Results of the Surgical Treatment for Mitral Stenosis

Abstract

An analysis of the first 100 consecutive cases of mitral stenosis treated by commissurotomy is presented. Frank hemoptysis was noted in 25 individuals and systemic arterial emboli in 22 others; no recurrence of these complications was found one to three and one-half years after surgery. "Pure" mitral stenosis was present in 64, and an associated insufficiency in 27; in nine others there was an associated aortic insufficiency.. A sinus rhythm changed to auricular fibrillation after surgery in 15; in nine the change was permanent. In one instance auricular fibrillation changed to sinus rhythm postoperatively. A rough correlation was found between the extremes of pulmonary artery systolic pressure and the clinical, roentgen and electrocardiographic findings Calcium was found in the mitral valves in 52 patients and did not, per se, predicate a poor functional result. No instance of rheumatic fever occurred postoperatively, even though 14 of 78 biopsied auricular appendages indicated rheumatic infection. Functional improvement occurred in 78 patients, and there were nine unimproved. There were 11 deaths due to surgery and two who died during this three-year follow-up from intercurrent infection.

The Effects of Mitral Valvuloplasty on Cardiovascular and Renal Function at Rest and During Exercise 1

“…The resistances were calculated from the following formulae: 5 The "total pulmonary" resistance (actually, total resistance opposing the right ventricle) was obtained from the following equation: R = cao x 1,332 dynes seconds cm.f5.…”

“…The effects of mitral valvuloplasty on general cardiohemodynamic function in patients with mitral stenosis have been reported by many investigators (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Measurements of renal blood flow, glomerular filtration rate, and excretion of sodium and their correlation with changes in cardiac output, blood oxygen measurements, and vascular pressures also have been extensively studied in patients with various types of heart disease, with and without congestive failure, at rest (11,12) and during exercise (13)(14)(15).…”

Is possible to prevent the Post-Pericardiotomy Syndrome?

“…Such range depends on the adopted diagnostic criteria, institution, and type of cardiac surgery. In 1953, PPS was first described by Janton et al as a syndrome with fever and pleuritic chest pain after surgical treatment of rheumatic mitral stenosis [6,7]. The etiology was thought to be correlated with reactivation of the rheumatic process.…”

Diagnosis and Management of the Postpericardiotomy Syndrome

“…3,4 The syndrome has been first described following cardiac surgery for rheumatic mitral valve diseases and congenital heart diseases in the 50s. 5,6 The present review is aimed at the presentation of recent updates on the diagnosis, management, and prevention of the PPS according to publications in the last 24 months. Potentially relevant studies published up to March 2014 were searched in BioMedCentral, the Cochrane Collaboration Database of Randomized Trials, ClinicalTrials.gov, EMBASE, Google Scholar, MEDLINE/PubMed, and Scopus.…”