Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MITRAL STENOSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 577 records · Page 32Linked to original sources
PubMed1992

Comparison of outcome among double, bifoil and Inoue balloon techniques for percutaneous mitral valvuloplasty in mitral stenosis.

The efficacy and complications of three different methods of percutaneous mitral valvuloplasty (PMV) were evaluated in 245 patients with mitral stenosis (MS). Eight six patients (35%) had severe MS defined in the mitral valve area (MVA) less than 1.0 cm2 (0.8 +/- 0.2) and Echoscore greater than or equal to 8(8.9 +/- 1.1). The results including post MCA greater than or equal to 1.5cm2 and complications, i.e, increment of mitral regurgitation (MR) greater than or equal to +1 and atrial septal defect (ASD) with Qp/Qs greater than or equal to 1.5 were compared in overall and in severe MS groups. There was no statistically significant difference in size of MVA before and after PMV between overall patients group and severe mitral stenosis group (0.8 +/- 0.1 vs 1.7 +/- 0.4cm2 in the double technique, 0.8 +/- 0.2 vs 1.5 +/- 0.3cm2 in the Bifoil technique and 0.7 +/- 0.2 vs 1.8 +/- 0.3cm2 in the Inoue technique. p: NS). However, a significantly larger number of patients in the severe MS group had better MVA with the double than the Bifoil technique [MVA greater than or equal to 1.5cm2; 42 (72%) vs 6 (46%), p less than 0.005] whereas higher complications were observed with the Bifoil than the Inoue technique (MR greater than or equal to +1; 9 (69%) vs 4 (27%), ASD (Qp/Qs greater than or equal to 1.5' 6 (46%) vs 2 (13%) p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

[Assessment of myocardial damage and metabolic disorder in the left ventricle in patients with mitral stenosis using 201Tl and 123I-BMIPP myocardial SPECT].

This study was designed to evaluate the myocardial damage and metabolic disorder of the left ventricle in patients with mitral stenosis. We studied 15 patients with mitral stenosis. Their grade of chronic heart failure using New York Heart Association classification were class I: 5 patients, class II: 5, class III: 3, class IV: 2, respectively. The severely stenotic group (valve area < 1.5 cm2) included 6 patients, mildly stenotic group (1.5 cm2 < or = valve area < 2.5 cm2) included 9. A 111 MBq of 123I-BMIPP was intravenously injected at rest, SPECT images were obtained at 15 min and 3 hours after injection. A 111 MBq of 201Tl was intravenously injected at rest, and SPECT images were obtained at 15 min after injection. Washout rate (WR) of 123I-BMIPP from the whole left ventricle was obtained using polar maps. The concentration of norepinephrine (NE: pg/ml) in the blood at rest was measured. The mean values of pulmonary artery pressure was measured in ten patients using Swan-Ganz catheter. 123I-BMIPP myocardial SPECT and measurement of NE were reexamined in 5 patients after mitral valvuloplasty. NE values were 476 +/- 72 and 793 +/- 286 in classes I + II and III + IV, respectively. NE values was increased in the severe heart failure group (p < 0.05). NE values were 480 +/- 69 and 743 +/- 295 in the mildly and severely stenotic groups, respectively. NE value was increased in severely stenotic group (p < 0.05). Twelve patients showed normal uptake on both 201Tl and 123I-BMIPP myocardial SPECT. Three patients showed slightly reduced uptake on both 201Tl and 123I-BMIPP myocardial SPECT. WR was 27.2 +/- 4.8% and 44.3 +/- 6.7% in class I + II and class III + IV, respectively. WR was increased in severe heart failure group (p < 0.05). WR was 27.8 +/- 6.0% and 41.3 +/- 9.4% in the mildly and severely stenotic group, respectively. WR was increased in the severely stenotic group (p < 0.05). NE was correlated with WR (p < 0.001). In patients with mitral valvuloplasty, WR was 44.3 +/- 6.7% and 31.4 +/- 4.7% before and after mitral valvuloplasty, respectively. NE values were 857 +/- 266 and 574 +/- 165, respectively. Both WR and NE were decreased after mitral valvuloplasty (p < 0.01). In patients with mitral stenosis, WR was increased in the severe heart failure group and severely stenotic group without apparent myocardial damage. Myocardial metabolism in the left ventricle might be influenced by right heart failure through, for example, NE and neurohormonal factors.

Aged↗
PubMed1978

Pulmonary function in mitral stenosis.

The reported results of pulmonary function testing in patients with mitral stenosis are summarized, including a few studies done after operative correction of the mitral stenosis. The physiologic effects of increased pulmonary water explain most of the reversible abnormalities in pulmonary function. Fixed pathologic changes that occur with longstanding interstitial edema may account for the irreversible nature of other alterations in pulmonary function.

Airway Resistance↗
PubMed1991

Value and limitations of color Doppler echocardiography in the evaluation of percutaneous balloon mitral valvuloplasty for isolated mitral stenosis.

The limitations of 2-dimensional and pulsed Doppler echocardiography in patients undergoing mitral valvuloplasty are well known. This study was undertaken to assess the value of color Doppler flow imaging in 36 symptomatic mitral stenosis patients who subsequently underwent successful balloon mitral valvuloplasty by comparing the results to those obtained at cardiac catheterization. Color Doppler-guided conventional Doppler assessment agreed well with cardiac catheterization results in classifying mitral stenosis as mild, moderately severe and severe, both before and after valvuloplasty. Color Doppler was also useful in identifying patients who had moderate to severe mitral regurgitation before and after valvuloplasty. Color Doppler flow mapping was more sensitive than oximetry in the detection of iatrogenic atrial septal defects, which were noted in 25 patients. The defects of those patients with smaller defects by color Doppler (diameter less than 0.7 cm) or echocardiographic shunt volume less than 0.7 liters/min tended to close, usually within 6 months, as opposed to those with larger defects or higher shunt volumes, which tended to persist. Echocardiographic shunt volumes revealed a fair correlation with oximetric results.

Cardiac Catheterization↗
PubMed1996

Right ventricular systolic performance before and after surgery for tricuspid regurgitation associated with mitral stenosis.

The reversibility of right ventricular function in patients with mitral stenosis associated with secondary tricuspid regurgitation (TR) is as yet undetermined. We assessed the right ventricular systolic performance by cardiac catheterization before and 19 months after surgery in 18 patients who underwent DeVega's tricuspid annuloplasty plus mitral valve replacement (MS plus TR group) and in 9 with mitral valve replacement for isolated mitral stenosis (MS group). After surgery, the right ventricular systolic pressure decreased significantly in both groups (both p < 0.01). In the MS plus TR group, the postoperative right ventricular end-diastolic and end-systolic volume indices (RVEDVI and RVESVI, respectively) were significantly decreased compared with the respective preoperative values (both p < 0.001). No significant difference was noted between the groups with regard to the right ventricular peak-systolic pressure/end-systolic volume index ratio (RVPSP/ESVI) either before or after surgery. Various left ventricular indices were comparable between the groups both before and after surgery. Linear regression analysis revealed significant correlations between RVEDVI and the RVPSP/ESVI, and between RVPSP and the RVPSP/ESVI both before and after surgery. These results indicate that right ventricular systolic performance in patients with MS plus secondary TR became comparable to those that in patients with isolated MS after surgery, and that this was probably due to nearly equivalent right ventricular contractility before surgery.

Adult↗
PubMed1986

Effect of atrial fibrillation and mitral regurgitation on calculated mitral valve area in mitral stenosis.

Forty-nine patients with mitral stenosis (MS) were studied by Doppler echocardiography and 2-dimensional (2-D) echocardiography to assess the ability of Doppler ultrasound to accurately measure mitral valve orifice area and to assess whether atrial fibrillation (AF) or mitral regurgitation (MR) affected the calculation. Twenty-four patients underwent cardiac catheterization. Mitral valve area by Doppler was determined by the pressure half-time method. Mean mitral valve area of all 49 patients by Doppler and 2-D echocardiography correlated well (r = 0.90). There was good correlation between Doppler and 2-D echocardiography in patients with pure MS in sinus rhythm (r = 0.88), in patients with MR (r = 0.93) and in patients with AF (r = 0.96). In the 7 patients with pure MS in sinus rhythm, there was good correlation between Doppler, 2-D echocardiography and cardiac catheterization (r = 0.95). In patients with either MR or AF, cardiac catheterization appeared to underestimate mitral valve orifice compared with both Doppler and 2-D echocardiography (p less than 0.05). Doppler echocardiography can estimate valve area in patients with MS regardless of the presence of MR or AF.

Adult↗
PubMed1993

[Percutaneous transvenous mitral commissurotomy in elderly patients with mitral stenosis].

Sixteen elderly patients (age > or = 60 years, elderly group) with mitral stenosis and 20 young patients (age < or = 59 years, young group) underwent percutaneous transvenous mitral commissurotomy (PTMC) by the single balloon technique. Pulmonary arterial and mean left atrial pressures, mitral valvular pressure gradient and left atrial dimension were significantly decrease in both groups after PTMC. Mitral valve areas by Gorlin formula were significantly increased from 1.14 +/- 0.40 to 1.78 +/- 0.66 cm2 in the elderly group and from 1.25 +/- 0.50 to 2.04 +/- 0.81 cm2 in the young group after PTMC. Thirteen elderly and 19 young patients became in NYHA class I or II after PTMC, and three elderly patients with early gastric cancer had the lower risk of the gastrectomies by preoperative PTMC. But, two elderly patients remained in NYHA class III or IV due to increased mitral regurgitation and late tamponade, and one elderly patient died by heart failure after PTMC. PTMC has the advantages of shorter hospitalization and lower invasion for the patients compared with surgery, therefore PTMC is an effective treatment in both elderly and young groups. Elderly patients with severe mitral stenosis have higher risk of PTMC and are needed discrete strategy.

Aged↗
PubMed1991

Percutaneous balloon valvotomy for patients with mitral stenosis: initial and follow-up results.

Percutaneous double balloon mitral valvotomy (PMV) was performed in 25 patients with severe mitral stenosis who were followed for at least 6 months after the procedure. There were 22 women and 3 men, with a mean age of 51 +/- 14 years (range, 27 to 74). Hemodynamic and angiographic findings were evaluated before and after PMV and clinical status was assessed at follow-up. There was a significant decrease in mitral gradient following PMV, from 15.4 +/- 5.1 to 5.0 +/- 2.6 mm Hg (p less than .0001); an increase in cardiac output, from 4.6 +/- 1.1 to 5.2 +/- 1.1 L/min (p less than .01); and an increase in calculated mitral valve area, from 0.9 +/- 0.2 to 2.2 +/- 0.6 cm2 (p less than 0.0001). Mitral regurgitation developed or increased in severity in six patients (24%). At the time of follow-up (mean, 12 +/- 5 months), three patients required elective mitral valve replacement for symptomatic mitral regurgitation and 91% (20 of 22) of the remaining patients had continued improvement in functional class. PMV can safely be performed in properly selected patients with symptomatic mitral stenosis with good immediate and follow-up results.

Adult↗
PubMed1978

[Surgical treatment of mitral stenosis].

Open and closed methods of mitral commissurotomy are appraised in comparison. Open correction of mitral stenosis was performed under conditions of extracorporeal circulation, closed correction was accomplished by the instrumental method from right and left approaches. The advantages of open mitral commissurotomy in complicated forms of the disease (intraatrial) thrombosis, calcinosis, restenosis, concomitant regurgitation) are demonstrated. The indications for both methods of surgical treatment are substantiated and recommendations for their effective application are given.

Humans↗
PubMed1993

Percutaneous balloon valvuloplasty in mirror-image dextrocardia and rheumatic mitral stenosis.

A 28-year-old woman with mirror-image dextrocardia and severe rheumatic mitral stenosis underwent successful percutaneous balloon mitral valvuloplasty (PBMV). Standard technique was altered to include transseptal catheterization via the left femoral vein and inter-atrial septal puncture with the transseptal needle rotated to a 7 o'clock position. The predilatation transmitral gradient (mean) of 16 mmHg decreased to 5 mmHg following PBMV. The valve area improved from 1.0 cm2 to 2.6 cm2. There were no complications. This case illustrates that transseptal catheterization can be accomplished safely in patients with unusual cardiac anatomy and mitral valvuloplasty can be performed in patients with mirror-image dextrocardia and rheumatic mitral stenosis.

Adult↗
PubMed2005

The clinical and hemodynamic results of mitral balloon valvuloplasty for patients with mitral stenosis complicated by severe pulmonary hypertension.

BACKGROUND: Percutaneous balloon mitral valvuloplasty (PBMV) has become the procedure of choice for isolated, uncomplicated mitral stenosis (MS) with favorable morphology and may be a useful method for surgical high-risk conditions such as advanced age, the presence of severe tricuspid regurgitation, New York Heart Association (NYHA) class IV at presentation, and severe pulmonary hypertension (PH). The development of PH is a common and important sequela in patients with advanced mitral stenosis and is associated with hemodynamic and clinical decompensation. However, the influence of PBMV on patients with severe PH has seldom been evaluated. Our objective was to probe into the immediate and long-term effects of PBMV on patients with MS complicated by severe PH and to predict the factors that determine the prognosis of patients with severe PH. METHODS: We included 44 patients with MS complicated by severe PH (systolic pulmonary pressure >80 mm Hg, group S) and 67 patients with MS complicated by mild PH (systolic pulmonary pressure <50 mm Hg, group M) in this study and we compared their immediate and late results after a follow-up period of 24 months after PBMV. RESULTS: Compared with group M, patients in group S were older, presented more frequently with NYHA III-IV class, valvular echo score >or=8, and more severe tricuspid regurgitation, and had a bigger left atrial diameter before PBMV. The successful rate and the incidence of severe complications from the PBMV procedure were similar in both groups. There were more cases of post-PBMV mitral valve area >or=1.5 cm(2) in group M than in group S, and the average mitral valve area in group M was somewhat larger than that of group S. After PBMV, NYHA class obviously improved in both groups, but there were more patients with NYHA 0.05). NYHA class I or II was present for 80.6% in group M and 59.1% in group S (p<0.10). RESULTS: PBMV is a safe and effective procedure for patients with severe PH. It can remarkably improve clinical outcomes, although hemodynamic effects of PBMV on this subgroup are not complete. Pre-existing older age, more severe valvular lesion and tricuspid regurgitation, worse cardiac function, and bigger left atrial size in patients with severe PH may be important risk factors for the poor hemodynamic outcomes of PBMV.

Journal Article↗
PubMedDate not supplied

[2-dimensional echocardiographic measurement of the valvular area in mitral stenosis. Surgical correlations].

The calculation of mitral valve orifice area in patients with mitral stenosis is important because it establish the surgical indication and the type of surgical procedure to be done (commisurotomy, valvuloplasty or valve replacement). Moreover, the postoperative measurement of the mitral orifice area may be useful to evaluate the surgical results and to differentiate between inadequate commisurotomy and restenosis. We studied 12 patients with measurement of mitral orifice area by two-dimensional echocardiography imaging and digital microproccesing. The measurements were compared with the surgeon's estimate. The correlation obtained was of r = 0.86 (p less than or equal to 0.05). The description of the surgeon corroborated the echocardiographic findings respecting mitral subvalvular apparatus in all except one patient. Concerning the thickening of the values, echocardiographic and surgical findings were concordant in 10 patients. The mitral orifice area showed inverse relationship with pulmonary artery wedge pressure measured by catheterization in 5 patients (r = -0.844). After commisurotomy, the mitral orifice area was analyzed in 9 patients, since one patient requerired valve replacement and in two we did not obtain echocardiographic studies. The postoperative increase of the mitral orifice area was significant; (before surgery X 0.6 cm2 +/- 0.16) and after surgery (X 2.7 cm2 +/- 0.22) p less than or equal to 0.001).

Adult↗
PubMed1986

[Repeat operations on patients with recurrent mitral stenosis].

An analysis of 282 reoperated mitral commissurotomies was made. Under consideration was the dependence of late results of the operation on the morphological state of the valve, regurgitation degree and concomitant defects of other heart valves. Remote results were good in 47 patients (28.2%), mediocre in 102 patients (51.3%) and bad in 43 patients (20.5%). Indications for the repeated closed mitral commissurotomy and for prosthesis of the mitral valve are given for patients with recurrent mitral stenosis.

Adult↗
PubMed1986

Percutaneous mitral valvuloplasty in an adult patient with calcific rheumatic mitral stenosis.

A 75 year old man with long-standing rheumatic mitral stenosis who refused surgical intervention was treated with percutaneous balloon valvuloplasty. Prevalvuloplasty evaluation revealed a heavily calcified mitral valve, a mean transvalvular gradient of 18 mm Hg, a Fick cardiac index of 1.7 liters/min per m2, a mitral valve area of 0.6 cm2 and 1 + mitral regurgitation. After transeptal catheterization and balloon dilation of the interatrial septum with an 8 mm angioplasty balloon, a 25 mm valvuloplasty balloon was advanced over a guide wire across the interatrial septum and positioned across the mitral anulus. Subsequent balloon inflation at 3 atm pressure resulted in a reduction of the mean mitral valve gradient to 12 mm Hg, an increase in cardiac index to 2.5 liters/min per m2, an increase in mitral valve area in 1.4 cm2 and an increase in mitral regurgitation from 1 + to 2 +. Valvuloplasty was well tolerated without embolization of clot or valvular debris, and resulted in marked clinical improvement with decreased dyspnea and increased exercise tolerance. Repeat catheterization 2 months after valvuloplasty showed further resolution of pulmonary hypertension and no evidence of valvular restenosis or worsening mitral regurgitation, but detected a small atrial septal defect with a pulmonary to systemic blood flow ratio of 1.8. It is concluded that percutaneous valvuloplasty is possible in the adult patient with calcific rheumatic mitral stenosis, and may result in a significant improvement in valvular function without producing life-threatening complications.

Aged↗
PubMed1999

Increased systemic coagulation activity in patients with rheumatic mitral stenosis: assessment of the clinical and echocardiographic determinants.

In this study, we aimed to determine systemic coagulation activity in patients with rheumatic mitral stenosis and to define determinants of a possible prethrombotic state. Peripheral venous plasma level of thrombin-antithrombin III complex was measured in 84 consecutive patients with rheumatic mitral stenosis who had no left atrial thrombus by transesophageal echocardiography. The patients had significantly higher thrombin-antithrombin III complex values (mean +/- SD = 9.6+/-15.9 ng/ ml) compared with the healthy subjects (2.1+/-1.8 ng/ml) (P<0.001). Among many clinical and echocardiographic variables, severe mitral regurgitation (odds ratio = 6.7, P<0.001) and left atrial spontaneous echo contrast (odds ratio = 22.8, P<0.001) appeared as significant predictors of the increased systemic coagulation activity in multivariate logistic regression analysis. In conclusion, systemic coagulation activity is increased in the patients with rheumatic mitral stenosis, and coexistence of severe mitral regurgitation and presence of left atrial spontaneous echo contrast are determinants of this increment.

Adult↗
PubMed1978

[Anatomical and functional assessment of mitral stenosis using echocardiography before and after commissurotomy].

In 36 patients with pure mitral stenosis verified during catheterization and operation the results of echocardiography were compared with the operative findings. The changes in the mitral echogram and the degree of valve calcification before commissurotomy were studied. The hemodynamic changes in pulmonary circulation were approximately appraised by determining the degree of delay of the EF interval on the echogram of the anterior cusp of the mitral valve. Significant conformity between the dimished rate of diastolic movement of the anterior mitral cusp and the degree of mitral stenosis was established. The importance of the advancement of the posterior mitral cusp to the front of the horizontal line passing through point C of mitral valve closure in the appraisal of the degree of its stenosis is underscored.

Adult↗
PubMed2005

[Functional assessment of the left atrial appendage with transesophageal echocardiography before and after percutaneous valvotomy in the mitral stenosis].

OBJECTIVE: To assess the effects of the relief of the mitral stenosis by percutaneous ballon valvotomy in the function of the left atrial appendage. METHODS: Twelve patients with symptomatic mitral stenosis, in sinus rhythm, were studied. They were submitted to the transesophageal echocardiogram before and after effective percutaneous ballon valvotomy. Concerning the left atrial appendage, the peak flow velocities and the respective integral of the anterograde and retrograde flow, in addition to the ejection fraction calculated through the planimetry of the area of that structure, were analyzed at the pulsatile Doppler. RESULTS: There was a significant increase of the anterograde flow velocity of the left atrial appendage after percutaneous ballon valvotomy (pre: mean of 0.30 m/s; post: mean of 0.47 m/s; p<0.05) and their respective integrals. The same happened with the retrograde flow velocity (pre: mean of 0.35 m/s, post: mean of 0.53 m/s; p<0.05). There was a tendency of increase of the ejection fraction of the left atrial appendage after the procedure (pre: mean of 20%, post: mean of 31%; p=0.08). CONCLUSION: The effective opening of the stenosed mitral orifice resulting from the percutaneous ballon valvotomy determined an improvement of the flow pattern of the left atrial appendage, which can potentially contribute for the reduction of the embolic risk.

Adolescent↗
PubMed1987

Effect of aortic regurgitation on the assessment of mitral valve orifice area by Doppler pressure half-time in mitral stenosis.

Evaluation of the severity of mitral stenosis by continuous-wave Doppler pressure half-time measurement is now well established. However, few data exist regarding the effect of aortic regurgitation (AR) on the validity of this method. Therefore, 73 patients were studied in whom cardiac catheterization and Doppler echocardiographic examinations were performed. Mitral valve orifice area was determined by the Gorlin equation, 2-dimensional echocardiography and Doppler pressure half-time. Doppler pressure half-time and catheterization estimates of mitral valve area correlated well (r = 0.85) in patients without significant mitral regurgitation. This correlation was maintained in patient subgroups with and without significant (at least 2+) AR (r = 0.86 and 0.83, respectively). Similarly, Doppler and 2-dimensional echocardiographic assessment of mitral valve area showed a strong correlation (r = 0.84). Again, the correlation between the 2 methods was similar in patients with and without significant AR (r = 0.86 and 0.82, respectively). Thus, Doppler pressure half-time estimates of mitral valve orifice area are accurate even in patients with AR.

Adult↗