心臓手術による心音の推移に関する臨床的研究 : 心房中隔欠損症,心室中隔欠損症および僧帽弁狭窄症について

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Phonocardiographic studies were undertaken on the patients with congenital and acquired heart diseases before and after cardiac surgery in hope that follow-up studies on the changes in heart sounds and murmurs might reflect the effect of surgery and normalization of cardiopulmonary function. Materials and Methods Twenty cases of atrial septal defect (ASD), 29 cases of ventricular septal defect (VSD), and 10 case of mitral stenosis (MS) were subjected to this study. Phonocardiograms were also taken in sixteen cases of normal individuals in order to obtain normal values (Table 1). A multifilter system phonocardiograph and microphone of dynamic type^* were used. Phonocardiograms were taken at a speed of 100 mm per second together with electrocardiograms. Responses of cardiac murmurs to amyl nitrite and phenylephrine were analyzed to differentiate the origin of murmurs before and after surgery. Right heart catheterization was performed before surgery in all cases and was repaeted one month after surgery in 10 cases of ASD, 10 cases of VSD and 8 cases of MS. Results 1. ASD Postoperative right heart catheterization study showed normal RV and PA pressure and absence of shunt in 8 cases out of 10, and per sisting elevation of RV and PA pressure with a residual shunt in the remaining 2 cases (Fig. 6). Q-I interval was slightly prolonged preoperatively and it returned to normal range within 1 month after operation. Two case with a residual shunt, however, still showed prolongation even 6 months after operation (Fig. 1). Apical first sound was accentuated in 16 cases before operation. Accentuation persisted, though in a decreased intensity, in 5 cases 1 month after operation, and in 3 cases 6 months after operation. The cases with a residual shunt showed a persistent increase in intensity of apical first sound (Fig. 2).
1965-08-20

心臓手術による心音の推移に関する臨床的研究 : 心房中隔欠損症,心室中隔欠損症および僧帽弁狭窄症について

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