Systemic Embolism in Mitral Stenosis: Relation to the Size of the Left Atrial Appendix

Somerville, Walter; Chambers, R. J.

doi:10.1136/bmj.2.5418.1167

Cited by 51 publications

(20 citation statements)

References 7 publications

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“…We believe, however, that a comparison is valid along the lines set out in Tables IV and V Left atrial appendage Somerville and Chambers (1964) Baker, Brock, Campbell, and Wood (1952). In many cases embolism had occurred some time before the patient was seen and a retrospective definition of effort tolerance is not accurate.…”

Section: Pre-operative Embolic Incidencementioning

confidence: 99%

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 Incidencementioning

confidence: 99%

Incidence of systemic embolism before and after mitral valvotomy

Deverall

Olley

Smith

et al. 1968

Thorax

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“…Another study is required to assess the relation of depth of LAA to its outflow velocity. Somerville et al have shown that LAA size is associated with increased risk of stroke [5]. However Di Biase et al did not support this finding in his study [2].…”

Section: Discussionmentioning

confidence: 72%

Left Atrial Appendage Morphology, Does it Matter?

Faisal¹,

Mishra²,

Asar³

2017

J Clin Exp Cardiolog

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“…The variants of LAA structure and function have been studied in relation to thrombus formation and stroke. The LAA size is associated with increased thromboembolic risk (Somerville &Chambers, 1964). Studies with transesophageal echocardiography have reported occurrence of spontaneous echocontrast and smoke-like effect most likely in patients with larger LAA (Pollick &Taylor, 1991).…”

Section: Role Of the Laa In Cardiac Pathophysiologymentioning

confidence: 99%