Robert P. Glover

Does Mitral Stenosis Recur after Commissurotomy

The ultimate fate of the incised commissure following surgery for mitral stenosis will remain unknown for years to come. A clinical appraisal of patients living five years after commissurotomy and a review of available autopsy material from patients surviving surgery for periods up to four years indicates that valvular restenosis does not occur within the first half decade provided the commissurotomy has been properly performed.

Circumferential suture of the mitral valve for the correction of regurgitation.

Abstract This paper describes in detail the technic for mitral circumferential suture as currently used. It describes some of the minor changes which have been used and emphasizes the reasons for the various steps of the procedure. The early and late clinical results of application of this operation in 58 patients with severe “pure” or predominant mitral regurgitation are briefly summarized.

Mitral Commissurotomy in the Older Aged Patient: An Analysis of Twenty Patients Over the Age of Fifty

An analysis of 20 consecutive cases of mitral stenosis (from a total of 400 cases) in patients between the ages of 50 and 61 treated by mitral commissurotomy from May 1951, to October 1952, is presented. The data suggests that the patient over 50 with symptomatic mitral stenosis can have a functionally satisfactory commissurotomy performed without undue operative risk and with essentially the same ultimate degree of improvement enjoyed by patients requiring treatment at an earlier age.

Status of Fifty Patients Four and a Half to Seven Years after Mitral Commissurotomy

The first 50 consecutive patients undergoing mitral commissurotomy approximately 4½ to 7 years ago have been subjected to a detailed analysis in an attempt to ascertain their present subjective and objective status. Operative mortality was 6 per cent and late mortality was 12 per cent. Forty-one patients (82 per cent) are living and have formed the basis for conclusions. After a comprehensive study of each living patient, including an appraisal of the patients subjectively reported clinical state, as well as a correlation of the clinical findings, electrocardiographic tracings, teleroentgenograms, and catheterization data, we conclude that 29 patients (71 per cent of those living or 58 per cent of the original 50) are in better condition and living a more nearly normal life than they were prior to surgery.

The direct surgical attack on pulmonary stenosis in the tetralogy of Fallot.

Summary Thirty consecutive patients with the tetralogy of Fallot have been operated upon, using a direct intracardiac approach to relieve the pulmonary stenosis. Twenty-three patients have survived and the results have been very satisfactory. The over-all mortality rate was 23.3 per cent, the operative mortality rate being 20 per cent. The objections to this direct relief of the stenosis are briefly reviewed and its advantages summarized.

A simple method for the determination of aortic valve gradients at surgery

Abstract 1. 1. A simple Y bridge is described which facilitates the determination of pressure gradients across the aortic valve during surgery. 2. 2. Comparison of preoperative and operative gradients in patients with aortic and pulmonic stenosis has shown satisfactory correlation, enhancing the value of operative pressure studies.