Fourteen patients undergoing single aortic or mitral valve replacement had measurements made of lung volumes, static pressure-volume (P-V) relationships, and conductancepressure relationships during deflation before operation and again between one and two years later. At follow-up, total lung capacity (TLC), functional residual capacity (FRC), residual volume (RV), and static tidal compliance (slope of static P-V deflation line for one litre above FRC) had increased significantly, in association with a decrease in heart size. There was a change in the shape and position of some P-V curves both in the aortic and mitral patients. In the patients with aortic disease P-V deflation curves shifted to the left after operation. In the patients with mitral disease the P-V deflation curves before operation crossed those measured after operation, so that at high lung volumes recoil became less after operation, but at low lung volumes recoil increased. Conductance had increased at high lung volumes. The data suggest that in longstanding pulmonary congestion, airways are more rigid making them less distensible at high and less compressible at low transpulmonary pressures than after operation when congestion has been at least partly relieved.
Bicoronary-pulmonary artery fistulae are rare congenital coronary artery fistulae. We report the case of a 57-year-old man who presented with biventricular failure and angina pectoris. At angiography the coronary arteries were normal, but bicoronary-pulmonary fistulae were noted; severe mitral regurgitation secondary to mitral valve prolapse was also present. At right heart catheterization the calculated left to right shunt was 2.1. Fistula ligation and repair of both mitral and tricuspid valves was undertaken. The literature regarding coronary-pulmonary fistula is also reviewed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.