mobile valve in less developed countries and during pregnancy - use closed mitral valvotomy (inserting dilator through a beating left ventricle via left thoracotomy)
mobile valve - method of choice - open mitral valvotomy with separation of fused papillary muscles and chordae, mobilisation of posterior leaflet by division of secondary chordae and correction of any mitral regurgitation by inserting a valvoplasty ring
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