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tained above 20 minutes; if the patient tended to bruise easily or had a considerably raised venous pressure; and in elderly patients with lax inelastic subcutaneous tissues. Local reactions were minim ized by the use of an isotonic solution of heparin mixed with 1% procaine and by applying firm pressure over the injection site, but the development of haematomata prevented further administration of heparin in 25% of the cases. Of the 37 cases 35 suffered no further thromboembolic incidents, one patient died after a clinically typical recurrent myocardial infarction, and another experienced a mild recurrent infarction despite adequate prolongation of the coagulation times.

Mitral Valve Disease in the Light of Surgical Treatment