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Results for “MITRAL STENOSIS”

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At least 1,333 records · Page 74Linked to original sources
PubMed1988

Influence of a single dose of captopril on pulmonary haemodynamics and right ventricular function in mitral stenosis with pulmonary hypertension.

The response of the pulmonary circulation to captopril 75 mg has been examined in 21 patients with pulmonary hypertension secondary to mitral stenosis. The effects of captopril were measured every 15 min up to 2 h by recording pressures in the pulmonary and systemic circulations and by measuring cardiac output. Pulmonary artery systolic pressure fell significantly by 21.6% (from means = 54.6 to 42.8 mm Hg), pulmonary artery diastolic pressure by 23.3% (from 26.2 to 20.1 mm Hg), and the pulmonary artery mean pressure by 23.2% (from 36.9 to 28.3 mm Hg). Right ventricular end-diastolic pressure also fell significantly by 7% (8.1 to 7.5 mm Hg). Heart rate decreased by 6.5% (from 76.3 to 71.3 beats.min-1). Cardiac index and stroke volume index did not change. The total and vascular pulmonary resistance dropped significantly by 23.2% (from 721 to 553.7 dyn.s.cm-5) and 40% (from 287.2 to 172 dyn.s.cm-5), respectively. The right ventricular stroke work index fell by 33% (from 15.1 to 10.1 g/beat/m2). Systemic systolic pressure decreased by 10.5% (from 124.5 to 111.4 mm Hg). Thus, captopril lowered pulmonary pressures and resistances and no deterioration in right ventricular function was observed.

Blood Pressure↗
PubMed1989

Digoxin or verapamil or metoprolol for heart rate control in patients with mitral stenosis--a randomised cross-over study.

The effect and choice of a drug to control heart rate for symptomatic improvement in patients with isolated mitral stenosis with normal sinus rhythm (n = 10) or atrial fibrillation (n = 10) were studied. Digoxin (0.25-0.5 mg daily), metoprolol (50-100 mg twice a day) and verapamil (40-80 mg three times a day) were evaluated for this purpose. An open randomised cross-over design was followed. The efficacy of a drug was evaluated by: (1) subjective improvement on a visual analog scale, and (2) objective improvement on repeated multi-stage symptom-limited treadmill exercise. In patients with sinus rhythm greater than or equal to 50% subjective improvement was seen in 90%, 40% and nil with metoprolol, verapamil and digoxin, respectively. The total work done by these patients was 1008 +/- 541 kpm (control), 2869 +/- 1418 kpm on metoprolol, 2369 +/- 884 kpm on verapamil and 1654 +/- 918 kpm on digoxin. In patients with atrial fibrillation greater than or equal to 50% subjective improvement was seen in 80%, 40% and 30% with verapamil, metoprolol and digoxin, respectively. The total work done by these patients was 555 +/- 232 kpm (control), 1379 +/- 553 kpm on verapamil, 1251 +/- 575 kpm on metoprolol and 716 +/- 340 kpm on digoxin. The degree of improvement on a drug appeared to be a function of its ability to control resting and exercise heart rates in two different rhythms in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Bronchial hyperresponsiveness before and after percutaneous transluminal mitral commissurotomy in patients with mitral stenosis].

To study the effects of percutaneous transluminal mitral commissurotomy (PTMC) on bronchial responsiveness to inhaled methacholine in patients with mitral valve stenosis (MS), methacholine inhalation tests and pulmonary function tests were done in 10 patients with MS before and one week after PTMC. The mean log cumulative dose producing a 35% decrease in respiratory conductance (PD35Grs) was significantly higher after PTMC in nine patients in whom PTMC was successful (p < 0.05). There were no significant changes in the results of pulmonary function tests after PTMC. One patient had severe mitral regurgitation after PTMC, and a decrease in PD35Grs. Six of the other nine patients in whom PTMC was successful continued to be hyperresponsive to inhaled methacholine. These data show that bronchial hyperresponsiveness in patients with MS is less severe after PTMC, concomitant with the relief of pulmonary congestion, and they suggest that the remaining bronchial hyperresponsiveness is responsible for peripheral airway narrowing with organic remodeling.

Bronchial Hyperreactivity↗
PubMed1985

[1- and 2-dimensional echocardiographic studies on the evaluation of the severity of mitral stenosis based on valve kinetics].

It is reported on the results of unidimensional and bidimensional echocardiographic investigations of the valve kinetics in 64 patients with a pure or predominating mitral stenosis (27 patients stage II, 37 patients stage III). The authors establish that the decreased amplitude of the opening and the diminution of the early diagnostic back stroke movement of the anterior mitral valve, the index of the closure of the mitral valve, the evacuation index of the atrium and the relation filling index to evacuation index of the atrium allow of a subdivision into stages in the group, that, however, they do not permit a secure judgment of the degree of severity in the individual case. The determination of the opening surface of the mitral valve from the bidimensional picture brings a clear enlargement of the findings. Finally the authors adopt a definite attitude to the value of echocardiography in the preoperative diagnostics.

Adolescent↗
PubMed1977

Exercising pulmonary blood flow in mitral stenosis with anomalous pulmonary venous connection.

Exercising pulmonary blood flow was estimated from indicator-dilution curves in a patient with the infrequent combination of rheumatic mitral stenosis and anomalous pulmonary venous connection from the left lung. During supine exercise against progressively increasing external workloads, the proportion of flow to each lung remained nearly constant. The pulmonary vascular resistance was highest in the left lung, which emptied into the low-pressure systemic vein. Although right and left atrial pressures differed markedly during supine exercise, the proportion of pulmonary blood flow shunted to the systemic venous sytem remained essentially unchanged.

Adult↗
PubMed1997

Hemodynamic correlates of effective arterial elastance in mitral stenosis before and after balloon valvotomy.

This study had the purpose of documenting the hemodynamic correlates of effective arterial elastance (Ea; i.e., an accurate estimate of hydraulic load) in mitral stenosis (MS) patients. The main hypothesis tested was that Ea relates to the total vascular resistance (R)-to-pulse interval duration (T) ratio (R/T) in MS patients both before and after successful balloon mitral valvotomy (BMV). High-fidelity aortic pressure recordings were obtained in 10 patients (40 +/- 12 yr) before and 15 min after BMV. Ea value was calculated as the ratio of the steady-state end-systolic aortic pressure (ESAP) to stroke volume (thermodilution). Ea increased after BMV (from 1.55 +/- 0.63 to 1.83 +/- 0.71 mmHg/ml; P < 0.05). Throughout the procedure, there was a strong linear relationship between Ea and R/T: Ea = 1.09R/T - 0.01 mmHg/ml, r = 0.99, P = 0.0001. This ultimately depended on the powerful link between ESAP and mean aortic pressure [MAP; r = 0.99, 95% confidence interval for the difference (MAP - ESAP) from -18.5 to +4.5 mmHg]. Ea was also related to total arterial compliance (area method) and to wave reflections (augmentation index), although to a lesser extent. After BMV, enhanced and anticipated wave reflections were observed, and this was likely to be explained by decreased arterial compliance. The present study indicated that Ea depended mainly on the steady component of hydraulic load (i.e., R) and on heart period (i.e., T) in MS patients.

Adult↗
PubMed1996

[Two cases of mitral stenosis associated with ball thrombus in the left atrium].

Two patients (55-year-old female and 77-year-old female) were operated on for mitral stenosis associated with left atrial ball thrombus. The first case had the episode of cerebral infarction and second case had syncopal attack. Both of them presented with systemic arterial embolism. After confirmation of the diagnosis by echocardiography, removal of ball thrombi, OMC and MVR were carried out urgently. Considering high risk of "hole in one sudden death" and multiple-episodes of systemic embolization, ball thrombus should be removed as urgent following confirmation of diagnosis.

Coronary Thrombosis↗
PubMed1997

[A case of modified Fontan operation for corrected transposition of great arteries (I.D.D.) with atrial septal defect, ventricular septal defect, pulmonary stenosis, mitral atresia and hypoplastic left ventricle].

A 14-year-old boy with corrected transposition of the great arteries (I.D.D.), atrial septal defect, ventricular septal defect, pulmonary stenosis, mitral atresia and hypoplastic left ventricle was successfully operated. He had undergone modified Blalock-Taussig shunt at the age of two. After atrial septal defect was closed with bovine pericardial patch, small ventricular septal defects were closed directly through left ventricular incision. Then the incisional line on the left ventricle was extended to pulmonary artery. The stenotic and thickened pulmonary valve was excised. The upper part of the incisional line on the right atrium and that on the left ventricle were anastomosed. Consequently the connection between the right atrium and the pulmonary artery was able to be made through hypoplastic left ventricle. This case is extremely rare type in terms of mitral atresia and is classified as Group II, type B according to Eliot's classification. This type of repair is similar to Björk's method, however, we could not make use of left ventricular contraction because it was weak. The merit of this procedure was to be able to reconstruct blood tract without using artificial conduits.

Adolescent↗
PubMed1979

[Systolic murmur in mitral stenosis].

Phonocardiograms recorded before operation in the usual auscultation points were compared with the findings during operation in 223 patients and the results of autopsy of 12 persons who had undergone mitral commissurotomy. A systolic murmur at the apex of the heart had been recorded in 184 patients and in 9 persons who had died. In 87 patients it was associated with regurgitation. In 97 patients and in 9 who had died a pure mitral stenosis was revealed on operation. Besides the possible regurgitation as the result of coase deformity of the mitral valve and infravalvular apparatus, the causes of the systolic murmur may be relative incompetence of the tricuspid valve, functional stenosis of the pulmonary artery and concomitant aortic stenosis. In 10 cases the cause of the systolic murmur was not disclosed. The question of its origin calls for further study.

Adult↗
PubMed1995

Prognostic significance of changes in the compliance of the pulmonary venous system after isosorbiddinitrate in patients with mitral stenosis.

It is agreed that a stiff pulmonary venous bed can cause severe pulmonary hypertension. This condition can also influence the clinical and hemodynamic outcome of mitral valve replacement (MVR). This study has been aimed at assessing whether changes in the pulmonary venous compliance (PVcomp) after application of isosorbiddinitrate (ISDN) can be of prognostic value in patients 6 months after MVR. PVcomp was calculated according to the Hirakawa equation in 34 patients with isolated mitral stenosis (MS) before and after ISDN. In 19 patients (group I) there was an increase of PVcomp by more than 15% (5.3 vs. 8.1 ml/mmHg), while 15 patients (group II) showed no differences in PVcomp after ISDN, despite the significant decrease in PAP and PWP in both groups (measured with the use of Swan-Ganz thermodilution catheters). Six months after MVR a significant decrease in PAP, PWP, PVR and an increase in SVI was observed in both groups during rest. During effort (25 W), significant increases in PAP and PWP were recorded in most of patients from the group II, as opposed to group I. It is concluded that significant increase in PVcomp after ISDN in patients with MS can be a prognostic of good clinical results 6 months after MVR.

Adult↗