STUDIES IN MITRAL STENOSIS: I. A Correlation of Physiologic and Clinical Findings

MITRAL stenosis is unique in that it is the only type of heart disease in which there is a mechanical barrier to the entrance of blood into the left side of the heart. This results in a tendency to congestion and elevation of pressure throughout the pulmonary circulation. Unlike the dynamic situation in left ventricular failure, this stenotic dam may remain static for a long period, with little change in the clinical state of the patient. Ultimately, however, secondary effects on the left auricle, the pulmonary circulation, or the right ventricle develop to such a degree as to determine the final outcome. This condition lends itself, therefore, to the theoretical possibility of relief by reconstructive surgical measures at the site of obstruction, the mitral valve. In recent years this theoretical possibility has been increasingly translated into the realm of the practical with the development of operative procedures which are giving