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G de Gevigney

Publications and source records attributed to G de Gevigney.

54 records · Page 3Linked to original sources
PubMed1995

[Has life expectancy of patients after surgery for aortic valve endocarditis improved over the last twelve years?].

Between 1983 and 1991, 104 patients (average age: 52 +/- 13 years) with aortic endocarditis (94 on native and 10 on prosthetic valves), were operated, 81 before the end of antibiotic therapy. Blood cultures were negative in 17 patients, identified a streptococcus in 49 patients, a staphylococcus in 16 patients, and a Gram negative or other organism in 22 patients. The following complications were observed before surgery: severe cardiac failure in 67 patients, renal failure in 24 patients, conduction defects in 13 patients, neurological complications in 13 patients, systemic or coronary embolism in 12 patients. Aortic valve replacement was performed in all patients, associated with mitral valve replacement in 25 patients and tricuspid valve replacement in 1 patient. Twelve patients died after surgery (11/81 of early operations, 1/23 operated later; NS). During a follow up of 3.5 +/- 2.8 years, there were 24 late deaths, 12 of non cardiovascular causes. Of the 20 variables tested, 3 were related to perioperative and late mortality (age, cardiac and renal failure). The 5 year survival (58.1 +/- 5.7%) is identical to that of the period 1970-1982 despite a very significant drop in perioperative mortality. Some of the causes of late mortality (older age of patients, changes in the infecting organisms) provide little hope of improving the prognosis in the near future. Others suggest that earlier surgery could improve the long term prognosis.

Actuarial Analysis↗
PubMed1994

[Prognosis of non-revascularized triple coronary vessel disease. Apropos of 87 cases].

Between 1982 and 1988, 87 patients (74 men, 13 women), with an average age of 59.6 +/- 10.1 years, had triple coronary artery disease and did not undergo any medical or surgical revascularisation, mainly because of the severity of the coronary disease or left ventricular dysfunction. Sixty-four patients had previous myocardial infarction, 33 unstable angina and 37 left ventricular failure. At coronary angiography, 31 patients had Class III or IV (NYHA) angina. The cardiothoracic ratio was 0.50 +/- 0.06; the left ventricular ejection fraction was 0.47 +/- 0.20. During follow-up of 3.9 +/- 2.6 years (2 patients lost to follow-up), 35 patients died (26 of cardiac and 9 of non-cardiac causes), giving a 5 year actuarial survival of 63%. In univariate analysis, the factors predictive of increased cardiac mortality were: absence of alcohol consumption (p = 0.013); class 3 or 4 angina (p = 0.017); resting angina (p = 0.030); cardiac failure (p = 0.0006); chest X ray showing interstitial or alveolar oedema (p = 0.002); increased cardiothoracic ratio (p = 0.003). A decreased left ventricular ejection fraction was only at the limit of statistical significance (p = 0.054). In multivariate analysis (Cox model), only 4 variables were correlated with increased cardiovascular mortality: resting angina (relative risk, RR = 2.56), cardiac failure (RR = 2.55), increased cardiothoracic ratio (RR = 2.14), absence of alcohol consumption (RR = 4.43). These results confirm the poor prognosis of patients with triple vessel disease not revascularised. They show the value of clinical appreciation to determine the prognosis of these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Pre- and postoperative ventricular arrhythmia in mitral valve insufficiency].

In order to assess the prevalence and prognosis of ventricular arrhythmias in patients with surgical mitral regurgitation, a prospective cooperative study was undertaken in 14 French cardiological centres. Seventy-nine patients (45 men, 34 women, average age 62.8 +/- 12.8 years), who underwent mitral valvuloplasty (44 cases) or valve replacement (35 cases), were included. Three 24 hour Holter recordings were performed before, 15 days and 6 months after surgery. Etiology of mitral disease was dystrophic in 49 patients, degenerative in 11, rheumatic in 10, post-endocarditis in 3 and undetermined in 6. Only 5 patients had a left ventricular ejection fraction < or = 45 %. Complex ventricular arrhythmias (Lown > or = 4) were recorded before surgery in 22 patients (28 %), more often in dystrophic disease (17/49 versus 5/30, p = 0.04). No significant correlation was observed between the ventricular arrhythmias and the other preoperative findings, except for a tendency to an inverse correlation between the left ventricular ejection fraction and the Lown grade. Two patients died in the immediate postoperative period (Lown 1); 1 died of a non-cardiac cause at the 2nd month (Lown 4A). The prevalence of complex arrhythmias was unchanged after surgery (34 % on early Holter and 22% on late Holter recordings) with no difference between valvuloplasty and valve replacement. In conclusion, these results indicate that ventricular arrhythmias do not influence the early and 6 month postoperative prognosis in mitral regurgitation with good left ventricular function.

Aged↗
PubMed1994

[Can irreversible ventricular dysfunction be identified in patients with heart valve disease?].

Cardiologists and heart surgeons are often faced with the problem of the optimal therapeutic indication in patients with valvular heart disease presenting with severe myocardial dysfunction, as it is difficult to evaluate the degree of reversibility of a severe alteration of ventricular function in these patients. Myocardial dysfunction is often multifactorial in patients with valvular heart disease and the role of myocardial ischaemia secondary to associated coronary heart disease must not be neglected. On the other hand, the compensatory capacity of the myocardium varies from one patient to another ("constitutional" myocardial factor or related to the aetiology of the valvular heart disease?). Although the methods of investigation of myocardial function currently available are able to precisely evaluate the degree of severity of myocardial dysfunction, they are unable to accurately predict the degree of reversibility. 1. In pure mitral stenosis, severe left ventricular dysfunction is very rare; more or less rapidly, pulmonary hypertension induces slowly progressive right ventricular dysfunction which remains reversible for a long time. 2. In mitral incompetence, left ventricular systolic function is correctly evaluated by the ejection fraction (LVEF). There is a high risk of irreversible left ventricular dysfunction in operated patients with an LVEF of less than 0.40. In these patients, left ventricular function is slightly improved after mitral repair, while LVEF decreases after mitral valve replacement. The combined study of right ventricular systolic function is useful in patients with mitral disease, as this function may be insidiously altered and the presence of right heart failure, regardless of its cause, considerably increases the late postoperative mortality of mitral valve disease. 3. In aortic stenosis, left ventricular dysfunction, hypertrophy and interstitial fibrosis remain reversible for a long time. Severe alteration of LV function therefore does not exclude the possibility of very good postoperative recovery. However, this is improbable in the presence of: a very marked increase in LV mass and/or end-systolic volume, and/or inoperable associated coronary artery disease, and/or the combination of low ejection fraction, severely decreased cardiac output, and low transvalvular gradient (not increased by cautious dobutamine infusion), and/or clinical signs of complete heart failure. 4. In aortic incompetence, progressive alteration of left ventricular function, often asymptomatic, is reflected by the increased dimensions of the LV and a reduction of the fraction of ejection. The reversibility of LV dysfunction is difficult for evaluate. The long clinical course of this dysfunction is one of the most reliable predictors of irreversibility, together with a fall in the resting isotope LVEF.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗
PubMed1994

Late survival up to 20 years after isolated coronary by-pass surgery using internal mammary artery in patients with severe left ventricular dysfunction.

Coronary patients with left ventricular ejection fraction (LVEF) < 40% and abnormal motion of all left ventricular walls on cineangiography but without significant valve disease or left ventricular aneurysm were selected for this study. From January 1970 to December 1990, 155 patients meeting the above criteria consecutively underwent coronary by-pass surgery; preoperatively, 149 patients had angina class III or IV, and 49 patients had dyspnea class II or III. LVEF was 31 +/- 7%. During this 20-year period, two different surgical techniques have been used: from 1970 to 1981, 79 patients (group I) received internal mammary artery upon left anterior descending artery with associated simple saphenous grafts, under intermittent aortic cross clamping; from 1982 to 1990, 76 patients (group II) received internal mammary artery upon left anterior descending artery with associated sequential saphenous vein graft, under oxygenated cardioplegic myocardial protection. The mean number of by-pass was 1.6 in group I and 3.7 in group II (p = 0.001). Early mortality rate was lower in group II than in group I: 2.6% vs 7.6% (p = 0.01). After a follow-up of 79 +/- 14 months, there were 51 late deaths, 6 patients were lost to follow-up and 90 patients were still alive; 80% of all deaths were from cardiac causes, including 38% due to heart failure. Actuarial survival rate at 5, 10, 15 years was 79 +/- 7%, 63 +/- 10%, and 36 +/- 15% respectively. The 5-year survival rate was 71 +/- 10% in group I and 88 +/- 8% in group II (p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1993

Postoperative and long-term prognosis of myotomy-myomectomy for obstructive hypertrophic cardiomyopathy: influence of associated mitral valve replacement.

Several surgical techniques have been proposed for obstructive hypertrophic cardiomyopathy (OHCM): myotomy, mitral valve replacement (MVR), or myotomy-myomectomy (MM). We reviewed our series of 47 patients who had undergone surgery in order to determine their prognosis and to know whether MVR+MM was better than MM only. Left intraventricular gradient decreased from 86 +/- 34 mmHg to 15 +/- 20 mmHg (P < 0.0001). Postoperatively, three patients died from low cardiac output (6.4%); five died later. Annual mortality (including postoperative deaths) was 3.0%. Follow-up was 5.7 +/- 0.7 years. Survival was 87 +/- 11% at 12 years. After operation, 91% had NYHA class I or II dyspnoea (before surgery this had been 28%); chest pain was CCS class I in 88% (vs 47%); 12% had had syncope since operation (vs 53%). The gradient decrease was larger in the MM+MVR group (P < 0.05). Survival and functional improvement were similar in the two groups. Mitral regurgitation decreased from 2.7 to 0 in the MM+MVR group (P < 0.0001), whereas it decreased from 1.5 to 1.2 in the MM group (ns). MM appears to be the procedure of choice. When mitral regurgitation is important or when an intrinsic disease of the mitral valve exists, the addition of MVR should be considered.

Adult↗
PubMed1993

[Risk of bacterial endocarditis and native heart diseases].

Although there are no epidemiological studies allowing precise evaluation of the risk of infective endocarditis in given cardiac pathologies, a review of the literature allows classification of different conditions in three groups of decreasing risk: 1: high risk group: cyanotic, congenital heart disease, patients with previous infective endocarditis, aortic valve disease, mitral regurgitation and unoperated left-to-right shunts apart from atrial septal defects; 2: moderate risk group: mitral valve prolapse with myxoid valves or a systolic murmur, mitral stenosis, tricuspid valve disease, pulmonary stenosis, hypertrophic obstructive cardiomyopathy; 3: low or negligible risk: isolated atrial septal defect, operated or unoperated (bypass graft) ischaemic heart disease, operated left-to-right shunts without residual shunt, mitral valve prolapse with normal valve thickness and without a murmur, mitral ring calcification without regurgitation.

Cardiomyopathy, Hypertrophic↗
PubMed1993

[Risk of bacterial endocarditis after cardiac surgery].

The risk of infective endocarditis (IE) after intracardiac surgery is dominated by the risk of IE on valvular prostheses. The reported prevalence of IE on prosthetic valves varies according to the chosen diagnostic criteria of IE and its timing. The risk of early IE is 0.4 to 1.3% and the linearized annual risk of late IE is about 0.5%. These values appear to be identical irrespective of the type and site of the prosthesis: the risk is higher in multiple valve replacement. In early IE, the commonest infecting organism is the staphylococcus: the bacteriological spectrum of late IE is the same as that of IE on native valves. The portal of entry is often detected in early IE but more rarely (50%) in late IE. The risk of IE in operated congenital heart disease is very low after surgery of left-to-right shunts or valvular stenosis; it is higher for patients with Tetralogy of Fallot and those with complex cyanotic disease, especially in cases with residual ventricular septal defects and with palliative surgery such as systemico-pulmonary anastomosis. The risk of IE on endocavitary catheters (pace-maker, defibrillator) after interventional cardiac procedures and after cardiac transplantation, seems to be very low. These results show that preventive measures against IE are only routinely required in prosthetic valve patients and after surgery of Tetralogy of Fallot and complex cyanotic cardiac disease.

Anti-Bacterial Agents↗
PubMed1993

[Obstructive hypertrophic cardiomyopathy: medical or surgical treatment?].

This retrospective study assesses the results of medical and surgical treatment on survival and functional capacity of patients with hypertrophic obstructive cardiomyopathy (HOCM). Between 1981 and 1991, 73 patients were referred for treatment of HOCM: 24 were operated (Group 1) and 49 were treated medically (Group 2). Patients in Group 1 had more severe forms of HOCM than those in Group 2: 83% were in > or = NYHA Class III compared with only 20% in Group 2 (p = 0.003); 42% had previous cardiac failure compared with 16% in Group 2 (p = 0.02); 29% had atrial fibrillation compared with only 8% in Group 2 (p = 0.004); the average intraventricular pressure gradient was 78 mmHg compared with 42 mmHg in Group 2 (p = 0.001); mean pulmonary arterial pressures were 24 mmHg compared with 15 mmHg in Group 2 (p < 0.001); the cardiac index was 2.2 l/min/m2 compared with 2.7 l/min/m2 in Group 2 (p = 0.001); Sellers > or = grade 3 mitral regurgitation was present in 48% compared with 12% in Group 2 (p = 0.002). However, a family history of HOCM or of sudden death was commoner in Group 2 (28% vs 4% in Group 1: p = 0.03). Surgery consisted of myomectomy alone (5 patients) or associated with mitral valve replacement (MVR) (17 patients) or MVR alone (2 patients). Two patients in Group 1 died (1 perioperative death, 1 late death due to dissection of the aorta), giving over a 3.4 +/- 3.0 year follow-up period without any losses to follow-up, an abnormal mortality of 2.4%.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1993

[Pre- and postoperative right cardiac insufficiency in patients with mitral or mitral-aortic valve diseases].

The prognosis of right ventricular failure in patients with mitral valve disease would seem to depend on its chronicity and progression according to the results of a study of 382 cases of mitral valve disease: 231 women, 151 men: average age 55 +/- 13 years, operated between January 1983 and December 1986, most (321) for mitral valve replacement, one third (108) with associated aortic valve replacement. Right ventricular failure was or had been present before surgery in 161 patients: the peri-operative mortality was 11.2% and the secondary mortality 21.7% in these cases, significantly higher than in patients without RVF (respectively 5.0%, p = 0.02, and 8.1%, p < 0.0005). The RVF was present in the immediate post-operative phase in 43 patients, 8 of whom had no signs of this complication beforehand. The cause of this "de novo" early RVF is multifactorial. Ten other patients developed secondary RVF without any obvious cause in 3 cases. The prognosis of "de novo" RVF is very poor (28% survivors at 75 months). At the end of 60.4 +/- 13.6 months 20 patients were lost to follow-up, RVF was present in 60/286 patients followed up. The mortality was high in the patients with residual RVF (38.3% vs 4.0% in patients without: p < 0.0001). This study confirms the poor prognosis of RVF in patients with mitral valve disease whatever the timing with respect to surgery. Right ventricular failure occurring for the first time after surgery is rare (4.7% of cases), of uncertain cause, and carries a particularly poor prognosis.

Actuarial Analysis↗
PubMed1992

[Myocardial infarction beyond the 48 first hours: treatment with calcium channel antagonists].

Calcium channel blocking agents prevent calcium entering cardiac and smooth muscle cells. With reduction of the blood pressure, heart rate and myocardial contractility, they reduce myocardial oxygen demand. By relieving spasm and coronary constriction, and dilating the collateral coronary vessels, they improve perfusion of the ischemic zones. The results in experimental infarction are contradictory: the reduction in the infarct size and ischaemia is not constant. In the Myocardial Infarction Study, a trial of lidoflazine in 1792 subjects followed up for an average of 5 years, there was no significant difference between the mortality rates of the two groups. In the Danish Verapamil Infarction Trial I, which included 436 subjects receiving 360 mg/day of verapamil or placebo, the 6 months mortality was less (NS) in the verapamil group (12.8%) than in the placebo group (13.9%) as was the reinfarction rate (7.8% versus 9.2%; NS). In the DAVIT II trial of 1775 subjects, treatment was introduced 9 +/- 2.7 days after admission. Mortality was lower (NS) in the verapamil group (11.1%) than in the placebo group (13.8%) and the recurrences were less common (p = 0.04) in the treatment group (11.0%) than with placebo (13.2%). The Secondary Prevention Reinfarction Israeli Nifedipine Trial is a comparison of Nifedipine 30 mg/day and placebo introduced 7-21 days after infarction in 2276 subjects. After 10 months, the mortality and reinfarction rate were similar in both groups, as in the SPRINT II trial (60 mg/day of nifedipine or placebo) at 6 months. In the Multicenter Diltiazem Postinfarction Trial of 2466 patients, Diltiazem 240 mg/day or placebo was administered 3 to 15 days after infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Should asymptomatic aortic valve disease be treated surgically?].

The problems posed by asymptomatic aortic valve disease with regards to surgery differ according to whether the lesion is aortic stenosis or regurgitation. In stenotic lesions, even severe, the risk of spontaneous evolution is very small when the subject is totally asymptomatic. However, the quality of the results of surgery in asymptomatic or pauci-symptomatic patients and the increased difficulties in the very elderly are incentives not to differ surgery when the stenosis is severe, and especially when left ventricular function begins to degrade. In aortic regurgitation, the risk of progression is also low in asymptomatic patients but left ventricular dysfunction may develop before symptoms occur: this explains the necessity for regular clinical, echocardiographic and eventually radioisotopic examination of patients with severe aortic regurgitation. In dystrophic aortic regurgitation, an aneurysm of the sinuses of Valsalva and/or of the ascending aorta, or progressive fusiform dilatation of the ascending aorta are reasons for not postponing surgery for replacement of the aortic valve and the ascending aorta.

Aortic Valve Insufficiency↗
PubMed1992

[Heart valve surgery and associated diseases in aged subjects].

The object of this study was to assess the additional risk related to associated pathology in patients aged 70 or over undergoing valvular heart surgery. Two hundred and thirty nine patients aged 70 to 87 years (average 74.6 +/- 3.2) underwent this form of surgery between October 1979 and June 1989. Sixty seven had coronary artery disease, 26 had atherosclerotic occlusive peripheral arterial disease, and 149 had one or more extracardiovascular pathology. Two hundred and thirteen patients underwent monovalvular and 26 bivalvular replacement. Coronary bypass was associated in 25 cases. Eighteen patients (7.5%) died in the 30 days following surgery. The perioperative mortality was not significantly greater in patients with extra-cardiac pathology (9.4% vs 4.4%; NS), in patients with coronary artery disease (11.9% vs 5.8%; NS), in patients with respiratory failure and FEV1 < 1 litre (1 death out of 20 cases) or in patients with renal failure and serum creatinine levels > or = 175 mumol/l (20% vs 6.3%, NS). Respiratory failure was the only extra-cardiac variable identified with increased perioperative morbidity. The perioperative mortality of elderly patients with valvular heart disease is greater than that of patients under 70 years of age (6.4% vs 2.1%) in our experience of the last 6 years p < 0.01). Associated arterial and extra-cardiac pathology does not significantly increase the mortality and strict selection of elderly inoperable patients together with improved surgical techniques and postoperative care has considerably reduced perioperative morbidity and mortality in this group of patients.

Aged↗
PubMed1991

[Results of surgery in mitral valve insufficiency with impaired left ventricular function].

This cooperative study (8 French Cardiology Departments) was undertaken to determine the postoperative outcome of patients with pure, chronic, non-ischemic mitral regurgitation and poor left ventricular function (ejection fraction less than 50%). Seventy-three patients, 48 males and 25 females with a mean age of 55.5 +/- 12.1 years were included. Fifty-eight patients were in Class III or IV of the NYHA Classification. The average cardiothoracic ratio was 0.59 +/- 0.07. Forty-six patients were in atrial fibrillation. The average ejection fraction was 43 +/- 5 per cent (end systolic volume: 97.8 +/- 37.9 ml/m2; end diastolic volume: 175.2 +/- 67.6 ml/m2). Sixty-one patients underwent prosthetic mitral valve replacement and 12 had a Carpentier valvuloplasty. Two patients died after the operation and 20 died during follow-up (average 48.1 +/- 27.6 months), giving a 5 year actuarial survival rate of 69.6 per cent. In the long-term, fifteen per cent of patients were in NYHA Class III or IV. A multivariate Cox analysis showed that the only predictive factors of a poor outcome were age and female sex. These results of surgery for mitral regurgitation with moderate to severely altered left ventricular function were relatively good, but this study does not allow evaluation of the evolution of patients with mitral regurgitation and very poor left ventricular function (no patients with ejection fraction less than 25%).

Actuarial Analysis↗
PubMed1990

[Echocardiography in selecting patients to undergo Carpentier's mitral valvuloplasty].

The aim of this study was to confront preoperative echocardiographic data with the anatomic operative findings in patients with mitral insufficiency (MI) undergoing Carpentier's mitral valvuloplasty in order to determine the mechanism(s) of the regurgitation, to classify MI by the echocardiographic changes and to thereby answer the question as to whether echocardiography can identify the patients likely to benefit from this operation. Between February 1985 and November 1987, 66 patients (47 men, 19 women, average age 58 +/- 9 years) with pure MI were referred for surgery with a view to mitral valvuloplasty. This operation was possible in 49 patients (2 of 6 rheumatic MI and 47 of 60 dystrophic MI). The sensitivity of echocardiography was excellent and its specificity very good in diagnosing prolapse of one or the other mitral leaflets. Echocardiography was not as good in distinguishing rupture from elongation of the chordae tendinae and myxoid degeneration from fibro-elastic leaflets. Echocardiography allowed preoperative classification of MI in 4 groups: Group 1 (n = 46) with prolapse of the posterior leaflet; Group 2 (n = 4) with prolapse of the anterior leaflet; Group 3 (n = 8) with prolapse of both mitral leaflets; Group 4 (n = 2) with abnormalities of the mitral annulus alone. Carpentier's valvuloplasty was possible in 43/46 patients in Group 1, 2/4 patients in Group 2, 1/8 patients in Group 3 and 1/2 patients in Group 4. In conclusion, echocardiography is a good tool for selecting patients with dystrophic MI for Carpentier's valvuloplasty.

Aged↗
PubMed1989

[Staphylococcal endocarditis on a heart valve prosthesis. Apropos of 28 cases].

The purpose of this retrospective study of 28 cases of staphylococcal endocarditis on cardiac valve prosthesis was to evaluate the prognosis of that disease and the possible causes of its recent improvement. Between March 1977 and May 1987, 69 patients were treated for bacterial endocarditis on cardiac valve prosthesis. Among these, 28 patients (19 men, 9 women, mean age 53.2 +/- 14.3 years) had staphylococcal endocarditis (Staph. epidermidis in 18 cases, Staph. aureus in 10 cases) of early (10 cases) or late (18 cases) onset. Complications were present in no less than 27 out of 28 patients, the most frequent being heart failure, embolism or neurological disorders. The mortality rate was high (61 p. 100). Among the clinical variables studied, only a state of shock seemed to be predictive of death. Mortality was higher in the group treated medically (100 p. 100) than in the group treated surgically (50 p. 100). Since 1984, however, a significant decrease of mortality was noted; it coincided with the systematic use of vancomycin but also with surgical treatment in all cases. As a result of this study, we suggest that all patients with staphylococcal endocarditis on cardiac valve prosthesis should be operated upon and that this should be done as soon as possible, before the end of the classical antibiotic therapy period.

Adolescent↗
PubMed1989

[Doppler echography in the evaluation of mitral valve function following Carpentier's valvuloplasty].

In the present study Doppler-echocardiography was used to evaluate the quality of mitral valve regurgitation (MVR) repair by Carpentier valvuloplasty. Between January, 1984 and June, 1987, this operation was performed in 51 patients (39 men, 12 women; mean age 58 +/- 10.9 years) presenting with mitral valve regurgitation; 25 were in class III and 14 in class IV of the NYHA classification. Two patients died soon after the operation and 2 others some time later. The 47 survivors were followed up for a mean period of 20.5 +/- 11.2 months: 3 of them required mitral valve replacement for residual MVR or mitral stenosis, one developed cerebral embolism. At the latest control, 18 patients were in NYHA class I and 26 in NYHA class II. Doppler velocimetry showed no or little mitral valve dysfunction; the residual MVR was below grade 1 in 37 of the 44 survivors who were not reoperated upon. Mitral function was satisfactory after Carpentier valvuloplasty, with a mean transmitral gradient of 3.3 +/- 1.3 mmHg and a mean mitral valve area of 2.9 +/- 0.98 cm2. In 3 patients an intraventricular gradient of 10 to 20 mmHg, reflecting moderate ventricular obstruction, was detected by Doppler velocimetry. These data obtained with the combined Doppler-echocardiographic method confirm that the quality of mitral function is excellent after Carpentier mitral valvuloplasty.

Aged↗