14. Mitral valve prolapse: Clinical and cineangiographic findings

Abstracts of Papers In 2 of this series,

this method

other usual procedures Adequate arteries

perfusion

of

is now possible.

ma1 replacement of the aortic

the

when

Surgery

a solution

and

employing

arch

a valve

prosthesis

to this complicated

problem.

The

study consists

complete

heart

Linda,

Calif.

of 100 unselected

block

with or without

with

Fifty were seen prior to, and 50 following

advent

of permanent

pacing.

trocardiographic

features

to complications

and eventual

ventricular

rate,

and ventricular

rates, width

block,

and

clinical

features

present

myocardial

congestive

related

presence

or absence

cardial

infarctions,

factors

in prognosis.

new myocardial in mortality 60

to

80

reduction

In

rates

patients

to 10 per cent. of acute

presence

paced

before

patients.

of all patients a mortality The

group,

with complete

attack

It is probable

of was

group

a

single

was

in the presence

documented indication to

a characteristic

of

Stokesin the

Stokes-Adams

Clinical and Cine-

KENNETH

B.

CRILEY,

LEWIS

and

Md. valvular

cineangiocardiographic

with

appearance

temof the

murmur

appearance

was

of

val-

in

medical

gonococcal

no

cases

was

septicemia,

There

disease

histories,

4 other

peri-

was no evidence

in any of these

sign&cant

patients.

cardiac

signs

or

studies

establish valvular

that

some

origin,

systolic

and

that

to late systole may be indicative

clicks

murmurs

of a specific

incompetence.

Ohio.

Improvement has The

of

for

resulted

by

the

from

us.

construction,

of prosthetic

continued advance

has been

this

silicone

rubber-hinged

lens

well in dogs for periods

up to

accelerated

fatigue

report

several a shorter

(one-third duced

prostheses the

compared the

of the with

ball

adjusting

cage

larger design.

and

dynamic

closing

the density of blood.

valve

a ball valve

of equal

of re-

size

than

has

of a lens

effects during

of valve been

gradients

are not different

re-

of lens

is possible

mass

inertial

phases

shorter The

insertion

reduced

orifice

lens

cage).

function.

achieved

of the lens to equal

Pressure

the lenticular

The

may be made

orifice

advantage

consisting

does a ball of equiv-

permits

The

weak-

use.

steel cage which

of the ball

with a ball decreases

opening

Further

than

thus the cage

of the height

bulk

a valve

advantages.

excursion

alent diameter,

clinical

a stainless

significant

previously

tests indicated

describes

closure within

quires

the adoption

reported

ness at the hinge which precluded

offers

of these

for the past five years.

closure

Although

present

and valves

valve

has functioned

The

heart

investigation

in our laboratory

most promising

valve

design,

insertion

of a lens-shaped

gravity dysfunction

re-

15. A Caged Lens Prosthesis for Replacement of the Mitral and Aortic Valves, FREDERICK S. CROSS, M.D.,F.A.C.C. and RICHARD D. JONES, PH.D., Cleve-

with

heart block.

MICHAEL

correlated

of the systolic

etiology

had

of mitral

a lenticular

for pacing.

with pacing

related

Baltimore,

form of mitral

These are

20 months,

in 17

approached

a strong

HUMPHRIES,

RICHARD S. Ross, A specific

cent

40 per cent

14. Mitral Valve Prolapse: angiographic Findings, J. O’NEAL

figures

comprising

attacks rather than to the complete

J.

there

heart block,

that improvement

noncoronary

hand,

a

or uremia.

presence

of them

problems

infarction-

62 per

of 80 to 90 per cent

either diabetes Adams

This

and

or

pacing

by mitral

of prolapse

had no significant

artery

techniques

to pacing

in mortality

myocardial

pacing

prior

with

On the other

in

Five

myo-

improvement

prior

and

improvement

60 per cent

without

e.g.,

mortality,

new

present, extent

nodosa and trauma.

of coronary

land,

were critical

a striking

was noted,

cent

measured

and

and uremia

was no apparent the

and and

status or prognosis.

of prior

diabetes infarctions

per

criteria

to clinical

cinebulg-

valve into the

followed

delayed

syndrome,

confined

failure.

was significantly

Marfan’s

form of mitral

uremia

heart

symptoms.

atria1

age, sex, prior

onset

presumed

following

diabetes,

of the mitral

when

the

patients

the

of chang-

were appraised: infarctions,

Two

or absence The

Left

aneurysmal

vular incompetence.

atria1 rate,

of both

late with

QRS.

presence of the

elec-

in relation

prognosis:

of variation

None of the electrocardiographic The

following

were examined

degree

ing

The

the

finding

click introduced

patients.

systole,

click,

The

correlated

arteritis

Stokes-Adams

attacks.

A systolic

with the maximal

leaflets.

encountered

of the clinical

in the latter part of systole in all 6 patients.

systolic

porally

has been

demonstrated

in early

gurgitation

and

patients

murmur.

in 3 of these

atrium

The

*13. Electrocardiographic and Clinical Features in the Prognosis of Complete Heart Block, RICHARD S. COSBY, M.D., F.A.c.c., EDWIN A. CAFFERKY, M.D., FRANCIS Y. K. LAW, M.D. and RUSSELL A. ROHDE, and Loma

course because

ing of one or both leaflets left

there has been one late death.

M.D., Los Angeles

of a late systolic angiocardiography

have been successfully operated upon;

Seven patients

clinical studied

the murmur

aneurys-

graft and control

with

and a benign in 6 patients

coronary

with an impervious regurgitation

has provided

was diagnostic

were equivocal.

by

the specific

measured than

across

those for

size at flow rates up to

THE AMERICANJOURNAL OF CARDIOLOGY