PubMed · 5168172
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T Nimura, T Furukawa, M Inoue, K Kimura, T Kato. 1971. [Spatial phase cardiophonogram. 2].. https://pubmed.ncbi.nlm.nih.gov/5168172/
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BACKGROUND: Color Doppler and magnetic resonance imaging give pictures of abnormal jets within which the respective contribution of fluid mechanics and image artifacts are difficult to establish because of current technical limitations of these modalities. We conducted the present study to provide numerical descriptions of the velocity fields within regurgitant free jets. METHODS AND RESULTS: Laser Doppler measurements were collected in rigid models with pulsatile flow conditions, giving several series of two-dimensional flow images. The data were studied with the use of two-dimensional or M-mode flow images as well as regular plots. Numerical descriptions validated in steady flow conditions were tested at the various times of the cycle. In these free jets, the momentum was conserved throughout the cycle. The transverse velocity profiles were approximately similar. A central laminar core was found at peak ejection and during the deceleration. Its length (l = 4.08 d-0.036 mm, r = .99) and its diameter (d) were proportional to the orifice diameter. At peak ejection, the velocity decay was hyperbolic, and the transverse velocity profiles were clearly gaussian. The different relations that were tested could be combined in a single formula describing the velocity field: V(x,y,t peak) = V(O,O,t peak).4.(d/x).10(-45(y/x)2) (r = .92). CONCLUSIONS: These in vitro measurements demonstrated the presence of a central laminar core and similar transverse velocity profiles in free turbulent jets. This allowed us to validate a series of numerical relations that can be combined to describe the velocity fields at peak ejection. On the other hand, further studies are needed to describe the various singularities often encountered in pathology.
Mitral valve surgery was performed in 88 patients with severe pulmonary hypertension (average systolic pulmonary artery pressure, 94.7 +/- 22 mm Hg; range, 70-180 mm Hg) over a 10-year period. Sixty-four patients (73%) were in New York Heart Association Functional Class III or IV. There were 64 valve replacements and 24 open mitral commissurotomies. Operative mortality was 5.6% (5 patients) and was not related to the degree of pulmonary hypertension, surgical procedure performed, or type of valve lesion. A 100% follow-up was obtained, ranging from nine months to 10 years, with a mean of 44 months. Six late cardiac deaths (7.2%) occurred, 5 in patients with valve replacement and 1 in a patient who underwent a commissurotomy. Actuarial survival was 86 +/- 3% at five years and 83 +/- 4% at 10 years. Fourteen patients underwent right ventricular catheterization a mean of 24 months following operation. Systolic pulmonary artery pressure had decreased from a mean preoperative value of 101 +/- 22 to 40.5 +/- 7 mm Hg (p < 0.001). Cardiac index increased by 55% of the preoperative values. Functional status improved markedly; 71 survivors (93%) were in New York Heart Association Class I or II. These results indicate that, in patients with mitral valve lesions and severe pulmonary hypertension, (1) surgical procedures can be performed with an acceptable operative mortality; (2) excellent long-term survival and functional results can be obtained; and (3) pulmonary hypertension decreases significantly after operation. Patients with mitral valve disease may benefit from surgical treatment regardless of the degree of pulmonary hypertension.