1/565. An unusual combination of cardiovascular surgical disorders.A 53-year-year-old man presented with aortic regurgitation, subvalvular and supravalvular aortic stenoses, and aneurysms involving the ascending aorta, the arch, and the innominate, right subclavian, and left common carotid arteries. Surgery consisted of resection of the obstructive lesions, replacement of the aortic valve, graft replacement of the ascending aorta, and the arch resection of innominate and subclavian artery aneurysms and reconstruction with a side limb to which the right carotid artery was anastomosed. The patient has remained asymptomatic with full employment.- - - - - - - - - - ranking = 1keywords = valve (Clic here for more details about this article) |
2/565. Discrete subaortic valvular stenosis: the clinical utility and limitations of transesophageal echocardiography.Transesophageal echocardiography (TEE) is a useful technique in the diagnosis and intraoperative assessment of discrete subaortic stenosis (DSS). It allows clear visualization of the subaortic membrane, which may be missed by transthoracic echocardiography, differentiates DSS from other causes of left ventricular outflow tract obstruction, and accurately detects the presence of associated aortic regurgitation and bacterial endocarditis. Limitations in its use include inadequate visualization of the left ventricular outflow tract by TEE in the presence of a prosthetic mitral valve or mitral annular calcification, and improper alignment of the Doppler cursor across the outflow tract.- - - - - - - - - - ranking = 1keywords = valve (Clic here for more details about this article) |
3/565. Iatrogenic left main coronary artery stenosis.Iatrogenic left main coronary artery stenosis is a potentially life-threatening complication of cardiac valve replacement surgery due to injury by perfusion cannulas. This requires prompt clinical recognition and diagnosis by repeat coronary angiography, and treatment by early coronary artery bypass grafting. We present 3 patients who had normal coronary arteries prior to valve replacement surgery, and who developed severe left main coronary artery stenosis after surgery. Accelerating angina and refractory ventricular arrhythmia were presenting clinical manifestations. coronary artery bypass grafting was successfully performed in all 3 patients.- - - - - - - - - - ranking = 2keywords = valve (Clic here for more details about this article) |
4/565. The Freestyle stentless bioprosthesis for prosthetic valve endocarditis.We report a case of methicillin-resistant staphylococcus aureus-induced prosthetic valve endocarditis, which was successfully treated with aortic valve replacement using the Freestyle stentless bioprosthesis. The total root and stentless design of this bioprosthesis allows for more radical removal of infected tissue and easier treatment for annular abscess, while requiring less prosthetic materials than a conventional prosthesis. This bioprosthesis thus seems to be a valuable option for active endocarditis.- - - - - - - - - - ranking = 6keywords = valve (Clic here for more details about this article) |
5/565. Combined aortic and mitral stenosis in mucopolysaccharidosis type I-S (Ullrich-Scheie syndrome).The genetic mucopolysaccharidosis syndromes (MPS) are autosomal recessive inborn errors of metabolism. Heart valve involvement in MPS is not uncommon but only a few case reports of successful cardiac surgery are available. In particular, reports of combined aortic and mitral stenosis associated with MPS type I-S are very rare. Both type I and type VI MPS are associated with significant left sided valvar heart disease that requires surgical valve replacement because of irregular valve thickening, fibrosis, and calcification. A 35 year old man had severe mitral valve stenosis after successful surgical replacement of a stenotic aortic valve. Valvar heart disease was investigated by cardiac ultrasound and left heart catheterisation. Histomorphological characterisation of the affected mitral valve was performed. The case illustrates typically associated clinical features of cardiac and extracardiac abnormalities found in MPS type I-S.- - - - - - - - - - ranking = 6keywords = valve (Clic here for more details about this article) |
6/565. Recurrent endocarditis in silver-coated heart valve prosthesis.BACKGROUND AND AIM OF THE STUDY: In order to prevent prosthetic valve endocarditis (PVE), the implantation of a new silver-coated sewing ring has been introduced to provide peri- and postoperative protection against microbial infection. methods: A 56-year-old woman with aortic stenosis had elective replacement with a St. Jude Medical mechanical valve fitted with a silver-coated sewing ring (Silzone). The patient developed early PVE, which necessitated reoperation after one month. Despite a second Silzone prosthesis being implanted, the endocarditis recurred. During a third operation an aortic homograft was implanted, and after six months a fourth operation was performed for a pseudoaneurysm at the base of the homograft, in proximity to the anterior mitral valve leaflet. RESULTS: The diagnosis of PVE was confirmed by the presence of continuous fever, transesophageal echocardiography and growth of penicillin-resistant staphylococcus epidermidis from the valve prosthesis. CONCLUSION: The implantation of all prosthetic valves is encumbered with a risk of endocarditis. Although silver has bacteriostatic actions, the advantages of silver-coated prostheses in the treatment of this condition have yet to be assessed in clinical trials.- - - - - - - - - - ranking = 9keywords = valve (Clic here for more details about this article) |
7/565. Spontaneous native aortic valve thrombosis.Spontaneous thrombosis of a native aortic valve is an uncommon event that usually follows local trauma, such as cardiac surgery or left heart catheterization, or occurs as a complication of bacterial endocarditis. We report the case of a 65-year-old woman with a history of retinal artery occlusion and severe aortic valve stenosis, in whom transesophageal echocardiography revealed a mobile mass attached to the ventricular surface of the aortic valve. There was no evidence of any hypercoagulable state or infection process. Surgery was performed and a severely stenotic valve resected; a partially organized and firmly adherent free-floating thrombotic mass was observed on the ventricular surface of the aortic valve. Histologic examination demonstrated an organized thrombus. Eleven months after surgery the patient is doing well.- - - - - - - - - - ranking = 9keywords = valve (Clic here for more details about this article) |
8/565. Aortoventriculoplasty after a prior posterior root enlargement (Manougian): case report.A patient with congenital bicuspid aortic stenosis had an open commissurotomy followed 3 years later by a Manougian's operation along with an aortic valve replacement. Nine years later, due to residual aortic stenosis, a Konno's anterior root enlarging procedure with an aortic valve replacement was successfully done. Good relief of aortic and subaortic stenosis and the absence of significant gradient across the left ventricular outflow tract led us to believe that successful and effective relief could be obtained by adding a Konno-type of enlargement to a previously performed posterior enlargement procedure.- - - - - - - - - - ranking = 2keywords = valve (Clic here for more details about this article) |
9/565. Echocardiographic diagnosis of left ventricular outflow tract obstruction caused by an acquired subaortic membrane after mitral valve replacement.Although an acquired subaortic membrane has been reported as a cause of left ventricular outflow tract (LVOT) obstruction in various clinical settings, it previously has not been reported after mitral valve surgery. We describe 3 cases of acquired LVOT obstruction that resulted from development of a subaortic membrane after mitral valve replacement. This report emphasizes the role of an acquired subaortic membrane in LVOT obstruction after mitral valve replacement, the use of echocardiography in diagnosing this condition, and the importance of early intervention.- - - - - - - - - - ranking = 7keywords = valve (Clic here for more details about this article) |
10/565. Doppler echocardiography as a predictor of pregnancy outcome in the presence of aortic stenosis: A case report.Aortic stenosis in pregnancy can be a life-threatening condition, but fortunately it is rare. In the modern era, careful obstetric and cardiologic monitoring, particularly through echocardiography, have improved fetal and maternal outcomes. However, a test that could predict outcome has not been available for patients with aortic stenosis who seek prepregnancy counseling. We report a case in which exercise Doppler echocardiography was used to predict cardiac function and maximal gradients in a woman with a bicuspid aortic valve who wished to become pregnant.- - - - - - - - - - ranking = 1keywords = valve (Clic here for more details about this article) |
| | Next -> |