Congenital mitral regurgitation

Autor: Eugene Braunwald, William G. Roberts, Maurice M. Aygen, Andrew G. Morrow, E.Kent Carney
Rok vydání: 1962
Předmět:
Zdroj: The American Journal of Medicine. 33:223-235
ISSN: 0002-9343
DOI: 10.1016/0002-9343(62)90020-7
Popis: The results of detailed clinical and hemodynamic studies in nine patients with congenital regurgitation are described. In one patient this lesion was accompanied by a patent ductus arteriosus and in another by corrected transposition of the great vessels. The patients ranged in age from six to seventeen years at the time of study; three of them were asymptomatic. One patient died in congestive heart failure; five others presented symptoms indicating varying degrees of left ventricular failure. Apical systolic thrills were palpable in six patients and all had loud pansystolic murmurs in this region. Third heart sounds or apical mid-diastolic murmurs were heard in all nine patients. The electrocardiograms revealed left ventricular hypertrophy in five patients, combined ventricular hypertrophy in one and myocardial infarction with periinfarction block in the other. Roentgenographically the left atrium and left ventricle were enlarged in eight of the nine patients. In two patients the pulmonary artery pressure was within normal limits; in two others it was slightly elevated (systolic 31 to 40 mm. Hg); whereas in the other five patients more serious pulmonary hypertension was present. Mean left atrial pressure was normal in two patients and elevated to varying degree in the others. Retrograde arterial catheterization and selective angiocardiograms with left ventricular injection showed regurgitation of contrast material from the left ventricle to the left atrium in three patients. Mitral annuloplasty resulted in striking clinical and hemodynamic improvement in two patients who were in heart failure preoperatively. Ligation of the accompanying patent ductus arteriosus was of clinical benefit in one patient. The literature describing the nineteen patients with congenital mitral regurgitation who were previously reported on is reviewed.
Databáze: OpenAIRE
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