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Heart valve replacement in the young

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https://www.readbyqxmd.com/read/29674478/quadruple-valve-replacement-in-a-patient-with-severe-rheumatic-heart-disease
#1
Isaac Adembesa, Adriaan Myburgh, Justiaan Swanevelder
INTRODUCTION: RHD is the leading cause of cardiovascular morbidity and mortality among young people. TOE is valuable in confirming valvular heart pathology. DISCUSSION: We present a patient with severe rheumatic heart disease involving all the heart valves. TOE confirmed severe mitral stenosis, severe aortic regurgitation, severe tricuspid regurgitation and stenosis and severe pulmonary stenosis. This was consistent with TTE findings preoperatively. The patient underwent successful quadruple valve replacement in a single operation...
April 19, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29539266/optimizing-glutaraldehyde-fixed-tissue-heart-valves-with-chondroitin-sulfate-hydrogel-for-endothelialization-and-shield-against-deterioration
#2
Mario Lopez-Moya, Pedro Melgar-Lesmes, Kumaran Kolandaivelu, Jose Maria de la Torre Hernandez, Elazer R Edelman, Mercedes Balcells
Porcine glutaraldehyde-fixed pericardium is widely used to replace human heart valves. Despite the stabilizing effects of glutaraldehyde fixation, the lack of endothelialization and the occurrence of immune reactions contribute to calcification and structural valve deterioration, which is particularly significant in young patients where valve longevity is crucial. This report shows an optimization system to enhance endothelialization of fixed pericardium to mimic the biological function of a native heart valve...
March 14, 2018: Biomacromolecules
https://www.readbyqxmd.com/read/29415382/one-year-outcomes-after-rapid-deployment-aortic-valve-replacement
#3
Christopher Young, Günther Laufer, Alfred Kocher, Marco Solinas, Francesco Alamanni, Gianluca Polvani, Bruno K Podesser, Jose Ignacio Aramendi, Jose Arribas, Olivier Bouchot, Ugolino Livi, Massimo Massetti, Kim Terp, Christophe Giot, Mattia Glauber
OBJECTIVE: The goals of rapid-deployment aortic valve replacement include facilitation of minimally invasive surgery and reduced aortic crossclamp time. We report the short-term outcomes of a series of 493 patients undergoing rapid-deployment aortic valve replacement with the EDWARDS INTUITY valve system (Edwards Lifesciences, LLC, Irvine, Calif). METHODS: Assessing Standard oF Care and Clinical Outcomes UsiNg the EDWARDS INTUITY VAlve SysTem in a European multI-center, Active, pOst-market surveillaNce Study was a prospective, multicenter (n = 26) European registry designed to evaluate the safety and performance of the valve system...
February 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29390335/fever-of-unknown-origin-and-splenomegaly-a-case-report-of-blood-culture-negative-endocarditis
#4
Maria Livia Burzo, Mariangela Antonelli, Giovanni Pecorini, Angela M R Favuzzi, Raffaele Landolfi, Andrea Flex
RATIONALE: Fever of unknown origin (FUO) can be determined by different conditions among which infectious diseases represent the main cause. PATIENT CONCERNS: A young woman, with a history of aortic stenosis, was admitted to our unit for a month of intermittent fever associated with a new diastolic heart murmur and splenomegaly. Laboratory tests were negative for infectious screening. The total body computed tomography (CT) scan excluded abscesses, occulted neoplasia, or lymphadenopathy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29100642/medium-term-outcomes-after-implantation-of-expanded-polytetrafluoroethylene-valved-conduit
#5
Yoshio Ootaki, Allison S Welch, Michael J Walsh, Michael D Quartermain, Derek A Williams, Ross M Ungerleider
BACKGROUND: Pulmonary valve replacement is becoming the most frequent congenital heart surgery performed on adolescents and young adults. Numerous surgical options are available, including autologous pericardium, mechanical valves, allografts, and bioprosthetic valves. Each option has limitations with durability and freedom from reintervention for stenosis or insufficiency, particularly in the pediatric population. The purpose of this study was to analyze our uniquely designed, expanded polytetrafluoroethylene (ePTFE) valved conduit (VC) for right ventricular outflow tract reconstruction...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29029949/mitral-valve-replacement-using-carpentier-edwards-pericardial-bioprosthesis-in-patients-with-rheumatic-heart-disease-aged-below-40-years-17-year-results
#6
Ujjwal Kumar Chowdhury, Adil Rizvi, Rajeev Narang, Sandeep Seth, Mani Kalaivani, Suruchi Hasija, Lakshmi Kumari
BACKGROUND: This study was designed to evaluate patients aged less than 40 years implanted with tissue heart valves with respect to survival, thromboembolism, structural degeneration and quality of life. METHODS: Between January, 2000 and December, 2016, 132 patients (51 males) with rheumatic heart disease underwent mitral valve replacement using Carpentier-Edwards, perimount, pericardial bioprostheses. The patients' ages ranged between 12 and 39 years (mean±SD 30...
August 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28926643/skin-perfusion-pressure-as-an-indicator-of-tissue-perfusion-in-valvular-heart-surgery-preliminary-results-from-a-prospective-observational-study
#7
Young Song, Sarah Soh, Jae-Kwang Shim, Kyoung-Un Park, Young-Lan Kwak
Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28914661/percutaneous-aortic-leak-closure-in-a-small-and-frail-annulus-after-double-heart-valve-replacement
#8
Guglielmo Saitto, Paolo Nardi, Gian P Ussia, Domenico Sergi, Paolo Prati, Marco Russo, Francesco Romeo, Giovanni Ruvolo
: Paravalvular leak (PVL) is an uncommon but serious complication associated with the implantation of prosthetic valves. Following aortic valve replacement, up to 5% of patients affected by PVL develop clinical symptoms of heart failure, hemolysis or both. Percutaneous treatment of PVL has emerged instead of conventional surgery, as a well tolerated and less invasive procedure but remains a challenge. We present the case of a young woman with mechanical aortic and mitral prostheses, who presented surgical aortic PVL caused by a serious frailty of native annulus, became symptomatic after 5 months and was successfully percutaneously treated with an Amplatzer Duct Occluder device...
November 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28706868/tricuspid-valve-endocarditis
#9
Syed T Hussain, James Witten, Nabin K Shrestha, Eugene H Blackstone, Gösta B Pettersson
Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (IE), encompassing only 5-10% of cases of IE. Ninety percent of RSIE involves the tricuspid valve (TV). Given the relatively small numbers of TVIE cases operated on at most institutions, the purpose of this review is to highlight and discuss the current understanding of IE involving the TV. RSIE and TVIE are strongly associated with intravenous drug use (IVDU), although pacemaker leads, defibrillator leads and vascular access for dialysis are also major risk factors...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28698799/adults-with-repaired-tetralogy-low-mortality-but-high-morbidity-up-to-middle-age
#10
Mark Dennis, Ben Moore, Irina Kotchetkova, Lynne Pressley, Rachael Cordina, David S Celermajer
OBJECTIVE: Survival of patients with repaired tetralogy of Fallot (rToF) into young adulthood is very good. Concerns exist, however, over long-term morbidity and mortality as these subjects reach middle age. We aimed to assess survival and the prevalence of complications in patients with rToF seen in our Adult Congenital Heart Disease (ACHD) service. METHODS: One hundred and sixty-eight consecutive patients with 'simple rToF', aged over 16 years, followed up at our tertiary-level ACHD service in Sydney, Australia since 2000, were included...
2017: Open Heart
https://www.readbyqxmd.com/read/28623384/the-role-of-cardiopulmonary-exercise-testing-for-decision-making-in-patients-with-repaired-tetralogy-of-fallot
#11
REVIEW
Frederic Dallaire, Rachel M Wald, Ariane Marelli
Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. As a result of the surgical strategies employed at the time of initial repair, chronic pulmonary regurgitation (PR) is prevalent in this population. Despite sustained research efforts, patient selection and timing of pulmonary valve replacement (PVR) to address PR in young asymptomatic patients with repaired tetralogy of Fallot (rToF) remain a fundamental but as yet unanswered question in the field of congenital heart disease...
August 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28541520/cardiovascular-surgery-in-loeys-dietz-syndrome-types-1-4
#12
Kirsten Krohg-Sørensen, Per Snorre Lingaas, Runar Lundblad, Egil Seem, Benedicte Paus, Odd R Geiran
OBJECTIVES: The first publication of Loeys-Dietz syndrome (LDS) described aortic rupture at young ages. Experience with new LDS types showed that the clinical course varies, and thresholds for prophylactic surgery are discussed. As this is an uncommon disease, experience needs to be shared. METHODS: Retrospective review of patients with LDS types 1-4 undergoing cardiovascular surgery during the years 1991-2016. RESULTS: Thirty-five patients (including 6 children with LDS2) underwent 57 operations...
December 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28520540/virtual-surgery-for-conduit-reconstruction-of-the-right-ventricular-outflow-tract
#13
Chin Siang Ong, Yue-Hin Loke, Justin Opfermann, Laura Olivieri, Luca Vricella, Axel Krieger, Narutoshi Hibino
PURPOSE: Virtual surgery involves the planning and simulation of surgical reconstruction using three-dimensional (3D) modeling based upon individual patient data, augmented by simulation of planned surgical alterations including implantation of devices or grafts. Here we describe a case in which virtual cardiac surgery aided us in determining the optimal conduit size to use for the reconstruction of the right ventricular outflow tract. DESCRIPTION: The patient is a young adolescent male with a history of tetralogy of Fallot with pulmonary atresia, requiring right ventricle-to-pulmonary artery (RV-PA) conduit replacement...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28481746/aortic-valve-myxoma-in-a-young-man-a-case-report-and-review-of-literature
#14
Zhenchun Ji, Longgang Wang, Jiacheng Sun, Wenxue Ye, Yunsheng Yu, Haoyue Huang, Yanqiu Hu, Ziying Yang, Zhenya Shen
Myxoma is the most commonly found cardiac primary tumor. The left atrium is the most common localization of myxoma, followed by the right atrium. However, it is rare in the left and right ventricles. Myxoma originating from cardiac valves is extremely rare. This article presents a case of a 17-year-old male who was admitted due to heart murmur for one year. Transthoracic echocardiography indicated a 1.9 cm round solid mass in the left ventricular outflow tract. Excision surgery and aortic valve replacement were performed in this patient...
April 30, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28434910/the-composition-and-biomechanical-properties-of-human-cryopreserved-aortas-pulmonary-trunks-and-aortic-and-pulmonary-cusps
#15
Tereza Kubíková, Petra Kochová, Jan Brázdil, Jaroslav Špatenka, Jan Burkert, Milena Králíčková, Zbyněk Tonar
Human cryopreserved allografts of pulmonary and aortic heart valves, aortas and pulmonary trunks are used for valve replacement. However, it is unknown how the composition of these allografts relate to their mechanical properties. Our aims were to correlate the histological compositions and passive mechanical properties of aortic and pulmonary valves and to observe the microcracks of aortas and pulmonary trunks. The following parameters were quantified: ultimate stress; ultimate strain; Young's modulus of elasticity; valve cusp wall thickness; pulmonary and aortic intima-media thickness; area fraction of elastin, collagen and calcification; and length density of elastic fibres...
April 21, 2017: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/28283226/differential-impact-of-net-atrioventricular-compliance-on-clinical-outcomes-in-patients-with-mitral-stenosis-according-to-cardiac-rhythm
#16
In-Jeong Cho, Hyuk-Jae Chang, Soo Yeon Lee, Chi Young Shim, Geu-Ru Hong, Namsik Chung
BACKGROUND: Net atrioventricular compliance (Cn), a parameter for the net compliance of the left atrium and left ventricle, is known to be a useful predictor of outcomes in patients with mitral stenosis (MS). The present study aimed to evaluate whether the impact of Cn on symptom status and clinical outcomes, as well as its contribution toward systolic pulmonary artery pressure (SPAP), differed according to cardiac rhythm. METHODS: We retrospectively reviewed patients (N = 308) with rheumatic pure MS...
June 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28247199/cost-effectiveness-of-genotype-guided-warfarin-dosing-in-patients-with-mechanical-heart-valve-replacement-under-the-fee-for-service-system
#17
Dong-Jin Kim, Ho-Sook Kim, Minkyung Oh, Eun-Young Kim, Jae-Gook Shin
BACKGROUND: Although studies assessing the cost effectiveness of genotype-guided warfarin dosing for the management of atrial fibrillation, deep vein thrombosis, and pulmonary embolism have been reported, no publications have addressed genotype-guided warfarin therapy in mechanical heart valve replacement (MHVR) patients or genotype-guided warfarin therapy under the fee-for-service (FFS) insurance system. OBJECTIVE: The aim of this study was to evaluate the cost effectiveness of genotype-guided warfarin dosing in patients with MHVR under the FFS system from the Korea healthcare sector perspective...
October 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28076623/low-cost-simulator-for-heart-surgery-training
#18
Roberto Rocha e Silva, Artur Lourenção, Maxim Goncharov, Fabio B Jatene
Objective: Introduce the low-cost and easy to purchase simulator without biological material so that any institution may promote extensive cardiovascular surgery training both in a hospital setting and at home without large budgets. Methods: A transparent plastic box is placed in a wooden frame, which is held by the edges using elastic bands, with the bottom turned upwards, where an oval opening is made, "simulating" a thoracotomy. For basic exercises in the aorta, the model presented by our service in the 2015 Brazilian Congress of Cardiovascular Surgery: a silicone ice tray, where one can train to make aortic purse-string suture, aortotomy, aortorrhaphy and proximal and distal anastomoses...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28049599/effective-orifice-area-during-exercise-in-bileaflet-mechanical-valve-prostheses
#19
Philippe B Bertrand, Matteo Pettinari, Hélène De Cannière, Herbert Gutermann, Christophe J P Smeets, David Verhaert, Robert A Dion, Pascal Verdonck, Pieter M Vandervoort
BACKGROUND: The aims of this study were to investigate the evolution of the transprosthetic pressure gradient and effective orifice area (EOA) during dynamic bicycle exercise in bileaflet mechanical heart valves and to explore the relationship with exercise capacity. METHODS: Patients with bileaflet aortic valve replacement (n = 23) and mitral valve replacement (MVR; n = 16) prospectively underwent symptom-limited supine bicycle exercise testing with Doppler echocardiography and respiratory gas analysis...
April 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27895692/impact-of-postoperative-duration-of-aspirin-use-on-longevity-of-bioprosthetic-pulmonary-valve-in-patients-who-underwent-congenital-heart-disease-repair
#20
Tae-Woong Hwang, Sung-Ook Kim, Sang-Yun Lee, Seong-Ho Kim, Eun-Young Choi, So-Ick Jang, Su-Jin Park, Hye-Won Kwon, Hyo-Bin Lim, Chang-Ha Lee, Eun-Seok Choi
PURPOSE: Generally, aspirin is used as a protective agent against thrombogenic phenomenon after pulmonary valve replacement (PVR) using a bioprosthetic valve. However, the appropriate duration of aspirin use is unclear. We analyzed the impact of postoperative duration of aspirin use on the longevity of bioprosthetic pulmonary valves in patients who underwent repair for congenital heart diseases. METHODS: We retrospectively reviewed the clinical data of 137 patients who underwent PVR using a bioprosthetic valve between January 2000 and December 2003...
November 2016: Korean Journal of Pediatrics
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