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May 1958

Determination of the End-Diastolic Pressure Gradient Across the Mitral Valve at Mitral Commissurotomy

Author Affiliations

Salt Lake City
From the Departments of Surgery and Medicine, University of Utah College of Medicine.

AMA Arch Surg. 1958;76(5):830-834. doi:10.1001/archsurg.1958.01280230170026

The attempted quantitation of mitral valvular obstruction from data obtained by right-heart catheterization1 has been extended and refined by techniques designed to record pressures directly from the left atrium and left ventricle2-6 and by the use of simultaneous right- and left-heart catheterization and central arterial pulse forms for the estimation of flow and pressures in the cardiovascular system.7-11 These procedures have made possible a reasonably accurate assessment of mitral-valve obstruction prior to surgery and have allowed an estimation of the degree of relief obtained by surgical intervention.12,13 The recent reports of "restenosis"14-20 raise the question whether these diagnostic adjuncts may not be of value in evaluating the surgical procedure itself.

This report concerns the application of the principles of left-heart catheterization to the operation of mitral commissurotomy, with a twofold purpose in mind: First, an accurate quantitation of the degree of mitral stenosis might be

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