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Results for “MITRAL VALVE STENOSIS”

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At least 91 records · Page 5Linked to original sources
PubMed1976

[Left ventricular function in mitral valve stenosis].

In 12 patients with mitral stenosis left ventricular performance was assessed by pharmacologically (Methoxamine) induced increased afterload. At rest ventricular enddiastolic pressure (6.2 +/- 3.1 mm Hg), left ventricular enddiastolic volume (68 +/- 20 ml/m2), endsystolic volume (26 +/- 11 ml/m2) and left ventricular ejection fraction (0.63 +/- 0.06) were normal in each subject. Methoxamine induced a mean increment in peak systolic atrial pressure of 65 mm Hg. Left ventricular stroke volume, stroke work, stroke power, enddiastolic pressure and volume increased with Methoxamine in each patient. The mean left ventricular ejection fraction remained unchanged for the group and remained within the normal range for all patients. No difference was observed between the response of the mitral stenosis group and a control group of 10 normal subjects with the exception of the account of mitral regurgitation during the pressure load in 9 mitral stenosis patients. This study indicates the left ventricle in mitral stenosis is capable of a normal response to a pressure load. No evidence of impaired left ventricular function was detected in this group of patients.

Adult↗
PubMed1977

[Intravital study of energy metabolism in the liver in mitral valve stenosis].

In 42 patients with mitral stenosis an intravital study was conducted comparing the liver energy exchange with the biochemical blood serum parameters and morpho-histochemical characteristics of the biopsy material. A correlation was established between the energy exchange and the clinical stage of the disease, the pigment function of the liver and the severity of its structural changes.

Adenosine Diphosphate↗
PubMed2005

Primary left atrial angiosarcoma mimicking severe mitral valve stenosis.

Primary cardiac tumours are quite rare and most of these tumours are benign. In this report, a patient presented with heart failure symptoms attributable to severe mitral valve stenosis. Echocardiography showed a dense left atrial mass causing functional mitral valve obstruction. The morphological and intraoperative presentation was highly suggestive of a myxoma but histopathological examination found a primary pedunculated cardiac angiosarcoma. The role of two dimensional and transoesophageal echocardiography in the assessment of cardiac masses and tumours is discussed.

Diagnosis, Differential↗
PubMed1984

[Function and interaction of the right and left ventricle in patients with mitral valve stenosis].

In 17 patients with mitral stenosis functional class III (NYHA) and chronic pulmonary hypertension, volumes and function of the right (RV) and left ventricle (LV) were analysed. Biplane cineventriculography of the right and left ventricle was performed subsequently and repeated 3 min after application of 1.6 mg nitroglycerin (NTG), which was given sublingually to decrease pre- and afterload. Pulmonary artery (PAP) and wedge pressures (PCW) were measured continuously. RV ejection fraction (EF) was 62.8 +/- 7.2% before and did not change significantly after NTG. RV enddiastolic volume index (EDVI) and endsystolic volume index (ESVI) was 80.7 +/- 27.2 ml/m2 and 31.7 +/- 11.9 ml/m2, respectively, and did not change significantly after NTG. Volumes and function of the LV were normal (LVEDVI: 66.5 +/- 13.5 ml/m2, LVESVI: 23.0 +/- 7.1 ml/m2, LVEF: 62.4 +/- 9.5%). Systolic PAP decreased significantly from 43.4 +/- 11.1 mm Hg before to 37.8 +/- 9.1 mm Hg after NTG (p less than 0.025) as well as total pulmonary resistance from 243 +/- 51 to 209 +/- 50.8 dynes . sec . cm-5 (p less than 0.05). No significant correlation was found between function and volumes of both ventricles. In 4 patients, however, the decrease in LV ejection fraction was associated with a considerable increase of right ventricular enddiastolic volume. Thus, the right ventricle compensates moderate pulmonary hypertension completely maintaining normal right ventricular function. If, however, septal dysfunction occurs, right ventricular insufficiency will develop in a shorter period of time.

Blood Pressure↗
PubMed1986

Percutaneous transarterial balloon valvuloplasty for mitral valve stenosis.

A new technique was developed that allows mitral commissurotomy without surgery. A balloon catheter was inserted percutaneously from the left femoral artery over a long guidewire introduced into the right femoral vein and advanced transseptally through the Brockenbrough catheter to the left ventricle and drawn out of the body through the left femoral artery using an intravascular retriever set. This procedure was performed in 3 patients with moderate mitral stenosis. After the procedure, the mean diastolic pressure gradient across the mitral valve was reduced and left ventriculography revealed no resultant mitral regurgitation in any of the patients. The procedure was easy to perform and caused no complications.

Adult↗
PubMed1977

[Relationship between the indicators of the lung rheogram and pulmonary artery pressure in mitral valve stenosis].

In 32 patients with rheumatic mitral stenosis a set of quantitative rheographic pulmonary data was compared with the values of pulmonary artery pressure obtained by way of pulmonary artery catheterization. The diagnostic value of the mean rate of slow filling (Vm.s) and of the Q--a interval was shown for the diagnosis of pulmonary hypertension, their introduction into everyday practice was substantiated. Appropriate regression equations for Vm.s and mean pulmonary artery pressure were compiled: y equals 83.7--94.x, and for the Q--a interval: y equals 4.46.281 300x. In mitral stenosis cases a reduction of the rheographic systolic index was established, as well as of the amplitude-frequency index and of the maximum rate of fast filling.

Adult↗
PubMed2002

Clinical application in routine practice of the proximal flow convergence method to calculate the mitral surface area in mitral valve stenosis.

BACKGROUND: Two-dimensional (2D) echocardiography planimetry, the Doppler pression half-time (PHT), and the continuity equation methods were used to estimate mitral valve area (MVA) in patients with mitral stenosis (MS). Recently, the proximal isovelocity surface area (PISA) method has been shown to be accurate for calculating MVA. The purpose of this study is (1) to compare in a large non-selected population the accuracy of the PISA and planimetry methods for echocardiographic estimation of MVA; (2) to determine the effect of atrial fibrillation (AF), Wilkins score, associated mitral regurgitation (MR), aortic regurgitation (AR), and of commissural calcifications on the accuracy of the PISA method. METHODS: One hundred and eight consecutive patients with rheumatic MS were studied (76 females and 32 males; mean age: 36 +/- 12 years); 64 were in sinus rhythm; 51 had associated MR and 46 had AR. By the PISA method. MVA was calculated assuming a uniform radius flow convergence region along a hemispherical surface. RESULTS: The mean value of 2D MVA was 1.32 +/- 0.59 cm2 (0.4-3.1 cm2) and that of PISA MVA 1.33 +/- 0.62 cm2 (0.38-3 cm2). MVA calculated using the PISA method correlated well with 2D MVA (r = 0.93, y = 0.97x + 0.04, p < 0.0001, SEE = 0.21 cm2). The correlation was also good in patients with AF (r = 0.93, y = 0.99x + 0.03, p < 0.0001, SEE = 0.21 cm2), with MR (r = 0.94, y = 1.0 14x + 0.003, p < 0.0001, SEE = 0.19 cm2), with AR (r = 0.93, y = 0.90x + 0.11, p < 0.0001, SEE = 0.2 cm2), when Wilkins score was >8 (r = 0.92, = 0.96x + 0.06, p < 0.0001, SEE = 0.19 cm2), and in patients with commissural calcifications (r = 0.90, y = 0.88x + 0.009, p < 0.0001, SEE = 0.20 cm2). CONCLUSION: Our study shows that in routine practice, MVA calculated by the PISA method correlated well with the area obtained by planimetry even in the presence of commissural calcifications, associated MR, AR, AF and of high Wilkins score. Therefore, the PISA method provides a reliable measurement of the MVA in MS under different anatomic and clinical conditions and may be a useful alternative method for calculating MVA.

Adolescent↗
PubMed1996

Management of mitral valve stenosis in pregnancy: case presentation and review of the literature.

Severe mitral stenosis is a challenging complication in pregnancy. A case is described in which mitral valve replacement was undertaken immediately following caesarean section at 34 weeks' gestation. A review of the literature discusses the evolution of treatment approaches for mitral stenosis in pregnancy, including open mitral commissurotomy and percutaneous mitral commissurotomy with the use of balloon catheters. With balloon procedures, potential risks to the fetus are minimized because the abdomen and pelvis are shielded. In addition, the use of adjunct transesophageal echocardiography shortens fluoroscopic time. In the case described, neither open nor percutaneous mitral commissurotomy were viable options because of moderate-to-severe mitral regurgitation and a heavily calcified valve. This is one of few such cases reported in the literature to date.

Adult↗
PubMed1995

[Clinico-morphological dissociation in patients with mitral valve stenosis].

PURPOSE: To study characteristics of the natural history of mitral stenosis (MS) in patients that have no correlation between mitral valve areas (MVA) and symptoms. METHODS: We studied 18 patients with MS, that presented no correlation between MVA and functional class (FC), 16 (89%) were female and two (11%) men, with age ranging from 16 to 54 (mean 33) years. Patients assigned to group A (8 cases) had FC III and MVA > or = 1.5 cm2 and group B (10 cases) FC I/II and MVA < 1.1 cm2. FC and MVA at the start (initial time-It) and after 12 months or before surgical correction (SC) or percutaneous mitral balloon valvuloplasty (PBV) (final time-Ft) were compared. All patients with predict O2 uptake (%PRED VO2) at It were evaluated. RESULTS: Five (63%) patients of group A, that maintained MVA > or = 1.5 cm2, changed to FC I/II but three (38%) needed a SC or PBV (2 with lesser MVA at Ft). At group B, six (60%) patients needed SC or PBV. CONCLUSION: MS patients with MVA > or = 1.5 and FC III, providing MVA do not decrease, improves their FC, becoming it more compatible with MVA %PRED VO2. The cases of group B presented the greatest probability of needing SC or PVB.

Adolescent↗
PubMed2002

[Mitral valve stenosis associated with a floating ball thrombus in the left atrium; report of a case].

A floating ball thrombus in the left atrium is relatively a rare case. A 70 year-old female patient who showed a symptom of heart failure was admitted to our hospital. By echocardiography, the mass in the dilated left atrium was appeared to be a floating ball thrombus, and the patient was diagnosed to be mitral valve stenosis. Following the treatment of heart failure, the patient underwent mitral valve replacement and the ball thrombus was successfully removed. Because of the high risk of sudden death with strangulated ball thrombus and systemic embolization, surgical removal of the ball thrombus should be done immediately after the diagnosis was established.

Aged↗
PubMedDate not supplied

Clinical, echocardiographic, and hemodynamic characteristics of rheumatic mitral valve stenosis and atrial fibrillation.

Chronic atrial fibrillation (AF) is associated with an increased frequency of embolic events and negative impact on cardiac function, and therefore, an increased morbidity and mortality risk in patients with rheumatic mitral valve stenosis (RMS). In the present study, the clinical, 2-D and Doppler echocardiographic, and left-and right-heart hemodynamic data were evaluated for 92 patients (68 women) with RMS and AF and compared with data from 118 patients (88 women) with RMS with sinus rhythm. The clinical, echocardiographic, and hemodynamic evaluations were performed within 1 to 7 days of each other. Patients with AF were older (45.7+/-13.4 vs 38.6+/-12.0 years, p < 0.01) and had a longer symptomatic period (108.2+/-117.9 vs 50.6+/-53.1 months, p < 0.01) compared with those with sinus rhythm. Most of the patients with AF were in NYHA functional capacity 3-4 (74% vs 19%), whereas most of the patients with sinus rhythm were in NYHA functional capacity 2. Patients with AF had a higher mitral valve score based on morphologic features ranging from 4 to 16 depending on the severity of disease (8.3+/-2.1 vs 6.5+/-1.9, p < 0.01) and greater left ventricular end-diastolic diameter (LVEDD) (52.3+/-8.7 vs 47.7+/-8.7 mm, p < 0.02), and end-systolic diameter (LVESD) (34.4+/-7.5 vs 30.9+/-7.5 mm, p < 0.01). Organic tricuspid valve involvement was diagnosed more frequently in patients with AF (61% vs 32%, p < 0.01). Mild mitral regurgitation was also more frequent in patients with AF (71%vs 51%, p < 0.03). The mitral valve area was similar in patients with and without AF (1.30+/-0.39 vs 1.39+/-0.41 cm2, p > 0.05). Mean diastolic mitral valve gradient and pulmonary artery pressure did not differ in patients with and without AF. Right atrial pressures were higher in patients with AF (7.6+/-3.3 vs 6.3+/-1.9 mm Hg, p < 0.02). The authors suggest that (1) AF occurred in older patients, who had a longer disease process and more serious symptoms; (2) hemodynamic derangements (mitral valve gradient, pulmonary artery pressure) did not differ in patients with and without AF; (3) greater mitral valve score, more tricuspid valve involvement, higher LVEDD, which are suggestive of greater rheumatic activity process were more frequently seen in patients with AF than in those without AF. These findings support the opinion that AF is a marker of widespread rheumatic damage in patients with RMS.

Adult↗
PubMed1990

[Surgical correction of mitral valve stenosis and its recurrence].

The article analyses the results of surgical treatment of 1,394 patients with mitral stenosis who were operated on in the period between January 1, 1986 and April 1, 1989. Hospital mortality was 2.0%. Distinct indications for transventricular commissurotomy and mitral valve prosthetics were determined. The choice of the method for mitral stenosis correction was based on the character of the morphological changes in the cusps and subcuspal structures, which were determined during echocardiographic examination. With proper indications transventricular commissurotomy presents a small risk. Hospital mortality was 0.8% in mitral stenosis (among 1,039 patients who underwent operation 8 died) and 2.5% in recurrent stenosis (among 197 patients 5 died). Lethal outcomes were not encountered in stage 11, the mortality rate was 0.6% in stage III and 2.2% in stage IV. Mitral valve prosthetics was performed in 158 patients with 15 (9.5%) lethal outcomes. Hospital mortality was 4.5% in stage III and 10.3% in stage IV of the disease. In the group of patients with mitral stenosis hospital mortality was 7.5% (93 patients underwent operation). Hospital mortality after operations for recurrent mitral stenosis (65) was 12.3%. The initial severity of the patients' condition is still the main factor which influences unfavorably of the immediate results of mitral valve prosthetics.

Adolescent↗