title: Mitral stenosis with severe pulmonary hypertension.
abstract: Consecutive catheterizations in 512 patients with mitral valve disease revealed 85 cases of mitral stenosis with systolic pulmonary artery pressures equal to or in excess of 100 mm Hg. Forty-four patients (51.8%) were in New York Heart Association functional Class IV; 30 (35.3%) were in Class III; and 11 (12.9%) were in Class II. Symptoms related to pulmonary capillary hypertension were prominent in 48 patients (56.5%) while the remaining patients showed signs of low cardiac output syndrome. Forty patients underwent surgery: mitral commissurotomy was performed in 26 patients; mitral valve replacement in 10 patients, and double valve replacement in four patients. Nitroprusside was infused into the pulmonary artery in six patients with severe perioperative low cardiac output; four of these patients survived. The overall operative mortality was 15% (six patients). Good long-term results were achieved in 30 cases.
authors.affiliation: Cardiovascular Surgical Center, Damascus Medical School, Damascus, Syria.
authors.forename: S S
authors.initials: SS
authors.lastname: Kabbani
authors.forename: T
authors.initials: T
authors.lastname: Bashour
authors.forename: R
authors.initials: R
authors.lastname: Dunlap
authors.forename: E S
authors.initials: ES
authors.lastname: Hanna