Studies on the Renal Circulation and the Renal Function in Mitral Valvular Disease

Renal circulation and function were studied simultaneously with pulmonary and systemic hemodynamics in 25 patients with mitral stenosis before and six weeks after valvulotomy. Postoperatively no essential change in renal circulation or function could be demonstrated whether significant relief of pulmonary hypertension had occurred or not. However, results from follow up studies made on 21 patients up to more than three years after operation showed that renal plasma flow could be increased in patients that were hemodynamically improved at the postoperative study. The effect of exercise was investigated in eight patients before and after valvulotomy. In seven the response pattern of renal circulation and function was essentially unchanged regardless of whether improvement in pulmonary pressures and cardiac output did or did not occur. In the eighth patient, the only one with elevated right atrial pressure before operation, the response to exercise improved markedly. Preoperative results obtained on seven patients who died in connection with operation showed that a fatal outcome was not necessarily related to the degree of impairment in renal circulation or function.