Original communication| Volume 32, ISSUE 6, P923-932, December 1952

The technique of mitral valvulotomy

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      The technique of mitral valvulotomy employed in twenty-one consecutive patients with mitral stenosis is presented. An anterior fourth intercostal space incision with division of the fourth costal cartilage has provided satisfactory exposure. The maneuvers of introduction and withdrawal of the finger without blood loss are described briefly. Digital dissection of the commissures is the standard procedure, but on occasion a valvulotome may be necessary to initiate the division of the commissures. Closure of the auricular appendage is done with multiple interrupted sutures. The amputated auricular appendage and a lung biopsy are studied for characteristic histologic changes. The use of procaine hydrochloride as intravenous injection, pericardial instillation, or myocardial infiltration has not been found necessary. Instead, quinidine is employed to reduce the complications produced by cardiac arrhythmias.
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        • Bailey C.P.
        The Surgical Treatment of Mitral Stenosis (Mitral Commissurotomy).
        Dis. of Chest. 1949; 15: 377
        • Baker Charles
        • Brock R.C.
        • Campbell M.
        Valvulotomy for Mitral Stenosis.
        Brit. M. J. 1950; 1: 1283
        • Bland E.F.
        • Sweet R.H.
        A Venous Shunt for Marked Mitral Stenosis, Case 53.
        Am. Pract. 1948; 2: 756
        • Brunton L.
        Surgical Operations for Mitral Stenosis.
        Lancet. 1902; 1: 352
        • Collins V.J.
        Anesthetic Management of Cardiac Patient With Reference to Diagnosis and Treatment of Cardiac Arrhythmias.
        J. Indiana State M. A. 1950; 43: 479
        • Cossio P.
        • Perianes I.
        Surgical Treatment of the Cardiac Lung.
        J. A. M. A. 1949; 140: 772
        • Cutler E.C.
        • Levine S.A.
        Cardiotomy and Valvulotomy for Mitral Stenosis.
        Boston M. & S. J. 1923; 188: 1023
        • Cutler E.C.
        • Beck C.S.
        The Present Status of the Surgical Procedures in Chronic Valvular Disease of the Heart.
        Arch. Surg. 1929; 18: 403
        • Harken D.E.
        • Ellis L.B.
        • Ware P.F.
        • Norman L.R.
        The Surgical Treatment of Mitral Stenosis. I. Valvuloplasty.
        New England J. Med. 1948; 239: 801
        • Huggins R.A.
        • Morse R.A.
        • Chapman D.W.
        • Schuhmacker L.F.
        The Effect of Quinidine or Arrhythmias Induced by Cyclopropane and Cyclopropane Epinephrine.
        Anesthesiology. 1950; 11: 623
        • Parker Jr., F.
        • Weiss S.
        Nature and Significance of Structural Changes in Lungs in Mitral Stenosis.
        Am. J. Path. 1936; 12: 573
        • Samways D.W.
        Cardiac Peristalsis; Its Motions and Effects.
        Lancet. 1898; 1: 927
        • Sellors T.H.
        Finger-nail Knife for Commissurotomy in Mitral Stenosis.
        Lancet. 1951; 1: 8
        • Sellors T.H.
        Finger-nail Knife for Commissurotomy in Mitral Stenosis.
        Lancet. 1951; 1: 448
        • Smithy H.G.
        An Approach to the Surgical Treatment of Chronic Valvular Disease of the Heart.
        in: Proc. 16th Assembly, Southeastern Surgical Congress, Hollywood, Fla.April, 1948
        • Souttar H.S.
        The Surgical Treatment of Mitral Stenosis.
        Brit. M. J. 1925; 2: 603