Airway compression secondary to left atrial enlargement and increased pulmonary artery pressure

Background: Mitral stenosis is often present with pulmonary hypertension. Closed Mitral Commissurotomy (CMC) is a treatment of choice for severe mitral stenosis. In this study, we examined the per-operative changes of pulmonary artery pressure following opening of stenosed mitral valve. Methods: All these CMCs were performed routinely through the left antero-lateral thoracotomy (4th intercostal space) and dilatation was done by metallic Tubb’s Dilator. Peroperative left atrial and Pulminary Arterial pressures were measured before and after dilatation. Results: 15 patients had undergone CMC. Following CMC, per-operative mean Pulmonary artery pressure was reduced from 45.5±7.1 mm of Hg to 39.0±8.8 mm of Hg (p=0.043). Mean left atrial pressure reduced from 35.9±5.6 mm of Hg to 30.0±9.1 mm of Hg (p = 0.049). At three months follow up after closed mitral commissurotomy mitral valve area at echocardiography was found 2.29±0.18 cm2. There was no case of death after closed mitral commissurotomy. Mild mitral regurgitation occurred in 1 patient. Conclusion: We conclude that there is immediate significant reduction of pulmonary Artery pressure following closed mitral commissurotomy. This reduction is apparently comparable with a similar reduction of left atrial pressure. Cardiovasc. j. 2019; 11(2): 147-151

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Clinical implication of inadvertent monitoring of pulmonary artery pressure via a “left atrial” catheter

Catheterization and Cardiovascular Diagnosis ◽

10.1002/ccd.1810130108 ◽

1987 ◽

Vol 13 (1) ◽

pp. 42-43

Author(s):

Adeniyi O. Molajo Mrcp ◽

Shirley R. Remington ◽

William F. Thomas ◽

Abdul K. Deiraniya

Keyword(s):

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Clinical Implication ◽

Left Atrial ◽

Artery Pressure ◽

Atrial Catheter

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Direct measurement of left atrial and pulmonary artery pressure in rats with pulmonary hypertension

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2018.05.026 ◽

2018 ◽

Vol 156 (3) ◽

pp. 1161-1163

Author(s):

Michael G. Katz ◽

Anthony S. Fargnoli ◽

Yassine Sassi ◽

Roger J. Hajjar ◽

Lahouaria Hadri

Keyword(s):

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Direct Measurement ◽

Left Atrial ◽

Artery Pressure

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Right Atrial and Pulmonary Artery Pressure as Indicators of Left Atrial Pressure during Fluid Therapy following Hemorrhagic Shock in the Baboon

Annals of Surgery ◽

10.1097/00000658-196911000-00012 ◽

1969 ◽

Vol 170 (5) ◽

pp. 801-812 ◽

Cited By ~ 4

Author(s):

GERALD S. MOSS ◽

LOUIS D. HOMER ◽

CLIFFORD M. HERMAN ◽

HERBERT J. PROCTOR

Keyword(s):

Pulmonary Artery ◽

Hemorrhagic Shock ◽

Pulmonary Artery Pressure ◽

Fluid Therapy ◽

Left Atrial ◽

Atrial Pressure ◽

Left Atrial Pressure ◽

Right Atrial ◽

Artery Pressure

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Development of a circulatory mock loop for biventricular device testing with various heart conditions

The International Journal of Artificial Organs ◽

10.1177/0391398820903316 ◽

2020 ◽

Vol 43 (9) ◽

pp. 600-605 ◽

Cited By ~ 1

Author(s):

Yuichiro Kado ◽

Takuma Miyamoto ◽

David J Horvath ◽

Shengqiang Gao ◽

Kiyotaka Fukamachi ◽

...

Keyword(s):

Heart Failure ◽

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Left Atrial ◽

Aortic Pressure ◽

Atrial Pressure ◽

Left Atrial Pressure ◽

Right Atrial ◽

Right Atrial Pressure ◽

Artery Pressure

This study aimed to evaluate a newly designed circulatory mock loop intended to model cardiac and circulatory hemodynamics for mechanical circulatory support device testing. The mock loop was built with dedicated ports suitable for attaching assist devices in various configurations. This biventricular mock loop uses two pneumatic pumps (Abiomed AB5000™, Danvers, MA, USA) driven by a dual-output driver (Thoratec Model 2600, Pleasanton, CA, USA). The drive pressures can be individually modified to simulate a healthy heart and left and/or right heart failure conditions, and variable compliance and fluid volume allow for additional customization. The loop output for a healthy heart was tested at 4.2 L/min with left and right atrial pressures of 1 and 5 mm Hg, respectively; a mean aortic pressure of 93 mm Hg; and pulmonary artery pressure of 17 mm Hg. Under conditions of left heart failure, these values were reduced to 2.1 L/min output, left atrial pressure = 28 mm Hg, right atrial pressure = 3 mm Hg, aortic pressure = 58 mm Hg, and pulmonary artery pressure = 35 mm Hg. Right heart failure resulted in the reverse balance: left atrial pressure = 0 mm Hg, right atrial pressure = 30 mm Hg, aortic pressure = 100 mm Hg, and pulmonary artery pressure = 13 mm Hg with a flow of 3.9 L/min. For biventricular heart failure, flow was decreased to 1.6 L/min, left atrial pressure = 13 mm Hg, right atrial pressure = 13 mm Hg, aortic pressure = 52 mm Hg, and pulmonary artery pressure = 18 mm Hg. This mock loop could become a reliable bench tool to simulate a range of heart failure conditions.

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