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

AMA Arch Surg. 1958;76(5):830-834. doi:10.1001/archsurg.1958.01280230170026.
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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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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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