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Prosthetic heart valve size

Andre Paixao, Mehmet Cilingiroglu
Paravalvular leak (PVL) remains as uncommon but serious complication after surgical prosthetic valve implantation. PVL when associated which congestive heart failure, hemolytic anemia, or infective endocarditis may require percutaneous treatment. High-surgical risk is common in this population. Dedicated PVL devices are lacking often limiting optimal treatment.
October 2016: Catheterization and Cardiovascular Interventions
Matthew Moore, Glenn R Barnhart, Walter Randolph Chitwood, John A Rizzo, Candace Gunnarsson, Swetha R Palli, Eugene A Grossi
OBJECTIVE: The recent development of the EDWARDS INTUITY Elite™ (EIE) valve system enables the rapid deployment of a prosthetic surgical heart valve in an aortic valve replacement (AVR) procedure via both the minimally invasive (MISAVR) and conventional (CAVR) approaches. In order to understand its economic value, this study performed a cost evaluation of the EIE valve system used in a MIS rapid-deployment approach (MIS-RDAVR) vs MISAVR and CAVR, respectively, compared to standard prosthetic aortic valves...
October 2016: Journal of Medical Economics
Khadija Aman
BACKGROUND: Mechanical prosthetic heart valves have been used for many decades to replace damaged native valves. Guidelines mandate the use of anticoagulant therapy in patients with mechanical prosthetic valves of any type, irrespective of the position in the heart. The rationale for this is to prevent valve thrombosis and thromboembolic complications without increasing the risk of excess bleeding. We report a case involving a patient with a functioning aortic mechanical valve without any anticoagulation therapy for 33 years...
2016: Journal of Medical Case Reports
Sean I Tracy, Sherry-Ann Brown, John T Ratelle, Anjali Bhagra
A 59-year-old man was admitted with a 3-month history of daily fevers as well as bilateral knee pain and swelling. Medical history was significant for bilateral knee arthroplasties 4 years prior to admission. Two sets of peripheral blood cultures as well as bilateral knee synovial fluid grew Enterococcus faecalis within 10 hours. Transoesophageal echocardiography revealed aortic and mitral valve vegetations suggestive of infectious endocarditis, with severe regurgitation secondary to large size. The patient's hospitalisation was complicated by acute heart failure, necessitating emergent mitral valve repair and aortic valve replacement, followed shortly thereafter by bilateral total knee arthroplasty resection with placement of antibiotic spacers...
2016: BMJ Case Reports
Yeşim Güray, Esra Gücük İpek, Burak Acar, Mevlüt Serdar Kuyumcu, Fatih Uçar, Habibe Kafes, Lale Asırcıklı, Gizem Çabuk, Burcu Demirkan, Ümit Güray
OBJECTIVE: Prosthetic valve endocarditis (PVE) is associated with increased mortality and morbidity. Information regarding the long-term outcome of PVE is scarce in Turkey. The aim of this study was to evaluate long-term mortality rates of PVE and identify predictors of mortality in these patients. METHODS: From January 2008 through August 2013, 44 patients (25 male, 19 female; mean age 49.3±12.1 years) who received a definitive diagnosis of PVE enrolled in the study...
March 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Michele Celiento, Stefania Blasi, Andrea De Martino, Stefano Pratali, Aldo D Milano, Uberto Bortolotti
We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 patients) and 29 mm (40 patients). Follow-up ended in December 2012 and is 97% complete, with a cumulative duration of 611 patient-years (mean duration, 6 ± 4.6 yr; maximum, 17.7 yr). The early mortality rate was 10% (6% in elective patients); late deaths occurred in 31 patients (5 valve-related)...
February 2016: Texas Heart Institute Journal
Noah Barka, Jason Bourgoin, Erin Grassl, John A St Cyr
OBJECTIVE: Prosthetic heart valve implantation is commonly performed in patients that have valvular heart disease. Prior to clinical evaluation of newly developed prostheses, preclinical animal studies are performed for the assessment of both acute and chronic valvular function. Commonly, one size of valve is used in these preclinical studies, which can present difficulties with the implantation procedure and assessing valve function. Due to these potential problems, we developed a preoperative screening assessment in potential ovine candidates for prosthetic aortic valve implantation...
August 2016: Therapeutic Advances in Cardiovascular Disease
Murat Biteker, Ibrahim Altun, Ozcan Basaran, Volkan Dogan, Birdal Yildirim, Gokhan Ergun
Prosthetic heart valve thrombosis (PVT) is a rare but serious complication with high morbidity and mortality. The optimal treatment of the PVT is controversial and depends on thrombus location and size, the patient's functional class, the risk of surgery or thrombolysis, and the clinician's experience. Although surgical therapy has been the traditional therapeutic approach, studies with low-dose and slow-infusion rates of thrombolytic agents have revealed excellent results. This article reviews the various treatment options in patient with PVT...
December 2015: Journal of Clinical Medicine Research
Feridoun Sabzi, Siavoosh Vaziri, Reza Faraji
We report the case of a 26-year-old male patient with 2-week history of Brucella aortic valve endocarditis that was referred from general hospital to our hospital emergency room with pallor of the skin and mucous membranes accompanied by systemic hypotension and chest pain. Trans esophageal echocardiography (TEE) revealed a 30-mm ascending aorta at the pulmonary trunk with no evidence of the false lumen or intimal flap. TEE also showed a large vegetation of the aortic valve that limited to noncoronary sinus with moderate pericardial effusion...
2015: Journal of Cardiovascular and Thoracic Research
Michele Grassia, Angela Romano, Giuseppe Esposito, Bartolomeo Braccio, Modestino Pezzella, Amalia Rosaria Rita Rossetti, Francesco Torelli, Giuseppe Izzo, Roberto Alfano, Natale Di Martino
INTRODUCTION: Wunderlich syndrome (WS) is a surgical emergency characterized by spontaneous, non-traumatic retroperitoneal hemorrhage. Angiomyolipoma (AML), a benign mesenchymal tumor, is the most frequent cause of WS. We present a case of WS, appearance five days after a left hemicolectomy for cancer. PRESENTATION OF CASE: A 66 years-old man with a sigmoid adenocarcinoma and a small left AML (3.4cm) was undergone to left hemicolectomy. He was subjected to bridging therapy with high doses of low-molecular-weight heparin for prosthetic replacement of heart valve secondary to endocarditis and atrial fibrillation...
2015: International Journal of Surgery Case Reports
Changtian Wang, Biao Xu, Lei Zhang, Haiwei Wu, Zhongdong Li, Hua Jing, Demin Li
OBJECTIVE: To investigate the result of surgical treatment of active infective endocarditis in patients with recent cerebrovascular events, and to evaluate the optimal indication and timing of surgical intervention. METHODS: The clinical data of 26 patients with cerebrovascular complications before surgery Between December 2007 and December 2013 were analyzed retrospectively. There were 17 male and 9 female patients, aged (42±14) years. Types of disease included single aortic valvular disease (n=8), single mitral valvular disease (n=12), multiple valvular disease (n=5), and aortic valvular disease with ventricular septal defect (n=1)...
June 1, 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Elena Sportelli, Tommaso Regesta, Antonio Salsano, Paola Ghione, Carlotta Brega, Gian Paolo Bezante, Giancarlo Passerone, Francesco Santini
BACKGROUND: To evaluate the impact of patient-prosthesis mismatch (PPM) on survival, functional status, and quality of life (QoL) after aortic valve replacement (AVR) with small prosthesis size in elderly patients. METHODS: Between January 2005 and December 2013, 152 patients with pure aortic stenosis, aged at least 75 years, underwent AVR, with a 19 or 21 mm prosthetic heart valve. PPM was defined as an indexed effective orifice area less than 0.85 cm/m. Median age was 82 years (range 75-93 years)...
February 2016: Journal of Cardiovascular Medicine
María Mutuberría-Urdaniz, José F Rodríguez-Palomares, Ignacio Ferreira, Jordi Bañeras, Gisela Teixidó, Laura Gutiérrez, German Zavala, Maria T González-Alujas, Artur Evangelista, Pilar Tornos, David García-Dorado
AIMS: To assess the effectiveness of different treatment strategies in patients with non-obstructive prosthetic valve thrombosis (NOPVT) during hospitalization and long-term follow-up. METHODS: NOPVT was diagnosed by transesophageal echocardiography. Resolution was defined as the disappearance or reduction of the thrombus under anticoagulation. All cases were first managed with optimization of anticoagulation. At discharge, patients received oral anticoagulation (OAC) alone or OAC and antiplatelet therapy (double treatment)...
October 15, 2015: International Journal of Cardiology
Dominika Suchá, Ceranza G Daans, Petr Symersky, R Nils Planken, Willem P Th M Mali, Lex A van Herwerden, Ricardo P J Budde
The implanted prosthetic heart valve (PHV) size is vital for the evaluation of suspected PHV dysfunction and in case of reoperation or valve-in-valve transcatheter approaches. The labeled size is not always known, and discrepancies exist between manufacturers' labeled sizes and true sizes. Reproducible methods for noninvasive PHV size assessment are lacking. We determined the reliability and agreement of PHV size measurements using multidetector-row computed tomography (MDCT) and provide reference values of MDCT measurements compared with manufacturer specifications...
July 1, 2015: American Journal of Cardiology
Wei Wei, Taiming Dong, Zhichao Zheng, Shuping Huang
OBJECTIVE: To evaluate the curative effects and risks of a medical therapy with combined anti-thrombotic agents for thrombosis on prosthetic heart valves. METHODS: Twenty-two patients who suffered from thrombosis on prosthetic valves with stable hemodynamics were divided into the inpatient group and the outpatient group. Thrombosis on the valves were demonstrated by transesophageal echocardiographies (TEE). A combined anti-thrombotic therapy with clopidogrel and warfarin were prescribed for all the patients during the whole treatment...
March 2015: Journal of Thoracic Disease
Gregory Suero, Moneal Shah, Rachel Hughes-Doichev
Blood cysts of the heart are benign cardiovascular tumors found incidentally in approximately 50% of infants who undergo autopsy at less than 2 months of age. These congenital cysts, frequently present on the atrioventricular valves of infants, are exceedingly rare in adults. Nonetheless, in adults, cardiac blood cysts have been found on the mitral valve, papillary muscles, right atrium, right ventricle, left ventricle, and aortic, pulmonic, and tricuspid valves. Reported complications include left ventricular outflow obstruction, occlusion of the coronary arteries, valvular stenosis or regurgitation, and embolic stroke...
February 2015: Texas Heart Institute Journal
Emanuele Durante-Mangoni, Domenico Iossa, Rosa Molaro, Roberto Andini, Irene Mattucci, Umberto Malgeri, Rosina Albisinni, Riccardo Utili
The pathogenesis of infective endocarditis (IE) involves activation of the haemostasis system at the site of endocardial defects. Whether prothrombotic conditions are associated with IE by enhancing early vegetation formation is unknown. In this study, we assess the prevalence and clinical significance of two major conditions associated with thrombophilia in patients with IE. Mutations G20210A of the prothrombin (PTH) gene and G1691A of factor V (FV Leiden) gene were studied by means of allele-specific polymerase chain reaction in 203 IE patients, 175 valvular heart disease (VHD) patients and 200 blood donors (BD)...
August 2015: Internal and Emergency Medicine
Jenna M Murray, Amy Hellinger, Roger Dionne, Loren Brown, Rosemary Galvin, Suzanne Griggs, Karen Mittler, Kathy Harney, Shannon Manzi, Christina VanderPluym, Annette Baker, Patricia O'Brien, Cheryl O'Connell, Christopher S Almond
Congenital heart disease is the leading cause of stroke in children. Warfarin therapy can be difficult to manage safely in this population because of its narrow therapeutic index, multiple drug and dietary interactions, small patient size, high-risk cardiac indications, and lack of data to support anticoagulation recommendations. We sought to describe our institution's effort to develop a dedicated cardiac anticoagulation service to address the special needs of this population and to review the literature. In 2009, in response to Joint Commission National Patient Safety Goals for Anticoagulation, Boston Children's Hospital created a dedicated pediatric Cardiac Anticoagulation Monitoring Program (CAMP)...
April 2015: Pediatric Cardiology
B Min Yun, Doff B McElhinney, Shiva Arjunon, Lucia Mirabella, Cyrus K Aidun, Ajit P Yoganathan
Despite pressing needs, there are currently no FDA approved prosthetic valves available for use in the pediatric population. This study is performed for predictive assessment of blood damage in bileaflet mechanical heart valves (BMHVs) with pediatric sizing and flow conditions. A model of an adult-sized 23 mm St. Jude Medical (SJM) Regent(™) valve is selected for use in simulations, which is scaled in size for a 5-year old child and 6-month old infant. A previously validated lattice-Boltzmann method (LBM) is used to simulate pulsatile flow with thousands of suspended platelets for cases of adult, child, and infant BMHV flows...
September 22, 2014: Journal of Biomechanics
María Carmen Manzano, Isidre Vilacosta, José A San Román, Paloma Aragoncillo, Cristina Sarriá, Daniel López, Javier López, Ana Revilla, Rocío Manchado, Rosana Hernández, Enrique Rodríguez
INTRODUCTION AND OBJECTIVES: To describe the clinical, microbiologic, echocardiographic characteristics, and disease progression in patients who experience an acute coronary syndrome during an episode of endocarditis. METHODS: The study included 586 consecutive patients who were diagnosed with infective endocarditis (481 left-sided) at one of five hospitals between 1995 and 2005. RESULTS: Overall, 14 patients (2.9%) had an acute coronary syndrome...
2007: Revista Española de Cardiología
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