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Prosthetic valve disease

Nader Makki, Xu Ghao, Bryan Whitson, Satya Shreenivas, Juan Crestanello, Scott Lilly
BACKGROUND: Precise quantification of paravalvular aortic regurgitation (PAR) is challenging. Aortic regurgitation index (AR index) has been validated in transcatheter aortic valve replacement (TAVR) cohorts; however, accuracy is limited by heart rate dependency. Diastolic pressure time (DPT) index has been suggested as an alternative and also predicts mortality after TAVR. We chose to evaluate the left ventricular diastolic filling slope (LVDFS) as a surrogate of AR, and suggest it is less heart rate dependent than the AR index and comparable to DPT index...
July 18, 2018: Catheterization and Cardiovascular Interventions
Gregory Y H Lip, Martin Jensen, Line Melgaard, Flemming Skjøth, Peter Brønnum Nielsen, Torben Bjerregaard Larsen
Aims: Substantial interest has been directed towards stroke risk stratification in patients with atrial fibrillation (AF) but prior studies have focused on AF without significant valvular heart disease (VHD), so-called 'non-valvular AF'. A formal validation exercise addressing stroke risks in relation to the CHA2DS2-VASc risk factor(s) in AF patients with VHD is lacking. Also, the use of the HAS-BLED score in anticoagulated patients with VHD has not been previously studied. The aim of this study was to investigate stroke and bleeding rates in AF patients with VHD in relation to the CHA2DS2-VASc and HAS-BLED scores...
July 6, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Mahmut Yesin, Süleyman Karakoyun, Macit Kalçık, Mustafa Ozan Gürsoy, Sabahattin Gündüz, Mehmet Ali Astarcıoğlu, Emrah Bayam, Sinan Cerşit, Ahmet Güner, Mehmet Özkan
Coronary thromboembolism (CE) is a rare cause of prosthetic valve derived complications. This study investigates the diagnosis and treatment strategies for non-ST elevation acute coronary syndrome (NSTEACS) in patients with prosthetic heart valves. Forty-eight NSTEACS patients with prosthetic heart valves (mitral:27; aortic:14; mitral+aortic:7) were included in this study. All patients underwent transthoracic and transesophageal echocardiographic examination and coronary angiography. Normal coronary angiographic findings, or visible trombus in one of the coronary arteries, international normalized ratio <2, concomitant prosthetic valve thrombosis (PVT) and absence of multivessel atherosclerotic disease favored CE rather than atherothrombosis...
May 11, 2018: American Journal of Cardiology
Rafael Quaresma Garrido, José Oscar Dos Reis Brito, Ralph Fernandes, Giovanna Ferraiuoli Barbosa, Marcelo Goulart Correia, Wilma Felix Golebiovski, Clara Weksler, Cristiane C Lamas
BACKGROUND: Early onset prosthetic valve endocarditis (EO-PVE) is an serious complication associated with heart valve replacement surgery. OBJECTIVES: To describe the epidemiologic, clinical, and laboratory profile of patients with EO-PVE in a cardiac surgical hospital. PATIENTS AND METHODS: A retrospective analysis of an endocarditis database, implemented prospectively, with a post hoc study driven by analysis of cases of adults with definite endocarditis occurring up to 12 months after heart valve surgery...
July 2018: Surgical Infections
Henry Y Chen, Jose A Diaz, Fedor Lurie, Sean D Chambers, Ghassan S Kassab
BACKGROUND: It has been shown that venous valves have pairing arrangements with specific relative orientation and spacing that contribute to helical flows. The studies to date have not quantified the hemodynamic impact of helical flow formation. A computational model allows various valve orientations and spacings to be studied to better understand the hemodynamic effect of valve pairing. METHODS: Simulations were performed for paired valves at physiologically relevant spacing and orientations to study the flow features and hemodynamics associated with valve pairing configurations...
July 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Ashleigh Long, Paul Mahoney
BACKGROUND: Transcatheter mitral valve-in-valve (TMVIV) or valve-in-ring (TMVIR) replacement has shown early promise in patients deemed poor surgical candidates as a less invasive alternative to conventional reoperative mitral valve (MV) replacement. OBJECTIVE: This retrospective, single-center study reviewed the procedural outcomes of all TMVIV and TMVIR procedures between 2013-2018 at a large tertiary referral center serving the southeastern United States. An analysis of patient safety measures was also performed, with a retrospective assessment of relative procedural safety that included preoperative risk stratification and postoperative mortality predictors, operative time, average blood loss, length of hospital stay, and readmission rates...
June 15, 2018: Journal of Invasive Cardiology
Christina Petridou, Lenka Strakova, Ruan Simpson
Introduction: Campylobacter is a common pathogen of the gastrointestinal tract, but invasive disease is rare. Campylobacter fetus can play a role in osteomyelitis, meningitis and joint infection and has a prediliction for the vascular endothelium, causing mycotic aneurysms, thrombophlebitis and endocarditis. Here we present a case of prosthetic valve endocarditis caused by C. fetus and a review of the literature. Case presentation: An 85-year-old woman with a tissue aortic valve replacement and atrial fibrillation was admitted to hospital with tonic-clonic seizures, right-sided hemiparesis, facial droop and hemianopia...
May 2018: JMM Case Reports
Athina Chasapi, Adam Hobbs, Theodore Velissaris, Benoy N Shah
No abstract text is available yet for this article.
September 2018: Echo Research and Practice
Kana Kubota, Katsura Soma, Masae Uehara, Toshiro Inaba, Akihito Saito, Norihiko Takeda, Masaru Hatano, Hiroyuki Morita, Ryo Inuzuka, Yasutaka Hirata, Atsushi Yao, Issei Komuro
Candida prosthetic endocarditis (CPE) is an uncommon and fatal complication in adults with congenital heart disease. The current guidelines for the management of fungal endocarditis recommend a combination of surgical and medical therapy. However, it still remains uncertain when surgical management in CPE patients should be performed. Therefore, the prognosis of CPE patients is very poor. Here we report a case of CPE in a 31-year-old woman who had undergone surgical repair for tetralogy of Fallot during childhood and pulmonary valve replacement at the age of 21 years...
June 6, 2018: International Heart Journal
Yiğit Çanga, Tolga Sinan Güvenç, Ali Nazmi Çalık, Mehmet Baran Karataş, Evliya Akdeniz, Gizem Yüksel, Ayşe Emre
BACKGROUND: Warfarin-related nephropathy (WRN) is a complication of warfarin over-anticoagulation that is associated with acute and/or chronic renal dysfunction and increased mortality. The long-term effects of warfarin on renal function has not been adequately studied in patients with a mechanical prosthetic valve (MPV). AIM: To study the time-dependent effects of over-anticoagulation on renal function in patients with a MPV. METHODS: A total of 193 patients who underwent MPV implantation and were followed up in this study were eligible for inclusion...
June 4, 2018: Wiener Klinische Wochenschrift
Lucia Musumeci, Nicolas Jacques, Alexandre Hego, Alain Nchimi, Patrizio Lancellotti, Cécile Oury
Aortic Valve Disease (AVD) is the most common Valvular Heart Disease (VHD), affecting millions of people worldwide. Severe AVD is treated in most cases with prosthetic aortic valve replacement, which involves the substitution of the native aortic valve with a prosthetic one. In this review we will discuss the different types of prosthetic aortic valves available for implantation and the challenges faced by patients, medical doctors, researchers and manufacturers, as well as the approaches that are taken to overcome them...
2018: Frontiers in Cardiovascular Medicine
Prerna Sharma, Mohamed Yassin
Introduction: Listeria monocytogenes is a food-borne pathogen which can cause invasive infection in immunocompromised adults. Listeria has been known to cause infections during pregnancy and in older adults. Listeria endocarditis is a rare condition. A case of listeria-related intracardiac device infection is reported below. Case Report: A 74-year-old male with a past medical history of coronary artery disease, congestive cardiac failure, permanent atrial fibrillation status after nodal ablation, and placement of a biventricular pacemaker presented to the hospital with complaints of generalized fatigue...
2018: Case Reports in Medicine
Heleen Lameijer, Ymkje J van Slooten, Monique R M Jongbloed, Martijn A Oudijk, Marlies A M Kampman, Arie P van Dijk, Marco C Post, Barbara J Mulder, Krystyna M Sollie, Dirk J van Veldhuisen, Tjark Ebels, Joost P van Melle, Petronella G Pieper
BACKGROUND: We evaluate pregnancy outcome and anticoagulation regimes in women with mechanical and biological prosthetic heart valves (PHV) for congenital heart disease. METHODS: Retrospective multicenter cohort studying pregnancy outcomes in an existing cohort of patients with PHV. RESULTS: 52 women had 102 pregnancies of which 78 pregnancies (46 women) ≥20 weeks duration (59 biological, 19 mechanical PHV). Miscarriages (n = 19, ≤20 weeks) occurred more frequently in women using anticoagulation (P < ...
May 23, 2018: International Journal of Cardiology
Lauge Østergaard, Kasper Adelborg, Jens Sundbøll, Lars Pedersen, Emil Loldrup Fosbøl, Morten Schmidt
The positive predictive value of an infective endocarditis diagnosis is approximately 80% in the Danish National Patient Registry. However, since infective endocarditis is a heterogeneous disease implying long-term intravenous treatment, we hypothesiszed that the positive predictive value varies by length of hospital stay. A total of 100 patients with first-time infective endocarditis in the Danish National Patient Registry were identified from January 2010 - December 2012 at the University hospital of Aarhus and regional hospitals of Herning and Randers...
May 30, 2018: Epidemiology and Infection
Aisha Shakoor, Ahmed El-Isa, Elizabeth Kinsella, Ryan Halas, Andrey Leonov
Infective endocarditis (IE) results from bacterial or fungal infection and is associated with significant morbidity and mortality. Several known risk factors exist for endocarditis, and 90% of pediatric cases have an underlying structural or congenital heart disease or prosthetic heart valve. Literature on IE in previously healthy children is relatively sparse, and the pathogenesis and underlying risk factors remain mostly unknown. Our patient was a 3-year-old male with a unique presentation of IE. His lack of structural and congenital risk factors for endocarditis prompted further workup, and labs were consistent with insufficient immunoglobulin, suggesting a primary immunodeficiency (PAD)...
2018: Case Reports in Infectious Diseases
James E Scriven, Antonia Scobie, Neville Q Verlander, Angela Houston, Tim Collyns, Vjeran Cajic, Onn Min Kon, Tamara Mitchell, Omar Rahama, Amy Robinson, Shirmila Withama, Peter Wilson, David Maxwell, Daniel Agranoff, Eleri Davies, Meirion Llewelyn, Shiu-Shing Soo, Amandip Sahota, Mike Cooper, Michael Hunter, Jennifer Tomlins, Simon Tiberi, Simon Kendall, Martin Dedicoat, Eliza Alexander, Teresa Fenech, Maria Zambon, Theresa Lamagni, E Grace Smith, Meera Chand
OBJECTIVES: Mycobacterium chimaera infection following cardiac surgery, due to contaminated cardiopulmonary bypass heater-cooler units, has been reported worldwide. However, the spectrum of clinical disease remains poorly understood. To address this, we report the clinical and laboratory features, treatment and outcome of the first 30 UK cases. METHODS: Case note review was performed for cases identified retrospectively through outbreak investigations and prospectively through on-going surveillance...
May 24, 2018: Clinical Microbiology and Infection
Sonia Chowdhury, Matthew L German
Endocarditis (IE) is defined by an infection of a native or prosthetic heart valve, the mural endocardium, or an indwelling cardiac device. Although viridan-group streptococci (VGS) and Staphylococci species have collectively been considered as the most common cause of endocarditis, uncommon pathogens may also lead to the disease with significant morbidity and mortality. Abiotrophia defectiva , a nutritionally variant streptococci (NVS), is a virulent bacterium that preferentially affects endovascular structure and is implicated in many culture-negative endocarditis with dreadful complications such as heart failure, septic embolization, and valve destruction...
2018: Case Reports in Infectious Diseases
Hideharu Hagiya, Takuya Semba, Takeshi Morimoto, Norihisa Yamamoto, Hisao Yoshida, Kazunori Tomono
Lancefield group G β-hemolytic Streptococcus dysgalactiae subspecies equisimilis (SDSE) has become a leading causative pathogen of invasive streptococcal infection. In this report, we describe a case of disseminated SDSE infection complicated by endogenous endophthalmitis, resulting in panophthalmitis and blindness. A 65-year-old man who underwent mitral valve replacement surgery two months previously was hospitalized due to high fever and right visual loss. A systemic investigation revealed endophthalmitis complicated by mediastinal abscess, prosthetic infective endocarditis, cerebral emboli and hemorrhage, and multiple arthritis...
May 8, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Daniel Tanase, Peter Ewert, Alfred Hager, Stanimir Georgiev, Julie Cleuziou, John Hess, Andreas Eicken
BACKGROUND: Patients with congenital cardiovascular disease involving the right ventricular outflow tract and with prosthetic valves in the heart are at high risk for developing infective endocarditis (IE). Recently, there has been concern about relatively high rates of IE after percutaneous pulmonary valve implantation (PPVI). Although there are factors specific to percutaneous valves that could plausibly contribute to the risk of IE, including procedural steps prior to implantation such as crimping the valved stent or mechanical forces during dilation, little is known about actual risk factors for this complication...
August 15, 2018: International Journal of Cardiology
Prasanna Subbaraju, Shipra Rai, Jwalit Morakhia, Geet Midha, Asha Kamath, Kavitha Saravu
AIMS: To dissect the clinical-microbiological profile of Infective endocarditis (IE) population and to determine the risk factors for IE related mortality. METHODS: A cohort study was conducted using relevant data from clinical records of patients (≥12years) with definite/possible IE from December 2007 to December 2013 and was analyzed using appropriate statistical tests. RESULTS: In the cohort of 139 IE patients, mean age was 47.9±15.8years, with male preponderance (68...
March 2018: Indian Heart Journal
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