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Results for “MITRAL VALVE STENOSIS”

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At least 613 records · Page 34Linked to original sources
PubMed1994

[Severe bronchospasm induced by extracorporeal circulation for cardiac surgery].

Cardiac surgery was performed on a 50-yr-old man suffering from mitral valve stenosis. He has no history of allergic disease or bronchial asthma. Mitral valve was replaced uneventfully under extracorporeal circulation, and ventilation with pure oxygen was tried. But the lung was so stiff that the bag of anesthetic circuit could not be squeezed by hand. Fiberoptic bronchoscopy revealed no obstruction in endotracheal tube or bronchial tree. A presumptive diagnosis of severe bronchospasm was made, and partial extracorporeal circulation was maintained. Soon after aggressive bronchodilator therapy, there was noticeable improvement in pulmonary compliance, and the patient was removed from bypass uneventfully. No further recurrence of bronchospasm was seen in the intra- or postoperative period. Although the exact causes for bronchospasm in our case are not clear, we concluded that severe bronchospasm was induced by extracorporeal circulation. Possible etiologies and the management of patients with this problem are reviewed.

Adult↗
PubMedDate not supplied

Echocardiogram analysis in a pattern recognition framework.

Echocardiogram analysis is treated in a pattern recognition framework. Anterior mitral leaflet waveforms are classified for the four-class problem consisting of the classes "normal," "mitral stenosis," "mitral valve prolapse," and "idiopathic hypertrophic subaortic stenosis." In addition, aortic root waveforms and left ventricular wall waveforms are classified for the two-class problem consisting of the classes "normal" and "idiopathic hypertrophic subaortic stenosis." One common method of analysis (Fourier analysis) underlies each classification scheme. Classification accuracy is sufficiently good to warrant the inference that successful automated decision-making based on the algorithms investigated is feasible.

Aortic Valve↗
PubMed1996

Mitral valve repair for mitral regurgitation with ventricular septal defect in children.

BACKGROUND: We examined the results of intermediate and long-term follow-up of 25 patients aged 3 months to 11 years (mean, 2.6 +/- 2.3 years) who initially underwent conservative mitral valve repair for mitral regurgitation associated with ventricular septal defect between April 1973 and March 1991. METHODS: The preoperative degree of mitral regurgitation was 2+ in 3, 3+ in 17, and 4+ in 5 patients, and the major causes of mitral regurgitation were annular dilatation and prolapse of the anterior leaflet. Annuloplasty was performed in all except 2 patients, suturing of the cleft was done in 3 patients, and posterior mitral leaflet advancement was done in 2 patients. In addition, the papillary muscle was incised and adhesive chordae were removed in 1 patient, and adhesive fused chordae were detached from a leaflet in 1 other patient. RESULTS: There were no early deaths. Two patients with residual mitral regurgitation with or without mitral stenosis underwent reoperation for mitral valve replacement 2 months and 6 years after the mitral repair, respectively. Late death occurred in 2 patients, and the actuarial survival rate was 92.0% at 15 years after operation. The freedom from reoperation was 91.3% at both 10 and 15 years after the initial operation. Postoperative color Doppler flow imaging was performed in 22 of the 23 survivors, and results showed no mitral regurgitation in 4, mild regurgitation in 14, and moderate regurgitation in 4 patients. Four patients presently have mitral stenosis, with a mean transmitral pressure gradient greater than 10 mm Hg. The residual lesion of moderate mitral regurgitation with or without mitral stenosis developed in 6 of 11 patients in whom bilateral mitral annuloplasty was applied after the initial operation. Nineteen of the 22 survivors without reoperation were in New York Heart Association class I, and 3 were in class II. CONCLUSIONS: Clinical improvement was observed after conservative mitral repair in most pediatric patients with ventricular septal defect. However, careful follow-up for growth potential still appears to be needed to detect changes in mitral regurgitation and the development of mitral stenosis after valve repair, especially after bilateral annuloplasty.

Child↗
PubMed1990

Long-term hemodynamic results of percutaneous transvenous mitral commissurotomy in rheumatic mitral stenosis with pliable, non-calcified valves.

Percutaneous transvenous mitral commissurotomy (PTMC) for severe, symptomatic mitral stenosis was successfully performed in 47 of 50 patients with pliable, non-calcified valves. The procedure resulted in immediate hemodynamic and sustained clinical improvements in all patients. Repeat cardiac catheterization was performed in 22 patients at a mean follow-up period of 15 months (range 12 to 29). The patients were similar to the other 25 patients in regard to gender, age, clinical and hemodynamic characteristics. There were 4 males and 18 females with a mean age of 37 years (range 20 to 61). Immediately after PTMC, there were significant increases in the mitral valve area (1.0 +/- 0.2 to 2.4 +/- .9cm2, p less than 0.001) and cardiac index (3.1 +/- 0.7 to 3.3 +/- 0.7 l/min/m2, p less than 0.05) and significant (p less than 0.001) decreases in the left atrial pressure (25.7 +/- 6.4 to 13.2 +/- 3.9 mmHg), the mitral valve gradient (15.7 +/- 5.7 to 3.9 +/- 1.4 mmHg), mean pulmonary arterial pressure (41.5 +/- 10.7 to 29.2 +/- 10.9 mmHg) and the pulmonary vascular resistance (4.2 +/ 3.4 to 3.5 +/- 2.9 Wood unit). At follow-up study, the mitral valve area (2.2 +/- 0.7 cm2) and the left atrial pressure (12.6 +/- 3.7 mmHg) remained unchanged. There were further decreases in the mean pulmonary arterial pressure (22.4 +/- 5.9 mmHg, p less than 0.05) and the pulmonary vascular resistance (2.0 +/- 1.5 Wood unit, p less than 0.05). There were significant (p less than 0.05) increases in the mitral valve gradient (6.6 +/- 2.5 mmHg) and the cardiac output (3.6 +/- 0.7 l/min/m2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Multiple systemic embolization from floating thrombus in left atrium].

A 66-year-old woman was referred to our hospital because of cerebral infarction, myocardial infarction and renal infarction. Further examination indicated that she was suffering from mitral valve stenosis with a floating thrombus in the left atrium. She underwent emergency mitral valve replacement and thrombectomy. The thrombus was attached to the left atrium by only four thin and weak strings and removed easily. We think that the thrombus was the precursor of a free-floating ball thrombus without stalk.

Aged↗
PubMed1990

[Genesis and clinical significance of an apical diastolic rumble in patients with mitral Björk-Shiley valve: a Doppler echocardiographic study].

The genesis and clinical significance of an apical diastolic rumble after replacement with mitral Björk-Shiley prosthesis were studied in 20 patients by left ventricular (LV) inflow dynamics using Doppler echocardiography. 1. The rumble was audible in 17 of the 20 patients (85%). In all but one patient, its intensity was less than Levine 2/6. Duration of the rumble ranged from 248 to 544 (mean 377) msec. There was no case of prosthetic valve dysfunction. Duration of the slow filling wave (SF interval) of the apexcardiogram in 19 cases ranged from 150 to 541 (mean 317) msec, and it correlated significantly with the duration of the rumble (r = 0.95) in 15 cases. 2. In 20 patients, peak velocity of the LV inflow obtained from continuous wave Doppler echocardiograms ranged from 1.17 to 1.89 (mean 1.56) m/sec, and pressure half time (PHT) ranged from 82 to 233 (mean 134) msec. In 19 patients, the SF interval correlated significantly with PHT (r = 0.87), but not with peak inflow velocity. 3. Peak inflow velocity was significantly slower in cases without a rumble than in cases with a rumble. PHT and the SF interval tended to be shorter in the former than in the latter. 4. There was no significant difference in the SF interval, peak inflow velocity and PHT between eight patients with smaller valve sizes (less than or equal to 25 mm) and 12 with larger valve sizes (greater than or equal to 27 mm). 5. There was no obvious relation between the direction of the main LV inflow jet as assessed by Doppler color flow mapping and the presence of the rumble in 19 patients. 6. In 19 patients, the SF interval correlated significantly with left atrial dimension (r = 0.47), but it did not correlate with LV end-diastolic dimension, fractional shortening of the LV, and the peak lengthening rate of LV internal dimension. 7. Three patients with both the rumble and SF lasting 500 msec had prolonged PHT longer than 190 msec. One of these three had congestive heart failure and suspected prosthetic mitral valve stenosis. From these results, we concluded that an apical diastolic rumble after replacement with mitral Björk-Shiley valve is mainly due to the increase in resistance and velocity of the LV inflow, and that both durations of the rumble and the SF intervals as well as PHT of the Doppler echocardiogram are useful in detecting stenosis of prosthetic mitral valves.

Adult↗