Development of operations of the closed type for the correction of mitral stenosis was an important pioneer step. The open type, however, makes it possible to perform precise dissections that have never been accomplished with nearly the same degree of effectiveness by the closed technique in the past. Operations by the open technique were done in 44 patients. Among the 22 who had primary mitral stenosis there were 2 operative deaths (9%). Among the remaining 22, who had combined mitral lesions, there were 4 operative deaths (18%). About 15% of the stenotic mitral valves at operation are found to be so severely damaged by disease that little benefit can be anticipated from either closed or open operation. For reliable evaluation of results it is necessary to obtain objective data sufficiently long after operation rather than clinical impressions during the immediate postoperative period.
Kay EB, Nogueira C, Zimmerman HA. SURGICAL TREATMENT OF MITRAL STENOSIS BY OPEN TECHNIQUE. JAMA. 1960;173(15):1644–1649. doi:10.1001/jama.1960.03020330012003
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