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At least 19 recordsLinked to original sources
PubMed1978

[Surgical treatment of associated coronary disease and heart valve disease].

25 patients underwent combined surgery for coronary artery and valvular heart disease. Although patients suffering from associated coronary artery and valvular lesions represent a high operative risk group, the combined surgical procedure is clearly justified by the functional improvement of the patients. Selective coronaro-angiography should be carried out in the assessment of patients over 40 years of age with valvular disease, since not all patients present angina in spite of diseased coronary arteries. Three hospital deaths (13.5%) indicate the gravity of the procedure, but the absence of intra- or postoperative myocardial infarction and the comparatively rapid recovery of the patients with relatively few complications are very encouraging.

Adult↗
PubMed1975

[Echography in heart valve diseases].

The authors discuss the value of echorcardiography in cardiac valvular disease. Exploration of the mitral valve gives very precise data concerning diagnosis and evaluation of the degree of mitral stenosis. It may be of value in the diagnosis of certain complications such as intra-atrial thrombosis and gives reliable information in postoperative surveillance. In mitral insufficiency, echocardiography sometimes permits the recognition of certain mechanisms such as rupture of the cordae, ballooning of the lesser cusp and abnormal kinetics in obstructive cardiomyopathy. Exploration of the aortic valve is less informative. Aortic insufficiency gives scarcely any direct signs, whilst echocardiography is of value in aortic stenosis. Ultrasonic study also is useful in surveillance of the kinetics of valvular prostheses. The total absence of risk makes repeated studies possible, rendering echocardiography an essential element in the study of valvular disease.

Aortic Valve Insufficiency↗
PubMed1977

[Perfusion scintigraphy of the myocardium in cardiological diagnosis. Coronary diseases, primary myocardial diseases and rheumatic heart valve diseases].

In 123 patients perfusion scintigrams were compared with the data of clinical investigation, right and left heart catheterisation and coronary arteriography. The intracoronary application of radioactive labelled human-albumin-microspheres and human-microaggregates were without any complications. The patients suffered from coronary heart diseases, primary myocardial diseases and rheumatic valvula heart diseases. There was a good correlation between the myocardial perfusion defect and the degree of coronary artery stenoses. Furthermore an excellent correlation was found between perfusion defects and levocardiographic findings: left ventricular aneurysms, akinetic or hypokinetic areas and the ejection fraction of the left ventricle. All myocardial infarctions were detected by a perfusion defect in the scintigrams. In 16 cardiacsurgery-patients large myocardial perfusion defects were found to be myocardial scars. In primary myocardial diseases perfusion scintigraphy is an effective method of detecting pathological myocardial patterns. The degree of perfusion defects correlates excellently with the levocardiographic findings. It seems that in rheumatic valvular diseases perfusion-scintigraphy is a method to discover rheumatic myocardial abnormalities--probably scar tissue. In comparison with thallium scintigrams it was shown that extensive myocardial failures (aneurysms) can be represented by both nuclear medical procedures but that perfusion scintigraphy is more sensitive and correlates more closely to the levocardiogram findings.

Angiography↗
PubMed1979

[Combined surgical treatment for coronary heart disease as well as heart valve diseases and carotid artery stenosis].

This is an account on combined procedures in 124 patients suffering from arteriosclerotic vessel disease. In order to judge the proceedings and the results the patients were divided up into two groups. in 15 patients (group I) a carotid endarterectomy combined with an aorto-coronary bypass operation was performed; once a subclavian artery stenosis was resected at the same time. One patient of that group died after 31 days (7%). In group II 108 heart valve operations were performed together with a coronary artery revascularisation. Early and late mortality divided up as follows: aortic stenosis 6/44 (14%) respectively 2/44 (5%); aortic insufficiency 1/14 (7%) resp. 0; combined aortic disease 1/8 )13%) resp. 0; mitral stenosis 1/11 (9%) resp. 0; mitral insufficiency 6/26 (23%) resp. 2/26 (8%); combined mitral valve disease 1/2 (50%) resp. 0; three times both valves (aorta, mitral) were replaced without mortality. In our opinion combined procedures, resection of supraaortic artery stenosis respectively cardiac valve operations and aorto-coronary bypass are indicated especially since the functional long-term results are excellent. Though one should consider the high operative risk in patients with mitral insufficiency and combined mitral valve disease.

Arterial Occlusive Diseases↗
PubMed1978

Nitroglycerin-induced improvement in exercise tolerance and hemodynamics in patients with chronic rheumatic heart valve disease.

Nitroglycerin reduces elevated left ventricular filling and pulmonary arterial pressures in resting patients with rheumatic valve disease and reduces symptoms when given over long periods to patients with primary myocardial disease. To determine whether nitroglycerin may prove effective therapeutically in ambulatory patients with heart valve disease, its effects on hemodynamics and exercise capacity were studied in 11 severely symptomatic adults who were already receiving optimal treatment with digitalis and diuretic agents. Seven had predominant mitral valve disease, one had predominant aortic insufficiency and three had equally severe mitral and aortic valve disease. Maximal exercise capacity was assessed with graded treadmill exercise after placebo and after nitroglycerin (0.5 mg sublingually) administered in random sequence to each patient. Exercise capacity (exercise time to limiting fatigue or dyspnea) increased from a mean of 8.3 minutes after placebo to 9.8 minutes after nitroglycerin (P less than 0.005). Eight patients were studied hemodynamically during further intense treadmill exercise. Pulmonary arterial pressure was significantly lower (P less than 0.05) after nitroglycerin than after placebo (mean 44 versus 56 mm Hg), but cardiac output was greater after nitroglycerin (5.0 versus 4.6 liters/min, P less than 0.005). Thus, nitroglycerin appears to increase exericse tolerance and improve the hemodynamic response to exercise in patients with heart valve disease and may be valuable in the long-term pharmacologic therapy of such patients.

Administration, Oral↗
PubMed1979

[Clinico-diagnostic criteria for the evaluation of social aspects in acquired heart valve diseases].

In spite of the retrogression of the acute rheumatic fever the acquired valvular defects still play an essential role for the morbidity and mortality above all for the younger and middle decenniums of life. In the preliminary diagnostics it is the task of the family doctor to diagnose the valvular defect, to differentiate it from non-organic findings and to estimate its degree of severity. The diagnosis of a carditis renders special difficulties, particularly in its chronic recurrent form. Certain situations of life do not demand only an actual analysis of the findings, but also an individual prognostic estimation. For the choice of profession, the ability for military service and driving a car general references and regularities must be taken into consideration. The indication to operation of the valvular defect is generally given in degree of severity and with restriction also in stage IV. A mitral stenosis is operated already in stage II, when stronger complaints and haemodynamic changes are present. Patients with degree of severity III and IV should avoid a pregnancy, in stage I and II under common control by the internist and obstetrician the pregnant patient may not have any scruples to carry to full term.

Abortion, Therapeutic↗