[Intracardiac hemodynamic characteristics in high-degree mitral stenosis and an assessment of the indications for its surgical treatment].
The data from the right cardiac catheterization, echocardiography M-type and radiocardiography were juxtaposed in 54 patients with "pure" or predominating severe mitral stenosis (MS)(mitral valvular opening under 1 cm2)--confirmed at operation, in the determination of their functional and hemodynamic characteristics. The patients were grouped into three groups depending on the degree of pulmonary--capillary pressure increase (PC)--greater than 2.666, greater than 3.999 and 4.132 kPa(greater than 20, greater than 30 and less than 31 mmHg). The first group covering 28 per cent of the patients with a mean PC--2,399 +/- 0.257 kPa = (18 +/- 1.93 mmHg) are of particular interest. A light to moderate increase of pulmonary arterial pressure, elevated TPVR, absence of right ventricular insufficiency with reduced M. V SI resp. were established in them. It was assessed as a group with hypovolemia and proper preoperation preparation but requiring attention as regards the eventual hypotension, intra- or post operation. The third group covers 22 per cent of the patients and is characterized with increased TPVR, high hypertension in pulmonary artery, elevated telediastolic pressure in right ventricle and normal or lightly increased MO, assessed as a group with an inadequate diuretic therapy pre-operatively. The second group is with typical hemodynamic characteristics of severe MS and includes 50 per cent of the patients. The analysis forces the conclusion, that for an adequate evaluation of hemodynamics and MS severity, the PC pressure is necessary to be always discussed in connection with blood volume and flow, as well as with the other hemodynamic indices, in order to avoid the omissions as regards MS operability.
D000328:Adult; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000503:physiopathology* / Q000601:surgery; D011651:Pulmonary Artery / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure
Osobenosti na intrakardialnata khemodinamika pri visokostepenna mitralna stenoza o otsenka na pokazaniiata za neinoto operativno lechenie.