[The surgical treatment of pulmonary stenosis].

This lecture is based on a review of my experiences in the treatment of 198 patients with pulmonary valve stenosis, a condition that has occupied a great deal of my attention during the last twelve years. I hope that it will be of value to you even though it deals with a subject with which we are all familiar today. The term pulmonary stenosis is, of course, a generic one for all types of the condition and I propose to confine my remarks to pulmonary stenosis with an intact ventricular septum. Incidence of Pulmonary Valve Stenosis. This brings me at once to an important fact that until the advent of pulmonary valvotomy pulmonary valve stenosis was thought to be exceedingly rare. As recently as 1947 Taussig wrote that she had never had the opportunity of studying a proven case and that her clinical description had, therefore, to be based on reports. How scanty these were is shown by Greene et al. who, in 1949, stated that they could find only 68 examples. Abbott in her analysis of 1000 cases of congenital heart disease studied at necropsy, reported 25 examples of which 6 had a persistent foramen ovale. The rapid recognition of cases following the introduction of operations on the heart is illustrated by Campbell's observation in 1953 that 1130 cases of congenital heart disease seen in his clinic at Guy's Hospital included 116 cases of pulmonary valve stenosis (an incidence of 10 per cent): in the same group were 104 cases of persistent ductus arteriosus. I would think that even today the incidence of these two conditions is roughly equal. Wood (1950) gives the incidence as 14 per cent of all cases of congenital heart disease.