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1/233. aortitis with multiple aneurysms mimicking infective endocarditis.

    aortitis usually produces aortic insufficiency by aortic root dilation. In rare cases the inflammation may involve the aortic valve cusps, causing valvular insufficiency. A patient in whom aortitis produced valvular masses, with aortic and peripheral arterial aneurysms, embolic episodes and aortic insufficiency is described. Valve replacement for suspected infective endocarditis was complicated by homograft dehiscence and multiple false aneurysms. Although immunosuppression was successful in decreasing the patient's vasculitis, he became infected and died of complications of aspergillus infection.
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keywords = insufficiency
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2/233. Massive left atrial thrombus: a case report.

    This case report describes a patient with aortic and mitral valvular disease who had a massive left atrial thrombus. The left atrial thrombus produced a disappearance of signs of mitral stenosis and a reversed pan diastolic mitral valve gradient. This gradient occurred in the absence of any diastolic mitral insufficiency and may have been due to artifactual lowering of the left atrial pressure by an organized left atrial clot.
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3/233. Mitral valve replacement through dilated aortic annulus in Marfan's syndrome.

    A 30-year-old man presented with severe aortic regurgitation due to an ascending aortic aneurysm and mitral valve insufficiency in conjunction with active endocarditis. He underwent combined aortic root replacement by a composite graft and mechanical mitral valve replacement. After excision of the aortic valve cusps the mitral valve was approached through the extremely dilated aortic annulus. This technique is seldom used. Mitral valve replacement through the aortic root can be advantageous in selected patients to minimize trauma and reduce myocardial ischemic time.
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keywords = insufficiency
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4/233. Ventricular thrombus and subarachnoid bleeding during support with ventricular assist devices.

    We report the case of a 23-year-old man with acute aortic valve insufficiency caused by endocarditis, who after emergency aortic valve replacement developed biventricular heart failure. The heart failure was treated with temporary assist devices. Subarachnoid bleeding and thrombus obstruction of the left ventricular outflow tract was detected. The postoperative course is presented with special emphasis on management of subarachnoid bleeding and the simultaneous use of anticoagulation necessary for ventricular assist devices.
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5/233. Congenital aortic insufficiency due to aortic cusp stretching: 'kite anomaly'.

    Aortic insufficiency may be either acquired or congenital. A 46-year-old male had a congenital pathology which resulted in aortic insufficiency due to the presence of a fibrous band that stretched from the non-coronary cusp to the aortic wall. The patient underwent successful aortic valve replacement. At surgery, the fibrous band was stretching the non-coronary cusp so that it prevented coaptation of the aortic valve. The situation was termed by us as the 'kite anomaly'.
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ranking = 2
keywords = insufficiency
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6/233. Ascending aortic aneurysm associated with aortic insufficiency due to Takayasu's arteritis.

    We report the case of a child with an ascending aortic aneurysm associated with aortic insufficiency. Histopathological examination of the ascending aorta and aortic valve showed findings in favor of Takayasu's arteritis, and subsequent evaluation of the entire aorta demonstrated the presence of multiple steno-occlusive lesions. This unusual clinical problem in the young population is discussed with regard to other eventual pathologies that should be taken into account in the differential diagnosis.
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keywords = insufficiency
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7/233. Acute aortic valvulitis as an initial presentation of systemic lupus erythematosus.

    Valvular involvement in patients with systemic lupus erythematosus (SLE) is not uncommon but patients rarely present with it. The mitral valve is most commonly involved. We report a 36-year-old man who had an episode of acute fever, arthritis, and acute aortic insufficiency with a small vegetation at the tip of the aortic valve mimicking infective endocarditis, proven later to be due to SLE. SLE should be considered as one of the uncommon causes of acute aortic insufficiency.
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keywords = insufficiency
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8/233. Acute aortic insufficiency associated with wegener granulomatosis.

    Cardiac valvular involvement associated with wegener granulomatosis is uncommon. We describe a 17-year-old male adolescent who sought medical attention because of a sore throat, arthralgias, low-grade fever, and fatigue of 3 weeks' duration. A rash was noted on his elbows, hands, and ankles; subsequently, a crusting lesion was noted in his internal nares, and infiltrates were detected on chest radiography. blood cultures were negative for pathogens. An echocardiogram disclosed mild left ventricular enlargement with grade 2 aortic insufficiency, and wegener granulomatosis was diagnosed based on an antineutrophil cytoplasmic antibody titer of 1:512. When blood cultures are negative for aortic valve endocarditis, a high index of clinical suspicion and antineutrophil cytoplasmic antibody testing may lead to the diagnosis of acute aortic insufficiency associated with wegener granulomatosis.
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ranking = 2
keywords = insufficiency
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9/233. Aortic valve patch closure: an alternative to replacement with HeartMate LVAS insertion.

    A PTFE patch sewn to the aortic valve and annulus, to occlude the ventriculoaortic junction is used to successfully correct aortic insufficiency with HeartMate (LVAS) insertion. This represents an inexpensive alternative to aortic valve replacement for aortic insufficiency or the presence of a mechanical aortic valve.
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keywords = insufficiency
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10/233. Membranous subpulmonic stenosis associated with ventricular septal defect and aortic insufficiency.

    We present a case report of a patient with conal septal hypoplasia (supracristal) ventricular septal defect (VSD) complicated by aortic insufficiency (AI) and subpulmonic stenosis from a fibrous membrane. The development of AI with VSD is a well-recognized problem. However, the association of VSD, AI, and significant right ventricular outflow tract obstruction (RVOTO) is less common. Mechanisms of RVOTO include prolapse of an aortic valve cusp across the VSD, as well as infundibular hypertrophy or muscle bundles. Technical echocardiographic issues can make the diagnosis of VSD, AI, and RVOTO challenging. The presence of a discrete fibrous subpulmonary membrane is uncommon in this setting.
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keywords = insufficiency
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