Valvulotomy for Pulmonary

An earlier paper, reporting 3 successful cases (Brock, 1948), showed the feasibility of valvulotomy for the relief of pulmonary valvular stenosis. The present paper deals with our clinical and operative experience in 33 cases-a number large enough to allow certain conclusions to be drawn. Of the 33 patients submitted to operation, 18 had pure pulmonary stenosis, by which we mean pulmonary valvular stenosis with a closed interventricular septum, regardless of the patency or potential patency of the foramen ovale, and in 7 this was confirmed by necropsy (see Table I); all but 3 probably had a patent foramen ovale and in 6 this was proved by necropsy. In the other 15 (see Table II) valvular stenosis was thought to be part of a Fallot's tetralogy and in 3 this was confirmed by necropsy. Increasing experience in the diagnosis and surgical treatment of pulmonary stenosis has led us from a grave mortality of just over 50 per cent in the first 11 patients, most of whom were unlikely to live long as they had very large hearts and often congestive failure, to a mortality of 18 per cent in the remaining 22, these including many younger patients in whom thTe stenosis had not yet caused such serious changes;.