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Koichi Muramatsu, Noriyasu Kawada, Toshiyuki Hoshina, Hirokuni Naganuma, Kazuhiro Hasimoto
A 65-year-old woman with severe mitral stenosis was admitted to our hospital. She had been previously diagnosed with systemic lupus erythematosus (SLE) and had been taking prednisolone (5 mg/day) for 19 years. As SLE patients with prolonged steroid use are known to be at risk of an aortic dissection and aneurysm, femoral artery was chosen for arterial perfusion to reduce the risk of a dissection of the ascending aorta. However, hemostasis was difficult at the insertion point of the catheter to infuse the antegrade cardioplegic solution...
October 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Davina Gorton, Suchandan Sikder, Natasha L Williams, Lisa Chilton, Catherine M Rush, Brenda L Govan, Madeleine W Cunningham, Natkunam Ketheesan
Rheumatic fever and rheumatic heart disease (RF/RHD) develop following repeated infection with group A streptococci (GAS). We used the Rat Autoimmune Valvulitis (RAV) model of RF/RHD to demonstrate that repetitive booster immunization with GAS-derived recombinant M protein (rM5) resulted in an enhanced anti-cardiac myosin antibody response that may contribute to the breaking of immune tolerance leading to RF/RHD and increased infiltration of heart valves by mononuclear cells. With each boost, more inflammatory cells were observed infiltrating heart tissue which could lead to severe cardiac damage...
August 25, 2016: Autoimmunity
Michael R Batzloff, Anne Fane, Davina Gorton, Manisha Pandey, Tania Rivera-Hernandez, Ainslie Calcutt, Grace Yeung, Jon Hartas, Linda Johnson, Catherine M Rush, James McCarthy, Natkunam Ketheesan, Michael F Good
Streptococcus pyogenes (group A streptococcus, GAS) causes a wide range of clinical manifestations ranging from mild self-limiting pyoderma to invasive diseases such as sepsis. Also of concern are the post-infectious immune-mediated diseases including rheumatic heart disease. The development of a vaccine against GAS would have a large health impact on populations at risk of these diseases. However, there is a lack of suitable models for the safety evaluation of vaccines with respect to post-infectious complications...
August 19, 2016: Human Vaccines & Immunotherapeutics
Ali Naderi Mahabadi, Bassam Alhaddad, Stanley Ballou
Cardiac involvement is fairly common in patients with systemic lupus erythematosus (SLE). It may involve all layers of the heart and coronary arteries as well as the heart valves. We report an extremely rare presentation of valvulitis and valvular dysfunction associated with systemic lupus erythematosus. This is the first case of lupus valvulitis which required three mechanical prosthetic valve replacements with disease recurrence leading to a fatal outcome. This is, in our point of view, the consequence of aggressive natural history of the disease and perhaps late diagnosis and treatment of underlying SLE which was unsuccessful...
2016: Case Reports in Rheumatology
Celia McNeilly, Samantha Cosh, Therese Vu, Jemma Nichols, Anna Henningham, Andreas Hofmann, Anne Fane, Pierre R Smeesters, Catherine M Rush, Louise M Hafner, Natkuman Ketheesan, Kadaba S Sriprakash, David J McMillan
The C-terminal region of the M-protein of Streptococcus pyogenes is a major target for vaccine development. The major feature is the C-repeat region, consisting of 35-42 amino acid repeat units that display high but not perfect identity. SV1 is a S. pyogenes vaccine candidate that incorporates five 14mer amino acid sequences (called J14i variants) from differing C-repeat units in a single recombinant construct. Here we show that the J14i variants chosen for inclusion in SV1 are the most common variants in a dataset of 176 unique M-proteins...
2016: PloS One
Camille Rérolle, Maxime Faisant, Thierry Lefrancq, Pauline Saint-Martin
We report the case of a 5-year-old boy who died from complications of rheumatic heart disease with atypical presentation. He was hospitalized for recent inflammatory and neurological symptoms. He was diagnosed with viral encephalitis. He died the day after he was discharged. The macroscopic autopsy findings were unremarkable. Histology revealed typical rheumatic heart disease. Neuropathology showed cerebral infarction due to an embolic event linked with the rheumatic valvulitis. The cause of death was determined as heart failure due to rheumatic heart disease secondary to an undiagnosed acute rheumatic fever...
May 2016: Journal of Forensic Sciences
Cengiz Ozturk, Hamidullah Haqmal, Sevket Balta, Sait Demirkol, Murat Unlu, Mustafa Koklu, Ali Osman Yildirim, Mustafa Demir, Turgay Celik, Atila Iyisoy
No abstract text is available yet for this article.
April 1, 2016: International Journal of Cardiology
Fujito Numano, Chisato Shimizu, Adriana H Tremoulet, Dan Dyar, Jane C Burns, Beth F Printz
Coronary artery inflammation and aneurysm formation are the most common complications of Kawasaki disease (KD). Valvulitis and myocarditis are also well described and may lead to valvar regurgitation and left ventricular dysfunction. However, functional changes in the right heart have rarely been reported. We noted several acute KD patients with dilated pulmonary arteries (PA) and thus sought to systematically characterize PA size and right-heart function in an unselected cohort of KD patients cared for at a single clinical center...
March 2016: Pediatric Cardiology
D G Buys, C Greig, S C Brown
Congenital heart lesions involving the right ventricular outflow tract (RVOT) are a common problem in paediatric cardiology. These patients need multiple surgical interventions in the form of valved conduits over a lifetime. Surgical re-valvulation was the standard treatment option until the introduction of percutaneous pulmonary valves over a decade ago. These valves can be used to prolong the lifespan of conduits and reduce the number of re-operations. The Melody(®) valve (Medtronic, Minneapolis, MN, USA) was introduced as the first dedicated percutaneous pulmonary valve...
July 2015: Cardiovascular Journal of Africa
Ying-Jui Lin, Ming-Chou Cheng, Mao-Hung Lo, Shao-Ju Chien
BACKGROUND: Kawasaki disease shock syndrome (KDSS) and toxic shock syndrome (TSS) can present as shock and fever with skin rash, but the management of these 2 groups of patients is different. This report proposes to help clinicians earlier distinguish these 2 diseases and expedite institution of appropriate therapy. METHODS: We retrospectively reviewed the medical records of patients admitted to the pediatric intensive care unit with the diagnosis of KDSS or TSS from January 2000 through December 2010...
November 2015: Pediatric Infectious Disease Journal
Shahzad Khan, Athanasios Smyrlis, Dmitry Yaranov, David Oelberg, Eric Jimenez
Infective endocarditis (IE) is an infection of the endocardium that involves valves and adjacent mural endocardium or a septal defect. Local complications include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. If left untreated, IE is generally fatal. Diagnosing IE can be straightforward in patients with the typical oslerian manifestations such as bacteremia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena...
2015: Case Reports in Cardiology
G M Bushmanova, I G Zorina, D B Nikityuk, R D Nepomnyashchikh, G A Lapii, O A Postnikova, D E Semenov
Results of long-term prospective follow-up of patients with early stages of mitral and aortic valvulitis and primary chronic septic endocarditic are presented. Clinical diagnostics of the diseases is described and the key role is assigned to pathognomic (absolute) clinical symptoms. The tendency to progressive fibrosis of endocardial structures with subsequent gradual development of valve dysfunction and stenosis (especially for the mitral valve) is revealed. It is shown that early treatment increases the effective valve area and promotes reversion of mitral stenosis...
May 2015: Bulletin of Experimental Biology and Medicine
Michael Yeong, Marcus Silbery, Kirsten Finucane, Nigel J Wilson, Thomas L Gentles
Rheumatic mitral valve disease is associated with valvulitis and valvular regurgitation; however, the effect of the rheumatic process on the mitral valve geometry and function is not well understood. To assess mitral valve annulus remodelling in rheumatic mitral valve disease, 16 subjects aged 6-15 years with rheumatic mitral valve regurgitation [MR] [6 mild or moderate (Group 1), 10 severe (Group 2)] and 7 age- and body size-matched normal controls with adequate trans-thoracic echocardiograms were recruited...
April 2015: Pediatric Cardiology
Sebastien Hascoët, Philippe Acar, Younes Boudjemline
Since the first transcatheter implantation of a pulmonary valve in 2000 in a twelve year-old boy with a dysfunctional right ventricle to pulmonary artery conduit by Philip Bonhoeffer and Younes Boudjemline, the Melody(®) valve has become worldwide used. It represents an efficient alternative to open-heart surgery. We aimed in this comprehensive review to describe the current indications of percutaneous pulmonary valve implantation, the devices currently used and the clinical results.
November 2014: Archives of Cardiovascular Diseases
Catherine M Rush, Brenda L Govan, Suchandan Sikder, Natasha L Williams, Natkunam Ketheesan
Rheumatic fever (RF) and rheumatic heart disease (RHD) are sequelae of group A streptococcal (GAS) infection. Although an autoimmune process has long been considered to be responsible for the initiation of RF/RHD, it is only in the last few decades that the mechanisms involved in the pathogenesis of the inflammatory condition have been unraveled partly due to experimentation on animal models. RF/RHD is a uniquely human condition and modeling this disease in animals is challenging. Antibody and T cell responses to recombinant GAS M protein (rM) and the subsequent interactions with cardiac tissue have been predominantly investigated using a rat autoimmune valvulitis model...
2014: Frontiers in Pediatrics
Sophie Malekzadeh-Milani, Magalie Ladouceur, Laurence Iserin, Younes Boudjemline
BACKGROUND: Fontan circulation is fragile and unfavourable evolution is frequent. Fontan physiology largely depends on respiration and gravity. The hypothesis for valvulation is that valvulation of the circuit reduces the effects of respiration and the proclive position, and increases anterograde flow towards the systemic circulation, with increasing exercise capacity and benefits for enteropathy. Because it originates from the bovine jugular vein, the Melody(®) valve (Medtronic, Minneapolis, MN, USA) is naturally designed to work in a low-pressure environment...
November 2014: Archives of Cardiovascular Diseases
Zakaria Jalal, Jean-Benoit Thambo, Younes Boudjemline
Percutaneous pulmonary valve implantation now has a key role in the setting of dysfunctional right ventricle-to-pulmonary artery conduits or failing bioprosthetic pulmonary valves. However, despite the excellent results obtained with the two devices available currently (the Melody(®) valve [Medtronic Inc., Minneapolis, MN, USA] and the Edwards SAPIEN(®) valve [Edwards Lifesciences, Irvine, CA, USA]), many patients eligible for pulmonary valve replacement remain unsuitable for percutaneous pulmonary valve implantation, mainly because of large native outflow tracts...
November 2014: Archives of Cardiovascular Diseases
Sophie Malekzadeh-Milani, Magalie Ladouceur, Sarah Cohen, Laurence Iserin, Younes Boudjemline
BACKGROUND: Although widely accepted worldwide, indications for percutaneous valve replacement are limited to treatment of dysfunction of prosthetic conduits inserted in the right ventricular outflow tract (RVOT). There has been little evaluation of the use of the Melody(®) valve for patched non-circular pulmonary pathways. AIM: To evaluate the outcomes of Melody valve insertion in patients with a patched non-circular RVOT. METHODS: We analysed procedural and outcomes data from 34 patients who underwent Melody valve implantation for a non-circular RVOT...
November 2014: Archives of Cardiovascular Diseases
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
Jennifer A Collins, Yang Zhang, Allen P Burke
BACKGROUND: There are few studies on the histologic findings in native infective endocarditis, especially regarding mimics of autoimmune valvulitis. METHODS: We prospectively studied 106 surgical specimens from 95 patients with a clinical diagnosis of infective endocarditis on native valves, and compared gross and histologic findings with culture results, underlying valve disease, risk factors and time interval from symptom onset to surgical intervention. RESULTS: There were 41 (39%) aortic, 33 (31%) mitral, 9 (9%) tricuspid, 1(...
December 2014: Pathology, Research and Practice
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