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Results for “MITRAL VALVE STENOSIS”

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At least 1,801 records · Page 100Linked to original sources
PubMed1992

Percutaneous closure of a secundum atrial septal defect and double balloon valvotomies of a severe mitral and aortic valve stenosis in a patient with Lutembacher's syndrome and severe pulmonary hypertension.

This is a 43-yr-old female presenting with recurrent atrial septal defect, closed surgically, 10 years prior, severe aortic and mitral stenosis, and severe tricuspid regurgitation. She was considered inoperable because of the severe pulmonary hypertension and the complexity of the disease. A percutaneous umbrella closure of the atrial septal defect in conjunction with mitral and aortic balloon valvotomies could be safely and successfully performed. After significant clinical and hemodynamic improvement, surgery was judged feasible, but was refused by the patient who suddenly expired 8 weeks later. The usefulness of percutaneous therapy as a rescue procedure and the management of patients with Eisenmenger's physiology are discussed.

Adult↗
PubMed1989

Rheumatic tricuspid stenosis without involvement of the mitral valve.

We describe a case of rheumatic tricuspid stenosis without involvement of the mitral valve. Rheumatic disease of the tricuspid valve is very rare in the absence of concomitant mitral valvar disease. We suggest that the closing pressure at the valve is not the only factor governing localization of the rheumatic process.

Echocardiography↗
PubMed1994

Significant tricuspid regurgitation is a marker for adverse outcome in patients undergoing percutaneous balloon mitral valvuloplasty.

OBJECTIVES: This study examined the association between the presence of tricuspid regurgitation and immediate and late adverse outcomes in patients undergoing balloon mitral valvuloplasty. BACKGROUND: Significant tricuspid regurgitation has an adverse impact on morbidity and mortality in patients undergoing mitral valve surgery for mitral stenosis. METHODS: We studied 318 consecutive patients (mean [+/- SD] age 54 +/- 15 years) who underwent balloon mitral valvuloplasty and had color Doppler echocardiographic studies before the procedure. Patients were classified into three groups: 221 with no or mild (69%), 60 with moderate (19%) and 37 with severe (12%) tricuspid regurgitation. Clinical follow-up ranged from 6 to 62 months. RESULTS: Before mitral valvuloplasty, increasing degrees of tricuspid regurgitation were associated with a smaller initial mitral valve area (p < 0.05), higher echocardiographic score (p < 0.05), lower cardiac output (p < 0.01) and higher pulmonary vascular resistance (p < 0.01). Although the initial success rate did not differ significantly between groups, patients with a higher degree of tricuspid regurgitation had less optimal results, as reflected by a smaller absolute increase in mitral valve area (1.02 vs. 0.9 vs. 0.7 cm2, p < 0.01). The estimated 4-year event-free survival rate (freedom from death, mitral valve surgery, repeat valvuloplasty and heart failure) was lower for the group with severe tricuspid regurgitation (68% vs. 58% vs. 35%, p < 0.0001). At 4 years, 94% of patients with mild tricuspid regurgitation were alive compared with 90% and 69%, respectively, of patients with moderate or severe tricuspid regurgitation (p < 0.0001). Cox proportional analysis identified tricuspid regurgitation as an independent predictor of late outcome (p < 0.001). CONCLUSIONS: Patients with mitral stenosis and severe tricuspid regurgitation undergoing mitral valvuloplasty have advanced mitral valve and pulmonary vascular disease, suboptimal immediate results and poor late outcome.

Adult↗
PubMed1979

MITRAL VALVE PROLAPSE AND CONGENITAL PYLORIC STENOSIS IN IDENTICAL TWINS.

Both congenital pyloric stenosis and the mitral valve prolapse syndrome are reported to have a familial incidence. Although mitral valve prolapse has been documented in twins, only one case has received echocardiographic confirmation. The present account describes typical symptomatic mitral valve prolapse in identical twins, both of whom had undergone surgery during infancy to correct congenital pyloric stenosis.

Journal Article↗
PubMed1982

[Evaluation of mitral valve, subvalvular structures and valvular flexibility in mitral stenosis by two-dimensional echocardiography].

UNLABELLED: In order to identify the determinants for surgical procedures in mitral stenosis, we evaluated two-dimensional echocardiographic findings of the mitral valve and subvalvular structures in 35 patients undergoing open mitral commissurotomy (OMC) or valve replacement (MVR). As indices of a degree of subvalvular shortening and valvular flexibility, the distance between the mitral ring and the tip of the anterior mitral leaflet was measured by the LV long-axis view by in both midsystole (S) and early diastole (D). As a possible major determinant for MVR, a degree of valvular calcification (C) was semi-quantatively scored according to the extent of abnormally strong echo density. In nine of 11 patients undergoing MVR, a main reason for selecting MVR was a marked thickening or shortening of subvalvular structures. In patients in whom OMC was feasible, the degree of improvement of the mitral valve area (delta MVA) was assessed by the pre- and post-operative mitral valve areas (MVA) measured on the LV short-axis view, which were averaged 0.15 and 1.38 cm2, respectively. RESULTS: The index C was significantly higher in cases with MVR than those with OMC (9.2 +/- 2.6 vs 4.7 +/- 2.3 points, p less than 0.001), although there was a significant overlap between these two groups and index C did not correlate with delta MVA in the OMC patients. Similarly, the value S was significantly smaller in patients undergoing MVR than those undergoing OMC (1.2 +/- 0.4 vs 0.7 +/- 0.2 cm, p less than 0.001), though S did not correlate with delta MVA. On the other hand, the index of valve flexibility D--S was smaller in patients undergoing MVR (0.5 +/- 0.3 vs 0.8 +/- 0.3 cm, p less than 0.05) and correlated well with delta MVA (delta MVA = 0.699 x (D--S)+0.007, R = 0.678, p less than 0.02) in patients undergoing OMC. Furthermore, in all patients undergoing OMC with D--S greater than or equal to 0.8 cm, delta MVA was above 0.5 cm2, contrasting with delta MVA of 0.5 cm2 or less in 6 of 7 patients with D--S less than 0.7 cm. Using these indices, surgical procedures were successfully predicted in another 7 prospectively studied patients and predicted delta MVA in 4 patients was quite comparable with actual delta MVA. It was concluded that measurements of S and D by two-dimensional echocardiography are useful, 1) to predict patients requiring MVR and 2) to predict patients with inadequate delta MVA in whom OMC is surgically feasible.

Adult↗
PubMed1990

[Quantification of valvular stenosis by Doppler echography].

Doppler echocardiography has made decisive advances in the non-invasive quantification of valvular stenosis. The simplified Bernoulli formula gives access to the maximum and mean transvalvular pressure gradients which correlate very well with the gradients measured at catheterisation. In addition, it is possible to calculate valve surface area in aortic and mitral stenosis from the continuity equation providing its conditions of application are respected. The Doppler surface area of mitral stenosis can also be estimated with some reservations by measuring pressure half time. Doppler echocardiography provides a reliable non-invasive hemodynamic study of valvular stenosis and should lead to a reduction in the number of indications of cardiac catheterisation, especially as pulmonary artery pressures can be determined from Doppler recordings of tricuspid and pulmonary regurgitation.

Aortic Valve Stenosis↗
PubMed1987

[Percutaneous mitral valvuloplasty].

Thirty six adults with severe mitral stenosis underwent attempted percutaneous mitral commissurotomy. The valvuloplasty could not be performed in 6 cases; post-transseptal haemopericardium (1 case), inability to cross the mitral valve or the septum (5 cases). Therefore percutaneous commissurotomy was performed in 30 cases; the average age was 43 +/- 17 years (range 20-79 years). Eight patients had undergone previous valve surgery; 24 patients were very symptomatic (NYHA Classes III or IV). The valvuloplasty was performed with a single balloon in 22 cases and by simultaneous inflation of two balloons in 8 cases. Moderate mitral regurgitation present before the procedure was significantly aggravated in 2 cases leading to secondary surgery. In the other patients percutaneous commissurotomy led to a clear-cut haemodynamic improvement; the transvalvular pressure gradient fell from 15 +/- 4 to 6 +/- 2 mm Hg, p less than 0.01 and mitral valve surface area increased from 1.1 +/- 0.2 to 2.2 +/- 0.4 cm2, p less than .001. The best results were obtained with the double balloon technique in patients with little valve destruction. Percutaneous mitral valvuloplasty is therefore a tempting alternative to closed heart mitral commissurotomy in pure mitral stenosis with pliable valves. Larger series with a longer follow-up are needed to assess the morbidity and long-term results of this technique.

Adult↗
PubMed1988

Mitral stenosis in systemic lupus erythematosus. Successful management by mitral valve replacement.

A female Caucasian with a history of 18 years of systemic lupus erythematosus (SLE) developed symptoms and signs of mitral stenosis, but had no history of rheumatic fever. Investigations confirmed severe stenosis, and the diseased valve was replaced by a pericardial xenograft. Histological examination was compatible with steroid-modified Libman-Sacks endocarditis. She remains well 24 months postoperatively.

Adult↗

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