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Prosthetic valve rheumatic heart disease children

Hasim Olgun, Mustafa Buyukavci, Naci Ceviz, Irfan Oguz Sahin, Zuhal Keskin Yildirim, Abdurrahim Colak, Kadir Serafettin Tekgunduz, Ibrahim Caner
Thrombotic events may complicate the clinical course of many pediatric diseases. Drugs for therapeutic thrombolysis include streptokinase, urokinase and tissue plasminogen activator (t-PA). There is less experience with recombinant t-PA (rt-PA) in children. We aimed to present our experiences with rt-PA in children with intracardiac or peripheral arterial thrombus. We retrospectively reviewed the children who received rt-PA for thrombus. Twenty-two children (13 boys, 9 girls; age range: 1 day-17 years) with intracardiac (n = 5), prosthetic heart valve (n = 2) and peripheral arterial (n = 15) thrombus were evaluated...
October 2014: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
JaBaris D Swain, Daniel N Pugliese, Joseph Mucumbitsi, Emmanuel K Rusingiza, Nathan Ruhamya, Abel Kagame, Gapira Ganza, Patricia C Come, Suellen Breakey, Bonnie Greenwood, Jochen D Muehlschlegel, Cecilia Patton-Bolman, Agnes Binagwaho, R Morton Bolman
IMPORTANCE: Rheumatic heart disease (RHD) in the developing world results in critical disability among children, adolescents, and young adults-marginalizing a key population at its peak age of productivity. Few regions in sub-Saharan Africa have independently created an effective strategy to detect and treat streptococcal infection and mitigate its progression to RHD. OBJECTIVE: We describe a unique collaboration, where the Rwanda Ministry of Health, the Rwanda Heart Foundation, and an expatriate humanitarian cardiac surgery program have together leveraged an innovative partnership as a means to expand Rwanda's current capacity to address screening and primary prevention, as well as provide life-saving cardiac surgery for patients with critical RHD...
September 2014: World Journal of Surgery
Nigel Wilson
Rheumatic fever continues unabated among the indigenous Māori and Pacific Island New Zealanders. Ethnic disparities have increased in the past decade. The major success story for disease control has been secondary penicillin prophylaxis with 28-day intramuscular benzathine penicillin with high penicillin delivery rates and low recurrence rates. A landmark study for primary prevention of acute rheumatic fever for group A streptococcal pharyngitis was published in 2009. New Zealand has helped establish the role of echocardiography in acute rheumatic fever, with subclinical carditis incorporated into guidelines as a major criterion of rheumatic fever in high prevalence regions...
May 2010: Heart, Lung & Circulation
Walkiria Samuel Avila, Ana Maria Milani Gouveia, Pablo Pomerantzeff, Maria Rita Lemos Bortolotto, Max Grinberg, Noedir Stolf, Marcelo Zugaib
BACKGROUND: Cardiac surgery improves the maternal prognosis in cases refractory to medical therapy. However, it is associated with risks to the fetus when performed during pregnancy. OBJECTIVE: To analyze maternal-fetal outcome and prognosis related to cardiac surgery performed during pregnancy and puerperium. METHODS: The outcome of 41 gestations of women undergoing cardiac surgery during pregnancy and puerperium was studied. Fetal cardiotocography was performed throughout the procedure in patients with gestational age above 20 weeks...
July 2009: Arquivos Brasileiros de Cardiologia
Michael D Day, Kimberlee Gauvreau, Stanford Shulman, Jane W Newburger
BACKGROUND: Infective endocarditis in children is rare, and most reports describe the experience in referral centers. The purpose of our study was to assess the characteristics of children with infective endocarditis in a large national sample. METHODS AND RESULTS: We analyzed hospital discharge records with International Classification of Diseases, ninth revision, codes indicating infective endocarditis among admissions of patients <21 years of age in the Kids' Inpatient Databases 2000 and 2003; analyses for the 2 years were combined...
February 17, 2009: Circulation
Chao-zhong Long, Xin-min Zhou, Jian-guo Hu, Bang-liang Yin, Yi-feng Yang, Feng Liu, Jin-fu Yng
OBJECTIVE: To summarize the experience in prosthetic valve replacement in pediatric patients. METHODS: The clinical data of consecutive 105 children, 63 male and 42 female, aged 13 +/- 3 (1.5-16), with the underlying diseases of rheumatic heart disease (n = 55), congenital heart diseases (n = 43), and infective endocarditis (n = 5), with the preoperative cardiac function of class II (n = 36), or class III or IV (n = 69), who underwent prosthetic valve replacement, including replacement of mitral valve (n = 58), aortic valve (n = 28), tricuspid valve (n = 5), mitral and aortic valves (n = 13), and mitral and tricuspid valves (n = 1), and tricuspid valvuloplasty (n = 26), from May 1984 to May 2004, were respectively analyzed...
July 13, 2005: Zhonghua Yi Xue za Zhi [Chinese medical journal]
José Fragata, Pedro Coelho, Nuno Banazol, Graça Nogueira, Conceição Trigo
BACKGROUND: Valve surgery in children is aimed at restoring correct hemodynamics with few reoperations and limited resort to prostheses, which would imply early deterioration or definitive hypocoagulation. OBJECTIVES: Report a series of paediatric pts with acquired mitral valve disease, mostly due to rheumatic disease, in whom it was possible, for the great majority, to repair the damaged valve. DEMOGRAPHICS: Fifty children with predominant mitral valve disease, 47 rheumatic (94%) and 3 after endocarditis were consequently operated by the same surgical team over the last five years...
October 2004: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Fatemeh Kojori, Rui Chen, Christopher A Caldarone, Sandra L Merklinger, Anthony Azakie, William G Williams, Glen S Van Arsdell, John Coles, Brian W McCrindle
OBJECTIVE: We sought to define patient characteristics, outcomes, and associated factors after mitral valve replacement in children. METHODS: We included 104 children undergoing at least one mitral valve replacement between 1980 and 2003 and reviewed clinical records. Competing-risks methodology was used to determine time-related prevalence and associated risk factors after initial mitral valve replacement for death and repeat replacement. RESULTS: The underlying mitral valve disease was congenital in 83%, rheumatic in 13%, Marfan syndrome in 3%, and isolated endocarditis in 1%, with 64% having primarily regurgitation, 16% having stenosis, 20% having both, and 32% having undergone previous valvotomy, valvuloplasty, or repair...
November 2004: Journal of Thoracic and Cardiovascular Surgery
C Alexiou, M Galogavrou, Q Chen, A McDonald, A P Salmon, B K Keeton, M P Haw, J L Monro
OBJECTIVE: The purpose of this study was to assess the early and late outcome following mitral valve replacement (MVR) with mechanical prostheses in children. PATIENTS AND METHODS: Between 1981 and 2000, 44 consecutive children (mean age 6.8+/-4.7 years, 2 months--16 years) underwent mechanical MVR in Southampton. Twenty-three children were less than 5-years-old and nine were infants. Disease aetiology was congenital in 37, rheumatic in four, infective in two and Marfan's syndrome in one...
July 2001: European Journal of Cardio-thoracic Surgery
E Sharoni, J Katz, O Dagan, A Lorber, R Hirsch, L C Blieden, B A Vidne, E Birk
BACKGROUND: The need for aortic valve replacement in children and young adults poses a special problem to cardiologists and surgeons. Replacing the sick aortic valve with the patient's pulmonary valve as described by Ross has proven to be a good option in this special age group. OBJECTIVE: To review our initial experience in order to assess the short-term results. METHODS: From January 1996 to June 1999, 40 patients (age 8 months to 41 years) underwent aortic valve replacement with pulmonary autograft...
February 2000: Israel Medical Association Journal: IMAJ
C Alexiou, A McDonald, S M Langley, M J Dalrymple-Hay, M P Haw, J L Monro
OBJECTIVE: The choice of the most appropriate substitute in children with irreparable aortic valve lesions remains controversial. The aim of this study was to assess early and late outcomes following aortic valve replacement (AVR) with mechanical prostheses in children. PATIENTS: Fifty-six patients (42 male, 14 female, mean age 11.2, range 1-16 years) undergoing AVR with mechanical prostheses between October 1972 and January 1999 were evaluated. Thirty-six patients (64...
February 2000: European Journal of Cardio-thoracic Surgery
M D Plunkett, D J Schneider, J J Shah, S E Bash, L M Bond, D M Geiss
BACKGROUND: Recent reports have demonstrated successful early outcomes using mitral valve homografts in adults. We report our early results after homograft mitral valve replacement in 4 children with previous atrioventricular septal defects, previous placement of a prosthetic valve, and rheumatic valvular disease. METHODS: Between May 1996 and June 1997, 4 children (ages 5, 11, 13, and 15 years) underwent mitral valve replacement with cryopreserved mitral valve homografts at our institution...
September 1998: Annals of Thoracic Surgery
K A Al Jubair, A Jaralla, M Fadala, E Bukhari, Y Al Faraidi, H Al Qethami, M R Al Fagih
Between January 1985 and April 1994, 42 children aged between 7 and 14 years (mean 11.3 years) underwent repair of severely incompetent rheumatic mitral valves with no accompanying mitral stenosis. In 19 patients the tricuspid valve was severely incompetent, while 8 patients had severe aortic incompetence. Overall, the repair incorporated shortening of elongated tendinous cords and insertion of a Duran or Carpentier prosthetic ring. The repair was the sole procedure in 15 patients, whilst 19 patients also had a De Vega tricuspid valvar annuloplasty and 8 had repair or replacement of the aortic valve...
January 1998: Cardiology in the Young
A Buendía-Hernández, F Attié, C Zabal, A Juárez, J García-Bedoy, E Patiño
OBJECTIVE: To present our experience in 58 children (37 female, 21 male) aged 4 to 18 years (mean +/- SD = 14.9 +/- 2.7) with rheumatic mitral valve disease who underwent surgical reconstruction. METHODS: They were divided in four groups according to the abnormalities of the mitral apparatus: Group I had mitral regurgitation due to lesions located in the valvar structures with normal valvar movement (n = 1, 2%), group II mitral regurgitation with lesions located mainly in subvalvular structures with valve prolapse (n = 11, 19%), group III with mitral regurgitation due to lesion located both in valvular and subvalvular structures and restricted valvar motion (n = 38, 65%), and group IV included patients with stenosis (n = 8, 14%)...
September 1996: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
R A Kalil, F A Lucchese, P R Prates, J R Sant'Anna, F C Faes, E Pereira, I A Nesralla
OBJECTIVES: The aim of this study was to evaluate medium- and long-term (range 4 months to 17 years) clinical results in a series of patients treated surgically by unsupported mitral annuloplasty. BACKGROUND: Mitral valve regurgitation has usually been treated by valve replacement or ring annuloplasty. A few series have reported plastic repair procedures without annular support or remodeling. Furthermore, in rheumatic lesions the results have been inferior to those in degenerative mitral insufficiency, and the majority of previous reports have provided information on short- or medium-term follow-up...
December 1993: Journal of the American College of Cardiology
C Vosa, A Renzulli, P F Lombardi, G Damiani
Despite improving surgical techniques, treatment of heart valve disease in children remains controversial. Growth of the child and adequate anticoagulation level are the main concerns when valve replacement is performed in the pediatric age. We reviewed the case histories of 29 children who underwent valve replacement with mechanical prosthesis from 1979 to 1994 in order to evaluate the performance of mechanical valves in this age group. Age ranged from two years to 12 years (mean 8.97 +/- 3.7 years). A total of 31 valves were implanted; 17 children had atrioventricular (Av) valve replacement (15 mitral, one common Av (heterotaxia), one tricuspid (systemic ventricle)), 11 children had aortic valve replacement (one redo), and one child had double mitral and aortic valves implanted...
May 1995: Journal of Heart Valve Disease
F Joyce, J Tingleff, G Pettersson
During the past 2.5 years, 50 Ross operations have been performed at Rigshospitalet in Copenhagen in a broad range of patients with aortic valve disease including children and adults from 6 weeks to 71 years of age. Many patients had complicating conditions including endocarditis (n = 13, eight native, five prosthetic valve), prosthetic valve dysfunction (n = 4), subvalvular obstruction (n = 3) treated by septal myectomy (n = 1) or modified Konno operation (n = 2), ascending aortic aneurysm (n = 2), ventricular septum defect (n = 1), mitral valve disease (n = 6), rheumatic heart disease (n = 4), coronary artery disease (n = 1), and extreme obesity (n = 1)...
July 1995: Journal of Heart Valve Disease
C A Curcio, P J Commerford, A G Rose, J E Stevens, M S Barnard
In a series of 568 patients with glutaraldehyde-preserved porcine xenografts followed for up to 3 1/2 years, calcification and stenosis of the xenograft has proved to be an important cause of valve failure. We have seen this complication only in children and adolescents. Seven of 54 patients under 16 years of age at the time of initial operation have required reoperation for calcification and prosthetic stenosis. Three patients who died had calcified, stenosed prosthesis at autopsy. The calcification has involved all of the cusps of the affected prostheses, and the calcified area often was enclosed by a superficial layer of noncalcified cuspidal tissue...
April 1981: Journal of Thoracic and Cardiovascular Surgery
E G Benmimoun, B Friedli, W Rutishauser, B Faidutti
Haemodynamic variables and left ventricular function were studied before and after mitral valve replacement in 44 children age 3 to 17 years (mean 11.9 years). Thirty-nine Starr-Edwards prostheses and five Hancock prostheses were used; postoperative study took place two to six months (mean 3.9 months) after operation. Pulmonary hypertension was present preoperatively in most patients, with mean pulmonary artery pressures of 18 to 75 (mean 46.5 mmHg). Postoperatively there was a pronounced drop in pressure to a mean value of 25...
August 1982: British Heart Journal
K S Iyer, K S Reddy, I M Rao, P Venugopal, M L Bhatia, N Gopinath
Prosthetic valve replacement in young patients has been reported to be associated with a high mortality and morbidity because of valve-related problems. Of 549 patients undergoing valve replacement with the Björk-Shiley valve prosthesis, 136 were under the age of 20 years. Sixty-four patients were under 16 years of age, the youngest being 6 years old. Of the 136 patients, 61 underwent mitral valve replacement, 50 received an aortic valve, and 25 received both aortic and mitral valves. Overall operative mortality was 10...
August 1984: Journal of Thoracic and Cardiovascular Surgery
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