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Emergency Mitral Valvular Commissurotomy Preceding a Second Aortic Embolectomy

Emergency Mitral Valvular Commissurotomy Preceding a Second Aortic Embolectomy Abstract Embolization to the bifurcation of the abdominal aorta represents one of the more serious complications that may develop in a patient with rheumatic mitral stenosis. Unless prompt embolectomy is accomplished, the mortality rate is extremely high. The three survivals in the series of 11 consecutive operative cases of saddle embolus of aorta previously reported from this hospital1 all were subjected to surgery within seven hours of the onset of embolization. With the widespread performance of surgical procedures for the mechanical relief of the obstructed mitral valve, one may now evaluate the management of saddle embolization with reference to one of three time categories: occurring prior to, during, or after mitral valvular commissurotomy. Each of the three survivals previously reported fell into a different one of these categories. When aortic embolization occurs during the course of surgery on the mitral valve, prompt embolectomy is associated with a high degree of References 1. Schein, C. J.; Hoffert, P. W., and Hurwitt, E. S.: Aortic Embolectomy , Surgery 39:950, 1956. 2. Silverman, J. J., and Hurwitt, E. S.: Aortic Embolectomy in "Buttonhole" Mitral Stenosis , New York J. Med. 50:2289, 1950. 3. Gumbiner, S., and Keeley, J. L.: Pedunculated Thrombus of Left Auricle Causing Death During Aortic Embolectomy , Angiology 4:114, 1953.Crossref 4. Glenn, W. W. L., and McNeill, T. M.: Aortic Embolism Complicating Mitral Stenosis, with Particular Reference to Emergency Valvulotomy Before Embolectomy , New England J. Med. 256:295, 1957.Crossref 5. Shumacker, H. B., Jr., in discussion on Weismann, R. E., and Tobin, R. W.: Arterial Embolism Occurring During Systemic Heparin Therapy , A.M.A. Arch. Surg. 76:219, 1958.Crossref 6. Thomas, G. I.; Dillard, D. H., and Merendino, K. A.: Repeated Aortic Saddle Embolectomy with Success , Surgery 42:364, 1957. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Emergency Mitral Valvular Commissurotomy Preceding a Second Aortic Embolectomy

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Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1959.04320120151019
Publisher site
See Article on Publisher Site

Abstract

Abstract Embolization to the bifurcation of the abdominal aorta represents one of the more serious complications that may develop in a patient with rheumatic mitral stenosis. Unless prompt embolectomy is accomplished, the mortality rate is extremely high. The three survivals in the series of 11 consecutive operative cases of saddle embolus of aorta previously reported from this hospital1 all were subjected to surgery within seven hours of the onset of embolization. With the widespread performance of surgical procedures for the mechanical relief of the obstructed mitral valve, one may now evaluate the management of saddle embolization with reference to one of three time categories: occurring prior to, during, or after mitral valvular commissurotomy. Each of the three survivals previously reported fell into a different one of these categories. When aortic embolization occurs during the course of surgery on the mitral valve, prompt embolectomy is associated with a high degree of References 1. Schein, C. J.; Hoffert, P. W., and Hurwitt, E. S.: Aortic Embolectomy , Surgery 39:950, 1956. 2. Silverman, J. J., and Hurwitt, E. S.: Aortic Embolectomy in "Buttonhole" Mitral Stenosis , New York J. Med. 50:2289, 1950. 3. Gumbiner, S., and Keeley, J. L.: Pedunculated Thrombus of Left Auricle Causing Death During Aortic Embolectomy , Angiology 4:114, 1953.Crossref 4. Glenn, W. W. L., and McNeill, T. M.: Aortic Embolism Complicating Mitral Stenosis, with Particular Reference to Emergency Valvulotomy Before Embolectomy , New England J. Med. 256:295, 1957.Crossref 5. Shumacker, H. B., Jr., in discussion on Weismann, R. E., and Tobin, R. W.: Arterial Embolism Occurring During Systemic Heparin Therapy , A.M.A. Arch. Surg. 76:219, 1958.Crossref 6. Thomas, G. I.; Dillard, D. H., and Merendino, K. A.: Repeated Aortic Saddle Embolectomy with Success , Surgery 42:364, 1957.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Dec 1, 1959

References