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Repeat valve surgery

Gauranga Majumdar, Surendra Agarwal, Shantanu Pande, Satyendra Tewari
Right atrial myxomas are rare. Its occurrence in a previously operated patient of rheumatic mitral stenosis posed clinical diagnostic challenge. We herein report a case of right atrial myxoma who had undergone mitral valve repair 20 years ago and now presented in congestive heart failure. The tumor was arising from the ostium of the coronary sinus and prolapsed into the right ventricle causing significant right ventricular inflow and outflow obstruction. Urgent repeat cardiac surgery was successfully performed to remove the tumor along with mitral valve replacement...
September 2016: Indian Heart Journal
Shiro Miura, Takeshi Arita, Takenori Domei, Kyohei Yamaji, Yoshimitsu Soga, Makoto Hyodo, Shinichi Shirai, Kenji Ando
Optimal time to perform percutaneous mitral valvuloplasty (PMV) for patients with significant mitral stenosis (MS) and atrial fibrillation (AF) remains controversial. We sought to identify prognostic factors and evaluate long-term clinical outcomes after PMV of 77 consecutive patients with MS with a mitral valve area (MVA) <1.5 cm(2). According to baseline heart rhythm, these patients were divided into sinus rhythm (SR; n = 24) and AF (n = 53) groups. The study endpoint was defined as a composite of all-cause mortality, admission for heart failure, mitral valve surgery, repeated PMV, and major cerebral vascular accident during follow-up...
October 5, 2016: Cardiovascular Intervention and Therapeutics
Philipp Blanke, Jeanette Soon, Danny Dvir, Jong K Park, Christopher Naoum, Shaw-Hua Kueh, David A Wood, Bjarne L Norgaard, Kapilan Selvakumar, Jian Ye, Anson Cheung, John G Webb, Jonathon Leipsic
Valve-in-valve implantation of a transcatheter heart valve into a failed bioprosthetic heart valve has emerged as a treatment alternative to repeat conventional surgery. This requires careful pre-procedural assessment using non-invasive imaging to identify patients at risk for procedure related adverse events, such as ostial coronary occlusion. Herein we report how to comprehensively assess aortic root anatomy using computed tomography prior to transcatheter valve implantation for failed bioprosthetic aortic valves...
September 24, 2016: Journal of Cardiovascular Computed Tomography
Miriam Silaschi, Olaf Wendler, Moritz Seiffert, Liesa Castro, Edith Lubos, Johannes Schirmer, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schäfer, Hendrik Treede, Philip MacCarthy, Lenard Conradi
OBJECTIVES: Transcatheter aortic valve-in-valve implantation (ViV) is a new treatment for failing bioprostheses (BP) in patients with high surgical risk. However, comparative data, using standard repeat surgical aortic valve replacement (redo-SAVR), are scarce. We compared outcomes after ViV with those after conventional redo-SAVR in two European centres with established interventional programmes. METHODS: In-hospital databases were retrospectively screened for patients ≥60 years, treated for failing aortic BP...
September 13, 2016: Interactive Cardiovascular and Thoracic Surgery
Rachel L Bounds, Joseph Kuebler, Jill M Cholette, George M Alfieris, Sitaram M Emani, Carol A Wittlieb-Weber
A 2-month-old male with dysmorphic facies, neonatal thrombocytopenia, left congenital cataract, and long bone abnormalities became hypotensive with ST depression on induction of anesthesia for congenital cataract repair. Echocardiogram demonstrated decreased left ventricular function (ejection fraction 46%), mild mitral valve regurgitation (MR), and regional wall motion abnormalities. The left coronary artery could not be visualized. Subsequent cardiac catheterization confirmed atresia of the left main coronary artery...
September 12, 2016: World Journal for Pediatric & Congenital Heart Surgery
Patrick A Calvert, David B Northridge, Iqbal S Malik, Leonard Shapiro, Peter Ludman, Shakeel A Qureshi, Michael Mullen, Robert Henderson, Mark Turner, Martin Been, Kevin P Walsh, Ivan Casserly, Lindsay Morrison, Nicola L Walker, John Thomson, Mark S Spence, Vaikom S Mahadevan, Angela Hoye, Philip A MacCarthy, Matthew J Daniels, Paul Clift, William R Davies, Philip D Adamson, Gareth Morgan, Suneil K Aggarwal, Yasmin Ismail, Julian O M Ormerod, Habib R Khan, Sujay Subash Chandran, Joseph de Giovanni, Bushra S Rana, Oliver Ormerod, David Hildick-Smith
BACKGROUND: Paravalvular leak (PVL) occurs in 5% to 17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery. METHODS: All UK and Ireland centers undertaking percutaneous PVL closure submitted data to the UK PVL Registry. Data were analyzed for association with death and major adverse cardiovascular events (MACE) at follow-up. RESULTS: Three hundred eight PVL closure procedures were attempted in 259 patients in 20 centers (2004-2015)...
September 27, 2016: Circulation
Samuel Fernandes, Ana Rita Gonçalves, Luís Araújo Correia
A 73-year-old man was admitted to our clinic with sudden left quadrant abdominal pain and hematochezia. There was no history of trauma. He denied other symptoms or taking off-the-counter medication. His medical history was relevant for ischemic and aortic-mitral valve disease with prosthetic valves for which he was medicated with aspirin and warfarin. On physical examination the patient presented normal vital signs with tenderness on palpation of the left side of the abdomen. Laboratory tests revealed moderate anemia (10...
August 2016: Revista Española de Enfermedades Digestivas
Hideharu Hagiya, Takeshi Tanaka, Kohei Takimoto, Hisao Yoshida, Norihisa Yamamoto, Yukihiro Akeda, Kazunori Tomono
BACKGROUND: With the development of invasive medical procedures, an increasing number of healthcare-associated infective endocarditis cases have been reported. In particular, non-nosocomial healthcare-associated infective endocarditis in outpatients with recent medical intervention has been increasingly identified. CASE PRESENTATION: A 66-year-old man with diabetes mellitus and a recent history of intermittent urethral self-catheterization was admitted due to a high fever...
2016: BMC Infectious Diseases
Deepakraj Gajanana, David Wheeler, David Hsi, Richard Kovach, Jon C George
BACKGROUND: Percutaneous balloon aortic valvuloplasty (PBAV) is a palliative therapeutic option for relief of severe aortic stenosis (AS) in patients that are poor surgical or transcatheter aortic valve replacement (TAVR) candidates or as a bridge to definitive therapy. The outcomes following PBAV are highly variable and studies identifying factors that correlate with outcomes are sparse. The purpose of this study was to identify predictors at the time of the index procedures that can predict 1-year survival or need for repeat PBAV...
August 5, 2016: Journal of Interventional Cardiology
Miriam Silaschi, Sanjay Chaubey, Omar Aldalati, Habib Khan, Mohammed Mohsin Uzzaman, Mrinal Singh, Max Baghai, Ranjit Deshpande, Olaf Wendler
BACKGROUND: Because of demographic changes, a growing number of elderly patients present with mitral valve (MV) disease. Although mitral valve repair (MV-repair) is the "gold standard" treatment for MV disease, in elderly patients, there is controversy about whether MV-repair is superior to mitral valve replacement. We reviewed results after MV surgery in elderly patients treated over the past 20 years. METHODS AND RESULTS: Our in-hospital database was explored for patients who underwent MV surgery between 1994 and 2015...
August 2016: Journal of the American Heart Association
Saroj Neupane, Naga Va Kommuri, Noora Kazanji, Pertha Chowdhury
Development of left ventricular pseudoaneurysm is a rare complication of mitral valve surgery and requires urgent surgical intervention. We describe a case of pseudoaneurysm of membranous septum following repeat mitral valve replacement with the use of multimodality imaging.
July 11, 2016: Echocardiography
P Saphina, C A Mansoor, A Jemshad, Mohthash Musambil
Candida endocarditis is an emerging infectious disease, usually involving patients with intravascular prosthetic devices, and associated with substantial morbidity and mortality. A 28-year-old primigravida at 32 weeks of gestation was admitted with low-grade fever and lower abdominal pain for 2 weeks. She had undergone open appendicectomy 2 months before admission. Echocardiogram showed a pedunculated 24 mm × 21 mm mass attached to the undersurface of anterior mitral leaflet near the tip and moderate mitral regurgitation...
July 2015: Heart Views: the Official Journal of the Gulf Heart Association
James Cockburn, Maureen Dooley, Jessica Parker, Andrew Hill, Nevil Hutchinson, Adam de Belder, Uday Trivedi, David Hildick-Smith
BACKGROUND: Redo surgery for degenerative bioprosthetic aortic valves is associated with significant morbidity and mortality. Report results of valve-in-valve therapy (ViV-TAVI) in failed supra-annular stentless Freedom Solo (FS) bioprostheses, which are the highest risk for coronary occlusion. METHODS: Six patients with FS valves (mean age 78.5 years, 50% males). Five had valvular restenosis (peak gradient 87.2 mm Hg, valve area 0.63 cm(2) ), one had severe regurgitation (AR)...
June 17, 2016: Catheterization and Cardiovascular Interventions
Laura Brown, Lowell Tilzer, Fred Plapp
A 33-year-old male was admitted to the hospital for a repeat mitral valve replacement. The original surgery, performed in India in 2008 due to rheumatic heart disease, required massive amounts of plasma replacement during and after the surgery. The patient was admitted to our hospital with extremely low Factor V and Factor VIII activities due to a rare combined Factor V and Factor VIII deficiency. His clinical condition on admission was grave due to severe pulmonary hypertension. It was decided to replace the patient's Factor V using therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) just prior to surgery, and his Factor VIII with Factor VIII concentrate...
June 16, 2016: Journal of Clinical Apheresis
Christin Howard, Brea Lipe
Combined factor V and factor VIII deficiency is an extremely rare bleeding disorder for which research is lacking. We present the case of a 33-year-old man requiring repeat mitral valve replacement. A multidisciplinary team approach was utilized to minimize his risk of bleeding which included the use of plasma exchange, intravenous factor replacement, and platelet transfusion. This approach created an operative experience that did not require blood transfusion or the use of other hemostatic medications.
June 6, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Kosuke Takagaki, Satoshi Osawa, Tatsuhiro Ito, Moriya Iwaizumi, Yasushi Hamaya, Hiroe Tsukui, Takahisa Furuta, Hidetoshi Wada, Satoshi Baba, Ken Sugimoto
An inverted Meckel's diverticulum is a rare gastrointestinal congenital anomaly that is difficult to diagnose prior to surgery and presents with anemia, abdominal pain, or intussusception. Here, we report the case of 57-year-old men with an inverted Meckel's diverticulum, who was preoperatively diagnosed using double-balloon enteroscopy. He had repeatedly experienced epigastric pain for 2 mo. Ultrasonography and computed tomography showed intestinal wall thickening in the pelvis. Double-balloon enteroscopy via the anal route was performed for further examination, which demonstrated an approximately 8-cm, sausage-shaped, submucosal tumor located approximately 80 cm proximal to the ileocecal valve...
May 7, 2016: World Journal of Gastroenterology: WJG
Naveed Nilforushan, Maryam Yadgari, Anis Alsadat Jazayeri, Nasser Karimi
PURPOSE: To evaluate the outcome of the second Ahmed glaucoma valve (AGV) surgery in eyes with failed previous AGV surgery. DESIGN: Retrospective case series. PATIENTS AND METHODS: Following chart review, 36 eyes of 34 patients with second AGV implantation were enrolled in this study. The primary outcome measure was surgical success defined in terms of intraocular pressure (IOP) control using two criteria: Success was defined as IOP ≤21 mmHg (criterion 1) and IOP ≤16 mmHg (criterion 2), with at least 20% reduction in IOP, either with no medication (complete success) or with no more than two medications (qualified success)...
March 2016: Indian Journal of Ophthalmology
A De Bruyn, P Dendale, E Benit
Paravalvular leak is a common complication after surgical mitral valve replacement. Surgically implanted prosthetic valves are complicated with paravalvular leaks in 17%.(1) Surgical closure of paravalvular leaks is the most common therapy for these defects. Percutaneous closure is an alternative to repeat surgery for a selected high-risk population. We present a case of a patient who developed severe haemolytic anaemia and secondary renal failure after partially successful percutaneous closure of paravalvular leakage of a prosthetic mitral valve...
February 3, 2016: Acta Clinica Belgica
Maria-Sînziana Moldovan, Daniela Bedeleanu, Emese Kovacs, Lorena Ciumărnean, Adrian Molnar
Pannus-related prosthetic valve dysfunction, a complication of mechanical prosthetic valve replacement, is rare, with a slowly progressive evolution, but it can be acute, severe, requiring surgical reintervention. We present the case of a patient with a mechanical single disc aortic prosthesis, with moderate prosthesis-patient mismatch, minor pannus found on previous ultrasound examinations, who presented to our service with angina pain with a duration of 1 hour, subsequently interpreted as non-ST segment elevation myocardial infarction (NSTEMI) syndrome...
2016: Clujul Medical (1957)
Hirofumi Kasahara, Yoshito Inoue, Satoru Suzuki
This report describes a unique case of a 56-year-old female who suffered from recurrent stroke after double mechanical valve replacement. During the four years after the surgery, she remained in normal sinus rhythm, received adequate anticoagulation therapy, and no apparent left atrial thrombus was detected. She underwent redo surgery to prevent further stroke after fourth instance of cerebral infarction. Intraoperative findings revealed a 'dome-shaped' pannus formation covering the sewing ring of the mitral prosthesis circumferentially, probably leading to clot formation and repeated infarctions...
January 2016: Journal of Thoracic Disease
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