Systemic and Pulmonary Emboli before and after Mitral Commissurotomy

Kellogg, Frederick; Liu, Chi Kong; Fishman, Inna; Larson, Roger K.

doi:10.1161/01.cir.24.2.263

Cited by 39 publications

(8 citation statements)

References 7 publications

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“…OPERATIVE EMBOLISM The operative embolic incidence of 3*7% found in this study is less than the generally accepted figure of 5% (Stephenson, 1966), but in nine of the 11 cases the patient died as a result of the embolus, an operative embolic mortality of 3%, which compares with previous reports (American College of Chest Physicians, 1959; Kellogg et al, 1961;Stephenson, 1966).…”

Section: Pre-operative Embolic Incidencecontrasting

confidence: 64%

“…Previous authors (Ellis et al, 1959;Bannister, 1960;Kellogg et al, 1961 ;Greenwood et al, 1963 ;Szekely, 1964), in discussing the effect of mitral valvotomy on the incidence of systemic embolism, have found difficulty in determining the pre-operative incidence. In any retrospective study it has proved impossible to define the point at which vulnerability to systemic embolism begins in the course of the natural history of chronic rheumatic heart disease.…”

Section: Pre-operative Embolic Incidencementioning

confidence: 99%

“…These arguments are acceptable only if it is shown that valvotomy reduces embolic incidence. Taber and Lam (1960) and Kellogg, Liu, Fishman, and Larson (1961) have questioned the earlier belief, the latter workers stating that 'mitral valvotomy does not prevent systemic emboli and does not decrease the natural incidence of such emboli'. This view is supported by Szekely (1964) but opposed by Harken (1961), Greenwood et al (1963), Lowther and Turner (1962), and Bakoulas and Mullard (1966).…”

mentioning

confidence: 99%

“…The present study represents a further contribution to this controversy and seeks to determine, first, the overall embolic incidence before and after mitral valvotomy, and, second, whether Wood (1954Wood ( , 1956 and Kellogg et al (1961), being cerebral in 60%, peripheral in 30%, and visceral in 10%.…”

mentioning

confidence: 99%

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Incidence of systemic embolism before and after mitral valvotomy

Deverall

Olley

Smith

et al. 1968

Thorax

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Mitral valvotomy is of established value in improving the clinical condition and life expectancy of patients with rheumatic mitral stenosis. Its value in preventing or reducing the incidence of systemic arterial embolism is less certain. A comparison of pre-and post-operative embolic incidence can only be accepted if it is clear that the method of assessing the pre-operative figure is reliable. It is shown that the figure varies according to the length of the pre-operative study, and evidence is presented to show a changing incidence with increasing length of chronic rheumatic history. By studying patients in whom the time of onset of rheumatic heart disease is accurately known, a rising embolic incidence with the passage of time is shown. A comparison is made between groups of patients who have experienced the same length of chronic rheumatic history but who differ in respect of mitral valvotomy. We conclude from our comparison that this operation does not diminish the incidence of embolism, though only about a quarter of all our patients had atrial appendagectomy at the time of valvotomy. A reduction in the incidence of recurrent embolism in a given patient after mitral valvotomy is shown but may be more apparent than real. Operative embolism, defined here as that occurring either at or within 48 hours of operation, has an incidence of 3-8%. The factors related to pre-operative, operative, and postoperative embolism are presented.

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Section: Pre-operative Embolic Incidencecontrasting

confidence: 64%

Section: Pre-operative Embolic Incidencementioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Incidence of systemic embolism before and after mitral valvotomy

Deverall

Olley

Smith

et al. 1968

Thorax

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“…Other retrospective studies have concluded that surgery does not decrease the incidence of systemic emboli. 380,428,429 One prospective study has reported decreased risk for arterial embolism after mitral commissurotomy. 430 …”

Section: Classmentioning

confidence: 99%