Haemodynamic findings after insertion of the Lillehei-Kaster valve in the mitral ostium.

Clinical deterioration after insertion of prosthetic mitral valves may be caused by myocardial failure or valve dysfunction or a combination of both. The need for a method to decide which is predominantly causative is obvious. This study describes the haemodynamic findings with special reference to prosthesis rheology among 13 patients with lillehei-Kaster valves in the mitral ostium. Three patients were re-operated on because clinical signs of valvular dysfunction. Our investigation indicates that stroke volumes of less than 35 ml were useful in predicting valve dysfunction and that pulmonary wedge and mean arterial pressure at rest were significantly increased in this group of patients. It is advocated that such haemodynamic findings should lead to further evaluation of valve gradient and valve flow.