[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 18.206.12.79. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
April 27, 1957

RECURRENT MITRAL STENOSIS: DIAGNOSIS BY CATHETERIZATION OF THE LEFT SIDE OF THE HEART

Author Affiliations

Philadelphia

Professor and Head, Department of Thoracic Surgery, Hahnemann Medical College and Hospital, and Director, Bailey Thoracic Clinic (Dr. Bailey); Assistant Professor, Department of Medicine, Hahnemann Medical College and Hospital, Director, Brith Sholom Cardiopulmonary Laboratory, Hahnemann Medical College and Hospital, and Cardiologist, Bailey Thoracic Clinic (Dr. Goldberg); and Chief Resident, Department of Thoracic Surgery, Hahnemann Medical College and Hospital ( Dr. Morse ). Dr. Morse, who did this work during the tenure of a National Heart Institute Fellowship, is now in New York.

JAMA. 1957;163(17):1576-1583. doi:10.1001/jama.1957.02970520010003
Abstract

• Analysis of the results of mitral commissurotomy in 1,000 patients revealed that 22 had recurrent symptoms caused by restenosis. Six of the 22 had given evidence of clinical improvement for one or more years after the original operation but subsequently developed congestive heart failure and died; at autopsy they were found to have a severe degree of mitral stenosis due to refusion of the parts that had been separated surgically. In the other 16 reoperation was done because of the recurrence of symptoms, and direct examination of the restenosed valves was possible. Data from all 22 patients are tabulated, and six of the histories are given in some detail. Evidence of continued active rheumatic endocarditis was found in some cases. Simultaneous catheterization of right and left sides of the heart proved valuable in establishing the diagnosis of restenosis. Recent improvements in technique include a right-sided approach to the mitral valve. This permits a more complete separation of the valve elements and should reduce the incidence of restenosis.

×