TREATMENT OF MITRAL STENOSIS BY FINGER FRACTURE VALVULOTOMY

THE DEVELOPMENT of a satisfactory technique for the relief of mitral stenosis has been one of the most challenging problems in surgery. The prediction that surgeons would operate upon the mitral valve was made by Samways in 1898.¹ Shortly thereafter Sir Lauder Brunton investigated the problem of mitral stenosis experimentally and suggested that improvement might follow surgical incision of the diseased valve.² This statement led to the publication of a series of letters in The Lancet for 1902, most of which were opposed to this type of surgery. During the next 20 years the subject was explored seriously in this country, both in the laboratory and clinically.³ It is interesting to recall that Harvey Cushing was one of the first to investigate the possibility of producing mitral stenosis experimentally, with a view toward its relief by surgical intervention.^3a

During this period a good deal of effort