Subsequent experience of the progress of cases treated on this basis with great symptomatic and hemodynamic improvement confirms the truth of this assertion. Many workers have published large series of such cases, Baker et al. (1952) and Wood (1954) making important reports from this country.
Fleming et al. (1959) studied this question.