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Heart valve replacement in the young

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https://www.readbyqxmd.com/read/28706868/tricuspid-valve-endocarditis
#1
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
#2
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
#3
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...
June 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28541520/cardiovascular-surgery-in-loeys-dietz-syndrome-types-1-4
#4
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...
May 24, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28520540/virtual-surgery-for-conduit-reconstruction-of-the-right-ventricular-outflow-tract
#5
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
#6
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
#7
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
#8
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...
March 7, 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
#9
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...
February 28, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28076623/low-cost-simulator-for-heart-surgery-training
#10
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
#11
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...
December 31, 2016: 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
#12
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
https://www.readbyqxmd.com/read/27855225/incidence-predictors-and-clinical-outcomes-of-postoperative-cardiac-tamponade-in-patients-undergoing-heart-valve-surgery
#13
Seng Chan You, Chi Young Shim, Geu-Ru Hong, Darae Kim, In Jeong Cho, Sak Lee, Hyuck-Jae Chang, Jong-Won Ha, Byung-Chul Chang, Namsik Chung
This study aimed to investigate the incidence, predictors, and clinical outcomes of cardiac tamponade after heart valve surgery. A total of 556 patients who underwent heart valve surgery in a single tertiary center between January 2010 and March 2012 were studied. All patients underwent transthoracic echocardiography (TTE) about 5 days after surgery and TTE was repeated regularly. Patients with suspected acute pericardial hemorrhage were excluded. Cardiac tamponade occurred in twenty-four (4.3%) patients and all underwent surgical or percutaneous pericardial drainage...
2016: PloS One
https://www.readbyqxmd.com/read/27756541/growth-and-maturation-of-heart-valves-leads-to-changes-in-endothelial-cell-distribution-impaired-function-decreased-metabolism-and-reduced-cell-proliferation
#14
Lindsey J Anstine, Chris Bobba, Samir Ghadiali, Joy Lincoln
Risk factors of heart valve disease are well defined and prolonged exposure throughout life leads to degeneration and dysfunction in up to 33% of the population. While aortic valve replacement remains the most common need for cardiovascular surgery particularly in those aged over 65, the underlying mechanisms of progressive deterioration are unknown. In other cardiovascular systems, a decline in endothelial cell integrity and function play a major role in promoting pathological changes, and while similar mechanisms have been speculated in the valves, studies to support this are lacking...
November 2016: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/27696730/the-future-of-heart-valve-replacement-recent-developments-and-translational-challenges-for-heart-valve-tissue-engineering
#15
REVIEW
Emanuela S Fioretta, Petra E Dijkman, Maximilian Y Emmert, Simon P Hoerstrup
Heart valve replacement is often the only solution for patients suffering from valvular heart disease. However, currently available valve replacements require either life-long anticoagulation or are associated with valve degeneration and calcification. Moreover, they are suboptimal for young patients, because they do not adapt to the somatic growth. Tissue-engineering has been proposed as a promising approach to fulfil the urgent need for heart valve replacements with regenerative and growth capacity. This review will start with an overview on the currently available valve substitutes and the techniques for heart valve replacement...
September 30, 2016: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/27621906/transcatheter-aortic-valve-implantation-in-a-young-heart-transplant-recipient-crossing-the-traditional-boundaries
#16
Khalil Ahmad, Christian Juhl Terkelsen, Kim Allan Terp, Ole Norling Mathiassen, Bjarne Linde Nørgaard, Henning Rud Andersen, Steen Hvitfeldt Poulsen
Transcatheter aortic valve implantation (TAVI) is an established therapeutic alternative to surgical aortic valve replacement (SAVR) in high-risk or inoperable patients with symptomatic aortic valve stenosis. Hitherto, TAVI is not recommended in young and low-intermediate risk patients. However, TAVI may also serve as an alternative to SAVR in selected young patients, e.g., patients who have previously undergone multiple cardiac surgery procedures. We report a case of trans-femoral TAVI in a 25-year-old heart transplant (HTx) recipient with prior surgery for congenital heart disease...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27610249/severe-bioprosthetic-mitral-valve-stenosis-and-heart-failure-in-a-young-woman-with-systemic-lupus-erythematosus
#17
Siddharth Wartak, Isaac Akkad, Adnan Sadiq, Gregory Crooke, Manfred Moskovits, Robert Frankel, Gerald Hollander, Jacob Shani
A 23-year-old African American woman with a past medical history of systemic lupus erythematous (SLE), secondary hypertension, and end stage renal disease (ESRD) on hemodialysis for eight years was stable until she developed symptomatic severe mitral regurgitation with preserved ejection fraction. She underwent a bioprosthetic mitral valve replacement (MVR) at outside hospital. However, within a year of her surgery, she presented to our hospital with NYHA class IV symptoms. She was treated for heart failure but in view of her persistent symptoms and low EF was considered for heart and kidney transplant...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27570204/planar-biaxial-testing-of-heart-valve-cusp-replacement-biomaterials-experiments-theory-and-material-constants
#18
Michel R Labrosse, Reza Jafar, Janet Ngu, Munir Boodhwani
OBJECTIVES: Aortic valve (AV) repair has become an attractive option to correct aortic insufficiency. Yet, cusp reconstruction with various cusp replacement materials has been associated with greater long-term repair failures, and it is still unknown how such materials mechanically compare with native leaflets. We used planar biaxial testing to characterize six clinically relevant cusp replacement materials, along with native porcine AV leaflets, to ascertain which materials would be best suited for valve repair...
November 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27547146/transcatheter-aortic-valve-in-valve-replacement-instead-of-a-4th-sternotomy-in-a-21-year-old-woman-with-aortic-homograft-failure
#19
José G Díez, Michael Schechter, Kathryn G Dougherty, Ourania Preventza, Joseph S Coselli
Transcatheter aortic valve replacement (TAVR) is a well-established method for replacing native aortic valves; however, it was conceived for elderly patients with aortic valve stenosis, and the lack of data on long-term durability has led practitioners to restrict the use of TAVR to patients who have short life expectancies. Here, we describe the case of a 21-year-old woman who had undergone 3 previous open aortic valve replacements and who presented with symptoms of recurrent valvular failure. Transthoracic echocardiograms and computed tomographic angiograms revealed a degenerating aortic root homograft with substantial calcification, moderate-to-severe aortic valve stenosis, and severe aortic valve regurgitation...
August 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/27530875/fortune-or-misfortune-asymptomatic-delayed-presentation-of-complete-dehiscence-of-mechanical-aortic-valve-conduit-and-pseudoaneurysm
#20
Kyung Taek Oh, Joseph Derose, Cynthia Taub
Complete dehiscence of a composite aortic valve graft with pseudoaneurysm formation is a rare complication following aortic root replacement. This complication often takes place in the setting of acute graft infection and accompanies symptoms of heart failure, valve insufficiency or sepsis. We present a delayed, asymptomatic presentation of this complication in a young man with distant history of aortic root replacement and medically treated prosthetic valve endocarditis a year postoperatively. He had been non-adherent to warfarin over 10 years, but otherwise maintained a healthy life...
August 16, 2016: BMJ Case Reports
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