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Mechanical valve obstruction

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https://www.readbyqxmd.com/read/28912041/postoperative-b-type-natriuretic-peptide-monitoring-for-the-assessment-of-the-magnitude-of-shunting-through-blalock-taussig-anastomoses
#1
Cristian Mirabile, Alessandra Mazzola, Liana Valeanu, Vanessa Lopez-Lopez, Claudio Barbanti, Camilla Biselli, Carole Hennequin, Sophie Malekzadeh-Milani, Mirela Bojan
BACKGROUND: The Modified Blalock-Taussig shunt (MBTS) is the most common palliative operation performed in patients with complex cardiac defects. Postoperative morbidity and mortality rates are high, mainly due to shunt thrombosis and over-shunting. Over-shunting may be difficult to identify postoperatively based on conventional criteria. Since plasma B-type natriuretic peptide (BNP) concentrations correlate with the magnitude of shunting in various left-to-right shunt cardiac defects, we investigated its ability to identify postoperative MBTS over-shunting...
September 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28898345/-endoscopic-lung-volume-reduction-in-advanced-pulmonary-emphysema-initial-experience-in-chile
#2
Sebastián Fernández-Bussy, Gonzalo Labarca, Iván Caviedes, Hiren J Mehta, Michael Jantz, Adnan Majid
Chronic obstructive pulmonary disease (COPD) has no curative treatment, and in moderate to advanced stages, functional parameters and quality of life are affected. Lung volume reduction improves respiratory parameters and quality of life of these patients. Endoscopic lung volume reduction is a minimally invasive procedure that uses endobronchial valves or coils. Valves are unidirectional, blocking the air from entering the target lobe during inspiration, allowing the exit of air and secretions during expiration...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28885112/management-of-failing-bioprosthesis-in-elderly-patients-who-have-undergone-transcatheter-aortic-valve-replacement
#3
Ozan M Demir, Neil Ruparelia, Angela Frame, Sayan Sen, Ghada W Mikhail, Michael Fertleman, Iqbal S Malik
Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of symptomatic aortic stenosis. The number of TAVR procedures is expected to increase exponentially in the next decade. Therefore, patients will inevitably present with signs and symptoms attributable to TAVR bioprosthesis failure many years after an acutely successful procedure. Their management will become increasing important moving forward. Areas covered: The aim of this article is to review the causes of bioprosthesis failure and outline optimal management strategies in elderly patients...
September 8, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28856722/the-doppler-paradox
#4
Ioannis Ntalas, Júlia Karády, Stam Kapetanakis, Ronak Rajani
Obstructive prosthetic valve thrombosis (PVT) is a rare but severe complication that usually occurs in the presence of suboptimal anticoagulation. Although fluoroscopy is commonly used to detect abnormal leaflet motion as a surrogate marker for PVT, its inability to directly visualize adjacent tissue and valve physiology leaves it susceptible to miss clinically important PVT. In this manuscript, we report the case of a 54-year-old woman with a mechanical mitral valve who was admitted to our institute with exertional dyspnea...
August 30, 2017: Echocardiography
https://www.readbyqxmd.com/read/28826894/usefulness-of-mitral-valve-prosthetic-or-bioprosthetic-time-velocity-index-ratio-to-detect-prosthetic-or-bioprosthetic-mitral-valve-dysfunction
#5
Sushil Allen Luis, Lori A Blauwet, Himabindu Samardhi, Cathy West, Ramila A Mehta, Chris R Luis, Gregory M Scalia, Fletcher A Miller, Darryl J Burstow
This study aimed to investigate the utility of transthoracic echocardiographic (TTE) Doppler-derived parameters in detection of mitral prosthetic dysfunction and to define optimal cut-off values for identification of such dysfunction by valve type. In total, 971 TTE studies (647 mechanical prostheses; 324 bioprostheses) were compared with transesophageal echocardiography for evaluation of mitral prosthesis function. Among all prostheses, mitral valve prosthesis (MVP) ratio (ratio of time velocity integral of MVP to that of left ventricular outflow tract; odds ratio [OR] 10...
July 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28822668/intrinsic-wave-propagation-of-myocardial-stretch-a-new-tool-to-evaluate-myocardial-stiffness-a-pilot-study-in-patients-with-aortic-stenosis-and-mitral-regurgitation
#6
Cristina Pislaru, Mahmoud M Alashry, Jeremy J Thaden, Patricia A Pellikka, Maurice Enriquez-Sarano, Sorin V Pislaru
BACKGROUND: Left ventricular (LV) filling following atrial contraction generates LV myocardial stretch that propagates from base to apex with a speed proportional to myocardial elasticity. The aim of this study was to test the hypothesis that intrinsic velocity propagation of myocardial stretch (iVP) would be altered in patients with valvular disease and chronic LV pressure overload or volume overload, which may adversely affect mechanical properties of the LV tissue. A second aim was to compare iVP with flow propagation velocity in the chamber...
August 16, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28814849/tiotropium-bromide-exerts-anti-inflammatory-effects-during-resistive-breathing-an-experimental-model-of-severe-airway-obstruction
#7
Dimitrios Toumpanakis, Konstantinos Loverdos, Vassiliki Tzouda, Vyronia Vassilakopoulou, Eleni Litsiou, Christina Magkou, Vassiliki Karavana, Michael Pieper, Theodoros Vassilakopoulos
INTRODUCTION: Resistive breathing (RB), a hallmark of obstructive airway diseases, is characterized by strenuous contractions of the inspiratory muscles that impose increased mechanical stress on the lung. RB is shown to induce pulmonary inflammation in previous healthy animals. Tiotropium bromide, an anticholinergic bronchodilator, is also shown to exert anti-inflammatory effects. The effect of tiotropium on RB-induced pulmonary inflammation is unknown. METHODS: Adult rats were anesthetized, tracheostomized and breathed spontaneously through a two-way non-rebreathing valve...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28780660/update-on-valvular-heart-disease-in-pregnancy
#8
REVIEW
Lucy M Safi, Sarah V Tsiaras
Valvular heart disease in women of childbearing age poses an increased risk of adverse maternal and fetal outcomes, and management in pregnancy can be challenging. Ideally, patients with suspected valvular disease should have preconception counseling by a multidisciplinary team including cardiologists with expertise in pregnancy and a maternal-fetal medicine specialist. Preconception planning should include a cardiac assessment of maternal risk, determination of frequency of surveillance, and a cardiovascular management plan during delivery...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28780576/mechanical-and-surgical-bioprosthetic-valve-thrombosis
#9
REVIEW
Wei Yao Lim, Guy Lloyd, Sanjeev Bhattacharyya
Valve thrombosis can occur in mechanical prosthetic valves and is increasingly recognised in transcatheter and surgically implanted bioprosthetic valves. The risk of thrombosis of mechanical valves is higher in the mitral position compared with aortic position and in older generation valves (ball and cage valves). There is a wide spectrum of presentation from the asymptomatic patient to those with embolic complications or cardiogenic shock. A combination of transthoracic and transesophageal echocardiography is required to assess the haemodynamic effect of thrombosis (valve gradients and area), leaflet motion and thrombus size...
August 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28755616/endotracheal-hamartoma-case-report-two-contrasting-clinical-presentations-of-a-rare-entity
#10
Curtis Hon, Carl J O'Hara, Virginia R Litle
INTRODUCTION: The majority of tracheal tumors in adults are malignant. The finding of a benign tumor in the trachea is uncommon and endotracheal hamartomas are rare. PRESENTATION OF CASE: We report two cases presenting within six months at our institution. The first patient is a 67 year-old man who was found to have an asymptomatic endotracheal hamartoma on chest imaging for aortic valve replacement. The second patient is a 46 year-old man with an extensive continued tobacco use disorder and a known endotracheal lesion identified 8 years prior to intervention...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28752019/complex-frontal-pneumosinus-dilatans-associated-with-meningioma-a-report-of-two-cases-and-associated-literature-review
#11
Sara Timms, Raj Lakhani, Steve Connor, Claire Hopkins
Introduction  Pneumosinus dilatans (PSD) is a rare phenomenon involving the expansion of the paranasal sinuses, without bony destruction or a mass. Previously documented cases have demonstrated simple expansion of a solitary air cell. We present two unique cases of PSD in the presence of meningioma, in which complex new cells developed within the frontal sinus. One of the two patients developed associated sinus disease. Case 1  A 28-year-old man presented with facial pain. A computed tomography scan showed an abnormally enlarged, septated right frontal sinus, not present on childhood scans...
July 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28705798/a-mass-obstructing-mechanical-prosthetic-heart-valve-thrombus-or-pannus
#12
Kunal Mahajan, Sanjeev Asotra, Prakash Negi, Prince Kumar Paul
No abstract text is available yet for this article.
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28655532/surgical-relief-of-left-ventricular-outflow-tract-obstruction-in-adults-with-congenital-aortic-stenosis-and-associated-aortic-annulus-hypoplasia-and-or-subaortic-obstruction
#13
Tanveer Ahmad, Amalan Thuraisingam, Marco Larobina, Peter Skillington
BACKGROUND: In children and adolescents, a Ross/Konno operation is commonly done to both enlarge the aortic root and provide a competent aortic valve with relief of left ventricular outflow tract obstruction (LVOTO). Optimum management is not so straightforward in adults. METHODS: Between 1995 and 2014, 16 patients of mean age 39.4 years (18-57 years) with hypoplastic aortic annulus (AA) measuring 20mm and less, and mean aortic valve/LVOT gradient of 61mmHg (30-70mmHg) presented for surgery...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28651993/evaluation-of-bleeding-risk-in-patients-on-anticoagulation-for-mechanical-cardiac-valve-operated-for-benign-prostatic-obstruction
#14
S Gardic, V Misrai, A R Azzouzi, A Campeggi, J-N Cornu, A De La Taille, S Lebdai, R Mathieu, G Robert, A Descazeaud
OBJECTIVE: To evaluate bleeding risk in patients on anticoagulation for mechanical cardiac valve operated for benign prostatic obstruction (BPO). MATERIAL AND METHOD: Fifty-eight patients operated between 1998 and 2014, in seven French departments of Urology were included. Forty-five patients were operated by conventional surgery (transurethral resection of the prostate 38, open simple prostatectomies 7), and 13 patients were operated by Greenlight™ photovaporization of the prostate (PVP)...
June 23, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28641192/obstructive-neonatal-atrial-myxoma
#15
Federica Iezzi, Andrea Quarti, Alessandro Capestro, Marco Pozzi
INTRODUCTION: Cardiac myxoma is a benign neoplasm representing the most common primary cardiac tumor in adults, however it is unusual in neonates. It is represented by an endocardial mass that occupies the cardiac chamber. Although the majority of myxomas are attached to the fossa ovalis of the interatrial septum, they also attach to the walls of the cardiac chambers and to valve leaflets surfaces. Approximately 75% of myxomas are found in the left atrium, 20% are located in the right atrium, and rarely in the ventricles...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28615887/an-unusual-cause-of-chest-discomfort-case-report-of-oesophageal-hirudiniasis
#16
Cristóvão Figueiredo, Joana Alves, Cláudia Carvalho, António Sarmento
Hirudiniasis is caused by sanguivorous leeches feeding on mucous membranes with possible severe obstructive or haemorrhagic manifestations. Few cases have been reported in humans, and most occur in tropical countries. A seventy-year-old female patient presented to our Emergency Department (ED) with retrosternal discomfort. She was taking warfarin for a mechanical prosthetic heart valve. While in the ED, a leech was spontaneously extruded from her mouth, with symptomatic resolution. Endoscopy revealed an area of previous leech attachment in the distal oesophageal, without severe bleeding...
June 2017: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
https://www.readbyqxmd.com/read/28608799/in-vitro-and-in-vivo-studies-of-alar-nasal-cartilage-using-autologous-micro-grafts-the-use-of-the-rigenera-%C3%A2-protocol-in-the-treatment-of-an-osteochondral-lesion-of-the-nose
#17
Gabriele Ceccarelli, Pietro Gentile, Marco Marcarelli, Martina Balli, Flavio Lorenzo Ronzoni, Laura Benedetti, Maria Gabriella Cusella De Angelis
Cartilage defects represent a serious problem due to the poor regenerative properties of this tissue. Regarding the nose, nasal valve collapse is associated with nasal blockage and persistent airway obstruction associated with a significant drop in the quality of life for patients. In addition to surgical techniques, several cell-based tissue-engineering strategies are studied to improve cartilage support in the nasal wall, that is, to ameliorate wall insufficiency. Nevertheless, there are no congruent data available on the benefit for patients during the follow-up time...
June 13, 2017: Pharmaceuticals
https://www.readbyqxmd.com/read/28540078/use-of-multidetector-row-computed-tomography-scan-to-detect-pannus-formation-in-prosthetic-mechanical-aortic-valves
#18
REVIEW
Mohamed A Aladmawi, Claudio Pragliola, Olga Vriz, Domenico Galzerano
Obstruction of a mechanical aortic valve by pannus formation at the subvalvular level is a major long-term complication of aortic valve replacement (AVR). In fact, pannus is sometime difficult to differentiate from patient-prosthesis mismatch or valve thrombosis. In most cases cine-angiography and echocardiography, either transthoracic or transesophageal, cannot correctly visualize the complication when the leaflets show a normal mobility. Recent technological refinements made this difficult diagnosis possible by ECG-gated computed tomography (CT) scan which shows adequate images in 90% of the cases and can differentiate pannus from fresh and organized thrombus...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523177/systolic-anterior-motion-of-the-mitral-valve-the-mechanism-of-postural-hypotension-following-left-intrapericardial-pneumonectomy
#19
Javier D Lasala, January Tsai, Andrea Rodriguez-Restrepo, Scott Michael Atay, Boris Sepesi
Systolic anterior motion (SAM) is defined as displacement of the distal portion of the anterior leaflet of the mitral valve toward the left ventricular outflow tract obstruction. SAM can occur in patients without hypertrophic cardiomyopathy (HOCM) and is a well-recognized cause for unexplained sudden hypotension in perioperative settings. We present a case of persistent orthostatic hypotension caused by SAM following left intrapericardial pneumonectomy and mediastinal lymph node dissection for squamous cell carcinoma of the lung invading intrapericardial portion of the inferior pulmonary vein...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28515741/respiratory-functional-status-after-conventional-and-minimally-invasive-aortic-valve-replacement-surgery-a-propensity-score-analysis
#20
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Kamil Fijorek, Michał Mędrzycki, Janusz Andres, Bogusław Kapelak
INTRODUCTION: Reports describing respiratory function of patients after conventional or minimally invasive cardiac surgery are infrequent. AIM: To compare pulmonary functional status after conventional (AVR) and after minimally invasive, through right anterior minithoracotomy, aortic valve replacement (RT-AVR). MATERIAL AND METHODS: This was an observational analysis of 212 patients scheduled for RT-AVR and 212 for AVR between January 2011 and December 2014 selected using propensity score matching...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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