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Journal of Heart Valve Disease

Pragnesh Joshi, Sameer Thakur, Christopher Finn, Paul Sadlier
The case described here is the first reported case of successful isolated aortic valve replacement (AVR) via a right anterior thoracotomy (RAT) in a patient with osteogenesis imperfecta (OI). The most common reported complication in patients with OI undergoing AVR or other cardiac surgery is bleeding and sternal complications. By using a RAT approach, it was possible to replace the aortic valve without major bleeding, transfusion, or sternal complications.
November 2017: Journal of Heart Valve Disease
Selim Isbir, Sinan Arsan, Koray Ak, Adnan Cobanoglu
The case is reported of a 62-year-old man with severe aortic regurgitation that was related to failed prior valve-sparing ascending aortic aneurysm repair, and who was successfully treated with a Perceval Sutureless valve.
November 2017: Journal of Heart Valve Disease
Moustafa Elsheshtawy, Mahmoud Abdelghany, Jacob Shani, Manfred Moscovits
Adult congenital heart diseases present a unique challenge in assessing right-sided cardiac chambers, where pressures can be mistakenly calculated using standard echocardiographic formulae. A challenging case is presented of a combined inlet ventricular septal defect and ventriculo-atrial Gerbode defect. The diagnosis of such adult congenital heart diseases requires an in-depth understanding of cardiac pathophysiology and hemodynamics. Video 1: Transthoracic echocardiography. Apical four-chamber view, showing a large inlet VSD with bidirectional shunt (Eisenmenger syndrome)...
November 2017: Journal of Heart Valve Disease
Alice Wang, Asvin M Ganapathi, Andrew Wang, G Chad Hughes
The modified Ross procedure, which involves replacement of the aortic valve with a pulmonary autograft root supported within a Dacron tube graft, was developed with the goal of preventing late autograft dilatation and associated aortic insufficiency. The case is reported of an adult patient who had a bicuspid aortic valve (BAV), underwent a modified Ross procedure, and developed severe aortic insufficiency within one year and subsequently required reoperation for aortic valve replacement. While advances have been made to increase the success of the Ross procedure via modifications to prevent aortic root dilatation, no modifications have yet been devised to improve the ability of the pulmonary valve to withstand systemic aortic pressures...
November 2017: Journal of Heart Valve Disease
Mauricio-Damian Gomez, Mario Gomez-Sanchez, Jose Antonio Arias-Godinez, Silvia Jimenez-Becerra, Valentin Herrera-Alarcon
Malignant primary tumors of the heart are among the most unusual forms of cancer. Cardiac malignancy accounts for about 20% of all primary cardiac tumors, with most arising from the atria and less frequently the ventricles; very unusual locations include the great vessels and the cardiac valves. A rare case is presented of a young female that arrived at the authors' emergency room in pulmonary edema and circulatory collapse secondary to a true tumor of the mitral leaflets that caused severe mitral valve stenosis...
November 2017: Journal of Heart Valve Disease
Julia Pohl, Peter Luedike, Rolf Alexander Jánosi, Tienush Rassaf
MitraClip® implantation is commonly used in patients with severe mitral regurgitation (MR) and who are at high risk for surgical mitral valve repair. The occurrence of stroke or transient ischemic attack is a potential complication in patients undergoing MitraClip implantation, and incidences of up to 2.6% have been reported. Herein is reported the case of an 84-year-old woman with severe MR and a thin filamentous structure at the rim of the left atrial appendage of unknown etiology. Due to a high surgical risk, the heart team decided to perform endovascular mitral valve repair using the MitraClip procedure...
November 2017: Journal of Heart Valve Disease
Federico Paredes, Arnaldo Estigarribia Bernal, Eduard Permanyer, Javier Poncela, Alejandro Ysasi, Enrique Herrero, Manuel Maynar, Rafael Llorens
BACKGROUND: The study aim was to assess the hemodynamic results and implantation technique for the latest-generation St. Jude Medical aortic valve bioprosthesis, the Trifecta™ GT, which was first marketed in 2016. METHODS: The first 100 patients (mean age 74.59 ± 7.41 years) undergoing aortic valve replacement (AVR) with the Trifecta GT, whether associated or not with other procedures, were included and assessed. All patients underwent a baseline ultrasound scan prior to hospital discharge to monitor postoperative gradients and the presence of periprosthetic leakage...
November 2017: Journal of Heart Valve Disease
Piotr Duchnowski, Tomasz Hryniewiecki, Patrycjusz Stokłosa, Mariusz Kuśmierczyk, Piotr Szymański
BACKGROUND: Numerous studies have shown that elevated red cell distribution width (RDW) is associated with poor outcomes in patients with cardiovascular diseases such as acute myocardial infarction, stroke, and chronic heart failure. The prognostic utility of RDW in patients with valvular disease undergoing heart valve surgery is unknown. METHODS: A prospective study was conducted on a group of consecutive patients with hemodynamically significant valvular heart disease that underwent elective valvular surgery...
November 2017: Journal of Heart Valve Disease
Raúl Garcia Rinaldi, Juan Rodriguez-Acosta, David Bermúdez, Ángel Galera, Shaira Quinones, Jeanette Quinones
BACKGROUND: A mechanical aortic prosthesis (MAP) may cause platelet activation secondary to shear forces, and the release of adenosine diphosphate (ADP). This platelet-mediated event may lead to arterial embolism. Traditionally, warfarin has been used to treat such cases, although this anticoagulant has no inhibitory effects on platelets. The study aim was to determine if antiplatelet agents could prevent thromboembolic events in patients with a MAP. METHODS: Since 2001, a total of 265 patients (average age 64...
November 2017: Journal of Heart Valve Disease
Alberto Cresti, Pasquale Baratta, Francesco De Sensi, Incoronata D'Aiello, Alessandro Costoli, Ugo Limbruno
BACKGROUND: The involvement of atrial embryonic remnants in infective endocarditis (IE) has seldom been reported. The study aim was to evaluate the prevalence of vegetations on right atrial embryonic remnants (RAER) in patients with a definitive diagnosis of IE. METHODS: Since 1998, all consecutive patients with suspected IE were referred to the authors' institution to undergo transesophageal echocardiography (TEE). Patients with a high probability of IE but with a negative result underwent a further TEE examination within 10 days...
November 2017: Journal of Heart Valve Disease
Cristian Aguilar, Daniel Espinoza, Pedro Segura, Jean A Donet
Cardiac myxomas are the most common primary tumors of the heart. Although these tumors have been reported in all cardiac chambers, myxomas arising from heart valves are extremely rare. Here, the details are described of a patient with mitral valve myxoma, and a review is provided of 99 cases reported in the literature. Mitral valve myxomas most often occur in middle-aged patients, with a slight female predominance. Most of the tumors arise in an isolated fashion on the atrial side of the anterior mitral valve leaflet...
November 2017: Journal of Heart Valve Disease
Masashi Takeshita, Hirokuni Arai, Tomohiro Mizuno, Keiji Oi, Masahumi Yashima
BACKGROUND: True parachute mitral valve and parachute-like asymmetric mitral valve are associated with congenital anomalies of the papillary muscles, which involves an abnormal anatomy of the papillary muscles and chordae. METHODS: Two patients are described with mitral valve regurgitation and papillary muscle anomalies. Mitral valve repair using artificial chordae reconstruction and ring annuloplasty was attempted in both cases. RESULTS: The first patient had a true parachute mitral valve, while the second patient had a parachute-like asymmetric mitral valve...
November 2017: Journal of Heart Valve Disease
Morgane Evin, Julien Magne, Stuart M Grieve, Régis Rieu, Philipe Pibarot
BACKGROUND: Reference values of hemodynamic parameters for the assessment of prosthetic heart valves are necessary, and ideally need to be provided by entities independent of the valve manufacturers. Thus, the study aim was to provide, in vitro, normal reference values of the effective orifice area (EOA) for different models and sizes of mitral prosthetic valve, and to assess the determinants of EOA and mean transvalvular pressure gradient (mTPG). METHODS: Four models of mechanical prostheses were tested (one mono-leaflet, three bi-leaflet) and four models of bioprostheses (two bovine pericardial, two porcine) on a double-activation pulsed duplicator that was specifically designed and optimized for assessing the hemodynamic performance of mitral prosthetic valves...
November 2017: Journal of Heart Valve Disease
Chad M House, Katie A Moriarty, William B Nelson
BACKGROUND: The study aim was to determine the prevalence of normally functioning mitral prostheses with mean gradient ≥10 mmHg, and to identify the characteristics and echocardiographic variables that might be useful to distinguish normal function from dysfunction. METHODS: A total of 56 consecutive patients with a prosthetic mitral valve and mean gradient ≥10 mmHg was retrospectively identified. Nineteen patients without subsequent imaging confirming normal prosthesis function or dysfunction were excluded; hence, 37 patients were classified as obstruction, insufficiency, or normal prosthesis (high-gradient; NPHG)...
November 2017: Journal of Heart Valve Disease
Inês Rodrigues, Luísa Branco, Lino Patrício, Luís Bernardes, João Abreu, Duarte Cacela, Ana Galrinho, Rui Ferreira
BACKGROUND: Percutaneous balloon mitral valvuloplasty (PMV) is the cornerstone of rheumatic mitral stenosis treatment in suitable patients. Previous studies have reported low rates of technical failure and few major complications, with good long-term results after successful PMV. The study aim was to assess the very long-term outcome in patients after PMV performed at a single tertiary center. METHODS: Between 1991 and 2010, a total of 213 consecutive patients underwent PMV at the authors' center...
November 2017: Journal of Heart Valve Disease
Tomás Benito-González, Rodrigo Estévez-Loureiro, Ignacio Iglesias-Gárriz, Javier Gualis, Armando Pérez de Prado, Carmen Garrote, Martin J Swaans, Jan A S Van der Heyden, Ted Feldman, Cristina Giannini, David Alonso, Miguel Rodriguez-Santamarta, Mario Castaño, Felipe Fernández-Vázquez
BACKGROUND: The MitraClip® system is a percutaneous treatment for mitral regurgitation (MR) that has shown promising results in patients who are inoperable or at high risk for mitral surgery. Data on the efficacy of the system over optimal medical therapy, above all in patients with functional MR, are scarce. The study aim was to assess the effect of MitraClip on the survival of patients with moderate/severe or severe MR compared to medical therapy, using meta-analytical techniques. METHODS: Independently, reviewers searched electronically for relevant articles based on predefined criteria and end-points...
November 2017: Journal of Heart Valve Disease
Ahmed A Aldajani, Montaha A Mudhry, Ali Mir, Raidah S Albaradie
Cardioembolic stroke is an uncommon phenomenon in pediatric patients. Although the heart is the usual source of the condition, cardiac myxomas are still considered to be a rare cause in children. The case is presented of a 13-year-old, right-handed Saudi boy who showed right-sided weakness for 30 h prior to hospital admission that involved the face, arm, and leg, with slurred speech. The patient had been discharged previously from a local hospital, without active management. An examination showed decreased strength on the right side, with hyperreflexia and an up-going plantar response...
November 2017: Journal of Heart Valve Disease
Charalampos Katselis, George Samanidis, Anastasia Papasotiriou, Ioannis Kriaras, Theofani Antoniou, Mazen Khoury, Alkiviadis Michalis, Konstantinos Perreas
BACKGROUND: Composite graft replacement of the aortic root is the treatment of choice for an array of aortic root pathologies, such as annuloaortic ectasia, Marfan syndrome and acute or chronic aortic dissection type A. In this retrospective study of the authors' aortic surgery database, an exploration was made of factors related to early and long-term morbidity and mortality of patients who underwent this procedure. METHODS: Between 2000 and 2009, a total of 200 consecutive patients (male:female ratio 4:1; mean age 56...
November 2017: Journal of Heart Valve Disease
Amer Harky, Matthew Fok, Saied Froghi, Haris Bilal, Mohamad Bashir
BACKGROUND: Aortic root aneurysms represent a significant risk of morbidity and mortality. Composite root replacement is the preferred practice for repair, although recently valve-sparing replacement has become a popular alternative. The study aim was to identify comparative studies that simultaneously analyzed composite root and valve-sparing root replacement outcomes. METHODS: A systematic review of the current literature was performed through four major databases, from inception until 2016...
November 2017: Journal of Heart Valve Disease
Berhane Worku, Andreas de Biasi, James Horowitz, Polydoros Kampaktsis, Adham Elmously, Robert Minutello, Shing-Chu Wong, Arash Salemi
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is associated with several conduction abnormalities and a need for pacemaker placement. The study aim was to describe all electrocardiographic (ECG) changes seen after TAVR, to compare such changes between transapical (TA) and transfemoral (TF) patient cohorts, and to assess their impact on postoperative outcomes. METHODS: Between March 2009 and July 2014, a total of 286 consecutive patients underwent TAVR at the present authors' institution...
November 2017: Journal of Heart Valve Disease
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