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Mechanical valve dysfunction

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https://www.readbyqxmd.com/read/28058458/-vitamin-k-antagonists-is-their-prescription-really-medical-malpractice-%C3%A2-today
#1
E Rafflenbeul, J Müller-Ehmsen
Atrial fibrillation and venous thromboembolisms are frequent cardiovascular diseases. Until a few years ago only vitamin K antagonists (VKA) were available for oral anticoagulation as primary and secondary prevention of thrombembolic events. Currently, the non-vitamin K dependent new oral anticoagulants (NOAC) dabigatran, rivaroxaban, apixaban and edoxaban are approved for use. The approval studies, meta-analyses and data from registries provide evidence for the superiority of NOAC vs. VKA with respect to reduction of thrombembolisms and reduced bleeding complications; therefore, in the 2016 European Society of Cardiology (ESC) guidelines the use of NOAC is recommended as first line therapy for anticoagulation in atrial fibrillation (recommendation grade I/evidence level A)...
January 2017: Der Internist
https://www.readbyqxmd.com/read/28052663/acute-single-leaflet-dysfunction-and-spontaneous-recovery-of-a-previously-implanted-bi-leaflet-mechanical-mitral-prosthesis-during-unrelated-isolated-minimally-invasive-aortic-valve-replacement-a-surgical-decision-making-dilemma-in-a-high-risk-patient
#2
https://www.readbyqxmd.com/read/28046050/postsystolic-shortening-is-associated-with-altered-right-ventricular-function-in-children-after-tetralogy-of-fallot-surgical-repair
#3
Radosław Pietrzak, Bożena Werner
: The aim of the study was to determine whether segmental interactions, as expressed by postsystolic shortening (PSS), affects RV mechanics and are connected with impaired systolic and diastolic function in rTOF children. PATIENTS AND METHODS: 55 rTOF adolescent (study group), and 34 healthy volunteers (control group) were examined using classical Doppler flow (Doppler), Tissue Doppler Imaging (TDI) and Speckle Tracking Echocardiography (STE). PSS was found to occur when time to peak (TTP) was longer than pulmonary valve closure time (PVCT)...
2017: PloS One
https://www.readbyqxmd.com/read/28045414/evaluation-of-left-atrial-mechanical-function-and-atrial-conduction-abnormalities-in-patients-with-isolated-bicuspid-aortic-valve
#4
Arif Arısoy, Kadriye Memiç, Selami Demirelli, Kayıhan Karaman, Fatih Altunkaş, Metin Karayakalı, Yusuf Karavelioğlu, Ataç Çelik
OBJECTIVE: Present study is an evaluation of left atrial (LA) mechanical and conduction function in patients with bicuspid aortic valve (BAV) without significant valve dysfunction, and an investigation of relationship between LA function and aortic elasticity. METHODS: Study population consisted of 34 isolated BAV patients (mean age: 34±13 years) and 29 healthy, age- and sex-matched volunteers (mean age: 30±10 years). LA volume was measured using biplane area-length method and LA active and passive emptying volume and fraction was calculated...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#5
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Rajan Sharma, Anne Child, Mark Edsell, Jean-Pierre van Besouw, Marjan Jahangiri
There is evidence that high surgical volume and team consistency improve outcomes. Mortality of 4%-12% for aortic root surgery has been reported in the United States and UK. We aim to assess outcomes of patients undergoing aortic root surgery by a consistent, high-volume team. Data on patients undergoing elective or urgent aortic root replacement (ARR) were collected prospectively. Patients undergoing emergency surgery were excluded. A standardized perioperative approach was maintained and was achieved by delivering training to team members, including surgical trainees, anesthetic, nursing, and perfusion staff, whenever there was a change of team...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28035639/mycobacterium-infection-from-a-cardiopulmonary-bypass-heater-cooler-unit-in-a-patient-with-steroid-induced-immunosuppression
#6
Yi Cai, Kevin Landolfo, Johnathan R Renew
PURPOSE: To present a case of mycobacterium infection transmitted through a heater-cooler unit during cardiac bypass surgery. CLINICAL FEATURES: A 63-yr-old woman with a past medical history of aortic coarctation repair in 1963 and a mechanical aortic valve replacement in 2010 was prescribed antibiotics and steroids at an outpatient care facility in September 2015 for symptoms of an upper respiratory tract infection. Four months later, she developed malaise and intermittent fever with anemia and acute kidney dysfunction...
December 29, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27989073/surgical-management-and-postoperative-outcomes-of-mechanical-valve-dysfunction-a-six-year-single-center-study
#7
Mingwen Li, Yingbin Xiao, Lin Chen
BACKGROUND: Although many mechanical heart valves are replaced worldwide each year, mechanical valve dysfunction (MVD) remains one of the most common complications following this surgery. In an attempt to improve the postoperative and surgical management of MVD, the study plan was to investigate a group of patients who had undergone redo mechanical valve replacement to treat MVD at the authors' institution. METHODS: A total of 52 consecutive patients diagnosed with MVD underwent redo mechanical valve replacement between January 2007 and December 2013...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27978952/prosthetic-heart-valve-thrombosis
#8
REVIEW
George D Dangas, Jeffrey I Weitz, Gennaro Giustino, Raj Makkar, Roxana Mehran
Although surgery was the mainstay of treatment for valvular heart disease, transcatheter valve therapies have grown exponentially over the past decade. Two types of artificial heart valve exist: mechanical heart valves (MHV), which are implanted surgically, and bioprosthetic heart valves (BHV), which can be implanted via a surgical or transcatheter approach. Whereas long-term anticoagulation is required to prevent thromboembolism after MHV replacement, its value in patients receiving BHVs is uncertain. Patients undergoing transcatheter BHV replacement are at risk for thromboembolism in the first few months, and recent data suggest that the risk continues thereafter...
December 20, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27898434/the-continuing-challenge-of-evaluating-diastolic-function-by-echocardiography-in-children-developing-concepts-and-newer-modalities
#9
Wadi Mawad, Mark K Friedberg
PURPOSE OF REVIEW: Assessment of diastolic function by echocardiography is challenging but important. Left ventricular filling has been more extensively studied than the right ventricle, and predominantly in adult populations. Although multiple parameters exist to assess diastolic function, they all have limitations, including load and heart rate dependency, which make assessment of diastolic function particularly challenging. The purpose of this article is to review evolving concepts and modalities for echo assessment of diastolic function in children...
January 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27856308/dysregulation-of-hyaluronan-homeostasis-during-aortic-valve-disease
#10
Varun K Krishnamurthy, Andrew J Stout, Matthew C Sapp, Brittany Matuska, Mark E Lauer, K Jane Grande-Allen
Aortic valve disease (AVD) is one of the leading causes of cardiovascular mortality. Abnormal expression of hyaluronan (HA) and its synthesizing/degrading enzymes have been observed during latent AVD however, the mechanism of impaired HA homeostasis prior to and after the onset of AVD remains unexplored. Transforming growth factor beta (TGFβ) pathway defects and biomechanical dysfunction are hallmarks of AVD, however their association with altered HA regulation is understudied. Expression of HA homeostatic markers was evaluated in diseased human aortic valves and TGFβ1-cultured porcine aortic valve tissues using histology, immunohistochemistry and Western blotting...
November 15, 2016: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/27805283/increased-valvulo-arterial-impedance-differently-impacts-left-ventricular-longitudinal-circumferential-and-radial-function-in-patients-with-aortic-stenosis-a-speckle-tracking-echocardiography-study
#11
Elena Galli, Alain Leguerrier, Erwan Flecher, Christophe Leclercq, Erwan Donal
BACKGROUND: In aortic stenosis (AS), the left ventricle (LV) should face an increased afterload that is due to both the stenotic aortic valve and the peripheral vascular resistance (PVR). Valvulo-arterial impedance (ZVa ) is a recently introduced parameter, which permits the evaluation of global LV afterload in AS. Aim of this study was to assess the influence of increasing ZVa on the longitudinal, circumferential, and radial components of LV mechanics. METHODS: A total of 126 patients (mean age: 80...
November 2, 2016: Echocardiography
https://www.readbyqxmd.com/read/27789554/lnc-ing-notch1-to-idiopathic-calcific-aortic-valve-disease
#12
EDITORIAL
W David Merryman, Cynthia R Clark
No abstract text is available yet for this article.
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27770000/left-and-right-ventricular-hemodynamic-forces-in-healthy-volunteers-and-elite-athletes-assessed-with-4d-flow-magnetic-resonance-imaging
#13
Per Martin Arvidsson, Johannes Töger, Marcus Carlsson, Katarina Steding-Ehrenborg, Gianni Pedrizzetti, Einar Heiberg, Hakan Arheden
Intracardiac blood flow is driven by hemodynamic forces that are exchanged between the blood and myocardium. Previous studies have been limited to 2D measurements or investigated only LV forces. Right ventricular forces and their mechanistic contribution to asymmetric redirection of flow in the RV have not been measured. We therefore aimed to quantify three-dimensional hemodynamic forces in both ventricles in a cohort of healthy subjects, using magnetic resonance imaging 4D flow measurements. 25 controls,14 elite endurance athletes, and two patients with left ventricular dyssynchrony were included...
October 21, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27756541/growth-and-maturation-of-heart-valves-leads-to-changes-in-endothelial-cell-distribution-impaired-function-decreased-metabolism-and-reduced-cell-proliferation
#14
Lindsey J Anstine, Chris Bobba, Samir Ghadiali, Joy Lincoln
Risk factors of heart valve disease are well defined and prolonged exposure throughout life leads to degeneration and dysfunction in up to 33% of the population. While aortic valve replacement remains the most common need for cardiovascular surgery particularly in those aged over 65, the underlying mechanisms of progressive deterioration are unknown. In other cardiovascular systems, a decline in endothelial cell integrity and function play a major role in promoting pathological changes, and while similar mechanisms have been speculated in the valves, studies to support this are lacking...
November 2016: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/27716559/patients-with-calcific-aortic-stenosis-exhibit-systemic-molecular-evidence-of-ischemia-enhanced-coagulation-oxidative-stress-and-impaired-cholesterol-transport
#15
Laura Mourino-Alvarez, Montserrat Baldan-Martin, Laura Gonzalez-Calero, Carlos Martinez-Laborde, Tamara Sastre-Oliva, Rafael Moreno-Luna, Luis F Lopez-Almodovar, Pedro L Sanchez, Francisco Fernandez-Aviles, Fernando Vivanco, Luis R Padial, Finn Akerstrom, Gloria Alvarez-Llamas, Fernando de la Cuesta, María G Barderas
BACKGROUND: The most common valve diseases are calcific aortic stenosis (AS) and aortic regurgitation (AR). The former is characterized by thickening of valve leaflets followed by progressive calcification, which produces progressive aortic valve (AV) narrowing, increased pressure afterload on the left ventricle (LV) and subsequent LV hypertrophy. On the other hand, AR is due to malcoaptation of the valve leaflets with resultant diastolic reflux of blood from aorta back to the LV producing volume and pressure overload and progressive LV dilatation...
September 26, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27677877/the-association-between-the-transfusion-of-small-volumes-of-leucocyte-depleted-red-blood-cells-and-outcomes-in-patients-undergoing-open-heart-valve-surgery
#16
Armin Zittermann, Andreas Koster, David Faraoni, Jochen Börgermann, Uwe Schirmer, Jan F Gummert
OBJECTIVES: The relationship between the transfusion of red blood cell (RBC) units and outcomes in patients undergoing cardiac surgery is the subject of intense debates. In this study, we investigated the relationship between the transfusion of 1-2 leucocyte-depleted (LD) RBC units and outcomes in patients undergoing open-heart valve surgery. METHODS: The investigation encompassed consecutive patients undergoing open-heart valve surgery at our institution between July 2009 and March 2015 who received no (RBC- group) or 1-2 units of LD RBC (RBC+ group)...
September 27, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27645963/complete-transversal-disc-fracture-in-a-bj%C3%A3-rk-shiley-delrin-mitral-valve-prosthesis-43-years-after-implantation
#17
Jose María González-Santos, María Elena Arnáiz-García, María José Dalmau-Sorlí, Jose Alfonso Sastre-Rincón, Jesús Hernández-Hernández, María Elena Pérez-Losada, Víctor Sagredo-Meneses, Javier López-Rodríguez
A patient who underwent previous implantation of a mitral valve replacement with a Björk-Shiley Delrin (BSD) mitral valve prosthesis during infancy was admitted to our institution 43 years later after an episode of syncope and cardiac arrest. Under extreme hemodynamic instability, a mitral valve prosthetic dysfunction causing massive mitral regurgitation was identified. The patient underwent an emergent cardiac operation, and a complete disc fracture with partial disc migration was found. Exceptional cases of mechanical prosthetic heart valve fracture exist...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27636399/which-type-of-valve-should-we-use-in-tricuspid-position-long-term-comparison-between-mechanical-and-biological-valves
#18
Ana Redondo Palacios, José López Menéndez, Javier Miguelena Hycka, Miren Martín García, Laura Varela Barca, Andrea Ferreiro Marzal, Rafael Muñoz Pérez, Enrique Oliva De Anquín, Ignacio García Andrade, Tomasa Centella Hernández, Daniel Celemín Canorea, Jorge Rodríguez-Roda Stuart
BACKGROUND: Nowadays, Tricuspid valve replacement (TVR) is much less common than aortic or mitral valve replacement, since repair is almost always preferable. Prosthetic tricuspid valves are associated with high mortality and morbidity, mostly due to thrombotic or hemorrhagic events. Nevertheless, there is lack of evidence of which is the optimal type of valve (biological versus mechanical) in tricuspid position. METHODS: We analysed all the patients who underwent TVR in our Institution, from 2005 to 2015...
September 16, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27601135/relationship-between-abnormal-p-wave-terminal-force-in-lead-v1-and-left-ventricular-diastolic-dysfunction-in-hypertensive-patients-the-life-study
#19
Michael T Tanoue, Sverre E Kjeldsen, Richard B Devereux, Peter M Okin
BACKGROUND: Abnormal P-wave terminal force in lead V1 (PTF-V1) is an ECG marker of increased left atrial (LA) volume, elevated LA filling pressures and/or LA systolic dysfunction. Because left ventricular (LV) diastolic dysfunction is one of the potential mechanisms driving LA remodelling, we hypothesized that PTF-V1 might be an additional ECG marker of diastolic dysfunction. METHODS: LV diastolic function after 3 years' systematic antihypertensive treatment was examined in relation to baseline PTF-V1 in 431 hypertensive patients undergoing protocol-driven blood pressure reduction who had baseline and year-3 ECG and echocardiographic data and a preserved LV ejection fraction (EF >45%) at year-3...
April 2017: Blood Pressure
https://www.readbyqxmd.com/read/27535338/novel-mechanistic-insights-into-atrial-functional-mitral-regurgitation%C3%A3-3-dimensional-echocardiographic-study
#20
Tomoko Machino-Ohtsuka, Yoshihiro Seo, Tomoko Ishizu, Kimi Sato, Akinori Sugano, Masayoshi Yamamoto, Yoshie Hamada-Harimura, Kazutaka Aonuma
BACKGROUND: Left atrial remodeling caused by persistent atrial fibrillation (AF) causes atrial functional mitral regurgitation (MR), even though left ventricular (LV) remodeling and organic changes of the mitral leaflets are lacking. The detailed mechanism of atrial functional MR has not been fully investigated. METHODS AND RESULTS: Of 1,167 patients with AF who underwent 3D transesophageal echocardiography, 75 patients were retrospectively selected who developed no, mild, or moderate-to-severe atrial functional MR (n=25 in each group) despite an LV ejection fraction ≥50% and LV volumes within the normal range...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
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