1/83. Mitral regurgitation after pericardiectomy for constrictive pericarditis.We report a case of constrictive pericarditis in which trace mitral valve regurgitation was detected preoperatively and temporarily worsened after a pericardiectomy was performed. The early postoperative data suggested that the increased mobility of the lateral wall, in conjunction with an increase in the left ventricular volume, might be one of the causes of the perioperative mitral valve dysfunction. The mitral valve function returned to the preoperative baseline thirteen months after the pericardiectomy.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
2/83. Expeditious diagnosis of primary prosthetic valve failure.Primary prosthetic valve failure is a catastrophic complication of prosthetic valves. Expeditious diagnosis of this complication is crucial because survival time is minutes to hours after valvular dysfunction. The only life-saving therapy for primary prosthetic valve failure is immediate surgical intervention for valve replacement. Because primary prosthetic valve failure rarely occurs, most physicians do not have experience with such patients and appropriate diagnosis and management may be delayed. A case is presented of a patient with primary prosthetic valve failure. This case illustrates how rapidly such a patient can deteriorate. This report discusses how recognition of key findings on history, physical examination, and plain chest radiography can lead to a rapid diagnosis.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
3/83. Cardiac involvement in coffin-lowry syndrome.coffin-lowry syndrome is an X-linked recessive syndrome of mental retardation, characteristic facies and skeletal anomalies. In one patient with the syndrome, we observed early recurrent episodes of congestive heart failure with intercurrent normalization and the late development of mitral insufficiency due to annular dilation and congenital abnormalities of the valve apparatus. This unusual course of cardiac involvement, the non-adaptation of the left ventricular contractility to the aggravation of the mitral insufficiency and the postoperative persistence of the ventricular dysfunction, underline the possible role of an associated primary myocardial disease. This clinical observation demonstrates clearly that a mitral valve malformation can occur in patients with the syndrome, but also the role of a dilated cardiomyopathy, which can be secondary to the mitral regurgitation, but is more likely a myocardial disorder occurring as part of the syndrome.- - - - - - - - - - ranking = 83.03528523981keywords = ventricular dysfunction, dysfunction (Clic here for more details about this article) |
4/83. Transient severe mitral regurgitation complicating myocardial stunning due to coronary vasospasm.As in papillary muscle dysfunction complicating mitral prolapse, dyskinesis of the left ventricular wall underlying the papillary muscles has been shown to cause mitral regurgitation following myocardial infarction. myocardial stunning has been experimentally evidenced to cause mitral regurgitation due to a wall motion abnormality, but it has not yet been clinically defined. We report a clinical case of transient severe mitral regurgitation complicating myocardial stunning caused by coronary vasospasm. Transient wall motion abnormality beneath the anterolateral papillary muscle was considered to be responsible for the mitral regurgitation.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
5/83. Emergency correction of coagulation for mitral valve replacement in an orally anticoagulated 17-year-old patient with pronounced hepatic dysfunction.A 17-year-old patient with Shone's disease had to be readmitted to the hospital 3 months after implantation of an artificial aortic valve because of extreme mitral insufficiency with consecutive pulmonary edema and hepatic dysfunction. He had been orally anticoagulated and presented with a high international normalized ratio of 6.7. Emergency replacement of the mitral valve was possible only after administration of prothrombin-complex concentrate, as vitamin k(1) and fresh frozen plasma did not correct the hemostatic defect sufficiently.- - - - - - - - - - ranking = 5keywords = dysfunction (Clic here for more details about this article) |
6/83. 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 = dysfunction (Clic here for more details about this article) |
7/83. Anomalous origin of the right coronary artery from the pulmonary artery and mitral regurgitation in a newborn.Anomalous origin of the right coronary artery (RCA) from the pulmonary artery (PA) is a rare congenital anomaly, and only 28 cases have been reported in the pediatric age group. We describe the case of an infant who had progressive mitral regurgitation and papillary muscle dysfunction in association with anomalous origin of the RCA from the PA. The diagnosis was made by color flow Doppler, confirmed by angiography, and the case was successfully corrected by reimplantation of the anomalous RCA to the aorta. This is only the second case of anomalous origin of the RCA from the PA diagnosed in infancy without an associated congenital anomaly of the heart and great vessels.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
8/83. Mitral regurgitation after myocardial infarction. coronary artery bypass grafting and mitral valve replacement with chordae preservation.A patient with acute ischemic mitral regurgitation after acute myocardial infarction required emergency coronary artery bypass grafting and mitral valve replacement with chordae preservation. For severe mitral regurgitation and heart failure due to myocardial infarction and ischemic papillary muscle dysfunction, mitral valve replacement with chordae preservation was effective. Here, we discuss the etiology of ischemic mitral regurgitation and the operative method for valve repair or replacement.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
9/83. 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 = 83.03528523981keywords = ventricular dysfunction, dysfunction (Clic here for more details about this article) |
10/83. Aortic and mitral valve replacement in a patient with acute febrile neutrophilic dermatosis (Sweet's syndrome): report of a case.A 29-year-old woman was admitted to our hospital with severe orthopnea, fever, and acute dermatosis. She had a 5-year history of episodic acute neutrophilic dermatosis and peripheral leukocytosis following a high fever, which were symptoms consistent with a diagnosis of Sweet's syndrome. echocardiography revealed remarkable dysfunction of the left ventricle due to severe aortic regurgitation, which had not been present at a previous admission when mild mitral regurgitation was detected. The aortic and mitral valves were replaced with prosthetic valves on an emergency basis. The leaflets of the aortic valve were very thin and appeared fragile. The anterior leaflet of the mitral valve showed severe prolapse due to the torn chordae and hypoplasia of the posterior strut chordae. Her postoperative course was uneventful. Microscopic examination revealed fibrosal degeneration and the infiltration of lymphocytes and macrophages into both heart valves. This may be the first case report of valvulitis and Sweet's syndrome occurring simultaneously.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
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