Why the study?
Does pulmonary valvulotomy improve resting hemodynamics in patients with mild to moderate pulmonic stenosis?
Does pulmonary valvulotomy improve resting hemodynamics in patients with mild to moderate pulmonic stenosis?
In mild to moderate pulmonic stenosis, pulmonary valvulotomy provides clinical improvement without significant changes in resting hemodynamics.
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Symptom relief after valvulotomy in mild-moderate pulmonic stenosis occurs without resting hemodynamic change; hypothesis-generating and should not yet change practice.
Seven patients with mild to moderate pulmonic stenosis with intact ventricular septum were subjected to cardiac catheterization before and from 4 to 18 months after pulmonary valvulotomy. Despite uniform clinical improvement, remarkably slight changes were observed, following surgery, in right ventricular pressure, pulmonary artery pressure, pulmonary artery flow, and pulmonary valve area, when measured at rest. When present preoperatively, venoarterial shunt was reduced or eliminated after operation. It was speculated that further studies including the effect of exercise might show that valvulotomy increases the mobility of the valve under stress even when it does not increase valve area at rest.
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Lurie et al. (1953) studied this question.
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