The History of Mitral and Tricuspid Valve Surgery Before the Advent of Cardiopulmonary Bypass

  • Luigi Chiariello
  • Paolo Nardi
  • Giovanni Alfonso Chiariello


The history of mitral valve surgery runs parallel to the development of heart surgery, as at the turn of the last century rheumatic fever was an epidemic disease that led to late cardiac valve lesions, mostly to mitral stenosis. The year 1948 was historically an important step in the development of closed mitral surgery: on 10 June Bailey performed his first successful commissurotomy and on 16 June Harken performed his first valvuloplasty. Closed mitral valve surgery should be considered one of the most relevant landmarks of heart surgery especially because, focusing on the basic concepts of anatomy and physiopathology of the mitral valve, a simple and effective therapeutic procedure was developed, that briefly became one of the most diffuse cardiac operations performed. Once satisfactory results were obtained and mortality became consistently low, the fate of thousands of patients with rheumatic mitral stenosis dramatically changed. Closed mitral valvuloplasty was considered for long time to be a very effective procedure, in spite of the introduction and diffusion of open heart surgery: thus, until the 1970s most surgeons advised closed valvulotomy as the primary operation in all patients with mitral stenosis.


Mitral Valve Mitral Regurgitation Mitral Stenosis Mitral Valve Surgery Valve Orifice 


  1. 1.
    Davila JC (1998) The birth of intracardiac surgery: a semicentennial tribute (June 10, 1948–1998). Ann Thorac Surg 65:1809–1820PubMedCrossRefGoogle Scholar
  2. 2.
    Naef AP (2004) The mid-century revolution in thoracic and cardiovascular surgery: part 5. Interact Cardiovasc Thorac Surg 3:415–422PubMedCrossRefGoogle Scholar
  3. 3.
    Murray G, Wilkinson FR, Mackenzie R (1938) Reconstruction of the valves of the heart. Can Med Ass J 4:317–320Google Scholar
  4. 4.
    Brunton L (1902) Possibility of treating mitral stenosis by surgical methods. Lancet 1:35Google Scholar
  5. 5.
    Khan MN (1996) The relief of mitral stenosis. An historic step in cardiac surgery. Tex Heart Inst J 23:258–265PubMedCentralPubMedGoogle Scholar
  6. 6.
    Barber JM, Smiley TB, Marshall R (1950) Valvulotomy for mitral stenosis. Ulster Med J 19:186–189PubMedCentralPubMedGoogle Scholar
  7. 7.
    Cutler EC, Beck CS (1925) The present status of the surgical procedures in chronic valvular disease of the heart. Arch Surg 18:403–416CrossRefGoogle Scholar
  8. 8.
    Gonzalez-Lavin L, Bailey C, Harken D (1992) The dawn of the modern era of mitral valve surgery. Ann Thorac Surg 53:916PubMedCrossRefGoogle Scholar
  9. 9.
    Harken D (1967) Heart surgery—legend and a long look. Am J Cardiol 19:393–401PubMedCrossRefGoogle Scholar
  10. 10.
    Dobell AR (1996) Rival trailblazers: the origin of successful closed valvular surgery. Ann Thorac Surg 61:750–754PubMedCrossRefGoogle Scholar
  11. 11.
    Harken DE, Ellis LB, Ware PF et al (1948) The surgical treatment of mitral stenosis—valvuloplasty. N Engl J Med 239:801–809PubMedCrossRefGoogle Scholar
  12. 12.
    Harken DE, Dexter L, Ellis LB et al (1951) The surgery of mitral stenosis: finger-fracture valvuloplasty. Ann Surg 134:722–741PubMedGoogle Scholar
  13. 13.
    Ellis LB, Harken DE (1964) Closed valvuloplasty for mitral stenosis: a twelve year study on 1571 patients. N Engl J Med 270:643PubMedCrossRefGoogle Scholar
  14. 14.
    Baker C, Brock RC, Campbell M (1950) Valvulotomy for mitral stenosis. Report of six successful cases. Br Med J 3:1283–1293CrossRefGoogle Scholar
  15. 15.
    Crawford FA (1996) The origins of successful closed valvular surgery. Ann Thorac Surg 62:628–629PubMedCrossRefGoogle Scholar
  16. 16.
    Crawford FA (2010) Horace Smithy: pioneer heart surgeon. Ann Thorac Surg 89:2067–2071PubMedCrossRefGoogle Scholar
  17. 17.
    Alexi-Meskishvili VV, Potapov EV, Beyer EA et al (1998) Nikolai Terebinski: a pioneer of the open valve operation. Ann Thorac Surg 66:1440–1443PubMedCrossRefGoogle Scholar
  18. 18.
    Terebinski N (1938) Experimental stenosis of the atrioventricular valves of the heart and their repair. Khirurgia 12:36–43Google Scholar
  19. 19.
    Bailey CP, Jamison WL, Bakst AE et al (1954) The surgical correction of mitral insufficiency by the use of pericardial grafts. J Thorac Surg 28:551–603PubMedGoogle Scholar
  20. 20.
    Harken DE, Black H, Ellis LB et al (1954) The surgical correction of mitral insufficiency. J Thorac Surg 28:604–623PubMedGoogle Scholar
  21. 21.
    Trace HD, Bailey CP, Wendkos MH (1954) Tricuspid commissurotomy with a one year of follow-up. Am Heart J 47:613–618PubMedCrossRefGoogle Scholar
  22. 22.
    Brofman BL (1953) Right auriculoventricular pressure gradients with special reference to tricuspid stenosis. J Lab Clin Med 42:789Google Scholar
  23. 23.
    Likoff W, Berkowitz D, Denton C et al (1955) A clinical evaluation of surgical treatment of combined mitral and aortic stenosis. Am Heart J 49:394–406PubMedCrossRefGoogle Scholar
  24. 24.
    Kay JH, Zubiate P, Mendez MA et al (1978) Mitral valve repair for significant mitral insufficiency. Am Heart J 96:253–262PubMedCrossRefGoogle Scholar
  25. 25.
    Carpentier A (1983) Cardiac valve surgery: the “French correction”. J Thorac Cardiovasc Surg 86:323–337PubMedGoogle Scholar
  26. 26.
    Duran CG, Pomar JL, Revuelta JM et al (1980) Conservative operation for mitral insufficiency. Critical analysis supported by postoperative hemodynamic studies of 72 patients. J Thorac Cardiovasc Surg 79:326–337PubMedGoogle Scholar
  27. 27.
    Baker C, Brock RC, Campbell M et al (1952) Valvotomy for mitral stenosis; a further report, on 100 cases. Br Med J 17:1043–1055CrossRefGoogle Scholar
  28. 28.
    Bailey CP, Zimmerman J, Likoff W (1960) The complete relief of mitral stenosis. Ten years of progress towards this goal. Chest 37:661–674CrossRefGoogle Scholar
  29. 29.
    Glenn WW, Calabrese C, Goodyear AV et al (1969) Mitral valvulotomy. Open results after closed valvulotomy: a report of 500 cases. Am J Surg 117:493–501PubMedCrossRefGoogle Scholar
  30. 30.
    Ellis LB, Singh JB, Morales DD et al (1973) Fifteen- to twenty-year study of one thousand patients undergoing closed mitral valvuloplasty. Circulation XLVIII:357–364CrossRefGoogle Scholar
  31. 31.
    Augested KM, Martyushova K, Fedorov B et al (2000) Closed mitral commissurotomy in Archangel, Northern Russia, 1965–1993. Operative assessment of 367 patients operated on for rheumatic mitral stenosis. Scand Cardiovasc J 34:533–535CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • Luigi Chiariello
    • 1
  • Paolo Nardi
    • 1
  • Giovanni Alfonso Chiariello
    • 1
  1. 1.Department of Cardiac SurgeryTor Vergata University of Rome, Fondazione Policlinico Tor VergataRomeItaly

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