The use of simultaneous left heart pressure pulse measurements in evaluating the effects of mitral valve surgery

1. 1. The need for an objective method of measuring the adequacy of mitral valvulotomy by estimating the extent of residual mitral stenosis is emphasized. 2. 2. Measurement of the mitral valve filling pressure gradient appears to be the best method of determining the degree of hemodynamically significant mitral stenosis. A method for recording the pressure gradient between the left auricle and the left ventricle at the operating table, by inscribing simultaneous pressure pulses in the left heart, is described. 3. 3. The normal filling pressure gradient across the mitral valve approximates zero. The effect of valvulotomy on the elevated pressure gradient in mitral stenosis is to produce a fall of variable degree, depending on the adequacy of the surgical procedure. When this pressure gradient remains high after valvulotomy, relief of the obstruction can be termed inadequate. 4. 4. The method is also of value in the differential diagnosis of mitral stenosis, in aiding the surgeon at the operating table to decide whether sufficient manipulation of the valve has been carried out and in determining whether recurrence of obstruction has taken place in patients previously operated upon for mitral stenosis.