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Mechanical valve dysfunction

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https://www.readbyqxmd.com/read/29316662/recurrent-hemorrhagic-conversion-of-ischemic-stroke-in-a-patient-with-mechanical-heart-valve-a-case-report-and-literature-review
#1
Micheal Jace Tarver, Tyler Schmidt, Michael T Koltz
The authors present a unique case of recurrent stroke, discovered to be secondary to hemorrhagic conversion of microemboli from a mechanical aortic valve despite anticoagulation with Coumadin. The complexity of this case was magnified by the patient's young age, a mechanical heart valve (MHV), and a need for anticoagulation to maintain MHV patency in a setting of potentially life-threatening intracranial hemorrhage. Anticoagulant and antiplatelet therapy are risk factors for hemorrhagic conversion post-cerebral ischemia; however, the pathophysiology underlying endothelial cell dysfunction causing red blood cell extravasation is an active area of basic and clinical research...
January 7, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29313818/long-term-mortality-in-patients-with-severe-secondary-mitral-regurgitation-and-normal-left-ventricular-ejection-fraction-interventional-perspective
#2
Amr F Barakat, Mohammad Q Raza, Kinjal Banerjee, Rayji S Tsutsui, Amgad Mentias, Karim Abdur Rehman, Badal Thakkar, Sajjad Gul, Raquib Faruqui, Amar Krishnaswamy, Leonardo L Rodriguez, Richard Grimm, Brian Griffin, Emin Murat Tuzcu, Samir R Kapadia
AIMS: Patients with severe secondary mitral regurgitation (MR) and normal ejection fraction are being excluded from clinical trials evaluating transcatheter mitral devices. We sought to evaluate the long-term mortality with medical management alone in this patient population. METHODS AND RESULTS: We retrospectively evaluated patients diagnosed with ≥3+ mitral MR at our institution over 15 years. Only patients with ejection fraction ≥ 60% were included in the study...
January 9, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29302950/use-of-impella-5-0-prior-to-transcatheter-aortic-valve-replacement-in-a-patient-with-severe-aortic-stenosis-and-cardiogenic-shock
#3
Dustin W Johnson, John P ErwinIII
The use of transcatheter aortic valve replacement (TAVR) has risen dramatically during the past decade. Notably, the procedure can reduce symptoms and improve prognosis in patients who would otherwise be excluded from intervention due to prohibitive surgical risk. During the same time period, the use of percutaneous mechanical circulatory support devices for patients with severe left ventricular dysfunction, including the Impella System (Abiomed, Inc., Danvers, MA, USA), has also increased. These devices provide superior hemodynamic effects compared to intra-aortic balloon pumping...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29290485/tricuspid-valve-adaptation-during-the-first-interstage-period-in-hypoplastic-left-heart-syndrome
#4
Timothy Colen, Shelby Kutty, Richard B Thompson, Edythe Tham, Andrew S Mackie, Ling Li, Dongngan T Truong, Michiko Maruyama, Jeffrey F Smallhorn, Nee Scze Khoo
BACKGROUND: Tricuspid regurgitation (TR) is an important risk factor for morbidity and mortality in hypoplastic left heart syndrome (HLHS), yet the evolution of tricuspid valve (TV) dysfunction in HLHS is poorly understood. This study sought to examine changes in TV function in HLHS between the first two stages of surgical palliation and to determine the mechanism of TR at the time of stage two surgery-bidirectional cavopulmonary anastomosis (BCPA). METHODS: We prospectively investigated 44 infants at two time points-prior to Norwood-Sano (T1 - median age 5...
December 29, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29277547/recurrent-bioprosthetic-valve-thrombosis-should-long-term-anticoagulation-be-considered
#5
Matthew S Yong, Robert Grant, Pankaj Saxena, Sumit Yadav
Bioprosthetic valve thrombosis (BPVT) is an important and potentially reversible cause of valvular dysfunction. This complication can occur many years after surgery and understanding of the precise mechanisms and risk factors are limited. Anticoagulation therapy has been demonstrated to be effective in improving BPVT. However, the optimal duration of therapy and the risk of recurrence are unknown. Herein, we describe two cases-one of late BPVT and one of recurrence of BPVT after cessation of anticoagulation therapy...
December 11, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29248661/mitral-valve-adaptation-to-isolated-annular-dilation-insights-into-the-mechanism-of-atrial-functional-mitral%C3%A2-regurgitation
#6
Dae-Hee Kim, Ran Heo, Mark D Handschumacher, Sahmin Lee, Yun-Sil Choi, Kyu-Ri Kim, Yewon Shin, Hong-Kyung Park, Joyce Bischoff, Elena Aikawa, Jong-Min Song, Duk-Hyun Kang, Robert A Levine, Jae-Kwan Song
OBJECTIVES: This study hypothesized that compensatory mitral leaflet area (MLA) adaptation occurs in patients with persistent atrial fibrillation (AF) without left ventricular (LV) dysfunction but has limitations that augment mitral regurgitation (MR). The study also explored whether asymmetrical annular dilation is matched by relative leaflet enlargement. BACKGROUND: Functional MR occurs in patients with AF and isolated annular dilation, but the relationship of MLA adaptation with annular area (AA) is unknown...
December 8, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29237468/left-ventricular-synchrony-torsion-and-recoil-mechanics-in-ebstein-s-anomaly-insights-from-cardiovascular-magnetic-resonance
#7
Michael Steinmetz, Simon Usenbenz, Johannes Tammo Kowallick, Olga Hösch, Wieland Staab, Torben Lange, Shelby Kutty, Joachim Lotz, Gerd Hasenfuß, Thomas Paul, Andreas Schuster
BACKGROUND: Disease progression and heart failure development in Ebstein's Anomaly (EA) of the tricuspid valve is characterized by both right and left ventricular (LV) deterioration. The mechanisms underlying LV dysfunction and their role in heart failure development are incompletely understood. We hypothesized that LV dyssynchrony and impaired torsion and recoil mechanics induced by paradoxical movement of the basal septum may play a role in heart failure development. METHODS: 31 EA patients and 31 matched controls underwent prospective cardiovascular magnetic resonance (CMR)...
December 14, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29194051/blood-tissue-and-imaging-biomarkers-in-calcific-aortic-valve-stenosis-past-present-and-future
#8
Mylène Shen, Lionel Tastet, Jutta Bergler-Klein, Philippe Pibarot, Marie-Annick Clavel
PURPOSE OF REVIEW: Calcific aortic valve stenosis is the most prevalent valvular heart disease in the high-income countries. To this date, no medical therapy has been proven to prevent or to stop the progression of aortic valve stenosis. The physiopathology of aortic valve stenosis is highly complex and involves several signalling pathways, as well as genetic related factors, which delay the elaboration of effective pharmacotherapies. Moreover, it is difficult to predict accurately the progression of the valve stenosis and finding the optimal timing for aortic valve replacement remains challenging...
November 30, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29189934/mechanical-deformation-in-adult-patients-with-unrepaired-aortic-coarctation
#9
Leonel Avendaño-Pérez, María Elena Soto, Nydia Ávila-Vanzzini, Guillermo Bracamontes-Castelo, José Carlos Ruán-Díaz, Erick Alexanderson-Rosas, Nilda Espinola-Zavaleta
Aortic coarctation is a congenital heart disease that causes an increased left ventricular afterload, resulting in increased systolic parietal tension, compensatory hypertrophy, and left ventricular systolic and diastolic dysfunction. The speckle tracking is a new echocardiographic technique that allows the detection of subclinic left ventricular systolic dysfunction. The aim of this study was to detect early left ventricular dysfunction using mechanical deformation by echocardiography in adults with un-repaired aortic coarctation...
November 30, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29173672/acute-valvular-heart-disease
#10
REVIEW
Varun Maheshwari, Brian Barr, Mukta Srivastava
Valvular heart disease (VHD) is a common clinical entity. Recognition of decompensated VHD is crucial to instituting appropriate workup and management. Initial evaluation focuses on hemodynamics, peripheral perfusion, volume overload, and active myocardial ischemia. Initial therapy is targeted at improving hemodynamics, fluid status, and decreasing myocardial ischemia before intervention. Echocardiography can rapidly identify VHD etiology and severity along with physical examination findings. Owing to improved survival with cardiac surgery over the past several decades, prosthetic valve dysfunction should be recognized and initial treatment understood...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29134537/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-4-valvular-heart-surgery
#11
Kiyoharu Nakano, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
Data from the Japan cardiovascular surgery database from 2013 to 2014 were analyzed to demonstrate the mortality rate and choice of surgical procedures, especially concerning the selection of valve prosthesis for each valve position and patient age group, and the effects of preoperative complications on mortality and prosthetic valve selection. The proportion of each surgical procedure was compared for each patient age in the aortic, mitral, and tricuspid positions. The proportion of mechanical valve prostheses was 23...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29100642/medium-term-outcomes-after-implantation-of-expanded-polytetrafluoroethylene-valved-conduit
#12
Yoshio Ootaki, Allison S Welch, Michael J Walsh, Michael D Quartermain, Derek A Williams, Ross M Ungerleider
BACKGROUND: Pulmonary valve replacement is becoming the most frequent congenital heart surgery performed on adolescents and young adults. Numerous surgical options are available, including autologous pericardium, mechanical valves, allografts, and bioprosthetic valves. Each option has limitations with durability and freedom from reintervention for stenosis or insufficiency, particularly in the pediatric population. The purpose of this study was to analyze our uniquely designed, expanded polytetrafluoroethylene (ePTFE) valved conduit (VC) for right ventricular outflow tract reconstruction...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29092120/immunologic-responses-in-biological-and-mechanical-valve-prostheses-inflammation-and-functionality-are-not-always-related
#13
Alejandra Rodriguez-Hernandez, Maria Elena Soto, Jesus Vargas-Barron, Ricardo Marquez, Rafael Bojalil-Parra, Israel Perez-Torres, Jose Luis Salas-Pacheco, Valentin Jimenez-Rojas, Jose Antonio Arias-Godinez, Veronica Guarner-Lans
BACKGROUND: The aim of this retrospective study was to evaluate the inflammatory response in patients with aortic and/or mitral prostheses, and to correlate the level of inflammatory markers with prosthesis functionality. METHODS: A total of 48 patients with biological or mechanical prostheses was included in the study, in which levels of tumor necrosis factor-alpha (TNFα), interleukin (IL)-1, -4, and -6, interferon-gamma (IFNγ), osteopontin (OPN), intercellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM), endothelin-1 and C-reactive protein were analyzed...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29061390/integrated-geometric-and-mechanical-analysis-of-an-image-based-lymphatic-valve
#14
Daniel J Watson, Igor Sazonov, David C Zawieja, James E Moore, Raoul van Loon
Lymphatic valves facilitate the lymphatic system's role in maintaining fluid homeostasis. Malformed valves are found in several forms of primary lymphœdema, resulting in incurable swelling of the tissues and immune dysfunction. Their experimental study is complicated by their small size and operation in low pressure and low Reynolds number environments. Mathematical models of these structures can give insight and complement experimentation. In this work, we present the first valve geometry reconstructed from confocal imagery and used in the construction of a subject-specific model in a closing mode...
November 7, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29055505/2017-acc-expert-consensus-decision%C3%A2-pathway-on-the-management%C3%A2-of-mitral-regurgitation-a-report-of-the-american-college-of-cardiology-task-force-on-expert-consensus-decision-pathways
#15
REVIEW
Patrick T O'Gara, Paul A Grayburn, Vinay Badhwar, Luis C Afonso, John D Carroll, Sammy Elmariah, Aaron P Kithcart, Rick A Nishimura, Thomas J Ryan, Allan Schwartz, Lynne Warner Stevenson
Mitral regurgitation (MR) is a complex valve lesion that can pose significant management challenges for the cardiovascular clinician. This Expert Consensus Document emphasizes that recognition of MR should prompt an assessment of its etiology, mechanism, and severity, as well as indications for treatment. A structured approach to evaluation based on clinical findings, precise echocardiographic imaging, and when necessary, adjunctive testing, can help clarify decision making. Treatment goals include timely intervention by an experienced heart team to prevent left ventricular dysfunction, heart failure, reduced quality of life, and premature death...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29045647/mechanical-aortic-valve-replacement-in-non-elderly-adults-meta-analysis-and-microsimulation
#16
Nelleke M Korteland, Jonathan R G Etnel, Bardia Arabkhani, M Mostafa Mokhles, Arezo Mohamad, Jolien W Roos-Hesselink, Ad J J C Bogers, Johanna J M Takkenberg
Aims: To support decision-making regarding prosthetic valve selection in non-elderly adults, we aim to provide a detailed overview of outcome after contemporary mechanical aortic valve replacement (AVR). Methods and results: A systematic review was conducted for papers reporting clinical outcome after AVR with bileaflet mechanical valves with a mean patient age ≥18 and ≤55 years, published between 1 January 1995 and 31 December 2015. Through meta-analysis outcomes were pooled and entered into a microsimulation model to calculate (event-free) life expectancy and lifetime event risk...
May 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29026447/epigenome-alterations-in-aortic-valve-stenosis-and-its-related-left-ventricular-hypertrophy
#17
REVIEW
Igor Gošev, Martina Zeljko, Željko Đurić, Ivana Nikolić, Milorad Gošev, Sanja Ivčević, Dino Bešić, Zoran Legčević, Frane Paić
Aortic valve stenosis is the most common cardiac valve disease, and with current trends in the population demographics, its prevalence is likely to rise, thus posing a major health and economic burden facing the worldwide societies. Over the past decade, it has become more than clear that our traditional genetic views do not sufficiently explain the well-known link between AS, proatherogenic risk factors, flow-induced mechanical forces, and disease-prone environmental influences. Recent breakthroughs in the field of epigenetics offer us a new perspective on gene regulation, which has broadened our perspective on etiology of aortic stenosis and other aortic valve diseases...
2017: Clinical Epigenetics
https://www.readbyqxmd.com/read/29021348/early-right-ventricular-assist-device-use-in-patients-undergoing-continuous-flow-left-ventricular-assist-device-implantation-incidence-and-risk-factors-from-the-interagency-registry-for-mechanically-assisted-circulatory-support
#18
Michael S Kiernan, E Wilson Grandin, Marshall Brinkley, Navin K Kapur, Duc Thinh Pham, Robin Ruthazer, J Eduardo Rame, Pavan Atluri, Edo Y Birati, Guilherme H Oliveira, Francis D Pagani, James K Kirklin, David Naftel, Robert L Kormos, Jeffrey J Teuteberg, David DeNofrio
BACKGROUND: To investigate preimplant risk factors associated with early right ventricular assist device (RVAD) use in patients undergoing continuous-flow left ventricular assist device (LVAD) surgery. METHODS AND RESULTS: Patients in the Interagency Registry for Mechanically Assisted Circulatory Support who underwent primary continuous-flow-LVAD surgery were examined for concurrent or subsequent RVAD implantation within 14 days of LVAD. Risk factors for RVAD implantation and the combined end point of RVAD or death within 14 days of LVAD were assessed with stepwise logistic regression...
October 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29019299/additional-mechanism-for-left-ventricular-dysfunction-chronic-pulmonary-regurgitation-decreases-left-ventricular-preload-in-patients-with-tetralogy-of-fallot
#19
Pekka Ylitalo, Eero Jokinen, Kirsi Lauerma, Miia Holmström, Olli M Pitkänen-Argillander
BACKGROUND: Right ventricular dysfunction in patients with tetralogy of Fallot and significant pulmonary regurgitation may lead to systolic dysfunction of the left ventricle due to altered ventricular interaction. We were interested in determining whether chronic pulmonary regurgitation affects the preload of the left ventricle. In addition, we wanted to study whether severe chronic pulmonary regurgitation would alter the preload of the left ventricle when compared with patients having preserved pulmonary valve annulus...
October 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28988308/improving-the-role-of-echocardiography-in-studying-the-right-ventricle-of-repaired-tetralogy-of-fallot-patients-comparison-with-cardiac-magnetic-resonance
#20
Carolina D'Anna, Armando Caputi, Benedetta Natali, Benedetta Leonardi, Aurelio Secinaro, Gabriele Rinelli, Alessia Del Pasqua, Claudia Esposito, Adriano Carotti, Fabrizio Drago, Marcello Chinali
Right ventricular (RV) evaluation represents one of the major clinical tasks in the follow-up of repaired tetralogy of Fallot patients (rToF) with pulmonary valve regurgitation, as both severe RV dilatation and dysfunction are key factors in defining the need of pulmonary valve replacement. The aim of our study was to report the diagnostic accuracy of echocardiography in the identification of rToF patients with severely dilated and/or depressed RV as compared to cardiac magnetic resonance (CMR). Among our patients with rToF, a subgroup of 95 (17...
October 7, 2017: International Journal of Cardiovascular Imaging
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