The Physiologic Evaluation of Patients Before and After Mitral Commissurotomy

Cosby, Richard S.; Griffith, George C.; Levinson, David C.; Zinn, Willard J.; Oblath, Robert W.; Dimitroff, Sim P.; Herman, Lawrence

doi:10.1378/chest.23.5.499

Cited by 10 publications

(2 citation statements)

References 9 publications

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“…The effects of mitral valvuloplasty on general cardiohemodynamic function in patients with mitral stenosis have been reported by many investigators (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Measurements of renal blood flow, glomerular filtration rate, and excretion of sodium and their correlation with changes in cardiac output, blood oxygen measurements, and vascular pressures also have been extensively studied in patients with various types of heart disease, with and without congestive failure, at rest (11,12) and during exercise (13)(14)(15).…”

mentioning

confidence: 99%

The Effects of Mitral Valvuloplasty on Cardiovascular and Renal Function at Rest and During Exercise 1

Judson¹,

Hatcher²,

Hollander³

et al. 1955

J. Clin. Invest.

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mentioning

confidence: 99%

The Effects of Mitral Valvuloplasty on Cardiovascular and Renal Function at Rest and During Exercise 1

Judson¹,

Hatcher²,

Hollander³

et al. 1955

J. Clin. Invest.

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“…These observations differ from those of Linhart (I972) who found evidence of left ventricular dysfunction in 5 of the I3 patients with mitral stenosis by 'pacing ventricular function curves'. Left ventricular dysfunction has also been reported to be present in 3 to IOO per cent of patients with mitral stenosis studies by other techniques (Ferrer et al, I955;Fleming and Wood, I959;Ross and Braunwald, I964;Feigenbaum et al, I966;Kasalicky et al, I968;Bittar, Sosa, and Reid, I97I;Aronow, Kaplan, and Ellestad, I97I;Curry, Elliot, and Ramsey, 1972;Hildner et al, I972).…”

Section: Discussionmentioning

confidence: 95%

Haemodynamic effects of atrial pacing in rheumatic mitral stenosis.

Manchanda¹,

Ramesh²,

Roy³

1974

Heart

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Haemodynamic effects of right atrial pacing were studied in 12 patients (average age 25'6 years) with isolated rheumatic mitral stenosis in normal sinus rhythm. The cardiac output, systemic arterial pressure, and the left ventricular work did not change during atrial pacing. Both I966). Accordingly, the present investigation was designed to study the haemodynamic effects of increasing the heart rate by right atrial pacing in patients with rheumatic mitral stenosis. Subjects and methodsTwelve patients (7 men and 5 women) with isolated rheumatic mitral stenosis in normal sinus rhythm were studied. Their ages ranged between i6 and 34 years (average of 25 6 years). None of the patients had evidence of rheumatic activity as judged by the modified Jones criteria (I965). No one was receiving digitalis preparations for at least two weeks before the study. A right and percutaneous left heart catheterization study (Seldinger, I953) was performed in all in a fasting state Received 9 November I973. without any premedication, to assess the severity of mitral stenosis and to exclude mitral regurgitation. The nature of the procedure of right atrial pacing was fully explained to each patient and a written consent was taken for carrying out the procedure of atrial pacing in addition to right and left heart catheterization. Intracardiac pressures were recorded through P23 AA strain gauge transducers on a multichannel photographic recorder (DR-8 Electronic for Medicine Inc. U.S.A.). The baseline for all pressure measurements was taken as half the chest thickness at the second costal cartilage in the supine position (Roy, Gadboys, and Dow, I957).Cardiac output was estimated by a dye dilution technique (Hamilton et al., 1932). Indirect transmitral pressure gradients were obtained by simultaneous recording of pulmonary artery wedge pressure and left ventricular diastolic pressures using equisensitive preamplifiers with a common baseline. The precise point where left ventricular end-diastolic pressure was measured corresponded with the nadir of the atrial kick in the left ventricular tracing. In tracings where the atrial kick could not be clearly defined, the left ventricular enddiastolic pressure was measured at a point corresponding with the peak of the R wave in the surface electrocardiogram. A No. 6F NBIH bipolar catheter was introduced percutaneously through a venous dilator into the right femoral vein and positioned in the right atrium at a site where complete capture occurred during pacing with an extemal fixed rate pacemaker. Atrial pacing was performed at a minimum rate of 30 per cent above the resting heart rate. In 3 patients where the basal heart rate was less than go a minute, pacing was performed at two rates, one 30 per cent above the basal level and the other at the maximum rate of 140 a minute. All the haemodynamic variables were repeated during 8 to I0 minutes

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Mitral Commissurotomy

Ellis¹,

Kirklin²,

Parker³

et al. 1954

AMA Arch Intern Med

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The RELIEF of obstructing lesions of the mitral valve by mitral commissurotomy is now a widely accepted and extremely successful procedure. Sufficient time has elapsed since this procedure was first initiated to permit a valid appraisal of the over-all results. Although symptomatic results are important, the accumulation of objective data, when possible, adds greatly to our knowledge concerning the effect of an operative procedure. Such data are available in the form of hemodynamic studies carried out before operation, during operation, and at intervals after operation on patients undergoing mitral commissurotomy. We believe that the results of these hemodynamic studies present ample explanation for the marked symptomatic improvement that fully three quarters of these patients experience following operation.

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The Physiologic Evaluation of Patients Before and After Mitral Commissurotomy

Cited by 10 publications

References 9 publications

The Effects of Mitral Valvuloplasty on Cardiovascular and Renal Function at Rest and During Exercise 1

The Effects of Mitral Valvuloplasty on Cardiovascular and Renal Function at Rest and During Exercise 1

Haemodynamic effects of atrial pacing in rheumatic mitral stenosis.

Mitral Commissurotomy

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