PULMONARY VALVULAR STENOSIS THE INFUNDIBULAR FACTOR IN RELATION TO VALVOTOMY BY

It has been found that after pulmonary valvotomy for pulmonary valvular stenosis with an intact interventricular septum a satisfactory fall in right ventricular pressure is not always achieved imme-diately. In order to explain this, Kirklin, Connolly, Ellis, Burchell, Edwards, and Wood (1953) con-cluded that before the development of open heart surgery there were two main reasons: (1) failure to open the valve adequately (they advocated repeated attempts until a satisfactory diminution in the gradient could be demonstrated), and (2) steno-sis of the infundibulum due to right ventricular hypertrophy, a hypothesis also suggested by Soulie, Joly, Carlotti, Sicot, and Voci (1952). Introducing the open transarterial operatio