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Diagnosis and follow-up for aortic stenosis

Moshe Bronshtein, Zeev Blumenfeld, Asaad Choury, Ayala Gover
OBJECTIVES: To assess the natural history and outcome of fetal pulmonary stenosis [PS] detected at 14 to 16 weeks gestation. METHODS: This is a retrospective study, in the years 2004-2015, with serial follow up during pregnancy. Patients referred for complete early fetal ultrasound including all fetal systems and a fetal echocardiogram. Ninety seven percent of the women were low risk, and 3% had risk factors such as maternal type 1 diabetes mellitus, exposure to teratogenic drugs or anomalies in previous pregnancies or in other family members...
October 14, 2016: Ultrasound in Obstetrics & Gynecology
Abdellaziz Dahou, Haïfa Mahjoub, Philippe Pibarot
Prosthesis-patient mismatch (PPM) occurs when the effective orifice area (EOA) of a normally functioning prosthesis is too small in relation to the patient's body size, resulting in abnormally high postoperative gradients. PPM is frequent following aortic valve replacement (AVR), and it is associated with increased risk of morbidity and mortality proportionally to its severity. Differential diagnosis between PPM and prosthetic valve stenosis is made by comparing the measured valve effective orifice area, by assessing the changes in valve area and gradient during follow-up and by evaluating leaflet morphology and mobility...
November 2016: Current Treatment Options in Cardiovascular Medicine
Rodrigo Alonso, Jose Luis Díaz-Díaz, Francisco Arrieta, Francisco Fuentes-Jiménez, Raimundo de Andrés, Pedro Saenz, Gema Ariceta, José I Vidal-Pardo, Fatima Almagro, Rosa Argueso, Pablo Prieto-Matos, José P Miramontes, Xavier Pintó, Johana Rodriguez-Urrego, Leopoldo Perez de Isla, Pedro Mata
BACKGROUND: Homozygous familial hypercholesterolemia (HoFH) is a rare genetic disorder associated with very high levels of cholesterol, accelerated atherosclerosis and very premature death, often secondary to occlusion of the coronary ostia by supravalvular atheroma in untreated individuals. OBJECTIVE: To describe molecular and clinical characteristics of HoFH enrolled at SAFEHEART registry and to evaluate the role of the type of mutation in clinical expression...
July 2016: Journal of Clinical Lipidology
Phillip M Freeman, Majd B Protty, Omar Aldalati, Arron Lacey, William King, Richard A Anderson, Dave Smith
OBJECTIVES: Determine the real-world difference between 2 groups of patients with severe aortic stenosis and similar baseline comorbidities: surgical turn down (STD) patients, who were managed medically prior to the availability of transcatheter aortic valve implantation (TAVI) following formal surgical outpatient assessment, and patients managed with a TAVI implant. DESIGN: Retrospective cohort study from real-world data. SETTING: Electronic patient letters were searched for patients with a diagnosis of severe aortic stenosis and a formal outpatient STD prior to the availability of TAVI (1999-2009)...
2016: Open Heart
Akiko Kumagai, Atsushi Tashiro, Akihiko Abiko, Takeshi Kamada, Hitoshi Okabayashi, Motoyuki Nakamura
We report a rare case of a patient with hemolytic anemia who underwent emergency total arch replacement using the elephant trunk technique for type A acute aortic dissection 3 years earlier. The 78-year-old woman was referred to our hospital for diagnosis of the cause of the hemolytic anemia, which required twice weekly blood transfusion. Although contrast-enhanced computed tomography could not provide sufficient information, transesophageal echocardiography (TEE) revealed graft flection with high velocity...
September 2014: Journal of Echocardiography
Phani Chakravarty Mutnuru, S N Singh, John D'Souza, Lakshmi Manasa Perubhotla
INTRODUCTION: Rheumatic heart disease is the most common cause of valvular heart disease throughout the world. Echocardiography is the dominant imaging investigation in the assessment of cardiac valvular disease and the role of Magnetic Resonance Imaging (MRI) is so far limited. However, due to rapid improvements in the cardiac MRI technology in past few years, this non invasive technique is gaining interest in the examination of cardiac valves. AIM: Our study was undertaken to define the role of MRI in the evaluation of Rheumatic valvular heart disease and to compare the role of MRI with transthoracic echocardiography with regard to quantity of stenosis and volume regurgitation...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
C Meurice, E Dulgheru, L Piérard
Aortic stenosis (AS) is the most common valvular heart disease in adults. The most frequent aetiology is now degenerative AS. There is general agreement that, in the absence of serious co-morbidity, surgery must be recommended for patients with symptomatic disease. The management of asymptomatic patients with severe aortic disease remains controversial for several reasons: sudden death in asymptomatic patients has been reported with an incidence < 1 % per year. In addition, operative mortality is significantly higher in symptomatic, when compared with asymptomatic, patients...
January 2016: Revue Médicale de Liège
Minako Katayama, Hari P Chaliki
Aortic stenosis (AS) is a disease that progresses slowly for years without symptoms, so patients need to be carefully managed with appropriate follow up and referred for aortic valve replacement in a timely manner. Development of symptoms is a clear indication for aortic valve intervention in patients with severe AS. The decision for early surgery in patients with asymptomatic severe AS is more complex. In this review, we discuss how to identify high-risk patients with asymptomatic severe AS who may benefit from early surgery...
February 26, 2016: World Journal of Cardiology
Klaus Murbraech, Torgeir Wethal, Knut B Smeland, Harald Holte, Jon Håvard Loge, Espen Holte, Assami Rösner, Håvard Dalen, Cecilie E Kiserud, Svend Aakhus
OBJECTIVES: This study assessed the prevalence and associated risk factors for valvular dysfunction (VD) observed in adult lymphoma survivors (LS) after autologous hematopoietic stem cell transplantation (auto-HCT), and to determine whether anthracycline-containing chemotherapy (ACCT) alone in these patients is associated with VD. BACKGROUND: The prevalence of and risk factors for VD in LS after auto-HCT is unknown. Anthracyclines may induce heart failure, but any association with VD is not well-defined...
March 2016: JACC. Cardiovascular Imaging
Megan Brenner, Melanie Hoehn, William Teeter, Deborah Stein, Thomas Scalea
BACKGROUND: The skill set of the acute care surgeon can be expanded by formal training. We report the first series of traumatic vascular injury (TVI) treated by acute care surgeons trained in endovascular techniques (ACSTEV). METHODS: We retrospectively reviewed patients admitted to our trauma center with TVI over 5 months who survived for more than 24 hours and had catheter diagnosis and/or therapy by ACSTEV. Demographics, admission data, and outcomes were reviewed...
May 2016: Journal of Trauma and Acute Care Surgery
Paul J Wetstein, Margaret E Clark, Danielle E Cafasso, Scott R Golarz, Farhan S Ayubi, Dwight C Kellicut
Takayasu's arteritis is a large vessel vasculitis that can be a challenging diagnosis to make and has a varied clinical presentation. Management largely depends on affected vessel disease severity and individual patient considerations. The diagnosis must be considered in a young patient with large vessel aneurysms. We present a case of a 30 year-old woman of Pacific Islander descent who presented to the Tripler Army medical Center Vascular Surgery Department in Honolulu, Hawai'i seeking repair of her abdominal aortic and renal artery aneurysms prior to conception...
January 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Sorin V Pislaru, Vuyisile T Nkomo, Gurpreet S Sandhu
Calcific aortic valve stenosis is a common valve pathology that increases in prevalence with advancing age. Transcatheter aortic valve (TAV) replacement has now emerged as the preferred treatment for patients at high risk for surgery and for those who are inoperable. However, the use of this ground-breaking technology has inevitably been associated with a host of new problems. These new types of complications are frequently unrecognized or underestimated due to lack of familiarity with the normal and pathological appearance of TAV and often require redefining strategies for diagnosis and treatment...
February 2016: JACC. Cardiovascular Imaging
Tomohiko Taniguchi, Hiroki Shiomi, Masami Kosuge, Takeshi Morimoto, Kenji Nakatsuma, Masataka Nishiga, Tomoki Sasa, Naritatsu Saito, Takeshi Kimura
BACKGROUND: ST-segment elevation (STE) in leads V1-2 is often observed in patients with severe aortic stenosis (AS), but its significance remains unknown. METHODS AND RESULTS: We retrospectively evaluated baseline ECGs and 5-year clinical outcomes in 211 consecutive patients with severe AS, defined as peak aortic jet velocity (Aortic Vmax) >4.0 m/s, or mean aortic pressure gradient >40 mmHg, or aortic valve area (AVA) <1.0 cm(2). The primary outcome measure was a composite of death or surgical aortic valve replacement (AVR)...
2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Faruk İncecik, Özlem M Hergüner, Sevcan Alınç Erdem, Şakir Altunbaşak
OBJECTIVE: Cardiac manifestations of neurofibromatosis type 1 (NF1) may include hypertension, congenital heart disease, and hypertrophic cardiomyopathy. The aim of this study was to evaluate cardiac abnormalities in patients with NF1. METHODS: Sixty-five NF1 patients (mean age: 9±4.48 years) were retrospectively studied. Standard electrocardiography and echocardiography were performed in all patients. RESULTS: Cardiac abnormalities were found in 11 of the 65 patients (15...
December 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Michael Y C Tsang, Muaz M Abudiab, Naser M Ammash, Tasneem Z Naqvi, William D Edwards, Vuyisile T Nkomo, Patricia A Pellikka
BACKGROUND: Quadricuspid aortic valve (QAV) is a rare congenital cardiac defect. This study sought to determine QAV frequency in a large echocardiography database, to characterize associated cardiovascular abnormalities, and to describe long-term outcomes. METHODS AND RESULTS: Fifty patients (mean ± SD age, 43.5 ± 21.8 years at the time of the index diagnosis; female sex, 52%) received a diagnosis of QAV between January 1, 1975, and March 14, 2014 (frequency, 0...
January 19, 2016: Circulation
Tomohiko Taniguchi, Takeshi Morimoto, Hiroki Shiomi, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Makoto Miyake, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Kazuya Nagao, Tsukasa Inada, Tomoyuki Murakami, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Toshikazu Jinnai, Yuko Morikami, Ryuzo Sakata, Takeshi Kimura
BACKGROUND: Current guidelines generally recommend watchful waiting until symptoms emerge for aortic valve replacement (AVR) in asymptomatic patients with severe aortic stenosis (AS). OBJECTIVES: The study sought to compare the long-term outcomes of initial AVR versus conservative strategies following the diagnosis of asymptomatic severe AS. METHODS: We used data from a large multicenter registry enrolling 3,815 consecutive patients with severe AS (peak aortic jet velocity >4...
December 29, 2015: Journal of the American College of Cardiology
Michael O Murphy, Hannah Bellsham-Revell, Gareth J Morgan, Thomas Krasemann, Eric Rosenthal, Shakeel A Qureshi, Caner Salih, Conal B Austin, David R Anderson
BACKGROUND: Hybrid procedure offers patients with severe congenital heart disease an alternative initial procedure to conventional surgical reconstruction. We report the midterm outcomes of a cohort of neonates who had a hybrid procedure for variants of hypoplastic left heart syndrome because they were at high risk for the Norwood procedure. METHODS: Between December 2005 and January 2013, 41 neonates underwent bilateral pulmonary artery banding followed by ductal stenting by means of a sternotomy at a median age of 6 days (range, 2 to 18 days) and weight of 2...
December 2015: Annals of Thoracic Surgery
Andrew S Jack, Michael M Chow, Loretta Fiorillo, Thea Chibuk, Jerome Y Yager, Vivek Mehta
The acronym PHACE has been used to denote a constellation of abnormalities: posterior fossa anomalies, facial hemangiomas, arterial anomalies, cardiac anomalies, and eye abnormalities. Approximately 30% of patients with large facial hemangiomas have PHACE syndrome, with the vast majority having intracranial arteriopathy. Few reports characterize neurological deterioration from this intracranial arteriopathy, and even fewer report successful treatment thereof. The authors report on a case of a child with PHACE syndrome who presented with an ischemic stroke from a progressive intracranial arteriopathy and describe her successful treatment with bilateral pial synangiosis...
January 2016: Journal of Neurosurgery. Pediatrics
Adaya Weissler-Snir, Daniel Weisenberg, Sharon Natanzon, Tamir Bental, Mordehay Vaturi, Yaron Shapira, Daniel Monakier, Alik Sagie
Data regarding characteristics of young patients with mitral annular calcification (MAC) and its associations with other cardiovascular risk factors are scarce. Hence, we sought to characterize patients aged <50 years with MAC and to examine whether in these patients, MAC is also associated with cardiovascular risk factors. Consecutive patients who underwent an echocardiographic study were prospectively entered into a database. The database included clinical, laboratory, and echocardiographic parameters...
November 1, 2015: American Journal of Cardiology
Ja Kyoung Yoon, Kyung Jin Ahn, Bo Sang Kwon, Gi Beom Kim, Eun Jung Bae, Chung Il Noh, Jung Min Ko
PURPOSE: Kabuki syndrome is a multiple congenital malformation syndrome, with characteristic facial features, mental retardation, and skeletal and congenital heart anomalies. However, the cardiac anomalies are not well described in the Korean population. We analyzed the cardiac anomalies and clinical features of Kabuki syndrome in a single tertiary center. METHODS: A retrospective analysis was conducted for a total of 13 patients with Kabuki syndrome. RESULTS: The median age at diagnosis of was 5...
July 2015: Korean Journal of Pediatrics
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