The Failure of Hemodynamic Improvement After Valve Replacement Surgery
Authors: CHARLES R. PETERSON
Journal: Annals of Internal Medicine (1967)

Article1 January 1967The Failure of Hemodynamic Improvement After Valve Replacement SurgeryEtiology, Diagnosis, and TreatmentCHARLES R. PETERSON, M.D., RODNEY HERR, M.D., RICHARD V. CRISERA, M.D., ALBERT STARR, M.D., J. DAVID BRISTOW, M.D., HERBERT E. GRISWOLD, M.D.CHARLES R. PETERSON, M.D., RODNEY HERR, M.D., RICHARD V. CRISERA, M.D., ALBERT STARR, M.D., J. DAVID BRISTOW, M.D., HERBERT E. GRISWOLD, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-1-1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlthough most patients who have prosthetic replacement of diseased heart valves have significant symptomatic improvement after surgery, it has become apparent that a small percentage either becomes worse or fails to improve. Awareness of the causes of a poor surgical result and objective evidence that there has not been improvement can be helpful in correct diagnosis and management. The objective distinction between a good and poor surgical result may be difficult, however, because patients considered to have satisfactory relief of symptoms do not necessarily improve to a normal state as defined by the usual clinical or hemodynamic criteria. In addition,...References1. HERRSTARRMCCORDWOOD RACWJ: Special problems following valve replacement: embolus, leak, infection, red cell damage. Ann. Thorac. Surg. 1: 403, 1965. CrossrefMedlineGoogle Scholar2. KLOSTERBRISTOWGRISWOLD FEJDHE: Medical problems in mitral and multiple valve replacement. Progr. Cardiov. Dis. 7: 504, 1965. CrossrefMedlineGoogle Scholar3. STARREDWARDSGRISWOLD AMLHE: Mitral replacement: late results with a ball valve prosthesis. Progr. Cardiov. Dis. 5: 298, 1962. CrossrefMedlineGoogle Scholar4. BRISTOWMCCORDSTARRRITZMANNGRISWOLD JDCWALWHE: Clinical and hemodynamic results of aortic valvular replacement with a ball-valve prosthesis. Circulation 29 (suppl.): 36, 1964. Google Scholar5. BRISTOWFARREHIMCCORDSTARRGRISWOLD JDCCWAHE: Clinical and hemodynamic observations after combined aortic and mitral replacement. Circulation 31 (suppl. I): 67, 1965. Google Scholar6. BRISTOWKLOSTERHERRMCCORDGRISWOLD JDFERCWHE: Cardiac catheterization studies after combined tricuspid, mitral, and aortic replacement. Circulation 34: 437, 1966. CrossrefMedlineGoogle Scholar7. HODGES PC: Heart size from routine chest films. Radiology 47: 355, 1946. CrossrefMedlineGoogle Scholar8. SCHWARZ GS: Determination of frontal plane area from the product of the long and short diameters of the cardiac silhouette. Ibid., p. 360. Google Scholar9. JUDSONARDAIZSTRACHJENNINGS WEJTBRS: Postoperative evaluation of prosthetic replacement of aortic and mitral valves. Circulation 29 (suppl.): 14, 1964. MedlineGoogle Scholar10. MORROWHARRISONROSSROSSBRAUNWALDCLARK AGDCJRSNSWD: The surgical management of mitral valve disease: a symposium on diagnostic methods, operative techniques, and results. Ann. Intern. Med. 60: 1073, 1964. LinkGoogle Scholar11. ROCKOFFROSSOLDHAMMASONMORROWBRAUNWALD SDJNNDTAGE: Ventriculo-atrial regurgitation following prosthetic replacement of the mitral valve. Amer. J. Cardiol. 17: 817, 1966. CrossrefMedlineGoogle Scholar12. PIERIERAIBLEEDWARDSSIPOSSHANCOCKSTARR WSDALEGGWDA: Valve replacement: experience with the durability of silicone rubber. Circulation (suppl. II) 32: 171, 1965. Google Scholar13. MORROWCLARKHARRISONBRAUNWALD AGWDDCE: Prosthetic replacement of the mitral valve. Operative methods and the results of preoperative and postoperative hemodynamic assessments. Circulation 29 (suppl.): 2, 1964. Google Scholar14. SPENCERKENTREEVES FCTJT: Successful replacement of a thrombosed mitral valve prosthesis. JAMA 194: 1249, 1965. CrossrefMedlineGoogle Scholar15. RASTELLIKINCAIDKIRKLIN GCOWJW: Heart size after valve replacement. Mayo Clin. Proc. 41: 217, 1966. MedlineGoogle Scholar16. FLEMINGWOOD HAP: The myocardial factor in mitral valve disease. Brit. Heart J. 21: 117, 1959. CrossrefMedlineGoogle Scholar17. HARVEY RM: Mechanical and myocardial factors in rheumatic heart disease with mitral stenosis. Circulation 11: 531, 1955. CrossrefMedlineGoogle Scholar18. BRAUNWALDBRAUNWALDROSSMORROW ENSJAG: Effects of mitral-valve replacement on the pulmonary vascular dynamics of patients with pulmonary hypertension. New Eng. J. Med. 273: 509, 1965. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Portland, OregonFrom the Division of Cardiovascular-Renal Diseases, Department of Medicine, the Division of Cardiopulmonary Surgery, Department of Surgery, and the Department of Pathology, University of Oregon Medical School, Portland, Ore.This study was supported by program project grant HE 06336-03, U. S. Public Health Service, Washington, D. C.At the time of this study Dr. Peterson was a Fellow in Cardiology at the University of Oregon Medical School, Portland, Ore.Requests for reprints should be addressed to Herbert E. Griswold, M.D., University of Oregon Medical School, 3181 S.W. Sam Jackson Park Rd., Portland, Ore. 97201. 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BRUCE DUNKMAN, M.D., JOSEPH K. PERLOFF, M.D., F.A.C.P., JOHN A. KASTOR, M.D., F.A.C.P., JAMES C. SHELBURNE, M.D., F.A.C.P.Surgical management of coexisting coronary artery and valvular heart diseaseIsolated Aortic Valve Replacement: Analysis of Factors Influencing Survival After Replacement with the Starr-Edwards ProsthesisMitral valve replacement with cloth-covered composite-seat prosthesesShould coronary arteriography be performed routinely before valve replacement?The Safety of Combined Aortic Valve Replacement and Coronary Bypass GraftingIschemic myocardial injury during cardiopulmonary bypass surgeryAn Engineer's View of Prosthetic Heart Valve PerformanceMyocardial dysfunction associated with valvular heart diseaseMechanical malfunction and thrombosis of prosthetic heart valvesDetection of Fungal Vegetations Involving a Starr-Edwards Mitral Prosthesis by Means of UltrasoundClosed Mitral Commissurotomy Complications and Their Effect on SurvivalPericardial patch enlargement of the aortic outflow tractA late complication of caged ball mitral valve prosthesisSurvival After Starr-Edwards Aortic Valve ReplacementTHE CARDIAC RESPONSE TO EXERCISE IN AORTIC VALVULAR DISEASE BEFORE AND AFTER BALL VALVE REPLACEMENTMechanically-induced arrhythmias in digitalized heartsCoronary Artery Disease and Left Ventricular Function in Mitral StenosisIncidence of significant coronary artery disease in rheumatic valvular heart diseaseUnusual Location of the Mitral-Prosthesis MurmurAbsence of Opening Click in Dehiscence of Mitral-Valve ProsthesisCardiac function following prosthetic aortic valve replacementFactors associated with operative risk in mitral valve replacementMultiple Valve ReplacementCardiac SurgeryMultiple Valve ReplacementAortic Valve ReplacementTwo Unusual Complications of Prosthetic Valve SurgeryThe Management of Patients with Prosthetic Heart ValvesParavalvular leaks and hemolytic anemia following insertion of Starr-Edwards aortic and mitral valvesThe significance of coronary artery disease in aortic valve replacementMitral replacement 1 January 1967Volume 66, Issue 1Page: 1-24KeywordsAnatomical pathologyCardiac surgeryCardiovascular diseasesClinical pathologyElectrocardiographyHemodynamicsMedical servicesSurgeryThoracic surgeryValve replacement ePublished: 1 December 2008 Issue Published: 1 January 1967 Copyright & PermissionsCopyright ©, 1967, by The American College of PhysiciansPDF downloadLoading ...