Advertisement

Combined mitral and aortic stenosis

Clinical and physiologic features and results of surgery
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The clinical features and hemodynamic findings in 141 patients with combined mitral and aortic stenosis are presented. Dyspnea, fatigue, edema and hemoptysis were the most commonly occurring symptoms with angina pectoris, vertigo and syncope being noted less often. The mitral first sound was frequently less sharp than in isolated mitral stenosis and its characteristics were sometimes obscured by the aortic systolic murmur transmitted from the base.
      Hemodynamic alterations included a low cardiac index, elevated left atrial, pulmonary arterial and left ventricular systolic pressures and left atrial, left ventricular diastolic and left ventricular-aortic systolic gradients.
      Operative mortality by a variety of approaches was 19.2 per cent and improvement in symptoms was noted in 86.6 per cent of the survivors.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Uricchio J.F.
        • Litwak R.
        • Denton C.
        • Goldberg H.
        • Likoff W.
        A medical appraisal of transaortic commissurotomy.
        Ann. Int. Med. 1956; 44: 844
        • Goldberg H.
        • Denton C.
        • Bender S.
        • Uricchio J.F.
        The hemodynamic and clinical characteristic of rheumatic aortic stenosis.
        Dis. Chest. 1957; 33: 201
        • Lehman J.S.
        • Musser B.G.
        • Lykens H.D.
        Cardiac ventriculography.
        Am. J. Roentgenol. 1957; 77: 211
        • Uricchio J.F.
        • Lehman J.S.
        • Lemmon W.
        • Boyer R.
        • Likoff W.
        Cardiac ventriculography in the selection of patients for mitral valve surgery.
        Am. J. Cardiol. 1959; 3: 22
        • Goldberg H.
        • Dickens J.
        • Raber G.
        • Hayes Jr., E.
        Simultaneous (combined) catheterization of left and right heart.
        Am. Heart J. 1957; 53: 579
        • Bougas J.
        • Musser B.G.
        • Goldberg H.
        Left heart catheterization, clinical methods and applications.
        Am. Heart J. 1956; 52: 359
        • Van Slyke D.D.
        • Neill J.M.
        The determination of gases in blood and other solution by vacuum extraction and manometric measurement.
        J. Biol. Chem. 1924; 61: 523
        • Gorlin R.
        • Gorlin S.G.
        Hydraulic formulae for calculation of stenotic mitral valve and other valves and central circulatory shunt.
        Am. Heart J. 1951; 41: 1
        • Bailey C.P.
        • Bolton H.E.
        • Nichols H.T.
        • Jamison W.L.
        • Litwak R.S.
        The surgical treatment of aortic stenosis.
        J. Thoracic Surg. 1956; 31: 375
        • Bailey C.P.
        Surgery of the Heart.
        Lea & Febiger, Philadelphia1955
        • Dickens J.
        • Raber G.
        • Woldow A.
        • Lorange G.
        • Goldberg H.
        A study of mitral stenosis by combined catheterization of the left and right sides of the heart.
        New England J. Med. 1957; 256: 1017
        • Goldberg H.
        • Smith R.C.
        • Raber G.
        The estimation of the severity of aortic stenosis.
        Am. J. Med. 1958; 24: 853
        • Likoff W.
        • Berkowitz D.
        • Denton C.
        • Goldberg H.
        Clinical evaluation of the surgical management of combined mitral and aortic stenosis.
        Am. Heart J. 1955; 49: 394
        • Uricchio J.F.
        • Brachfield J.
        The importance of the myocardial factor in the surgical treatment of rheumatic aortic stenosis.
        Dis. Chest. 1959; 36: 81
      1. Goldberg, H., Uricchio, J. F., and Likoff, W. Unpublished data.

        • Dickens J.
        • Villaca L.
        • Woldow A.
        • Goldberg H.
        The hemodynamics of mitral stenosis before and after commissurotomy.
        Brit. Heart J. 1957; 19: 419
        • Uricchio J.F.
        • Likoff W.
        Effect of mitral commissurotomy on co-existing aortic valve lesions.
        New England J. Med. 1957; 256: 199