Central venous oxygen saturation (CVSO2) was measured in 31 patients with myocardial infarction. CVSO2 correlated well with the patients' clinical course. In those patients not in heart failure, mean + SEM for CVSO2 was 70 + 1%. When heart failure was present, CVSO2 averaged 56 + 1%. When both heart failure and shock were present, CVSO2 averaged 43 + 1%. In nine patients, serial determinations of arterial oxygen saturation and CVSO2 were made. In 22 of 26 instances, either a fall in CVSO2, was accompanied by an increase in the arteriovenous oxygen saturation difference or an increase in CVSO2 was accompanied by a decrease in arteriovenous oxygen saturation difference. Serial measurements of CVSO2 appear to be a useful method of monitoring changes in myocardial function in patients with myocardial infarction.Additional Indexing Words: Mixed venous oxygen saturation Central venous pressure MEASUREMENT of cardiac output and intracardiac pressures is used to assess myocardial function in the catheterization laboratory.

Twenty patients with mitral insufficiency (MI) due to ruptured chordae tendineae, papillary muscle infarction, or left ventricular enlargement with no organic disease of the mitral valve have been studied during the past 3 years. Nineteen had valve replacement, and one had plastic repair of ruptured chordae tendineae; all have been followed from 6 months to 3 years. Preoperative data were different in those who were improved by surgery (13 patients) and those who were not (seven patients). The group in which good results were obtained had a short history of heart failure, little or no evidence of left atrial (LA) enlargement in the electrocardiograms and x-rays, and striking LA v waves at catheterization. In the group demonstrating poor results, heart failure was of longer duration, gross four-chamber cardiomegaly was present, and LA v waves were only moderate. Thus, patients with nonrheumatic mitral insufficiency with high-pressure LA regurgitant waves and only moderate LA enlargement are likely to benefit from mitral valve surgery, even when the primary cardiovascular disease is hypertension, arteriosclerosis, or a cardiomyopathy. These patients generally have ruptured chordae tendineae.

No abstract

No abstract