Evaluation of surgery in rheumatic heart disease.

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Publication Type thesis
School or College School of Medicine
Department Surgery
Author Patel, Dali Jehangir.
Title Evaluation of surgery in rheumatic heart disease.
Date 1955-05
Description Clinical and/or hemodynamic studies were carried out on 39 patients with mitral stenosis, before and after surgery. Criteria have been established for more precise diagnosis and an attempt has been made to evaluate objectively the results of mitral surgery. To determine the significance of mitral stenosis, in the presence of mitral insufficiency, no single criterion was infallible. The contour of pulmonary artery "wedge" pressure tracing was sometimes helpful; otherwise the hemodynamic data were of not value. In general, the following criteria were found helpful in distinguishing predominance of mitral stenosis or insufficiency, in this series (Mitral Stenosis 1. opening snap, 2. accentuated first heart sound at apex, 3. absence of loud systolic murmur at apex, 4. normal sized heart, and 5. electrocardiographic evidence of mitral P waves, incomplete right bundle branch block or right ventricular hypertrophy; Mitral Insufficiency 1. loud apical systolic murmur, 2. enlarged heart with left ventricular enlargement, and 3 tall V waves in PA "wedge" pressure tracing). Hemodynamic data were found to be very helpful in evaluating the degree of incapacitation of those patients with mitral stenosis in whom the subjective complaints were out of proportion the objective clinical findings. It is concluded that the presence of normal hemodynamics is a definite contraindication to mitral surgery in spite of any clinical findings. The results of surgery were independent of the presence of a slight amount of mitral regurgitation, the initial value of pulmonary resistance, or the microscopic finding in the auricular biopsy. Objective evidence of improvement was found by electrocardiogram, x-ray and hemodynamic data in 70% of the patients with pure of predominant mitral stenosis who improved subjectively. It is stressed that a conclusion concerning the results of surgery in any given case should be reserve until objective data are available to substantiate the subjective and clinical improvement.
Type Text
Publisher University of Utah
Subject Hemodyamic; Electrocardiographic
Subject MESH Rheumatic Heart Disease; Surgery
Dissertation Institution University of Utah
Dissertation Name MS
Language eng
Relation is Version of Digital reproduction of "Evaluation of surgery in rheumatic heart disease." Spencer S. Eccles Health Sciences Library. Print version of "Evaluation of surgery in rheumatic heart disease." available at J. Willard Marriott Library Special Collection. RD14.5 1955 .P38.
Rights Management © Dali Jehangir Patel
Format Medium application/pdf
Identifier us-etd2,32
Source Original: University of Utah Spencer S. Eccles Health Sciences Library (no longer available).
ARK ark:/87278/s65t4108
Setname ir_etd
Date Created 2012-04-23
Date Modified 2021-12-08
ID 192633
Reference URL https://collections.lib.utah.edu/ark:/87278/s65t4108
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