Regression of pulmonary vascular changes following mitral valvuloplasty: An anatomic and physiologic case study

Abstract

A patient with tight mitral stenosis and severe pulmonary hypertension, which did not respond to tetraethylammonium chloride, benefited clinically from mitral valvuloplasty and showed maintenance of excellent hemodynamic improvement six years after operation. Pulmonary arterial pressure, which had exceeded systemic arterial pressure preoperatively, returned to normal. At the time of valvuloplasty the lingular biopsy specimen showed marked hypertensive vascular obstructive changes; eleven years later at autopsy the vascular changes had strikingly regressed. These qualitative changes were confirmed when a statistically significant decrease in the wall-lumen ratio of the small muscular arteries was found in the autopsy sections of lung compared to those of the biopsy specimen at the time of operation. This case is presented as evidence of the regression of pulmonary vascular obstructive changes following successful correction of mitral stenosis.