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. 1996;23(4):258–266.

The relief of mitral stenosis. An historic step in cardiac surgery.

M N Khan 1
PMCID: PMC337096  PMID: 8969024

Abstract

Significant progress has been achieved in cardiac surgery in the last 50 years. Mitral valve surgery (especially for the relief of mitral stenosis) has paralleled the innovations and trends of cardiac surgery and often has served as the benchmark of the latest procedures and techniques. A chronological survey of mitral valve surgery is presented, with emphasis on parallels to cardiac surgery in general and with highlights of key figures and events that have conclusively altered the surgeon's approach to and success with cardiac dysfunction. A few surgeons promulgated the idea of cardiac surgery in the late 19th century, but mitral valve surgeries were not performed in earnest until Souttar's and Cutler's initial attempts in the 1920s and were not successful on large groups of patients until Bailey and Harken made independent breakthroughs in the 1940s, finally laying to rest the idea of the "inviolable heart." Cardiopulmonary bypass provided cardiac surgeons with the time to implant mechanical and bioprosthetic valves for palliative benefit to patients. The "perfect" valve has yet to be found, but the Starr-Edwards mechanical valve since its inception in 1961 has been one of the most successful and widely used prosthetic valves. Gradual improvement in surgical technique and growing knowledge of valve function enabled the re-emergence of mitral valve repair in the 1980s as the preferred surgical method of treating mitral stenosis. In the last 10 years, mitral valve balloon dilation has provided a nonsurgical technique for relief of stenosis and represents the broader trend towards interventional techniques.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BAILEY C. P., BOLTON H. E. Criteria for and results of surgery for mitral stenosis. II. Results of mitral commissurotomy. N Y State J Med. 1956 Mar 15;56(6):825–839. [PubMed] [Google Scholar]
  2. BAKER C., BROCK R. C., CAMPBELL M. Valvulotomy for mitral stenosis; report of six successful cases. Br Med J. 1950 Jun 3;1(4665):1283–1293. doi: 10.1136/bmj.1.4665.1283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BIGELOW W. G., CALLAGHAN J. C., HOPPS J. A. General hypothermia for experimental intracardiac surgery; the use of electrophrenic respirations, an artificial pacemaker for cardiac standstill and radio-frequency rewarming in general hypothermia. Ann Surg. 1950 Sep;132(3):531–539. doi: 10.1097/00000658-195009000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. BRAUNWALD N. S., COOPER T., MORROW A. G. Complete replacement of the mitral valve. Successful clinical application of a flexible polyurethane prosthesis. J Thorac Cardiovasc Surg. 1960 Jul;40:1–11. [PubMed] [Google Scholar]
  5. Bittl J. A. Mitral valve balloon dilatation: long-term results. J Card Surg. 1994 Mar;9(2 Suppl):213–217. doi: 10.1111/j.1540-8191.1994.tb00930.x. [DOI] [PubMed] [Google Scholar]
  6. Carpentier A. Cardiac valve surgery--the "French correction". J Thorac Cardiovasc Surg. 1983 Sep;86(3):323–337. [PubMed] [Google Scholar]
  7. Collins J. J., Jr Dwight Harken: the legacy of mitral valvuloplasty. J Card Surg. 1994 Mar;9(2 Suppl):210–212. doi: 10.1111/j.1540-8191.1994.tb00929.x. [DOI] [PubMed] [Google Scholar]
  8. Cooley D. A. Recollections of early development and later trends in cardiac surgery. J Thorac Cardiovasc Surg. 1989 Nov;98(5 Pt 2):817–821. [PubMed] [Google Scholar]
  9. Craver J. M., Cohen C., Weintraub W. S. Case-matched comparison of mitral valve replacement and repair. Ann Thorac Surg. 1990 Jun;49(6):964–969. doi: 10.1016/0003-4975(90)90877-9. [DOI] [PubMed] [Google Scholar]
  10. Ellis L. B., Singh J. B., Morales D. D., Harken D. E. Fifteen-to twenty-year study of one thousand patients undergoing closed mitral valvuloplasty. Circulation. 1973 Aug;48(2):357–364. doi: 10.1161/01.cir.48.2.357. [DOI] [PubMed] [Google Scholar]
  11. Galloway A. C., Colvin S. B., Baumann F. G., Grossi E. A., Ribakove G. H., Harty S., Spencer F. C. A comparison of mitral valve reconstruction with mitral valve replacement: intermediate-term results. Ann Thorac Surg. 1989 May;47(5):655–662. doi: 10.1016/0003-4975(89)90113-6. [DOI] [PubMed] [Google Scholar]
  12. Garver D., Kaczmarek R. G., Silverman B. G., Gross T. P., Hamilton P. M. The epidemiology of prosthetic heart valves in the United States. Tex Heart Inst J. 1995;22(1):86–91. [PMC free article] [PubMed] [Google Scholar]
  13. Gibbon J. H., Jr The development of the heart-lung apparatus. Am J Surg. 1978 May;135(5):608–619. doi: 10.1016/0002-9610(78)90119-8. [DOI] [PubMed] [Google Scholar]
  14. Grüntzig A., Kumpe D. A. Technique of percutaneous transluminal angioplasty with the Grüntzig ballon catheter. AJR Am J Roentgenol. 1979 Apr;132(4):547–552. doi: 10.2214/ajr.132.4.547. [DOI] [PubMed] [Google Scholar]
  15. Guyton S. W., Paull D. L., Anderson R. P. Mitral valve reconstruction. Am J Surg. 1992 May;163(5):497–501. doi: 10.1016/0002-9610(92)90396-9. [DOI] [PubMed] [Google Scholar]
  16. HUFNAGEL C. A., VILLEGAS P. D., NAHAS H. Experiences with new types of aortic valvular prostheses. Ann Surg. 1958 May;147(5):636–645. doi: 10.1097/00000658-195805000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Harken D. E. The emergence of cardiac surgery. I. Personal recollections of the 1940s and 1950s. J Thorac Cardiovasc Surg. 1989 Nov;98(5 Pt 2):805–813. [PubMed] [Google Scholar]
  18. Inoue K., Owaki T., Nakamura T., Kitamura F., Miyamoto N. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg. 1984 Mar;87(3):394–402. [PubMed] [Google Scholar]
  19. KORTZ A. B., SWAN H. Direct vision trans-aortic approach to the aortic valve during hypothermia; experimental observations and report of successful clinical case. Ann Surg. 1956 Aug;144(2):205–214. doi: 10.1097/00000658-195608000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. LILLEHEI C. W., COHEN M., WARDEN H. E., VARCO R. L. The direct-vision intracardiac correction of congenital anomalies by controlled cross circulation; results in thirty-two patients with ventricular septal defects, tetralogy of Fallot, and atrioventricularis communis defects. Surgery. 1955 Jul;38(1):11–29. [PubMed] [Google Scholar]
  21. LILLEHEI C. W., GOTT V. L., DEWALL R. A., VARCO R. L. The surgical treatment of stenotic or regurgitant lesions of the mitral and aortic valves by direct vision utilizing a pump-oxygenator. J Thorac Surg. 1958 Feb;35(2):154–191. [PubMed] [Google Scholar]
  22. Lessana A., Carbone C., Romano M., Palsky E., Quan Y. H., Escorsin M., Jegier B., Ruffenach A., Lutfalla G., Aime F. Mitral valve repair: results and the decision-making process in reconstruction. Report of 275 cases. J Thorac Cardiovasc Surg. 1990 Apr;99(4):622–630. [PubMed] [Google Scholar]
  23. Lock J. E., Khalilullah M., Shrivastava S., Bahl V., Keane J. F. Percutaneous catheter commissurotomy in rheumatic mitral stenosis. N Engl J Med. 1985 Dec 12;313(24):1515–1518. doi: 10.1056/NEJM198512123132405. [DOI] [PubMed] [Google Scholar]
  24. MERENDINO K. A., BRUCE R. A. One hundred seventeen surgically treated cases of valvular rheumatic heart disease; with preliminary report of two cases of mitral regurgitation treated under direct vision with aid of a pump-oxygenator. J Am Med Assoc. 1957 Jun 15;164(7):749–755. doi: 10.1001/jama.1957.02980070031007. [DOI] [PubMed] [Google Scholar]
  25. Norman A. F. The first mitral valve replacement. Ann Thorac Surg. 1991 Mar;51(3):525–526. doi: 10.1016/0003-4975(91)90892-t. [DOI] [PubMed] [Google Scholar]
  26. Pluth J. R. The Starr valve revisited. Ann Thorac Surg. 1991 Feb;51(2):333–334. doi: 10.1016/0003-4975(91)90822-8. [DOI] [PubMed] [Google Scholar]
  27. ROSS D. N. Homograft replacement of the aortic valve. Lancet. 1962 Sep 8;2(7254):487–487. doi: 10.1016/s0140-6736(62)90345-8. [DOI] [PubMed] [Google Scholar]
  28. Reyes V. P., Raju B. S., Wynne J., Stephenson L. W., Raju R., Fromm B. S., Rajagopal P., Mehta P., Singh S., Rao D. P. Percutaneous balloon valvuloplasty compared with open surgical commissurotomy for mitral stenosis. N Engl J Med. 1994 Oct 13;331(15):961–967. doi: 10.1056/NEJM199410133311501. [DOI] [PubMed] [Google Scholar]
  29. STARR A., EDWARDS M. L. Mitral replacement: clinical experience with a ball-valve prosthesis. Ann Surg. 1961 Oct;154:726–740. doi: 10.1097/00000658-196110000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Sand M. E., Naftel D. C., Blackstone E. H., Kirklin J. W., Karp R. B. A comparison of repair and replacement for mitral valve incompetence. J Thorac Cardiovasc Surg. 1987 Aug;94(2):208–219. [PubMed] [Google Scholar]
  31. Schoen F. J., Levy R. J. Pathology of substitute heart valves: new concepts and developments. J Card Surg. 1994 Mar;9(2 Suppl):222–227. doi: 10.1111/j.1540-8191.1994.tb00932.x. [DOI] [PubMed] [Google Scholar]
  32. Treasure T., Hollman A. The surgery of mitral stenosis 1898-1948: why did it take 50 years to establish mitral valvotomy? Ann R Coll Surg Engl. 1995 Mar;77(2):145–151. [PMC free article] [PubMed] [Google Scholar]
  33. Ungerleider R. M. Direct-vision aortic valvotomy: predecessor to modern aortic surgery. Ann Thorac Surg. 1994 May;57(5):1351–1353. doi: 10.1016/0003-4975(94)91402-8. [DOI] [PubMed] [Google Scholar]

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