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Results for “MITRAL STENOSIS”

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At least 1,297 records · Page 72Linked to original sources
PubMed1984

Global left ventricular function and regional wall motion in pure mitral stenosis.

Global left ventricular function (LVF) and segmental wall motion of the left ventricle are registered in 113 patients presenting a pure mitral stenosis (MS) and in a control group of 50 individuals. The segmental wall motion is measured on the end-diastolic-end-systolic frames of the left ventricle, obtained from right anterior oblique (RAO) monoplane cineangiography. Measurement of the segmental wall shortening is performed using the Stanford method. Group 1 includes 68 patients (60% of the total number of patients studied). These patients show no pathological contraction abnormality. In this group, the global LVF is not different from the control group. Group 2 includes 45 patients (40% of the total) for whom contraction abnormalities are present: anterior hypokinesis in 20% of the cases (anterior area mean shortening (AAS) = 18 +/- 8%; p less than 0.001 vs. group 1 and control group), and posterior hypokinesis in 20% of the cases (posterior area mean shortening (PAS) = 9.8 +/- 5.8%, p less than 0.001 vs. group 1 and control group). In this group, global LVF is impaired; ejection fraction (EF) = 0.57 +/- 0.1% (p less than 0.001 vs. group 1); velocity of circumferential fiber shortening (VCF) = 1 +/- 0.3 circ/s (p less than 0.001 vs. group 1); enddiastolic pressure (EDP) = 11 +/- 5 mmHg (p less than 0.01 vs. group 1). Segmental contraction abnormalities appear to be the main factor involved in the global LVF impairment. Segmental wall motion abnormalities could be related to subvalvular fibrosis, or LV filling difficulties, or principally, to a possible interplay between the right and the left ventricles.

Adult↗
PubMed1993

[Emergent operation of left atrial ball thrombus associated with mitral stenosis].

A 71-year-old woman with old cerebral infarction and arterial obstruction was admitted with the diagnosis of a free floating ball thrombus in the left atrium associated mitral stenosis. The emergent open heart operation was performed for removal of ball thrombus and mitral commissurotomy. The size of ball thrombus was 4.8 x 4.0 x 3.0 cm. Postoperative course was uneventful.

Aged↗
PubMed2004

Warfarin-intractable, intraatrial thrombogenesis in a 52-year-old woman with mitral stenosis and chronic atrial fibrillation.

Thromboembolic events are serious complications of atrial fibrillation (AF). We histologically investigated intraatrial thrombogenesis in a 52-year-old woman with mitral stenosis and chronic AF who had recurrent attacks of cerebral infarction despite continuous warfarin therapy. She underwent cardiac surgery for mitral valve replacement and maze procedure including left atrial thrombectomy. Macroscopic thrombi were found on the endocardium and their surfaces appeared rough and dark red in most areas. Histological examination showed that a single thrombus mass was composed of several tissue layers or blocks on the endocardium. Immunohistochemistry revealed stratum-like accumulations of small platelet aggregate/fibrin clot complexes in the superficial, fresh thrombus layers and multiple neovessel formation in the basal organized tissue layers. This case study suggests that intraatrial thrombi may develop in a stepwise fashion on the endocardium involving platelet aggregate/fibrin clot complex formation.

Adult↗
PubMed2000

Usefulness of transesophageal echocardiography during open heart surgery of mitral stenosis.

BACKGROUND: The aim of this study was to verify if the use of intraoperative transesophageal echocardiography (TEE), by detecting mitral insufficiency or residual stenosis during surgery, may improve medium term results in patients with severe mitral stenosis who undergo open heart valvuloplasty. METHODS: This prospective study included twenty-two patients (20 women and 2 men) with a mean age of 49+/-13 years with severe mitral stenosis. Mean follow-up was 32 months (range 12-55 months). All the patients underwent transthoracic echocardiography (TrE) before surgery and intraoperative TEE. Before surgery the mean transmitral gradient was 11+/-6.8 mmHg, the mean pressure half time (PHT) area was 0.89+/-0.19 cm2, the mean echo score was 8.9+/-2.2. Intraoperative TEE before the repair showed a mean echo score of 7.9+/-1.8. RESULTS: Two patients with unsatisfactory repair at TEE underwent immediate valve replacement. In the remaining patients, mean transmitral gradient and PHT valve area before discharge was 5.2+/-3 mmHg and 2.5 cm2. No patients had more than trivial mitral regurgitation. During the follow-up two patients had to be reoperated. Patients with poor immediate (2 patients) or medium term results (2 patients), had a mean echocardiographic score of 12.24, while patients with a satisfactory medium term outcome had a mean score of 7.27 (p<0.001). CONCLUSIONS: Intraoperative TEE may guide the surgeon in the assessment of valvuloplasty. However the absence of mitral regurgitation after repair and at discharge cannot predict the medium term results, which are related to the degree of the disease of the mitral valve.

Adult↗
PubMed1996

Echocardiographic follow-up in patients with mild to moderate mitral stenosis: is a yearly examination justified?

The result of this study showed that echocardiographic and Doppler parameters in patients with mild to moderate mitral stenosis did not undergo any major changes over a relatively long observation period, reflecting the substantial stability of the valve disease process. Thus, unless such patients experience clinical deterioration, a yearly echocardiographic examination appears to be unjustified.

Aged↗
PubMed2003

The subvalvular apparatus in rheumatic mitral stenosis: methods of assessment and therapeutic implications.

The assessment of the structure and function of the subvalvular apparatus (SVA) in patients with rheumatic mitral stenosis (MS) is complex, yet is of major importance prior to therapeutic decision making. Currently available methods of assessment are neither sufficiently accurate nor feasible. We review anatomic and functional aspects of the SVA and define SVA involvement in rheumatic MS. The role of various noninvasive and invasive methods for evaluating the integrity and function of SVA in rheumatic MS, as well as clinical implications and pitfalls in assessment of SVA are also discussed.

Chordae Tendineae↗
PubMed1985

[Microcirculation in rheumatic mitral stenosis (clinico-morphological research by lung biopsies)].

The study of the microcirculation in lung and visceral pleura biopsies from patients with rheumatic mitral stenosis showed the involvement of all parts of the microcirculatory system including intra- and extravascular alterations and changes of the vascular wall as well as its lymphatic part. As the pressure in the small circulation circle increased and arterial hypertension established enhancement of the vascular reconstruction, rheological disturbances and dyscoagulation in the pulmonary microvessels took place. All this resulted in hemodynamic and metabolic homeostasis disturbances in the pulmonary artery system and, consequently, in the establishment of lung hypertension.

Adult↗
PubMed2003

Acquired mitral stenosis in a cat with hypertrophic cardiomyopathy.

A seven-year-old castrated male domestic shorthair cat was diagnosed with hypertrophic cardiomyopathy (HCM) and suspected mitral stenosis (MS) based on electrocardiography, thoracic radiographs and echocardiographic findings. Post-mortem examination of the heart revealed morphological features consistent with HCM. In addition, there was marked fibrous deposition on the surfaces of the chordae tendineae extending to both mitral valve leaflets, which caused total chordal fusion into pillars of fibrous tissue and fusion of the commissures. The present case indicates that acquired MS can occur in association with HCM in the cat.

Animals↗
PubMed1982

Cardiovascular responses to isometric exercise in patients with mitral stenosis. Comparison with normal subjects and patients with depressed ejection fraction.

The hemodynamic response to isometric handgrip was evaluated in 15 patients with mitral stenosis (MS), 12 normal subjects, and 13 patients with severe left ventricular failure (LVF). Acceleration of heart rate and rise in left ventricular systolic pressure were not significantly different between the three groups. Left ventricular end-diastolic pressure did not change in normal subjects and patients with MS during handgrip, but it was raised markedly in patients with LVF. Cardiac index increased in normal subjects but did not change in patients with MS and LVF. Stroke index declined in patients with LVF. In all groups there was a modest and similar increase in oxygen consumption and significant widening of the arteriovenous oxygen difference in patients with LVF. In patients with MS, pulmonary capillary pressure increased by an average of 10.6 mm Hg, with a parallel rise in mean pulmonary vascular resistance. It is concluded that patients with MS demonstrate a normal chronotropic and pressor response to isometric exercise. Normal left ventricular end-diastolic pressure response to isometric handgrip stress in patients with MS suggests good left ventricular performance.

Adult↗
PubMed2003

Exhaled nitric oxide during exercise and dobutamine stress echocardiography in patients with mitral stenosis.

BACKGROUND: Pulmonary hypertension (PH) is an important limiting factor of exercise tolerance in patients with mitral stenosis (MS). We wished to investigate the relationship between respiratory nitric oxide (NO), a potent vasodilator, and exercise tolerance in patients with moderate MS. In the same patients, we wondered whether acute change in pulmonary hemodynamics could affect respiratory NO. METHODS: Ten patients with moderate MS (valve area 1.4+/-0.2 cm(2)) were studied at rest, during incremental cycle ergometry exercise, and during dobutamine stress echocardiography (DSE). The concentration of NO in exhaled air (FE(NO)) and NO output (V'(NO)) were measured at baseline, at the end of exercise, and at the end of DSE. Eight healthy subjects served as normal controls for NO output during exercise. RESULTS: During exercise, FE(NO) decreased both in patients and in controls, while V'(NO) increased in both. At the end of exercise, both VO(2) max and V'(NO) were significantly higher in controls than in patients. The increase in V'(NO) during exercise was significantly correlated with VO(2) max, both in patients and in controls. During DSE, cardiac output (CO), pulmonary artery pressure (PAP), and mitral valve gradient increased. No changes in mean FE(NO), V'(NO), or ventilation were observed during DSE. There was a significant inverse correlation between FE(NO) and mitral valve gradient at the end of DSE. CONCLUSIONS: In patients with moderate MS, exercise performance is correlated with respiratory NO output. In the same patients, during DSE, the increase in CO, which is not accompanied by an increase in ventilation, is not associated with an increase in respiratory V'(NO).

Journal Article↗
PubMed1983

Method for computation of cardiac output in mitral stenosis independent of left ventricular dimensions and kinetic state: correlation with cardiac catheterization via the Fick method.

An hydraulic orifice formula offering the possibility of quantifying cardiac output in conditions of mitral stenosis is tested using potentially noninvasive portions of catheterization data from patients evaluated for obstructive mitral valve disease. The equation studied is V = (1/21) R A T2, where V is the cardiac output (ml/min), R is the heart frequency, A is the mitral valve area (cm2), and T is the diastolic filling interval (sec/min). The mitral valve area was determined by the Gorlin formula, and R and T were measured from the pressure tracings recorded at cardiac catheterization. The degree of correspondence between the equation tested and the measured cardiac output as determined by the Fick principle technique is characterized by r = 0.87, SE = 450 ml/min, N = 10. The results suggest that the new formulation may offer a noninvasive method for estimating the cardiac output status of patients with mitral valve disease once mitral valve area is measured either at catheterization or by two-dimensional echocardiography.

Cardiac Catheterization↗
PubMed1989

Semiquantitative evaluation of aortic regurgitation by Doppler echocardiography: effects of associated mitral stenosis.

The accuracy of pulsed and continuous wave (CW) Doppler methods for evaluating aortic regurgitation (AR) was compared in patients with and without mitral stenosis (MS), with aortic root angiography as a gold standard. AR was diagnosed with pulsed Doppler echocardiography, by the detection of broad frequency spectral patterns in the isovolumic relaxation time. If these indications were present, AR was graded by examining the extent of diastolic turbulence in the left ventricular cavity (flow mapping method). With CW Doppler echocardiography, AR was diagnosed by the detection of a peak velocity of greater than 2 m/s; if this velocity was attained, AR was graded by measuring the time from the peak velocity to half the peak velocity (half-time method). The angiographic grade corresponded to that determined by the pulsed and CW Doppler methods in 37 and 37 of 46 patients without MS, respectively. Angiographic grade corresponded to the grade determined by the pulsed and CW Doppler methods in 13 and 17 of the 23 patients with MS, respectively. Eight of 10 discrepancies between pulsed Doppler and angiographic grades were due to overestimation of AR by the flow mapping method, apparently because the transmitral jet produces diastolic turbulence in the left ventricular cavity independent of AR. On the other hand, three of six discrepancies between CW Doppler and angiographic grades were due to the incapability of detecting signals of AR by CW Doppler echocardiography. Thus both the pulsed and the CW Doppler methods are useful to evaluate AR in patients without MS. In patients with MS, however, AR is most accurately diagnosed by the detection of AR signals in the isovolumic relaxation time by pulsed Doppler echocardiography, and the degree of AR is more accurately assessed by the CW Doppler half-time method.

Adult↗
PubMed1977

Hypertrophic cardiomyopathy with midventricular obstruction associated with mitral stenosis: partial relief of the obstruction by papillary muscle and trabecular resection.

A patient is reported with hypertrophic cardiomyopathy where midventricular obstruction was found in association with mitral stenosis. Partial relief of the intraventricular obstruction was obtained by extensive papillary and trabecular muscle resection in the mid-left ventricular area, in conjunction with mitral valve replacement with a porcine heterograft.

Adult↗