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Results for “MITRAL VALVE STENOSIS”

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At least 1,117 records · Page 62Linked to original sources
PubMed1994

[Role of transesophageal echocardiography in mitral valve repair].

This study was designed to prove the utility of intraoperative echocardiography in the mitral valve repair, that offers many advantages over valve replacement. We have assessed 21 consecutive patients, 12 with mitral incompetence and 9 with mitral stenosis, undergoing mitral valve surgery over a period of 6 months. Preoperative transthoracic and intraoperative transesophageal or epicardial echocardiography were performed in all patients. We have assessed, before and after repair, the valve morphology, the presence and the severity of mitral regurgitation, the pulmonary venous flow, the presence of left ventricular outflow tract obstruction. The intraoperative echocardiographic examination revealed a successful mitral repair in all patients except one in whom, for the persistence of severe mitral regurgitation after repair, valve replacement was performed. In none patient systolic anterior motion of mitral apparatus was observed. Intraoperative echocardiography seems to be a useful technique to assess the adequacy of mitral valve repair before chest closure and, in the case of failure, the need for further surgery (valve reconstruction or replacement).

Adult↗
PubMed2003

Intrathoracic pulmonary artery catheter allocation in the background of left atrial dilatation.

AIM: The aim of the study was to find out whether dilatation of the left atrium (LA) influences the intra-thoracic distribution of thermodilution pulmonary artery (TPA) catheter in either branch of pulmonary artery and compare the measured cardiac output. METHODS: In this prospective study of 132 consecutive patients in a university hospital setting, LA size and ejection fraction was assessed by echocardiography, in the preoperative period. In 66 patients posted for coronary artery bypass grafting (Group 1), a standard anaesthesia regimen was used and TPA catheter was floated through the right internal jugular. In another 66 patients of long-standing mitral stenosis for mitral valve repair/replacement (Group 2), TPA catheters were similarly floated. Intrathoracic placement of the tip of the TPA catheter into the right or left pulmonary artery (PA) was confirmed on chest X-ray. TPA catheter length to its wedging, intra-arterial pressure, heart rate, PA pressure, pulmonary artery wedge pressure (PAWP) and cardiac output by thermodilution technique were noted. RESULTS: Leftwards TPA catheter placement was significantly (p<0.001) more frequent (71%) in mitral stenosis patients (group 2) than the CABG (group 1), (18%). On regrouping the observations of rightwards placed TPA (Group R) and leftwards placed TPA (Group L), we observed that large LA (> or = 25 mm3/m2) body surface area (BSA) and high PAWP (> or = 20 mmHg) was associated with significantly (p<0.001) higher incidence of leftwards TPA catheters. Positive predictive value of both the factors in combination was significantly higher (96%) than individual factors large LA (81%) and high PAWP (88%). CONCLUSION: In long standing mitral stenosis, left atrium enlargement, with high PAWP and the hypokinesia of left atrium (atrial fibrillation) likely to influence the angulation of left PA with main PA and so the predominant entry of TPA catheter tip in left PA.

Adult↗
PubMed1994

[Obstruction of the left ventricular outflow tract due to an anomalous muscle bundle and an accessory tissue on the mitral valve associated with mitral stenosis].

This paper details a rare cause of subaortic obstruction, a discrete membrane combined with an anomalous muscle bundle and an accessory tissue on the mitral valve. A 13-year-old boy was referred to our hospital for surgical relief of subaortic obstruction and mitral stenosis. He had received two additional operations, the first was for coarctation of aorta when 5 years old and the second was for discrete subaortic stenosis when 6 years old. Recatheterization at this time revealed an peak systolic gradient of 44 mmHg across the left ventricular outflow tract, and an peak diastolic gradient of 7 mmHg across the mitral valve. An echocardiogram revealed two longitudinally anomalous tissues in the left ventricular outflow tract. Excision of both anomalous tissue and mitral valve replacement were performed. The macroscopic findings and histological reports of the excised specimens showed that one was the accessory mitral valve tissue and another was the anomalous muscle bundle. Intraoperative epicardial echocardiography is beneficial for evaluating the obstructive status of the LV outflow tract before and after excision of the anomalous tissues in this case.

Adolescent↗