The surgical relief of obstruction at the valves of the heart and in the great vessels has been widely practiced for the last 10 years and has proved most successful. I am discussing the present position for patients with pulmonary stenosis, aortic stenosis, or coarctation of the aorta. The question is approaching a definitive answer for pulmonary stenosis and coarctation but not for aortic stenosis. I am reviewing our own experience at Guy's Hospital, London, rather than experience at other centers, but think they are in general agreement; this has the advantage that all the patients in the series referred to have been studied by me.
Coarctation of the Aorta
Most patients with coarctation feel well and can lead a normal life, but its presence carries serious hazards, especially in the third decade—hazards of aortic rupture, of intracranial hemorrhage from a berry aneurysm, and of subacute bacterial endocarditis. The blood