Pulmonary diffusion capacity in mitral stenosis and atrial septal defect

To assess the diffusion capacity in two groups of patients suffering from heart disease of a different aetiology. Preoperative single breath diffusion capacity [DL[co]] was measured by the carbon monoxide and helium dilution method in two groups of patients suffering from heart disease of a different aetiology: 79 patients with advanced rheumatic dominant mitral stenosis scheduled for valve replacement [MVR] surgery and 25 patients with congenital atrial septal defect [ASD] scheduled for surgical repair in the Chest Disease Hospital, Kuwait. The DL[co] was reduced with the patients in the MVR group and tended toward a more normal value with the patients in the ASD group. There was a statistically significant difference between the two groups for the DL[co] for both males [P<0.0001] and females [P<0.001]. Changes in DL[co] in patients with heart disease depends on the underling cardiac pathology

Beta 2 agonist in aortic valve disease.

Lung function studies in patients with severe aortic stenosis scheduled for aortic valve replacement [AVR] revealed an obstructive ventilatory pattern. The majority of those operated upon showed a similar pattern postoperatively. A blind study of the effect of placebo and beta[2] agonist [salbutamol] inhalation was performed in two separate groups of patients preoperatively and six months postoperatively, to evaluate the reversibility of airflow obstruction in these patients, using the following flow volume curve, body plethysmographic measurement of airway resistance [Rex] and intrathoracic gas volume [VTG]. The group of patients in the preoperative period showed significant differences between the placebo and the beta2 agonist responses for FEV[1], PEFR, Vmax[50], Rex and VTG [P<0.001], and also in the postoperative group for FEV[1]/FVC and Rex [P<0.01]. We conclude that salbutamol inhalation improves the obstructive impairment in patients with AVR both pre and post-operatively