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Diagnosis and follow-up for aortic stenosis

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https://www.readbyqxmd.com/read/28496512/takayasu-s-arteritis-presenting-with-headache-and-peripheral-facial-palsy-a-case-report
#1
Maryam Sotoudeh Anvari, Farzad Masoudkabir, Kyomars Abbasi, Mohammad Ali Boroumand, Manijeh Zarghampour, Hamidreza Goodarzynejad
Takayasu's arteritis (TA) is a rare case of granulomatous arteritis which mainly involves the aorta and its large branches. Although arterial hypertension is the most common feature of the disease in both adults and children, patients with TA may present with numerous clinical manifestations. Our patient was a 45-year-old woman, known to have hypertension from 3 years earlier following assessments made for severe headache. One year after the diagnosis of hypertension, she developed a left-sided lower motor neuron facial palsy, which was treated with oral corticosteroids (Prednisolone)...
October 3, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28483205/aortic-diameter-growth-in-children-with-a-bicuspid-aortic-valve
#2
Remy Merkx, Anthonie L Duijnhouwer, Evelien Vink, Jolien W Roos-Hesselink, Michiel Schokking
Knowledge of aortic growth in patients with bicuspid aortic valve (BAV) is essential to identify patients at risk for dissection, but data on children remain unclear. We retrospectively evaluated the aortic diameters of all pediatric BAV patients, identified through an echocardiographic database (2005 to 2013). Medical records were reviewed and aortic diameters re-measured on echocardiographic images at diagnosis and if available on variable mid- and endpoints follow-up. Dilatation (z-score >2) was based on 2 different z-score equation methods (Gautier/Campens)...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28458879/rare-cause-of-massive-lower-gastrointestinal-bleeding-due-to-primary-isolated-ilio-rectal-fistula
#3
Nuttapon Arpornsujaritkun, Chairat Supsamutchai, Wiwat Thirapanich, Pitichote Hiranyatheb, Namsiri Biadul
Massive lower gastrointestinal from primary isolated ilio-rectal fistula is a rare condition and difficult to diagnosis and emergency surgery for this situation has a high mortality rate. This report describes a successful operation in an 88-year-old man at present with massive lower gastrointestinal hemorrhage from ilio-rectal fistula and hypovolemic shock. Underlying diseases are prostate cancer, hypertension, dyslipidemia, aortic stenosis, mitral valve stenosis and chronic renal disease. Operative treatment is to explore laparotomy with internal iliac artery ligation and rectal resection...
April 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28377475/diagnosis-imaging-and-clinical-management-of-aortic-coarctation
#4
REVIEW
Elles J Dijkema, Tim Leiner, Heynric B Grotenhuis
Coarctation of the aorta (CoA) is a well-known congenital heart disease (CHD), which is often associated with several other cardiac and vascular anomalies, such as bicuspid aortic valve (BAV), ventricular septal defect, patent ductus arteriosus and aortic arch hypoplasia. Despite echocardiographic screening, prenatal diagnosis of CoA remains difficult. Most patients with CoA present in infancy with absent, delayed or reduced femoral pulses, a supine arm-leg blood pressure gradient (>20 mm Hg), or a murmur due to rapid blood flow across the CoA or associated lesions (BAV)...
April 4, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28377231/prevalence-and-impact-of-coexistent-bicuspid-aortic-valve-in-hypertrophic-cardiomyopathy
#5
Ratnasari Padang, Bernard J Gersh, Steve R Ommen, Jeffrey B Geske
BACKGROUND: The association between bicuspid aortic valve (BAV) and hypertrophic cardiomyopathy (HCM) has been reported but its true prevalence is unknown. This study investigated the prevalence and clinical impact of coexistent BAV in a large referral HCM population. METHODS: Retrospective analysis of 3765 echocardiograms between 2004 and 2014 in 2640 consecutive patients with HCM was performed to assess for BAV. Patients with coexistent conditions were studied...
March 8, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28270260/what-is-the-diagnostic-value-of-the-paediatric-exercise-tolerance-test-results-from-a-uk-centre
#6
Magdalena A Sajnach-Menke, Sarah C Walpole
Purpose The aim of this study was to determine whether the exercise tolerance test can provide diagnostic and prognostic information regarding children and young adults and help predict outcome. METHODS: A total of 87 patients, aged 7-29 years (median 13, mean 13.4) were selected retrospectively. They underwent exercise test at the Freeman Hospital from December, 2015 to May, 2016. There were two groups of patients - 46 had symptoms such as chest pain, palpitations, syncope, or dyspnoea on exertion and no cardiac diagnosis, and 40 patients had a cardiac diagnosis such as hypertrophic cardiomyopathy, transposition of the great arteries with post-arterial switch operation, aortic stenosis or regurgitation, tetralogy of Fallot, abnormal coronary arteries, Wolff-Parkinson-White syndrome, or supraventricular tachycardia...
March 8, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28254396/new-insights-on-tuberculous-aortitis
#7
Laure Delaval, Tiphaine Goulenok, Paul Achouh, David Saadoun, Julien Gaudric, Quentin Pellenc, Jean-Emmanuel Kahn, Nicoletta Pasi, Damien van Gysel, Patrick Bruneval, Thomas Papo, Karim Sacre
OBJECTIVE: Aortitis is an exceedingly rare manifestation of tuberculosis. We describe 11 patients with tuberculous aortitis (TA). METHODS: Multicenter medical charts of patients hospitalized between 2003 and 2015 with TA in Paris, France, were reviewed. Demographic, medical history, laboratory, imaging, pathologic findings, treatment, and follow-up data were extracted from medical records. TA was considered when aortitis was diagnosed in a patient with active tuberculosis...
February 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28217887/gastric-antral-vascular-ectasia-in-systemic-sclerosis-where-do-we-stand
#8
REVIEW
Hala El-Gendy, Kyrillus S Shohdy, Gehad G Maghraby, Kerolos Abadeer, Moustafa Mahmoud
Gastric antral vascular ectasia (GAVE) continues to be a challenge in both diagnosis and treatment. GAVE has a diverse group of associations and presumed causes, including cirrhosis, chronic renal failure and autoimmune connective tissue diseases. However, in most occasions, the management plan of GAVE itself is the same whatever the underlying disease by using Argon plasma coagulation (APC). Herein, we will discuss three cases of systemic sclerosis-associated GAVE presenting with either acute or chronic gastrointestinal bleeding showing variable responses to APC...
February 20, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28056819/quality-of-care-assessment-and-improvement-in-aortic-stenosis-rationale-and-design-of-a-multicentre-registry-impulse
#9
Norbert Frey, Richard P Steeds, Antonio Serra, Eberhard Schulz, Stephan Baldus, Matthias Lutz, Christiane Pohlmann, Jana Kurucova, Peter Bramlage, David Messika-Zeitoun
BACKGROUND: Severe aortic stenosis (AS) is a common, serious valve disease in which no effective medical therapy is available and, if not treated by intervention, has a 5-year survival of only 40-60%. Despite the availability of guidelines supporting the effective use of surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) to treat the majority of these patients, adherence to these guidelines in clinical practice is still unsatisfactory. Several recent studies have emphasised the necessity for improved communication between multidisciplinary teams, with the aim to ensure that severe AS patients receive appropriate treatment...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28052455/echocardiographic-follow-up-after-transcatheter-aortic-valve-replacement
#10
REVIEW
Vladislavs Sokalskis, Denisa Muraru, Chiara Fraccaro, Massimo Napodano, Augusto D'Onofrio, Giuseppe Tarantini, Luigi Paolo Badano
The use of transcatheter aortic valve replacement (TAVR) for high-risk patients with aortic stenosis has rapidly increased during the past years. Accordingly, more and more patients are referred for a follow-up echocardiographic study after TAVR. However, the echocardiographic evaluation of patients who underwent TAVR places specific demands on echocardiographers. Furthermore, TAVR may be associated with new types of complications, which are frequently unrecognized or underestimated due to lack of familiarity with the normal and pathological appearance of TAVR...
January 3, 2017: Echocardiography
https://www.readbyqxmd.com/read/28017933/20-years-experience-with-the-ross-operation-in-middle-aged-patients-the-autologous-principle-is-still-alive
#11
Francisco Diniz Affonso da Costa, Daniele Fornazari Colatusso, Eduardo Mendel Balbi Filho, Rafael Marchetti, Andreia Dumsch de Aragon Ferreira, Marise Brenner Affonso da Costa, Joao Gabriel Roderjan, Claudinei Colatusso
OBJECTIVES: Review our long-term results with the Ross operation in middle-aged patients. METHODS: Between 1995 and 2016, 129 consecutive patients (106 males); mean age (47.2 ± 5.2 years) underwent a Ross operation. Right ventricular outflow tract (RVOT) reconstruction was performed with cryopreserved (n = 45) or decellularized allografts (n = 84). Mean follow-up was 8.4 ± 5.3 years (0.1 -: 20.5 years). We analyzed early and late mortality, as well as valve related events and the need for reoperations...
December 25, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27989054/contribution-of-dobutamine-stress-echocardiography-to-the-diagnosis-and-prognosis-of-low-flow-low-gradient-aortic-stenosis
#12
Sílvia Aguiar Rosa, Luísa Moura Branco, Ana Galrinho, Guilherme Portugal, Joäo Abreu, Duarte Cacela, José Fragata, Rui Cruz Ferreira
BACKGROUND: Aortic valve replacement (AVR) is the treatment of choice in patients with severe symptomatic aortic stenosis (AS). Patients with a low left ventricular ejection fraction (LVEF) represent a challenge for evaluation and therapeutic decision. Dobutamine stress echocardiography (DSE) allows the distinction to be made between fixed low-flow/low-gradient (LF/LG) AS and pseudosevere AS. METHODS: Between 2001 and 2014 a retrospective analysis was conducted of patients who underwent DSE to investigate severe AS...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27903539/outcome-implication-of-aortic-valve-area-normalized-to-body-size-in-asymptomatic-aortic-stenosis
#13
MULTICENTER STUDY
Christophe Tribouilloy, Yohann Bohbot, Sylvestre Maréchaux, Nicolas Debry, Quentin Delpierre, Marcel Peltier, Momar Diouf, Michel Slama, David Messika-Zeitoun, Dan Rusinaru
BACKGROUND: Current guidelines define severe aortic stenosis in patients with aortic valve area normalized to body surface area (AVA/BSA) <0.6 cm(2)/m(2); yet, this cutoff has never been validated. Moreover, it is not known whether AVA normalization to other body size indexes allows improved outcome prediction. We aim to test the value of AVA normalized to body size for outcome prediction in asymptomatic aortic stenosis. METHODS AND RESULTS: We included 289 patients with asymptomatic aortic stenosis, preserved ejection fraction, and AVA<1...
November 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27903371/-impact-of-reduced-left-ventricular-ejection-fraction-on-all-cause-mortality-of-75-years-old-and-over-patients-with-moderate-to-severe-aortic-stenosis
#14
Z Li, Y Q Ye, M Y Wang, H Y Xu, S Y Teng, J Qian, W Wang, X Wang, Y J Wu
Objective: To evaluate the impact of left ventricular systolic dysfunction on all-cause mortality of 75 years old and over patients with moderate to severe aortic stenosis. Methods: Clinical data of 301 consecutive aged (≥75 years old) patients with a diagnosis of non-rheumatic moderate to severe aortic stenosis by echocardiography between January 1, 2008 and January 1, 2015 in our hospital were retrospectively analyzed. According to the LVEF, patients were divided into normal LVEF subjects and low LVEF subjects, and the low LVEF level was set at below 60%(≤60%(n=171)vs...
October 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27862233/transesophageal-echocardiographic-diagnosis-of-a-watchman-left-atrial-appendage-closure-device-thrombus-10-years-following-implantation
#15
Shariq Shamim, Anthony Magalski, Adnan K Chhatriwalla, Keith B Allen, Kenneth C Huber, Michael L Main
Left atrial appendage closure with the WATCHMAN device is an alternative to chronic oral anticoagulation for thromboembolic prophylaxis in atrial fibrillation patients. Left atrial device-related thrombus (DRT) has been described in the first year after implant with an incidence of ~6%. A 79-year-old man underwent WATCHMAN device placement in 2006. Routine protocol specified follow-up transesophageal echocardiograms (TEE) at 6 weeks, 6 months, and 1 year following implant showed no evidence for DRT or peri-device flow...
January 2017: Echocardiography
https://www.readbyqxmd.com/read/27741366/diverse-outcome-following-early-prenatal-diagnosis-of-pulmonary-stenosis
#16
M Bronshtein, Z Blumenfeld, A Khoury, A Gover
OBJECTIVE: To assess the natural history and outcome of fetal pulmonary stenosis (PS), particularly that detected at 14-17 weeks' gestation. METHODS: In this retrospective study we searched an electronic database of women from the general Israeli population attending a private ultrasound institute (Al-Kol ultrasound institute in Haifa) for routine complete early fetal ultrasound, including all fetal systems and a fetal echocardiogram, between 2004 and 2015. Ninety-seven percent of the women were at low risk of fetal malformations, and 3% had risk factors such as maternal Type-1 diabetes mellitus, exposure during pregnancy to teratogenic drugs, or anomalies in previous pregnancies or in other family members...
February 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27687067/prosthesis-patient-mismatch-after-aortic-valve-replacement
#17
REVIEW
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
https://www.readbyqxmd.com/read/27578128/clinical-and-molecular-characteristics-of-homozygous-familial-hypercholesterolemia-patients-insights-from-safeheart-registry
#18
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
https://www.readbyqxmd.com/read/27335656/severe-symptomatic-aortic-stenosis-medical-therapy-and-transcatheter-aortic-valve-implantation-tavi-a-real-world-retrospective-cohort-analysis-of-outcomes-and-cost-effectiveness-using-national-data
#19
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
https://www.readbyqxmd.com/read/27276896/usefulness-of-transesophageal-echocardiography-in-diagnosis-of-hemolytic-anemia-post-total-aortic-arch-replacement-using-the-elephant-trunk-technique
#20
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
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