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At least 109 records · Page 6Linked to original sources
PubMed1989

[An evaluation of long-term results of closed commissurotomy of mitral stenosis].

Closed mitral commissurotomy was performed in 206 consecutive cases with mitral stenosis from 1965 to 1987. Follow-up study from 8 months to 22 years showed that both early and long term postoperative results were satisfactory for mitral stenosis even in cases combined with mild mitral regurgitation. The long-term survival rate of this group of patients was 95.58% and the average time of maintenance of cardiac function classes I and II was 10.83 +/- 2.11 years. The influence of valvular calcification or high pulmonary arterial pressure on long-term effects was not serious, but preoperative atrial fibrillation or congestive cardiac failure might cause lead to poor results, indicating the benefit of early operation before their development. The peak period of restenosis with rapid decrease in cardiac function was 8-10 years postoperatively, and therefore more attention should be paid in this period to the decision of whether a reoperation is needed.

Adolescent↗
PubMed1991

End-tidal CO2 monitoring in mitral stenosis patients undergoing closed mitral commissurotomy.

Arterial to end-tidal carbon dioxide difference (P(a-E')CO2) was recorded in 20 mitral stenosis patients (group A) for closed mitral commissurotomy and 20 healthy individuals (group B) for elective limb surgery. Mitral stenosis patients showed a greater difference than group B patients. Repeated measurements of P(a-E')CO2 in mitral stenosis patients at various stages of closed mitral commissurotomy not only showed a mean increase from before thoracotomy but there was also no correlation between P(a-E')CO2 before thoracotomy with that after thoracotomy, after commissurotomy or after chest closure. This indicated that end-tidal CO2 monitoring was unsuitable to measure adequacy of ventilation during closed mitral commissurotomy.

Adult↗
PubMed2002

The long-term outcome of balloon valvuloplasty for mitral stenosis.

Percutaneous mitral commissurotomy (PMC) is the treatment of choice in young patients who have favorable valve anatomy. It affords an event-free survival greater than 90% at 5 to 7 years,. Economic considerations are the main limitation of PMC in such patients, who are mainly encountered in developing countries. Mitral stenosis in older patients with less favorable valve anatomy is the most frequent presentation in Western countries. This represents a heterogeneous group, but predictive analyses are helpful in deciding who should have PMC. The main conclusion is that the prediction of immediate and late results is multifactorial. Good results can be expected in young patients with unfavorable valve anatomy who do not have a very tight stenosis, are moderately symptomatic, and in sinus rhythm. In addition, PMC may reduce the thromboembolic risk related to mitral stenosis.

Age Factors↗
PubMed1999

A comparative study of balloon mitral valvuloplasty and closed mitral commissurotomy in patients with rheumatic mitral stenosis.

Rheumatic mitral stenosis is frequently encountered in our country. It affects younger population and is a major cause of morbidity Mitral valvotomy is the definitive therapy for this disease and can be achieved by closed mitral commissurotomy (CMC), open mitral commissurotomy (OMC) or by percutaneous transluminal mitral valvuloplasty (PTMV). Compared to CMC, PTMV is less invasive but more expensive at this moment. With the reduction of cost, PTMV may become the procedure of choice for the treatment of rheumatic mitral stenosis in future.

Adolescent↗
PubMed1998

Cardiogenic shock secondary to mitral stenosis treated by balloon mitral valvuloplasty.

Percutaneous balloon mitral valvuloplasty is a well-established elective treatment for mitral stenosis in selected patients; it has been used to treat cardiogenic shock secondary to aortic stenosis but has not been previously used for cardiogenic shock secondary to mitral stenosis. We describe a case of cardiogenic shock secondary to severe mitral stenosis, treated by balloon mitral valvuloplasty.

Catheterization↗
PubMed1991

Effects of exercise on transmitral gradient and pulmonary artery pressure in patients with mitral stenosis or a prosthetic mitral valve: a Doppler echocardiographic study.

Doppler echocardiography was used to determine changes in transmitral gradient and pulmonary artery pressure after exercise in 12 patients with mitral stenosis and 11 patients with a prosthetic mitral valve. The mean transmitral gradient in the mitral stenosis group was 9 +/- 7 mm Hg at rest and increased to 17 +/- 8 mm Hg after exercise. In patients with a prosthetic mitral valve, exercise resulted in an increase in mean transmitral gradient from 5 +/- 2 to 8 +/- 3 mm Hg. Calculated pulmonary artery systolic pressure increased with exercise from 41 +/- 19 to 70 +/- 32 mm Hg in the mitral stenosis group and from 28 +/- 8 to 39 +/- 15 mm Hg in patients with a prosthetic valve. Exercise Doppler echocardiographic evaluation of changes in transmitral gradient and pulmonary artery systolic pressure was found to be technically simple and an important addition to the noninvasive evaluation of patients with mitral valve disease.

Adult↗
PubMed1990

Doppler echocardiographic evaluation of mitral stenosis.

In mitral stenosis, both the pressure gradient and the valve area can be obtained noninvasively, and the effects of changes in heart rate with exercise and of medications on the pressure gradient can be readily assessed. When the appearance of the valve, the subvalvular apparatus, and chamber sizes obtained with imaging and the assessment of associated regurgitations and pulmonary hypertension by Doppler are added, this becomes a powerful tool for assessment of patients with mitral stenosis. On follow-up studies, disease progression and complications, as well as the effect of medical and surgical interventions, can be monitored.

Blood Flow Velocity↗
PubMed1992

Features of patients with severe mitral stenosis with respect to atrial rhythm. Atrial fibrillation in predominant and tight mitral stenosis.

The aim of this study was to assess the features of patients with severe mitral stenosis in relation to atrial rhythm. Six hundred and fifty patients (pts) with severe mitral stenosis (MS) (valve area less than or equal to 1.5 cm2) who underwent percutaneous balloon commissurotomy (n = 600) or surgery (n = 50) were classified into 3 groups according to their atrial rhythm (AR): group A: sinus rhythm (SR) (n = 379), group B: SR with episodes of transient atrial fibrillation (AF) (n = 65), group C: permanent AF (n = 206). Uni- and multivariate analysis of clinical, echocardiographic and hemodynamic parameters with respect to the atrial rhythm was performed. Some parameters were comparable in all 3 groups: sex, pulmonary, right and left atrial pressures, mitral valve area, incidence of associated aortic valve disease. Nine parameters were different: mean age, NYHA class III or IV, previous commissurotomy, previous embolism, cardiac index, mitral regurgitation, tricuspid regurgitation, left atrium diameter, mitral calcification. Multivariate analysis, identified age, left atrial diameter and presence of mitral calcification as independent predictors of atrial fibrillation. Transoesophageal echocardiography was performed in 167 cases. A spontaneous echo contrast was recorded in 106 cases (63.5%) and was significantly correlated with a history of embolism and or left atrial thrombi detected by echocardiography. Atrial fibrillation, size of left atrium, severity of mitral stenosis and cardiac index were found to be independent predictive factors of spontaneous echo contrast.

Adult↗
PubMedDate not supplied

Atrial contribution to left ventricular filling in mitral stenosis: effects of balloon mitral valvuloplasty.

Doppler echocardiographic contribution of atrial systole to left ventricular filling (AC) was studied in 20 patients with mitral stenosis and compared with that obtained from 15 matched controls in a prospective study. AC in mitral stenosis as a percentage of total filling volume was 8 +/- 2.8% compared to 12.5 +/- 3.3% in control subjects (p < 0.001) and was weakly correlated to diastolic filling period (r = -0.45), mitral valve orifice resistance (r = -0.36) and heart rate (r = 0.36). An increase in mitral valve orifice area following balloon mitral valvuloplasty (0.78 +/- 0.12 to 1.72 +/- 0.4 cm2, p < 0.0001) resulted in an increase in AC to near normal values (8 +/- 2.8% to 12.5 +/- 3.8%, p < 0.001) coupled with an increase in cardiac index and a significant decrease in diastolic filling period and left atrial size. In conclusion, AC in young patients with severe mitral stenosis is decreased proportionately less than that reported in the older patients, is weakly correlated to mitral orifice resistance and normalises following a successful mitral valvuloplasty.

Adult↗
PubMed1990

Improvement in pulmonary function in mitral stenosis after percutaneous transvenous mitral commissurotomy.

Before and after percutaneous transvenous mitral commissurotomy (PTMC), pulmonary function studies were performed in 25 patients with mitral stenosis, in order to determine the effects of pulmonary hemodynamics on pulmonary function in patients with mitral stenosis. After PTMC, dramatic improvements in pulmonary hemodynamics were seen in all patients. With regard to pulmonary function data, the VC as percent predicted value increased from 87.6 +/- 16.1 percent to 94.7 +/- 14.4 percent (p less than 0.001). Although the ratio of FEV1/FVC was unchanged, the MVV as percent predicted value increased, and the ratio of RV/TLC, CV, and the difference in nitrogen concentration between 750 ml and 1,250 ml of expired volume decreased significantly. According to the maximum expiratory flow-volume curves, V ax 50% and Vmax 25% improved. Despite marked improvements in pulmonary ventilatory function soon after PTMC, the percent predicted diffusing capacity of the lung for carbon monoxide decreased significantly after PTMC. Arterial blood gas data, such as the partial pressure of oxygen and carbon dioxide in arterial blood and the alveolar-arterial differences in partial pressure of oxygen, did not improve within one or two weeks after PTMC. We conclude that in mitral stenosis, the majority of ventilatory function impairments are caused by hemodynamic alterations that are mainly reversible.

Adult↗
PubMed2003

[Echocardiographic evaluation of associated valve lesions in mitral stenosis].

OBJECTIVE: When mitral stenosis is associated with other valve lesions, diagnosis, prognosis and the treatment strategies are affected. Mitral valve prolapse may occur in some pathological settings that affect mitral apparatus. We investigated the incidence of valve lesions including mitral valve prolapse that accompany mitral stenosis and assessed the relation between echocardiographic measures. METHODS: Two hundred and one patients (31 male, 170 female) between 16 and 72 years of age (mean age 40.9+/-11.4 years) with mitral stenosis were included in the study. Patients were divided into three groups according to the mitral valve area obtained by echocardiography using planimetric method as Group I (MVA<1.1 cm(2)), Group II (MVA -1.1-1.5 cm(2)) and Group III (MVA >1.5 cm2). RESULTS: Mitral stenosis with mitral regurgitation, aortic regurgitation, aortic stenosis, combined aortic valve disease, tricuspid regurgitation and tricuspid stenosis were found in 117 (58.2%), 84 (41.8%), 18 (9%), 9 (4.5%), 62 (30.8%) and 6 (3%) patients, respectively. Twenty- three patients (11.4%) had mitral valve prolapse in only anterior leaflet. Nobody of patients had mitral valve prolapse of posterior mitral valve leaflet. Age, gender, rhythm, degree of stenosis, degree of mitral and aortic regurgitations, mean pressure gradient, left atrial diameter, ejection fraction and valve score did not differ in patients with and without mitral valve prolapse. CONCLUSION: Our study has shown that valve lesions including mitral valve prolapse frequently accompany mitral stenosis and the incidence of mitral valve prolapse in patients with mitral stenosis is high.

Adolescent↗