1/111. 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.- - - - - - - - - - ranking = 1keywords = stenosis (Clic here for more details about this article) |
2/111. String-plucking as a mechanism of chordal rupture during balloon mitral valvuloplasty using inoue balloon catheter.Percutaneous transvenous mitral commissurotomy using the Inoue technique was performed in a 59-year-old female with mitral stenosis and a severely calcified mitral leaflets. Although not entrapped in the subvalvular apparatus, the balloon catheter was deviated away from the mitral orifice-apex axis of the left ventricle during the inflation of the proximal balloon, which plucked and severed the chordae tendineae of the posterior mitral leaflet and resulted in severe mitral regurgitation.- - - - - - - - - - ranking = 1keywords = stenosis (Clic here for more details about this article) |
3/111. Aortic valve replacement with the Nicks annulus enlargement procedure 12 years after mitral valve replacement.An aortic valve replacement was successfully performed employing the Nicks annulus enlargement procedure in a case of aortic valve stenosis with small annulus 12 years after mitral valve replacement. Previous mitral valve replacement does not preclude feasibility of the Nicks procedure.- - - - - - - - - - ranking = 1keywords = stenosis (Clic here for more details about this article) |
4/111. Difference in structural change in the Carpentier-Edwards pericardial valves implanted in the mitral and tricuspid positions.We report a 29-year-old patient with prosthetic valve dysfunction with severe calcific stenosis in the mitral position but no structural change in the tricuspid position after mitral valve replacement and tricuspid valve supra-annular implantation with same bioprostheses at the seven years before. The difference in structural change between the mitral position and the tricuspid position might be due mainly to the effect of mechanical stress on the cusps, rather than to any difference in serum calcium levels. However, some hormonal effect other than that of the parathyroid hormone on the systemic and pulmonary circulation might be related to the early progression in cusp calcification in the systemic circulation.- - - - - - - - - - ranking = 1keywords = stenosis (Clic here for more details about this article) |
5/111. Mitral valve plasty in systemic lupus erythematosus in the setting of antiphospholipid syndrome.The first case was of a 27-year-old female, who was diagnosed as having mitral valve stenosis with regurgitation, systemic lupus erythematosus and antiphospholipid syndrome at her previous pregnancy. We performed mitral valve plasty, which included open mitral commissurotomy and Kay's annulo plasty. The second case was of a 53-year-old female, who was diagnosed as old myocardial infarction, mitral regurgitation, systemic lupus erythematosus and antiphospholipid syndrome. She underwent mitral valve plasty and coronary artery bypass grafting. Both cases were treated by administration of methylpredonisolone and heparin perioperatively to avoid thrombosis and aggravation of systemic lupus erythematosus. Both patients showed good postoperative outcome without complications. We consider that it is important to perform the plasty as far as possible, and to administer effective anticoagulation treatment to prevent complications for patients in the setting of systemic lupus erythematosus and antiphospholipid syndrome.- - - - - - - - - - ranking = 1keywords = stenosis (Clic here for more details about this article) |
6/111. Mitral valve plasty using artificial chordae in a 1.5-year-old boy with congenital mitral stenosis and absent anterolateral chordae.A 1.5-year-old boy with refractory heart failure due to congenital mitral stenosis exhibited fusion of the anterolateral leaflets associated with moderate mitral regurgitation due to absent anterolateral chordae. Fused leaflets were incised and the mitral valve opening improved. Mitral regurgitation increased due to the absence of chordae, so 2 pairs of artificial chordae of 5-0 expanded polytetrafluoroethylene suture were anchored to the hypoplastic anterolateral papillary muscle, then attached to the free margin of incised leaflets. Postoperative examination showed improved mitral opening without exacerbated mitral regurgitation.- - - - - - - - - - ranking = 5keywords = stenosis (Clic here for more details about this article) |
7/111. Batista's operation with coronary artery bypass grafting and mitral valve plasty for ischemic dilated cardiomyopathy.A 52-year-old male was admitted for angina pectoris and congestive heart failure classified as new york Heart association class III. coronary angiography showed 95% stenosis in the left anterior descending artery, 99% stenosis in the first diagonal branch, total occlusion in the left circumflex artery, and a hypoplastic right coronary artery. Left ventriculography showed a severely dilated left ventricle (ejection fraction 20%) and mild mitral regurgitation. In the myocardial scintigram using 99m-tetrofosmin, there was no viability in the posterolateral wall although the other wall was viable. Partial left ventriculectomy, which is called Batista's operation, coronary artery bypass grafting and Alfieri's mitral valve plasty were performed concomitantly. Postoperatively, the ejection fraction was improved to 39%, and all grafts were patent. The patient was discharged in new york Heart association class I. We concluded that to succeed in partial left ventriculectomy for ischemic dilated cardiomyopathy, not only should there be no viability in the posterolateral wall to be resected for volume reduction, but the coronary artery which perfuses the residual myocardium with viability should be graftable.- - - - - - - - - - ranking = 2keywords = stenosis (Clic here for more details about this article) |
8/111. Prosthetic valve fungal endocarditis due to histoplasmosis.Fungal endocarditis is associated with severe patient morbidity and mortality. Unfortunately, fungal endocarditis is difficult to diagnose because fungal pathogens are uncommonly isolated from routine blood cultures. Histopathological examination of surgically excised cardiac valves, peripheral emboli and systemic ulcers may be useful in identifying pathogens as etiological agents of culture-negative endocarditis. The authors describe a 63-year-old man who had culture-negative endocarditis. Multiple echocardiograms showed progression of the vegetations with valve stenosis despite treatment with multiple antimicrobials. He had multiple peripheral emboli before surgery. Disseminated histoplasmosis was diagnosed by bone marrow culture. Yeast organisms consistent with histoplasma were shown in the vegetations of his excised mitral valve prosthesis. The patient was treated with amphotericin and has been doing well in the two years since his surgery. The diagnosis and management of fungal endocarditis are emphasized.- - - - - - - - - - ranking = 1keywords = stenosis (Clic here for more details about this article) |
9/111. Conversion of atrial fibrillation into a sinus rhythm by coronary angioplasty in a patient with acute myocardial infarction.Atrial tachyarrhythmias are important complications occurring in more than 8% of acute myocardial infarctions (AMI). atrial fibrillation (AFi) during the early phase of AMI is caused by atrial ischaemia, atrial distension due to the left ventricular failure or significant diastolic left ventricular dysfunction. AFi in patients with inferior and posterior AMI indicates at least two vessel coronary diseases, a circumflex coronary artery (CX) occlusion before taking off of the left atrial branches as well as significant stenosis or occlusion of the right coronary artery (RCA). In this article the case of a 67-year-old woman with an acute infero-posterior AMI is described. AMI was complicated with a left heart failure, acute AFi with tachyarrhythmia, transient arterial hypotension and ischaemic mitral regurgitation. Emergency coronary angiography disclosed occlusion of the CX, myocardial infarct related artery, and significant stenoses of the RCA. After opening the occluded CX during the PTCA, AFi with a tachyarrhythmia of 160 beats per minute (bpm) immediately converted into a sinus rhythm with 80 bpm, followed by a normalization of blood pressure and cardiac recompensation. Our case report supports the opinion that AFi in patients with inferior and posterior AMI indicates at least a two-vessel coronary disease. Reopening of the occluded atrial coronary branches during urgent medical treatment was casual and effective treatment of both ischaemic heart disease and consequent AFi.- - - - - - - - - - ranking = 1keywords = stenosis (Clic here for more details about this article) |
10/111. Mitral stenosis and regurgitation with systemic lupus erythematosus and antiphospholipid antibody syndrome.Cases of valvular disease accompanied by systemic lupus erythematosus and antiphospholipid antibody syndrome are uncommon. Here, we present a surgical case of mitral stenosis and regurgitation with systemic lupus erythematosus and antiphospholipid antibody syndrome. Mitral valve replacement was performed, and the postoperative course was uneventful. Pathohistological findings of the mitral valve showed degenerative change due to chronic inflammation, proliferative fibrous change and calcification without thrombus formation.- - - - - - - - - - ranking = 5keywords = stenosis (Clic here for more details about this article) |
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