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Multivalvular disease

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
A Grimaldi, A C Vermi, F Pappalardo, S Benussi, A Fumero, F Maisano, A Colombo, G La Canna, O Alfieri
Multivalvular heart disease (MHD) accounts for approximately 15% of the patients undergoing valve surgery in the EuroHeart Survey and for 8.6% of all valvular surgical interventions. Most clinical studies on valvular heart disease are focused on single-valve disease and very few data stress the difficulties encountered in the diagnostic assessment and clinical decision making of multiple defects, also concerning the reciprocal hemodynamic influence or the overlap of surgical indications. Many fields related to multiple valve disease are not encountered in the European Guidelines on Valvular Heart Disease (ESC) or the American College of Cardiology/American Heart Association (ACC/AHA)...
April 2013: Minerva Cardioangiologica
George Lazopoulos, George Papaioannou, Michael Kantartzis
Ergotamine is used to abort or prevent vascular headache. Valvular heart disease as an adverse effect of long-term ergotamine therapy has been rarely reported in the English literature, with only a few cases published. It is hypothesized that ergot-derived agents stimulate serotonergic receptors (5-HT2B), causing proliferation of myofibroblasts, with subsequent thickening of valve leaflets and chords. This case presentation aims at increasing clinicians' awareness of this potential complication.
August 2013: Thoracic and Cardiovascular Surgeon
Olufemi E Ajayi, Adesuyi A L Ajayi
BACKGROUND: Hypertensive heart disease (HHD) is the commonest cause of sudden cardiac death among Nigerians. A high frequency and early onset of valvular regurgitations (VHD) in hypertensives, and greater concentric hypertrophy are also common in that population. AIMS AND METHODS: To further investigate the relationship between VHD and cardiac arrhythmias and their correlates seen in the hypertensive spectrum and to test the hypothesis that VHD predisposes to cardiac arrhythmias in hypertensive heart failure (HHF)...
June 2013: Journal of Cardiovascular Medicine
Simona Daniela lonescu, Daniela Maria Tănase, Anca Ouatu, Paloma Manea
Infective endocarditis (IE) is a relatively rare disease that can take part of sepsis and may be a diagnostic and therapeutic challenge. Polyvalvular location of El is rare. We present a patient of 60 years diagnosed with plurivalvular infective endocarditis by Enterococcus faecalis with septic complications, visceral, dragged, hospitalized for a psychiatric pathology, who raised the problems of diagnosis and treatment, without being able to make assessments on the entrance gate. For help in diagnosing this case proved that cardiac ultrasound studies recommended that a screening method for patients with bacteremia, but the presence of vegetation is the major criterion for diagnosis of EI...
April 2012: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Bahaaldin Alsoufi, Bahaa Fadel, Ziad Bulbul, Mamdouh Al-Ahmadi, Majid Al-Fayyadh, Avedis Kalloghlian, Ghassan Siblini, Zohair Al-Halees
OBJECTIVES: The Ross procedure is the preferred aortic valve replacement (AVR) choice in small children. Nonetheless, it is a complicated surgery and there are concerns that subsequent cardiac reoperations are exceptionally complex and associated with high morbidity and mortality. We examine the surgical spectrum and report outcomes of cardiac reoperations in patients who had undergone the Ross procedure during childhood. METHODS: Records of 227 consecutive children (<18 years old) who had undergone the Ross procedure at our institution from 1991 to 2004 were reviewed...
July 2012: European Journal of Cardio-thoracic Surgery
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