1/32. Combined mitral and tricuspid valve repair in acute infective endocarditis.Combined repair of the mitral and tricuspid valves involved with acute infective endocarditis was carried out in a 38-year-old drug addict. mitral valve repair included vegetectomy, closure of posterior leaflet perforation, and posterior annuloplasty with a patch and a strip of glutaraldehyde-tanned autologous pericardium, respectively, while the tricuspid valve was reconstructed with the use of artificial chordae and valve bicuspidalization. At five months follow up the patient is asymptomatic, with echocardiographic evidence of only trivial mitral and tricuspid incompetence, and no signs of recurrent infection. This case report supports the use of valve reconstruction as a valuable option in patients in whom there is simultaneous involvement of the mitral and tricuspid valves with infective endocarditis.- - - - - - - - - - ranking = 1keywords = endocarditis (Clic here for more details about this article) |
2/32. Video-assisted tricuspid valve surgery: a new surgical option in endocarditis on pacemaker.A patient presenting with a pacemaker lead infection and tricuspid regurgitation underwent a minimally invasive video-assisted tricuspid valve replacement. The valve was approached through a right anterior mini thoracotomy. Under thoracoscopic vision and peripheral cardiopulmonary bypass, a catheter was placed on the ascending aorta for antegrade cardioplegia delivery. A transthoracic aortic cross-clamp was introduced through the third right intercostal space. Tricuspid valve replacement added to the pacemaker leads ablation was exclusively performed under thoracoscopic vision, providing an excellent video-image in this reduced operative field. After 22 months of follow up, the patient is asymptomatic, the echocardiography showing a normally functioning valve.- - - - - - - - - - ranking = 0.66666666666667keywords = endocarditis (Clic here for more details about this article) |
3/32. Isolated tricuspid regurgitation due to atypical morphology of anterior-posterior leaflets in an adult: a case report and review of the literature.A 73-year-old woman with congenital isolated organic tricuspid regurgitation was reported. She had neither the history of chest trauma nor rheumatic fever nor the evidence of infective endocarditis. The patient was successfully treated with a bioprosthetic valve replacement in tricuspid position. Operative findings revealed hypoplastic anterior leaflet and relatively large posterior leaflet. Structural anomaly of the valve, coaptation disorder due to the thickened valve leaflets, as well as enlarged valve ring and the occurrence of atrial fibrillation was thought to be the causes of massive regurgitation.- - - - - - - - - - ranking = 0.16666666666667keywords = endocarditis (Clic here for more details about this article) |
4/32. Stentless tricuspid valve replacement.Stentless tricuspid valve replacement was performed in a 21-year-old patient with severe destructive tricuspid valve endocarditis resistant to medical therapy. Postoperative recovery was uneventful. Stentless atrioventricular valves are considered an additional treatment option besides stented valves or homograft implantations for severe right-sided endocarditis. Transvalvular hemodynamics are excellent, and right ventricular function can be preserved by suspending the valve at the papillary muscles.- - - - - - - - - - ranking = 0.33333333333333keywords = endocarditis (Clic here for more details about this article) |
5/32. Surgical treatment of tricuspid regurgitation caused by Loffler's endocarditis.A 25-year-old man with a history of bone-marrow-transplantation for the treatment of Loffler's endocarditis underwent surgery for massive tricuspid regurgitation with paroxysmal atrial flutter. Dense fibrosis in the right ventricular endocardium with complete obliteration of the apex was seen intraoperatively, and the right ventricular cavity was diminished. Annular dilatation of the tricuspid valve and entrapment of the posterior leaflet to the endocardial fibrosis were also seen. Annuloplication at the posterior leaflet was performed. In addition, the right atrial free wall was widely resected and the septal and inferior vena cava-tricuspid valve isthmi were cryoablated for the treatment of atrial flutter. Postoperative catheterization revealed rather high right ventricular end-diastolic pressure. However, tricuspid regurgitation disappeared with the increased cardiac output. atrial flutter could not be induced by repetitive stimulation in the postoperative electrophysiological examination.- - - - - - - - - - ranking = 0.83333333333333keywords = endocarditis (Clic here for more details about this article) |
6/32. pulmonary valve endocarditis: mid-term follow up of pulmonary valvectomies.Four males aged 20-37 years (three drug addicts and one with a congenital mixed pulmonary valve lesion) were diagnosed in 1989, 1991 and 1993 with pulmonary valve endocarditis without tricuspid infection. Three patients were positive for hepatitis b, C or both, and one patient was hiv-positive. The predominant organism in blood cultures was staphylococcus aureus. Antibiotic treatment of pulmonary valve endocarditis had failed; thus partial or total valvectomies were performed. Postoperatively, all patients were cured of infection and initial recovery was good. At mid-term follow up (5-10 years) there were no recurrences, and tolerance of the resultant pulmonary insufficiency was good. Slight to severe tricuspid valve insufficiency developed, together with right ventricular dilatation, in all cases. hepatomegaly was apparent in two cases and peripheral edema in one. Despite treatment, the latter patient remained in moderate right ventricular failure, and may require homograft valve replacement. The other three patients remained in good clinical condition. Eradication of the infection was achieved in all patients. It is concluded that pulmonary valve resection is the treatment of choice for pulmonary valve endocarditis when antibiotic treatment has failed. Complete resection of all affected tissue should be performed in these cases. Analysis of preoperative data did not permit differentiation of those patients likely to develop right heart failure.- - - - - - - - - - ranking = 1.1666666666667keywords = endocarditis (Clic here for more details about this article) |
7/32. The pitfalls of transthoracic echocardiography. A case of eustachian valve endocarditis.A case of infective endocarditis involving the vestigial eustachian valve is presented and the available English medical literature is reviewed. Only 5 prior cases have been reported: 4 of those required transesophageal echocardiography for diagnosis, and the other was found at autopsy. This clinical entity is routinely missed on transthoracic echocardiography. Injection drug use is a common predisposing factor, and staphylococcus aureus is the most commonly identified organism. This report broadens the differential diagnosis of endovascular infections in injection drug users and highlights the importance of transesophageal echocardiography for diagnosis in selected patients.- - - - - - - - - - ranking = 0.83333333333333keywords = endocarditis (Clic here for more details about this article) |
8/32. Isolated tricuspid valve endocarditis due to candida parapsilosis associated with long-term central venous catheter implantation.A 72-year-old man was treated for fungal tricuspid valve endocarditis (TVE) with significant tricuspid valvular regurgitation and severe congestive heart failure caused by candida parapsilosis. The patient had received hyperalimentation and antibiotic therapy for three months through a central venous catheter after the surgical treatment of ileus. The patient was treated medically with amphotericin B and fluconazole because of high surgical risk due to severe pulmonary emphysema, and he responded well. Although TVE caused by C. parapsilosis is rare, we should consider this possibility in patients receiving long-term hyperalimentation and antibiotic therapy using a central venous catheter.- - - - - - - - - - ranking = 0.83333333333333keywords = endocarditis (Clic here for more details about this article) |
9/32. Tricuspid regurgitation following inferior myocardial infarction.Tricuspid regurgitation developed in two patients after inferior wall myocardial infarction. Neither patient had preexisting valvular heart disease or evidence of endocarditis, and neither had suffered chest trauma. Because abnormalities in right ventricular function may occur after inferior infarction, and because other known causes of tricuspid incompetence were not present, we postulate that these patients developed valvular regurgitation from dysfunction of the papillary muscle complex controlling tricuspid valve function, a mechanism similar to that proposed to explain mitral regurgitation seen with inferior wall ischemia.- - - - - - - - - - ranking = 0.16666666666667keywords = endocarditis (Clic here for more details about this article) |
10/32. Tear in mitral anterior leaflet as a complication of Manouguian's procedure in a woman with an aortic valve prosthesis.Complications of valve replacement are diverse. In addition to morbidity due to the prosthetic valve itself (e.g. endocarditis, thrombosis), complications due to operative technique may occur in complex cases, as in aortic valve replacement with annular enlargement. Postoperative echocardiography is a simple, non-invasive method to evaluate patients with prosthetic valves. Detailed knowledge of the surgical technique employed and of probable complications is necessary to make an accurate diagnosis. The case is reported of a woman with aortic valve replacement and annular enlargement who had mitral regurgitation due to a tear in the anterior mitral leaflet as a complication of Manouguian's annulus enlargement.- - - - - - - - - - ranking = 0.16666666666667keywords = endocarditis (Clic here for more details about this article) |
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