IT IS NOT the province of this paper to discuss in detail the diagnosis of mitral valve disease or to delineate our criteria for selection of patients for operation. We have considered the latter problem at a previous meeting of this Association.1 However, a few statements in this regard may be useful.
At the State University of Iowa Hospitals internists, radiologists, clinical physiologists, and surgeons work as a team (Fig. 1) in the selection of patients for mitral valvuloplasty and in their management. To date 95 cardiotomies have been performed on patients ranging from 11 to 60 years of age, with an operative mortality rate of only 4.3%. We do not recommend operation on patients in whom mitral stenosis exists but in whom there are no clinical symptoms referable to this lesion. All 95 patients have had symptomatic mitral valve disease; many had been deteriorating clinically, and a few