No abstract available.

No abstract available.

No abstract available.
Aortic Valve*

Fifty-seven patients underwent 58 pericardiectomies for constrictive pericarditis during the 22-year period between 1958 and 1979. They were 43 males and 14 females with peak age incidence in the second decade, and 26.3% of them were children under 15 years. The etiologies of pericarditis were tuberculous in 40.3%, non-specific in 38.0%, pyogenic in 19.3%, and post-traumatic in 1.8%. Clinical features were alomost identical with those described in the other major reports. Pericardial calcification was noted in 29.8%, pleural change in 63.2% and enlarged cardiac shadow in 73.7% on the chest roentgenograms; atrial fibrillation in 15.8% and low voltage in 45.6% on the electrocardiograms. Venous pressures were elevated and circulation times prolonged. Right heart catheterization were performed in near half of the cases which revealed the characteristics of pericardial constriction. There were 7 deaths after surgery or the hospital mortality rate of 12.3%. The most common and fatal complication was arrhythmia, especially sudden cardiac arrest occurred in pyogenic pericarditis of children. Fifty patients manifested marked clinical improvement from early postoperative days and all were discharged from hospital in excellent condition. Follow-up observations were possible in 30 cases(60.0%) for the average period of one year seven months when all were completely free of symptoms and had normal physical examinations. Abnormal preoperative electrocardiographic changes also revealed the tend-ency toward normalization from early postoperative days except persisting T-Changes. The grave prognosis of pyogenic pericarditis in children and the importance on careful consideration about early pericardiectomy for active tuberculous pericarditis were stressed. And, discussion was also made on the correlation between clinical improvement and hemod ynamic changes after pericardiectomy. Special interest was placed on the preoperative electrocardiographic patterns resembling right ventricular hypertrophy in constrictive pericarditis and the mechanism of its return to normal after surgery.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Cardiac Catheterization ; Cardiac Catheters ; Child ; Constriction ; Death, Sudden, Cardiac ; Electrocardiography ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Pericardiectomy* ; Pericarditis ; Pericarditis, Constrictive* ; Pericarditis, Tuberculous ; Physical Examination ; Prognosis ; Thorax ; Venous Pressure

Fifty-seven patients underwent 58 pericardiectomies for constrictive pericarditis during the 22-year period between 1958 and 1979. They were 43 males and 14 females with peak age incidence in the second decade, and 26.3% of them were children under 15 years. The etiologies of pericarditis were tuberculous in 40.3%, non-specific in 38.0%, pyogenic in 19.3%, and post-traumatic in 1.8%. Clinical features were alomost identical with those described in the other major reports. Pericardial calcification was noted in 29.8%, pleural change in 63.2% and enlarged cardiac shadow in 73.7% on the chest roentgenograms; atrial fibrillation in 15.8% and low voltage in 45.6% on the electrocardiograms. Venous pressures were elevated and circulation times prolonged. Right heart catheterization were performed in near half of the cases which revealed the characteristics of pericardial constriction. There were 7 deaths after surgery or the hospital mortality rate of 12.3%. The most common and fatal complication was arrhythmia, especially sudden cardiac arrest occurred in pyogenic pericarditis of children. Fifty patients manifested marked clinical improvement from early postoperative days and all were discharged from hospital in excellent condition. Follow-up observations were possible in 30 cases(60.0%) for the average period of one year seven months when all were completely free of symptoms and had normal physical examinations. Abnormal preoperative electrocardiographic changes also revealed the tend-ency toward normalization from early postoperative days except persisting T-Changes. The grave prognosis of pyogenic pericarditis in children and the importance on careful consideration about early pericardiectomy for active tuberculous pericarditis were stressed. And, discussion was also made on the correlation between clinical improvement and hemod ynamic changes after pericardiectomy. Special interest was placed on the preoperative electrocardiographic patterns resembling right ventricular hypertrophy in constrictive pericarditis and the mechanism of its return to normal after surgery.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Cardiac Catheterization ; Cardiac Catheters ; Child ; Constriction ; Death, Sudden, Cardiac ; Electrocardiography ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Pericardiectomy* ; Pericarditis ; Pericarditis, Constrictive* ; Pericarditis, Tuberculous ; Physical Examination ; Prognosis ; Thorax ; Venous Pressure

The 46 patients with pulmonary arterial hypertension out of 125 cases of mitral commissurotomy undergone during the 17 years period ending in April, 1975, were separaterly studied to find the clinical significance of pulmonary hypertension in mitral stenosis. They were in progressed symptomatic distress and 91.4% were in NYHA Class III and IV. The electrocardiogram had the characteristic findings of right axis deviation and right ventricular hypertrophy in most of the cases. The valvular calcification was present in 39.1% and the left atrial thrombi in 21.7% of the cases. Preoperative pulmonary capillary pressure and intraoperative left atrial pressure recorded in part of the patients were high (average 34mmHg) and demonstrated the severe degree of stenosis along with the pronounced degree of surgically estimated valvular narrowing. Comparing with the cases without pulmonary hypertension, the need of open mitral commissurotomy according to the criteria was hiher in the reported cases. Twenty-eight patients (60.9%) underwent closed valvulotomy with hospital deaths of 2 (7.1%) and 18 patients (39.1%) open valvulotomy with 6 deaths (33.3%), the overall hospital mortality of 17.4%. The hemodynamic sudies after surgery proved the beneficial effects of mitral commissurotomy on the intraoperative postcommissurotomy left atrial pressure and in 5 cases of recatheterization. The phonocardiographic measurements reflected the hemodynamic results. Clinical improvement was achieved in 79.3% of the 29 cases known and alive with single late death in the follow-up upto 8 years 3 months of the longest. The stress in discussion was placed on the significance of pulmonary hypertension in mitral stenosis which reflected the severe degree of stenosis and the more damaged valve and on the importance of achieving the good relief of stenosis which might be possible only with open surgery, although its risk was yet high in this report.
Arterial Pressure* ; Atrial Pressure ; Axis, Cervical Vertebra ; Capillaries ; Constriction, Pathologic ; Electrocardiography ; Follow-Up Studies ; Hemodynamics ; Hospital Mortality ; Humans ; Hypertension ; Hypertension, Pulmonary ; Hypertrophy, Right Ventricular ; Mitral Valve Stenosis

The 46 patients with pulmonary arterial hypertension out of 125 cases of mitral commissurotomy undergone during the 17 years period ending in April, 1975, were separaterly studied to find the clinical significance of pulmonary hypertension in mitral stenosis. They were in progressed symptomatic distress and 91.4% were in NYHA Class III and IV. The electrocardiogram had the characteristic findings of right axis deviation and right ventricular hypertrophy in most of the cases. The valvular calcification was present in 39.1% and the left atrial thrombi in 21.7% of the cases. Preoperative pulmonary capillary pressure and intraoperative left atrial pressure recorded in part of the patients were high (average 34mmHg) and demonstrated the severe degree of stenosis along with the pronounced degree of surgically estimated valvular narrowing. Comparing with the cases without pulmonary hypertension, the need of open mitral commissurotomy according to the criteria was hiher in the reported cases. Twenty-eight patients (60.9%) underwent closed valvulotomy with hospital deaths of 2 (7.1%) and 18 patients (39.1%) open valvulotomy with 6 deaths (33.3%), the overall hospital mortality of 17.4%. The hemodynamic sudies after surgery proved the beneficial effects of mitral commissurotomy on the intraoperative postcommissurotomy left atrial pressure and in 5 cases of recatheterization. The phonocardiographic measurements reflected the hemodynamic results. Clinical improvement was achieved in 79.3% of the 29 cases known and alive with single late death in the follow-up upto 8 years 3 months of the longest. The stress in discussion was placed on the significance of pulmonary hypertension in mitral stenosis which reflected the severe degree of stenosis and the more damaged valve and on the importance of achieving the good relief of stenosis which might be possible only with open surgery, although its risk was yet high in this report.
Arterial Pressure* ; Atrial Pressure ; Axis, Cervical Vertebra ; Capillaries ; Constriction, Pathologic ; Electrocardiography ; Follow-Up Studies ; Hemodynamics ; Hospital Mortality ; Humans ; Hypertension ; Hypertension, Pulmonary ; Hypertrophy, Right Ventricular ; Mitral Valve Stenosis

No abstract available.

No abstract available.
Heart Valves* ; Heterografts*

No abstract available.