F.: The responsibility of the physician in the selection of patients with mitral stenosis for surgical treatment. Circulation 5: 349

The anatomy of the mitral leaflets, a classification of the variations in pathologic morphology of rheumatic stenosis, and the evolution of a practical technic for relief of that stenosis while restoring valve action are considered. The life cycle of patients suffering from mitral stenesis is reviewed and a clinical classification of these patients is presented. Some indications and contraindications for surgery are discussed in the light of strength and weakness of present surgical methods. Results of surgical treatment are reviewed. M ANY people badly disabled by mitral stenosis are now being greatly im-proved by surgical treatment. To those of us who have lived through the troubled era when most of the patients died from at-tempts at surgical correction, it is gratifying to see properly selected patients subjected to operation with a mortality rate that is not high in relation to the severity of their disease. These results breed enthusiasm in surgeons that may be dangerous. Conversely, the lack of appreciation by physicians of the remarkable advantages that may accrue from the surgical treatment of mitral stenosis is equally danger-ous. The possibility of a proper place for surgical intervention in the life cycle of the disease must be investigated carefully and objectively. If in certain phases of the life cycle of the disease surgical treatment is the best treatment, it becomes the responsibility of all participating in the care of the patient to see that the best treatment is given. It is the physician who first sees the patient an