Cardiotomy and Valvulotomy for Mitral Stenosis; Experimental Observations and Clinical Notes Concerning an Operated Case with Recovery

Cutler, Elliott C.; Levine, Samuel A.

doi:10.1056/nejm192306281882601

Cited by 184 publications

(32 citation statements)

References 4 publications

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“…Vigorous attempts were also made to locate the nonresponders with the help of a social worker who made personal visits. The follow-up period ranged from 1 A mild degree of postoperative mitral regurgitation resulted in 18%, which we believe was not hemodynamically significant. Eleven subjects (incidence of 0.3%) developed severe mitral regurgitation.…”

Section: Methodsmentioning

confidence: 94%

Closed mitral valvotomy: early results and long-term follow-up of 3724 consecutive patients.

John¹,

Bashi²,

Jairaj³

et al. 1983

Circulation

186

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Between 1956 and 1980 closed mitral valvotomies were performed in 3724 consecutive patients (male:female ratio 1.1:1) with mitral stenoses. Their ages ranged from 6 to 69 years, with a mean (SD) of 27.3 (9.3). Mitral stenosis in the younger age group is a unique condition and a great majority of these patients rapidly develop significant pulmonary hypertension and congestive cardiac failure. In this study a large number of subjects belonged to functional class IV (41.5%). Hospital mortality was 1.5% over the last 5 years. After valvotomy, 11 patients (0.3%) developed severe mitral regurgitation that made valve replacement necessary in the immediate postoperative period. Early postoperative embolism occurred in 0.4% of those who were in atrial fibrillation and had preoperative anticoagulation whereas it occurred in 0.95% of those in sinus rhythm who had no anticoagulation. Late postoperative embolism occurred at a rate of 0.3 to 1.6 per 1000 patients per year over a 20 year period. Rheumatic reactivity occurred at a rate of 1.3 to 2.2 per 1000 patients per year during the same period. Rate of occurrence of restenosis varied from 4.2 to I 11.4 per 1000 patients per year between the fifth and fifteenth year of follow-up. Closed transventricular revalvotomy for restenosis was accomplished in 130 subjects with a 6.7% mortality. Excellent symptomatic improvement was evident in 86% of long-term survivors at the end of 15 years. Actuarial survival was 95%, 93.1%, 89.5%, and 84.2% at 6, 12, 18, and 24 years, respectively, after closed mitral valvotomy. Late deaths occurred in 4.3%. This study serves to highlight the excellent palliative effect of closed valvotomy for mitral stenosis without significant valvular calcification, substantial regurgitation, or significant associated valvular lesion. Circulation 68, No. 5, 891-896, 1983

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Section: Methodsmentioning

confidence: 94%

Closed mitral valvotomy: early results and long-term follow-up of 3724 consecutive patients.

John¹,

Bashi²,

Jairaj³

et al. 1983

Circulation

186

View full text Add to dashboard Cite

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“…This disorder was first reported in 1668 by John Mayow, an Oxford physiologist, 1 and until recently was the most discussed valvular heart disease. It is also the first valvular disorder to be successfully corrected by surgery 2 or percutaneous balloon valvuloplasty. 3 Although the prevalence of this disorder has declined over the last decade, especially in developed countries, it remains an important cause of morbidity.…”

Section: Itral Stenosis (Ms)mentioning

confidence: 99%

Degenerative Mitral Stenosis

et al. 2016

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Abstract-Degenerative mitral stenosis (DMS) is an important cause of mitral stenosis, developing secondary to severe mitral annular calcification. With the increase in life expectancy and improved access to health care, more patients with DMS are likely to be encountered in developed nations. These patients are generally elderly with multiple comorbidities and often are high-risk candidates for surgery. The mainstay of therapy in DMS patients is medical management with heart rate control and diuretic therapy. Surgical intervention might be delayed until symptoms are severely limiting and cannot be managed by medical therapy. Mitral valve surgery is also challenging in these patients because of the presence of extensive calcification. Hence, there is a need to develop an alternative percutaneous treatment approach for patients with DMS who are otherwise inoperable or at high risk for surgery. In this review, we summarize the available data on the epidemiology of DMS and diagnostic considerations and current treatment strategies for these patients.

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“…The initial attempts of surgical valve replacement in humans in the 1950s were disappointing. [22][23][24] However, research, technical improvements, persistence, experience, and courage led to the development of a product that eventually worked and saved the lives of thousands. This may well be the case with percutaneous repair of the mitral valve in patients with functional mitral regurgitation.…”

Section: Article See P 277mentioning

confidence: 99%