evidence of reduced venous return and alternating end-diastolic fiber length as causative factors. To the Editor: Attie et al.' reported their experience with valve replacement in children with mitral insufficiency. They divided their patients in three groups, depending on the type of prosthesis: mechanical valves, porcine xenografts and dura mater valves. Follow up times were 6.3, 3.3 and 1.9 ...

BACKGROUND Concomitant mitral regurgitation (MR) is frequently seen in patients undergoing aortic valve replacement (AVR) for aortic stenosis. This study was undertaken to characterize the magnitude of MR in these patients and identify factors associated with significant postoperative change. METHODS Between 2002 and 2006, 391 patients with stenotic AV disease but no structural mitral valve d...

Diastolic murmurs associated with the Starr-Edwards mitral prosthesis have not been described previously. In this report, five patients with mitral prostheses are described in whom apical mid-diastolic and presystolic murmurs resulted from two different causes. Three patients had clots obstructing the prosthetic orifice. The other two had normally functioning protheses and moderately severe aor...

The electrocardiograms in 32 patients with mitral valve disease have been compared with the pulmonary resistances, the pulmonary artery pressures, and the size of the mitral valve orifice. In patients with pure stenosis if the electrocardiogram showed the pattern of right ventricular hyper-trophy the total pulmonary resistance was usually 1000 dynes seconds cm.-5 or greater. If mitral insuffici...

We describe a 73 year-old patient with mitral valve pericardial bioprosthesis Carpentier-Edwards 29M implanted due to the rheumatic mitral stenosis 21 years ago. Hemodynamic destabilisation had emerged 18 months before the admission. Echocardiography revealed significant bioprosthesis degeneration with calcification of its leaflets, small pannus on the bioprosthetic ring, moderate mitral stenos...

We report a rare case of severe hemolytic anemia accompanied by moderate renal insufficiency after mitral valve repair. Although the degree of the residual mitral regurgitation was less than 1+ during the first three weeks after the operation, the maximum lactate dehydrogenase (LDH) was up to 7,430 U/l and the minimum hemoglobin was 4.9 g/dl. The mitral valve replacement successfully resolved t...

Twenty patients with mitral insufficiency (MI) due to ruptured chordae tendineae, papillary muscle infarction, or left ventricular enlargement with no organic disease of the mitral valve have been studied during the past 3 years. Nineteen had valve replacement, and one had plastic repair of ruptured chordae tendineae; all have been followed from 6 months to 3 years. Preoperative data were diffe...

A patient with rheumatic mitral valve stenosis and regurgitation presented with shortness of breath and a "noise" in her chest. Cardiac auscultation revealed an intermittent late systolic "whoop." An increase in severity of mitral valve insufficiency during the periods of "whoop" was observed by pulsed Doppler, hemodynamic tracings and left ventriculography.

Mitral insufficiency with mitral annular calcification occurring predominantly in elderly females has been described. We studied six patients with mitral diastolic obstruction associated with mitral annular calcification without stenosis of the mitral leaflets. Three were males and three were females, aged 43-77 years. All had significant diastolic gradients across the mitral valve (mean gradie...