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The potassium-sparing agents spironolactone, triamterene, and amiloride are often useful in combination with the loop diuretics and thiazides. Triamterene and amiloride act on the distal tubule to reduce potassium secretion. Their diuretic potency is only mild and not adequate for most patients with heart failure, but they may minimize the hypokalemia induced by more potent agents.
Side effects: Hyperkalemia, gastrointestinal symptoms, renal dysfunction and gynecomastia.
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Open Mitral Valvotomy : Technique: A median stemotomy is done; peri cardium opened and stay sutures taken. After heparinisation ascending aorta is cannulated and then SVC
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which is the molecular basis of inheritennce
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