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Multivalvular disease

Cagdas Baran, Mustafa Serkan Durdu, Fatih Gumus, Mehmet Cakici, Mustafa Bahadir Inan, Mustafa Sirlak, Ahmet Ruchan Akar
OBJECTIVES: Sutureless aortic valve replacement (SU-AVR) is an alternative technique to standard aortic valve replacement. We evaluated our experience with the Perceval SU-AVR with concomitant mitral valve surgery, with or without tricuspid valve surgery, and aimed to discuss the technical considerations. METHODS: From January 2013 through June 2016, 30 patients with concomitant severe mitral valve disease, with or without tricuspid valve disease, underwent SU-AVR with the Perceval prosthesis in a single center...
June 2018: Journal of Thoracic and Cardiovascular Surgery
Nagaraja Moorthy, Rajiv Ananthakrishna, Dattatreya P V Rao, Satvic C Manjunath, Manjunath C Nanjappa
Intermittent dysfunction of mechanical mitral valve prosthesis is an uncommon condition. It carries serious clinical implications if unrecognized. Here, we present a case of a 28-year-old female with a history of rheumatic multivalvular disease, for which she had undergone double valve replacement and tricuspid annuloplasty. Six months later, she presented with heart failure. Clinical examination revealed intermittent loss of closing clicks followed by a pansystolic murmur at the apex, suggestive of mitral prosthetic valve dysfunction...
March 2018: Echocardiography
Alejandra Rodríguez-Hernández, Martha García-Torres, Eduardo Bucio Reta, Francisco Martín Baranda-Tovar
OBJECTIVE: To analyse hospital mortality in patients subjected to cardiac surgery in Mexico during the year 2015, and identify the mortality risks factors, and its correlation with days of hospital stay in the cardiovascular intensive care unit. METHOD: The database of Cardiovascular Intensive Care of the National Institute of Cardiology was examined for this cases and controls study that included only adult patients subjected to cardiac surgery during the year 2015...
January 9, 2018: Archivos de Cardiología de México
Nicola Luciani, Eugenio Mossuto, Davide Ricci, Marco Luciani, Marco Russo, Antonio Salsano, Alberto Pozzoli, Michele D Pierri, Augusto D'Onofrio, Giovanni A Chiariello, Franco Glieca, Alberto Canziani, Mauro Rinaldi, Paolo Nardi, Valentina Milazzo, Enrico M Trecarichi, Francesco Santini, Michele De Bonis, Lucia Torracca, Eleonora Bizzotto, Mario Tumbarello
OBJECTIVES: Prosthetic valve endocarditis (PVE) is an uncommon yet dreadful complication in patients with prosthetic valves that requires a distinct analysis from native valve endocarditis. The present study aims to investigate independent risk factors for early surgical outcomes in patients with PVE. METHODS: A retrospective cohort study was conducted in 8 Italian Cardiac Surgery Units from January 2000 to December 2013 by enrolling all PVE patients undergoing surgical treatment...
October 1, 2017: European Journal of Cardio-thoracic Surgery
Catarina Ruivo, Joana Guardado, Fernando Montenegro Sá, Fátima Saraiva, Alexandre Antunes, Joana Correia, João Morais
We report a clinical case of a 40-year-old male with surgically corrected congenital heart disease (CHD) 10 years earlier: closure of ostium primum, mitral annuloplasty, and aortic valve and root surgery. The patient was admitted with acute heart failure. Transesophageal echocardiography (TEE) revealed a dysmorphic and severely incompetent aortic valve, a partial tear of the mitral valve cleft repair and annuloplasty ring dehiscence. A true left ventricular-to-right atrial shunt confirmed a direct Gerbode defect...
July 2017: Echocardiography
Sreyashi Sen, Sourav Chatterjee, Pinaki Mazumder, Sudakshina Mukherji
Rheumatic heart disease is the most common cardiac disease complicating pregnancy in developing countries. Heart disease accounts for 15% pregnancy-related mortality. In the presence of maternal heart disease, the circulatory changes of pregnancy may result in exacerbation of the hemodynamic perturbations due to complex cardiac valvular lesions leading to decompensation or death of mother or fetus. Determining the ideal anesthetic technique for cesarean section in the presence of complex cardiac conditions remains a much debated topic...
July 2016: Journal of Natural Science, Biology, and Medicine
Saibal Mukhopadhyay, Saurabh Varma, H N Mohan Kumar, Jamal Yusaf, Mayank Goyal, Vimal Mehta, Sanjay Tyagi
BACKGROUND: The regulatory T cell (Treg) is essential for prevention of autoimmunity. In a preliminary study, we showed significant deficiency of Tregs (CD4CD25 T cells) in rheumatic heart disease (RHD) patients (an autoimmune disease), but the markers used could not reliably differentiate Treg from nonregulatory conventional T cells (Tcon). The study aim was to reassess the level of circulatory Tregs by using more specific markers. METHODS: 70 adults of RHD and 35 controls were studied...
May 2016: Indian Heart Journal
Philippe Unger, Marie-Annick Clavel, Brian R Lindman, Patrick Mathieu, Philippe Pibarot
Multivalvular disease (MVD) is common among patients with valvular disease, and has a complex pathophysiology dependent on the specific combination of valve lesions. Diagnosis is challenging because several echocardiographic methods commonly used for the assessment of stenosis or regurgitation have been validated only in patients with single-valve disease. Decisions about the timing and type of treatment should be made by a multidisciplinary heart valve team, on a case-by-case basis. Several factors should be considered, including the severity and consequences of the MVD, the patient's life expectancy and comorbidities, the surgical risk associated with combined valve procedures, the long-term risk of morbidity and mortality associated with multiple valve prostheses, and the likelihood and risk of reoperation...
July 2016: Nature Reviews. Cardiology
Rodrigo Rodriguez-Fernandez, Rachel Amiya, Rosemary Wyber, Wishnu Widdodow, Johnathan Carapetis
BACKGROUND: Rheumatic heart disease (RHD) remains a significant cause of cardiovascular morbidity and mortality in developing countries such as Indonesia. Yet, despite being one of the most readily preventable chronic diseases, RHD has received scant research or policy attention, particularly in South-East Asia. AIM: To describe the pattern of RHD occurrence in a sample of presenting cases from an occupational cohort in Papua Province, Indonesia. METHODS: Clinical records of 15 608 mining workers (96...
2015: Heart Asia
Saim Sağ, Sümeyye Güllülü
Multivalvular heart valve disease is not an uncommon situation. Although many studies include only patients with regurgitation or stenosis involving only one heart valve, several scenarios in which patients present with regurgitation and/or stenosis involving two or more valves exist. Data on multivalve disease are scarce because of a large number of possible combinations and also owing to difficulties of exact quantification and an overlap in surgical indications. Therefore, many fields related to multiple valve disease are not encountered in the current valvular heart disease guidelines...
October 2014: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Liesl Zühlke, Mark E Engel, Ganesan Karthikeyan, Sumathy Rangarajan, Pam Mackie, Blanche Cupido, Katya Mauff, Shofiqul Islam, Alexia Joachim, Rezeen Daniels, Veronica Francis, Stephen Ogendo, Bernard Gitura, Charles Mondo, Emmy Okello, Peter Lwabi, Mohammed M Al-Kebsi, Christopher Hugo-Hamman, Sahar S Sheta, Abraham Haileamlak, Wandimu Daniel, Dejuma Y Goshu, Senbeta G Abdissa, Araya G Desta, Bekele A Shasho, Dufera M Begna, Ahmed ElSayed, Ahmed S Ibrahim, John Musuku, Fidelia Bode-Thomas, Basil N Okeahialam, Olukemi Ige, Christopher Sutton, Rajeev Misra, Azza Abul Fadl, Neil Kennedy, Albertino Damasceno, Mahmoud Sani, Okechukwu S Ogah, Taiwo Olunuga, Huda H M Elhassan, Ana Olga Mocumbi, Abiodun M Adeoye, Phindile Mntla, Dike Ojji, Joseph Mucumbitsi, Koon Teo, Salim Yusuf, Bongani M Mayosi
AIMS: Rheumatic heart disease (RHD) accounts for over a million premature deaths annually; however, there is little contemporary information on presentation, complications, and treatment. METHODS AND RESULTS: This prospective registry enrolled 3343 patients (median age 28 years, 66.2% female) presenting with RHD at 25 hospitals in 12 African countries, India, and Yemen between January 2010 and November 2012. The majority (63.9%) had moderate-to-severe multivalvular disease complicated by congestive heart failure (33...
May 7, 2015: European Heart Journal
Hyoung Woo Chang, Kyung-Hwan Kim, Ho Young Hwang, Jun Sung Kim
BACKGROUND AND AIM OF THE STUDY: Mitral valve reconstruction (MVP) is currently the standard treatment for degenerative mitral regurgitation (MR). However, when MR is due to infective endocarditis (IE) the range of pathophysiology present often makes any repair challenging. Hence, the authors' clinical experience of MVP to treat MR caused by IE was analyzed. METHODS: Between September 2004 and March 2011, a total of 26 patients (20 males, six females) who had been diagnosed with MR due to IE (single surgeon, retrospective review) were operated on...
May 2014: Journal of Heart Valve Disease
Takehiro Inoue, Shintaro Yugami, Takako Nishino, Toshihiko Saga
A 70-year-old man with severe multivalvular disease, atrial fibrillation, and kyphoscoliosis, had Cheyne-Stokes respiration with central sleep apnea. After triple-valve surgery with the maze procedure, adjunctive adaptive servo-ventilation therapy was initiated on the first postoperative day and continued seamlessly in the postoperative period. Seamless adaptive servo-ventilation therapy as an adjunct to triple-valve surgery is more likely to prevent heart failure remodeling without worsening of pulmonary hypertension and recurrence of atrial fibrillation...
March 2016: Asian Cardiovascular & Thoracic Annals
Benjamin H Goot, James Jaggers, Miran Rhee Anagnost, Kathryn K Collins
We report the clinical course of a female child with a normal karyotype and chromosomal microarray who presented as an infant with clinical findings consistent with congenital polyvalvular disease (CPVD). This clinical entity describes patients with multiple congenitally dysplastic valves, often showing nodular or cystic malformation in at least two cardiac valves. This patient then developed medically refractory multifocal ventricular arrhythmia and required radiofrequency ablation at seven months of age. She had good tachycardia control but became symptomatic with right heart failure related to progressive tricuspid, pulmonary, and mitral valve dysfunction necessitating multivalvular replacement at 21 months of age...
July 2014: World Journal for Pediatric & Congenital Heart Surgery
I G Zorina, G M Bushmanova
Echocardiographic manifestations of the early stages of primary chronic septic endocarditis are studied in patients with mono-, bi-, and multivalvular valvulitis. The basic morphological substrate of the disease is fibrosis; the main trend is progressive fibrosis of valvular and extravalvular endocardial structures leading in many cases to stenosis of the valvular orifices. The results in some cases do not permit us to regard fibrosis as a result of previous "healed" endocarditis ruling out the presence of an inflammatory process...
June 2014: Bulletin of Experimental Biology and Medicine
Gonçalo Cardoso, Marisa Trabulo, Maria João Andrade, Regina Ribeiras, Rui Rodrigues, José Pedro Neves, João Queiróz e Melo, Miguel Mendes
Prosthetic valve dysfunction is a significant clinical event. Determining its etiological mechanism and severity can be difficult. The authors present the case of a 50-year-old man, with two mechanical valve prostheses in aortic and mitral positions, hospitalized for decompensated heart failure. He had a long history of rheumatic multivalvular disease and had undergone three heart surgeries. On admission, investigation led to a diagnosis of severe dysfunction of both mechanical prostheses with different etiologies and mechanisms: pannus formation in the prosthetic aortic valve and intermittent dysfunction of the mitral prosthesis due to interference of a ruptured chorda tendinea in closure of the disks...
December 2013: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Alexandra Gonçalves, Scott D Solomon
No abstract text is available yet for this article.
November 5, 2013: Circulation
Pushpa Shivaram, Molla Imaduddin Ahmed, Pramod Theetha Kariyanna, Harika Sabbineni, Uma Mahesh R Avula
RATIONALE: Doppler echocardiography has been demonstrated to be accurate in diagnosing valvular lesions in rheumatic heart disease (RHD) when compared to clinical evaluation alone. OBJECTIVE: To perform Doppler echocardiography in children clinically diagnosed by the Jones criteria to have acute rheumatic fever (ARF), and to then compare the effectiveness of echo in detecting single/multi-valvular lesions with that of the initial clinical evaluation. METHODS AND RESULTS: We enrolled 93 children who were previously diagnosed with ARF by clinical examination...
2013: PloS One
N I Akkus, G S Mina, S Fereidoon, S Rajpal
Tattooing is becoming a popular practice and more commonly done. Although modern tattooing is considered a more hygienic and technological version of ancient methods, previously reported cases point out the risk of infection after tattooing due to use of nonsterile equipment or suboptimal infection-control practices. Infective endocarditis (IE) after tattooing has been reported only in 1 patient with bicuspid aortic valvular disease. Herein, we report a case of multivalvular IE secondary to tattooing in a patient without known prior valvular heart disease...
May 2014: Herz
Saibal Mukhopadhyay, Saurabh Varma, Sandeep Gade, Jamal Yusuf, Vijay Trehan, Sanjay Tyagi
BACKGROUND AND AIM OF THE STUDY: Autoimmunity plays an essential role in the pathogenesis of rheumatic heart disease (RHD). The CD4+CD25+ T cell (Tregs) is the chief regulator of autoimmunity, and is essential for the induction and maintenance of self-tolerance and prevention of autoimmunity. To date, the levels of Tregs in RHD have not been investigated. Hence, the study aim was to monitor levels of circulating Tregs in patients with RHD, and to determine whether these differ according to the extent of valvular involvement...
January 2013: Journal of Heart Valve Disease
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