Pulmonary Vein Flow in Mitral Valve Disease

Abstract

Pulmonary vein blood flow in mitral valve disease was studied peroperatively in 10 patients undergoing valve replacement. Flow was recorded using a Nycotron electromagnetic flowmeter with a cuff type probe on the right upper pulmonary vein. Pressures in the left atrium and ventricle were recorded simultaneously. the recordings were made both before cannulation for extracorporeal circulation and after mitral valve replacement. the flow curves had a pulsatile pattern and reflected the pressure events in the left atrium. Forward flow reached maximum during ventricular diastole and was reversed during ventricular systole. Maximum retrograde flow coincided with a peak of the left atrial v-wave. With a few exceptions, there was good agreement between the degree of pulmonary vein retrograde flow and grade of mitral insufficiency at left ventricular angiography. After valve replacement, no retrograde pulmonary vein flow was observed. in the majority of patients the v-wave in the left atrium was markedly reduced by surgery. the generation and the relationship of the left atrial v-wave and the retrograde pulmonary vein flow is discussed. It is concluded that the method described may be useful as a reference method when evaluating the degree of mitral insufficiency. It is a valuable tool for the analysis of the haemodynamic events in the left atrium and the pulmonary veins in heart disease.