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The correction of intracardiac anomalies under direct vision represents one of the great surgical triumphs of the last decade. The early application of "open heart" techniques was generally directed at congenital lesions, but in the past 5 years a rapidly increasing number of patients suffering from postrheumatic valvular deformities have been treated and improved by the open surgical approach.
Throughout this period closed mitral commissurotomy has remaind the most widely practiced procedure for the relief of symptomatic mitral stenosis. Its world-wide acceptance seemed justified in view of the clinical improvement reported by a majority of patients subjected to it, and the low mortality rates associated with its performance.
A clinical report published in this issue (p. 268) by Nichols and associates challenges this view and presents pertinent arguments in favor of open mitral commissurotomy for stenosis. The results of 200 consecutive operations under direct vision are presented.
The investigators outline
"OPEN" MITRAL COMMISSUROTOMY. JAMA. 1962;182(3):292. doi:10.1001/jama.1962.03050420068018
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