Closed mitral valvotomy (CMV) was the closed heart procedure being done to open up a narrowed mitral valve (mitral stenosis) in the yester years. The scar is seen on the left lower part of chest in those who have undergone this surgery decades back. Now it is seldom done and most cases of mitral stenosis are treated with balloon mitral valvotomy. In closed mitral valvotomy the surgeon opens the left side of the chest and then the left atrium. He feels the mitral valve and then introduce a Tubbs mitral valve dilator through the apex of the left ventricle. Tip of the dilator is positioned across the narrowed mitral valve, guided by the finger in the left atrium. The device is opened using its handle outside the left ventricle to enlarge the opening of the mitral valve. The finger in the left atrium checks for any mitral regurgitation and the efficacy of the dilatation. Serial dilatations are given if the results are not satisfactory.