Abstract
Heavy calcification of the mitral valve is the most important of adverse factors affecting prognosis after valvotomy. Its presence, however, should not itself be a contraindication to valvotomy either on grounds of operative mortality or of long-term results. Until further experience has been gained with valve replacement it seems that closed transventricular valvotomy should be advised in the 1st instance, and valve replacement should be carried out at a later date if the post-operative result is unsatisfactory.
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