1
|
Lloyd JW, Joseph TA, Cabalka AK, Guerrero M, Rihal CS, Eleid MF. Hemodynamic and clinical response to transseptal mitral valve‐in‐valve and valve‐in‐ring. Catheter Cardiovasc Interv 2019; 94:458-466. [DOI: 10.1002/ccd.28149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/14/2019] [Accepted: 01/28/2019] [Indexed: 11/09/2022]
Affiliation(s)
- James W. Lloyd
- Department of Cardiovascular DiseasesMayo Clinic Rochester Minnesota
| | - Timothy A. Joseph
- Department of Cardiovascular DiseasesMayo Clinic Rochester Minnesota
| | | | - Mayra Guerrero
- Department of Cardiovascular DiseasesMayo Clinic Rochester Minnesota
| | | | - Mackram F. Eleid
- Department of Cardiovascular DiseasesMayo Clinic Rochester Minnesota
| |
Collapse
|
2
|
Hayashi H, Abe Y, Morita Y, Nakane E, Haruna Y, Haruna T, Inoko M. The Accuracy of a Large V Wave in the Pulmonary Capillary Wedge Pressure Waveform for Diagnosing Current Mitral Regurgitation. Cardiology 2018; 141:46-51. [DOI: 10.1159/000493007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 08/16/2018] [Indexed: 11/19/2022]
Abstract
Background: Large V waves in the pulmonary capillary wedge pressure (PCWP) waveform traditionally indicate severe mitral regurgitation (MR). However, our understanding of MR etiology and hemodynamics has changed in recent decades. Objectives: We aimed to reevaluate the association between large V waves and current MR to determine whether traditional large V wave criteria remain optimal. Method: We reviewed 1,964 right heart catheterizations (RHCs) performed at our institution from 2010 to 2017, and retrospectively selected 126 patients with sinus rhythm who underwent echocardiography within 2 days (0.3 ± 0.5 days) of the RHC. The diagnostic accuracy of 3 traditional criteria for large V waves was assessed, and the optimal cut-off points were determined as those with the maximal Youden indices. Results: Severe MR was observed on echocardiography in 26 (21%) patients, including 15 (58%) with Carpentier classification type II MR and 11 (42%) with type IIIB MR. Large V waves, defined as a difference between the peak V wave and mean PCWP ≥10 mm Hg, had a high specificity of 94% (95% confidence interval: 87–98%), but a low sensitivity of 27% (12–48%) for diagnosing severe MR. The optimal cut-off point for the V wave was 3 mm Hg above the mean PCWP, with a sensitivity of 73% (52–88%) and a specificity of 64% (54–73%). Conclusions: For diagnosing current MR, the cut-off point for a large V wave should be reduced from that previously employed for rheumatic valvular heart disease. This information may be useful in guiding contemporary transcatheter therapies for MR under RHC monitoring.
Collapse
|
3
|
|
4
|
WELLS BG. The diagnosis of mitral incompetence from left atrial pressure curves. BRITISH HEART JOURNAL 2000; 20:321-8. [PMID: 13560688 PMCID: PMC479672 DOI: 10.1136/hrt.20.3.321] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
5
|
FAIRLEY KF. The influence of atrial size and elasticity on the left atrial pressure tracing. BRITISH HEART JOURNAL 1998; 23:512-20. [PMID: 13697952 PMCID: PMC1017823 DOI: 10.1136/hrt.23.5.512] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
6
|
REES RS, JEFFERSON KE, HARRIS AM. CINE-ANGIOCARDIOGRAPHY OF THE MITRAL VALVE. BRITISH HEART JOURNAL 1996; 27:498-504. [PMID: 14324107 PMCID: PMC503338 DOI: 10.1136/hrt.27.4.498] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
7
|
Kageji Y, Oki T, Iuchi A, Tabata T, Ito S. Relationship between pulmonary capillary wedge V wave and transmitral and pulmonary venous flow velocity patterns in various heart diseases. J Card Fail 1996; 2:215-22. [PMID: 8891860 DOI: 10.1016/s1071-9164(96)80044-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND A large V wave in a pulmonary capillary wedge pressure (PCWP) tracing is characteristic of mitral regurgitation. However, the V wave is often increased in patients without or with no significant mitral regurgitation. METHODS AND RESULTS The V wave was in the PCWP tracing investigated in 65 patients using transmitral flow (TMF) and pulmonary venous flow (PVF) velocity patterns obtained by transesophageal pulsed Doppler echocardiography. A large V wave was defined if the peak V wave minus the mean PCWP (V-mPCWP) was greater than 7 mmHg. Three study groups were formed: 15 patients with large V waves and significant mitral regurgitation, 15 patients with large V waves with no significant mitral regurgitation, and 35 patients with small V waves. The mPCWP and left ventricular end-diastolic pressure were greatest in the group with large V waves and no significant mitral regurgitation. Peak early diastolic TMF and PVF velocities were significantly greater in the two groups with large V waves. The peak second systolic PVF velocity was lowest in the group with large V waves and significant mitral regurgitation, followed by the group with large V waves and no significant mitral regurgitation. The V-mPCWP was positively correlated with the peak early diastolic TMF and PVF velocities and negatively correlated with the peak second systolic PVF velocities. Additionally, mitral regurgitation severity in patients with large V waves and significant mitral regurgitation was positively correlated with the peak early diastolic TMF and PVF velocities and negatively correlated with the peak second systolic PVF velocity. CONCLUSIONS These results suggest that large V waves in PCWP tracings appear not only in severe mitral regurgitation, but also in any condition with markedly elevated left ventricular end-diastolic pressure. Combined analysis of the TMF and PVF velocity patterns is helpful in determining the etiology of these hemodynamic abnormalities.
Collapse
Affiliation(s)
- Y Kageji
- Second Department of Internal Medicine, Tokushima University School of Medicine, Japan
| | | | | | | | | |
Collapse
|
8
|
Snyder RW, Glamann DB, Lange RA, Willard JE, Landau C, Negus BH, Hillis LD. Predictive value of prominent pulmonary arterial wedge V waves in assessing the presence and severity of mitral regurgitation. Am J Cardiol 1994; 73:568-70. [PMID: 8147302 DOI: 10.1016/0002-9149(94)90335-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Indwelling pulmonary arterial catheters are often used to monitor and to guide therapy in critically ill patients. The magnitude of the V wave recorded from the pulmonary arterial wedge (PAW) position is sometimes used to assess the presence and severity of mitral regurgitation (MR). The present study was performed to assess the relation (or lack thereof) between a "prominent" PAW V wave and qualitative and quantitative estimates of MR. In 903 subjects (445 men and 458 women, aged 49 +/- 13 [mean +/- SD] years) referred for cardiac catheterization, an oximetrically confirmed PAW pressure was recorded with a large-lumen stiff catheter, and a left ventriculogram was recorded. In 646 of these subjects (328 men and 318 women, aged 50 +/- 13 years), forward cardiac output was measured by the Fick principle, and a regurgitant fraction was calculated. Prominent PAW V waves--as defined in several ways--were insensitive and had poor positive predictive value in identifying moderate or severe MR. At the same time, the absence of prominent PAW V waves was relatively specific for the absence of moderate or severe MR, and the negative predictive value of small V waves was very good. Thus, the prominence of a PAW V wave cannot be used to assess the presence or severity of MR.
Collapse
Affiliation(s)
- R W Snyder
- Department of Internal Medicine (Cardiovascular Division), University of Texas Southwestern Medical Center, Dallas 75235-9047
| | | | | | | | | | | | | |
Collapse
|
9
|
Schwinger M, Cohen M, Fuster V. Usefulness of onset of the pulmonary wedge V wave in predicting mitral regurgitation. Am J Cardiol 1988; 62:646-8. [PMID: 3414561 DOI: 10.1016/0002-9149(88)90674-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- M Schwinger
- Department of Medicine, Mount Sinai School of Medicine, City University of New York, New York 10029
| | | | | |
Collapse
|
10
|
Moore RA, Neary MJ, Gallagher JD, Clark DL. Determination of the pulmonary capillary wedge position in patients with giant left atrial V waves. JOURNAL OF CARDIOTHORACIC ANESTHESIA 1987; 1:108-13. [PMID: 2979082 DOI: 10.1016/0888-6296(87)90003-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Thirteen patients with giant left atrial V waves during preoperative cardiac catheterization were admitted into the study group. While awake and breathing spontaneously, simultaneous recordings of electrocardiographic leads II and V5, radial arterial traces, and pulmonary arterial or pulmonary capillary wedge traces were obtained. Measurements were made on four consecutive cardiac cycles in the unwedged and wedged positions for the following intervals: Q wave to the radial arterial upstroke (220 +/- 20 milliseconds) and peak (360 +/- 10 milliseconds), Q wave to the pulmonary arterial upstroke (170 +/- 20 milliseconds) and peak (350 +/- 20 milliseconds), Q wave to the V wave upstroke (280 +/- 20 milliseconds) and peak (570 +/- 20 milliseconds), and QT interval (420 +/- 20 milliseconds). These findings indicate that the radial arterial and pulmonary arterial upstrokes and peaks occur nearly simultaneously. Upon wedging, the V wave upstroke occurs significantly later in the cardiac cycle (P less than .05) compared with the pulmonary arterial upstroke, and the V wave peak occurs significantly later compared with both the pulmonary arterial and the radial arterial peak (P less than .05). A rapid, simple beat-to-beat method for differentiating pulmonary arterial from pulmonary capillary wedge positions in the presence of giant left atrial V waves is the superimposition of the pulmonary arterial trace on the radial arterial trace. When a wedge position is attained, there is an immediate rightward shift in the upstroke and peak of the pulmonary arterial pressure trace, which can be easily identified by observing the relationship between the pulmonary arterial and systemic arterial traces.
Collapse
Affiliation(s)
- R A Moore
- Department of Anesthesiology, Deborah Heart and Lung Center, Browns Mills, NJ 08015
| | | | | | | |
Collapse
|
11
|
Pizzarello RA, Turnier J, Padmanabhan VT, Goldman MA, Tortolani AJ. Left atrial size, pressure, and V wave height in patients with isolated, severe, pure mitral regurgitation. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1984; 10:445-54. [PMID: 6518508 DOI: 10.1002/ccd.1810100505] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In recent years, some concepts regarding the etiology and hemodynamics present in the syndrome of mitral regurgitation have changed. Coronary artery disease and mitral valve prolapse have replaced rheumatic heart disease as the most frequent cause of mitral regurgitation. Hemodynamic studies have shown that tall V waves in the pulmonary capillary wedge tracings are neither specific nor sensitive in detecting the presence of mitral regurgitation. In this study, we evaluated the role of various clinical, echocardiographic, and hemodynamic findings with regard to left atrial (LA) size, pressure, and V wave height. We found that the mean pulmonary capillary wedge pressure (PCW) and V wave height for the subset of patients with acute mitral regurgitation (PCW = 24.1 +/- 10.9; V = 41.2 +/- 20.7 mm Hg) was similar to the subset with chronic mitral regurgitation (PCW = 17.9 +/- 7.5; V = 32.0 +/- 18.2 mm Hg). In addition, we found that there was a significant logarithmic relationship between the LA size and the duration of the mitral regurgitation (y = 1.404 [log X] + 3.948; R = 0.678; p less than 0.0005). Lastly, we found that LA size, compliance, regurgitant volume, and regurgitant valve orifice area all increase with time.
Collapse
|
12
|
Pichard AD, Diaz R, Marchant E, Casanegra P. Large V waves in the pulmonary capillary wedge pressure tracing without mitral regurgitation: the influence of the pressure/volume relationship on the V wave size. Clin Cardiol 1983; 6:534-41. [PMID: 6641038 DOI: 10.1002/clc.4960061104] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
We have previously demonstrated that a large V wave in the pulmonary capillary wedge tracing may occur in the absence of mitral regurgitation. This study evaluates the role of left atrial and pulmonary vein compliance on such a finding. We studied 11 patients with coronary disease, without clinical or angiographic mitral regurgitation. Heart rate, pulmonary capillary wedge mean, A and V waves, V-wave slope, left ventricular and aortic pressures, cardiac output, and left atrial echo and apical phonocardiogram were recorded simultaneously. Preload was modified acutely by volume overload and by the administration of i.v. nitroglycerine. Volume administration induced a marked increase in V-wave pressure (13.0 +/- 9.6 vs. 27.0 +/- 9.6 mmHg, p less than 0.05), without producing mitral regurgitation, and without appreciable change in left atrial dimension by echo (33.0 +/- 4.9 vs. 35.5 +/- 5.2 mm, NS), or stroke volume (101.7 +/- 26.2 vs. 97.8 +/- 34.3 ml, NS). An increase was also seen in the A wave (13.6 +/- 8.9 vs. 23.3 +/- 8.5 mmHg, p less than 0.05), pulmonary capillary wedge mean pressure (9.8 +/- 7.2 vs. 20.6 +/- 7.8 mmHg, p less than 0.05), and left ventricular diastolic pressure (7.4 +/- 5.5 vs. 14.6 +/- 6.3 mmHg, p less than 0.05). All values returned to baseline after nitroglycerine. The compliance of the left atrium/pulmonary veins decreased with increasing pulmonary capillary wedge pressures. With large filling volumes, a small stroke volume brings on a large pressure change, thus explaining the finding of large V waves in patients with elevated pulmonary capillary wedge pressure and without mitral regurgitation.
Collapse
|
13
|
Pichard AD, Kay R, Smith H, Rentrop P, Holt J, Gorlin R. Large V waves in the pulmonary wedge pressure tracing in the absence of mitral regurgitation. Am J Cardiol 1982; 50:1044-50. [PMID: 7137030 DOI: 10.1016/0002-9149(82)90415-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
14
|
Abstract
To study the usefulness of large V waves in pulmonary capillary wedge tracings in establishing the diagnosis of mitral regurgitation, data on 1,021 consecutive cardiac catheterizations were reviewed. Wedge tracings were obtained by Swan-Ganz catheterization in 208 patients, usually because of suspected valve disease. One hundred two patients had no trace of mitral regurgitation angiographically, 69 had mild to moderate and 37 had severe regurgitation. V waves were graded as trivial (less than 5), intermediate (5 to 10) or large (10 or more mm Hg above mean wedge pressure). Of 50 patients with large V waves, 18 (36 percent) had no or trace mitral regurgitation; these included 5 with mitral stenosis, 3 with a mitral valve prosthesis, 4 with coronary disease and congestive failure, 2 with aortic valve disease and congestive failure and 2 with a ventricular septal defect. Of 37 patients with severe mitral regurgitation, 16 (43 percent) had large and 12 (32 percent) had trivial V waves. Thus, mitral regurgitation is the most common cause of large V waves; however, large V waves are neither highly sensitive nor specific for severe regurgitation. Increased left atrial compliance may be associated with trivial V waves in the presence of severe regurgitation. Mitral obstruction, congestive heart failure and ventricular septal defect may all be associated with large V waves in the absence of significant mitral regurgitation.
Collapse
|
15
|
Bethea CF, Peter RH, Behar VS, Margolis JR, Kisslo JA, Kong Y. The hemodynamic simulation of mitral regurgitation in ventricular septal defect after myocardial infarction. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1976; 2:97-104. [PMID: 1260857 DOI: 10.1002/ccd.1810020113] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The development of a ventricular septal defect (VSD) following myocardial infarction is an uncommon complication which clinically can be confused with mitral insufficiency due to infarction of a papillary muscle. The clinical and hemodynamic records of six patients with documented acute VSD secondary to myocardial infarction were analyzed to determine which descriptors would be of value in clinically separating these two entities. All six of our patients had a right heart catheterization showing an oxygen step-up consistent with a VSD, and five had a large pulmonary wedge V wave suggesting concomitant mitral insufficiency. The echocardiogram showed only nonspecific chamber enlargement. Since these patients were being considered for open heart surgery to close the VSD, left and right cardiac catheterization including selective coronary arteriography was done. Despite large V waves being present in the pulmonary wedge and/or left atrial pressure tracing in five of the six patients, no mitral insufficiency was present on the left ventricular cineangiograms. It is concluded that a large pulmonary wedge and/or left atrial V wave does not necessarily indicate mitral insufficiency. Since both a VSD and mitral insufficiency are surgically correctable, patients who develop new holosystolic murmurs following myocardial infarction should have complete right and left heart catheterizations with LV angiography for accurate diagnosis if surgical correction of the lesion is contemplated.
Collapse
|
16
|
|
17
|
Grendahl H, Abrahamsen AM, Müller C. Methoxamine injections in the diagnosis of mitral insufficiency during routine right heart catheterizations. ACTA MEDICA SCANDINAVICA 1971; 189:315-20. [PMID: 5115507 DOI: 10.1111/j.0954-6820.1971.tb04382.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
18
|
|
19
|
Schoenmackers J, Adler E, Reul H, Gerling PE. Die normale Mechanik der Mitralklappe und der Einfluß von experimentellen Segelläsionen auf die Schlußfähigkeit. Basic Res Cardiol 1969. [DOI: 10.1007/bf02119464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
20
|
Experimentelle extravalvuläre Mitralinsuffizienz durch Klappenringdilatation. Basic Res Cardiol 1969. [DOI: 10.1007/bf02119802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
21
|
Über die Bedeutung der Oesophagoatriographie zur Beurteilung der Vorhofdynamik vor und nach herzchirurgischen Eingriffen unter besonderer Berücksichtigung des Vorhofseptumdefektes und der Mitralstenose. Basic Res Cardiol 1965. [DOI: 10.1007/bf02119414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
22
|
|
23
|
Abstract
It has been generally thought that significant elevations of the left atrial and pulmonary vascular pressures occur in patients with mitral regurgitation of sufficient severity to produce serious disability and gross enlargement of the left atrium. Ten patients with severe mitral regurgitation have been encountered in whom gross left atrial enlargement was accompanied by normal left atrial and pulmonary artery pressures. These patients ranged in age from 8 to 49 years, all were in functional classes III or IV, and the average duration of symptoms was 7.3 years. Nine patients had rheumatic mitral regurgitation while one had a congenital lesion. Atrial fibrillation and the physical findings of pure mitral regurgitation were present in all patients, as was striking left atrial enlargement on their roentgenograms. Left atrial pressure, determined by left heart catheterization, averaged 9.1 mm. Hg and did not exceed 12 mm. Hg in any patient, and the V wave was not particularly prominent. The cardiac index was markedly depressed and averaged 2.0 L./min./M.
2
B.S.A.
The observed discrepancy between left atrial size and pressure must reflect a disturbance in the compliance of the left atrial wall. It is suggested that long-standing mitral regurgitation may modify the mechanical characteristics of the atrial wall and that the presence of a normal left atrial pressure must not be assumed to exclude the presence of severe mitral regurgitation. The manner in which variations in left atrial compliance affect the clinical picture of mitral regurgitation and the selection of patients for operative intervention are discussed.
Collapse
|
24
|
|
25
|
CARNEY EK, BRAUNWALD E, ROBERTS WC, AYGEN M, MORROW AG. Congenital mitral regurgitation. Clinical, hemodynamic and angiocardiographic findings in nine patients. Am J Med 1962; 33:223-35. [PMID: 13876709 DOI: 10.1016/0002-9343(62)90020-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
26
|
|
27
|
IMPERIAL ES, BENDEZU J, ZIMMERMAN HA. Electrocardiographic analysis of pure mitral valvular disease: A study based on fifty-seven cases with open-heart operation. Am Heart J 1960; 60:705-15. [PMID: 13717617 DOI: 10.1016/0002-8703(60)90353-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
28
|
BENCHIMOL A, DIMOND EG, WAXMAN D, SHEN Y. Diastolic movements of the precordium in mitral stenosis and regurgitation. Am Heart J 1960; 60:417-32. [PMID: 13798726 DOI: 10.1016/0002-8703(60)90201-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
29
|
KATZNELSON G, JREISSATY RM, LEVINSON GE, STEIN SW, ABELMANN WH. Combined aortic and mitral stenosis. A clinical and physiological study. Am J Med 1960; 29:242-56. [PMID: 13751842 DOI: 10.1016/0002-9343(60)90021-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
30
|
RISS E, LEVINE SA. Some clinical notes on patients with mitral valvular disease who have had mitral valvuloplasty. Part I. Am Heart J 1958; 56:814-30. [PMID: 13594827 DOI: 10.1016/0002-8703(58)90191-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
31
|
Abstract
Dye-dilution curves obtained simultaneously from the pulmonary artery and from the femoral artery following an intravenous injection of T 1824 or Indocyanine Green in normal subjects and in patients with nonregurgitant heart disease yielded a similar contour. This suggested that in the absence of regurgitation the parameters of the distal (arterial) curve can be predicted from the proximal (pulmonary artery) curve. The distortion of the arterial curve by regurgitation can therefore be compared with the undistorted pulmonary artery curve. To the extent that 2 identifiable and measurable flow rates exist between the sites of sampling, a theoretical basis for quantitation of the degree of valvular regurgitation may be derived.
Collapse
|
32
|
LEVINSON DC, WILBURNE M, MEEHAN JP, SHUBIN H. Evidence for retrograde transpulmonary propagation of the V (or regurgitant) wave in mitral insufficiency∗. Am J Cardiol 1958; 2:159-69. [PMID: 13559147 DOI: 10.1016/0002-9149(58)90226-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
33
|
|
34
|
|
35
|
|
36
|
|
37
|
SCHILDER DP, HARVEY WP. Confusion of tricuspid incompetence with mitral insufficiency-a pitfall in the selection of patients for mitral surgery. Am Heart J 1957; 54:352-67. [PMID: 13458065 DOI: 10.1016/0002-8703(57)90122-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
38
|
|
39
|
WIERUM C, GLENN F. Electrocardiographic indications of significant mitral insufficiency in patients with mitral valve disease. Am Heart J 1957; 53:359-64. [PMID: 13402696 DOI: 10.1016/0002-8703(57)90171-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
40
|
BOUGAS J, GOLDBERG H, MUSSER BG. Left heart catheterization. II. With particular reference to mitral and aortic valvular disease. Am Heart J 1956; 52:567-80. [PMID: 13362063 DOI: 10.1016/0002-8703(56)90046-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
41
|
|
42
|
|
43
|
|
44
|
|
45
|
KENT EM, FORD WB, FISHER DL, CHILDS TB. The estimation of the severity of mitral regurgitation; a correlation of direct left atrial pressure recordings with observations made during surgical palpation of the valve area. Ann Surg 1955; 141:47-52. [PMID: 13218538 PMCID: PMC1609736 DOI: 10.1097/00000658-195501000-00005] [Citation(s) in RCA: 41] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
46
|
MCGREGOR M, ZION MM. The diagnosis of mitral incompetence in the presence of mitral stenosis. ACTA MEDICA SCANDINAVICA. SUPPLEMENTUM 1955; 306:111-24. [PMID: 13301401 DOI: 10.1111/j.0954-6820.1955.tb16285.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
47
|
|
48
|
|
49
|
Bayer O. Feindiagnostik erworbener Herzfehler. Langenbecks Arch Surg 1954. [DOI: 10.1007/bf02455775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
50
|
PALMER AJ, SINCLAIR-SMITH BC, BLACKET RB, FARRAR JF, HALLIDAY JH, MADDOX JK. Studies in mitral stenosis. III. The clinical features. AUSTRALASIAN ANNALS OF MEDICINE 1954; 3:202-13. [PMID: 13198774 DOI: 10.1111/imj.1954.3.3.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|