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Valve Lesion (valve + lesion)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

The Role of Natriuretic Peptides in Patients With Chronic Complex (Mixed or Multiple) Heart Valve Disease

CONGESTIVE HEART FAILURE, Issue 2 2010
FRACP, Naylin Bissessor MBChB
N-terminal prohormone B-type natriuretic peptide (NT-proBNP) is an important biomarker of prognosis in heart failure and single valve disease. There are limited studies of complex valve disease. Patients with complex valve disease adopt a sedentary lifestyle, so symptoms may be difficult to detect. The authors aimed to determine whether NT-proBNP correlates with the severity of the valve lesion and underlying cardiac function and whether resting NT-proBNP predicts impaired peak VO2 in patients with complex valve disease. Forty-five patients with complex moderate to severe stenosis or regurgitation of the heart valves underwent a clinical assessment, echocardiography, resting NT-proBNP assessment, and formal cardiopulmonary exercise testing. In a multivariate analysis, the log NT-proBNP (,=,9.3, SE=1.9, P<.0001) and lean body weight (,=0.59, SE=0.22, P=.01) were dominant independent predictors of peak VO2. An NT-proBNP value of 84 pmol/L had 77% sensitivity and 70% specificity to predict impaired functional capacity, peak VO2 <60% (predicted), area under the curve=0.80. Resting NT-proBNP was the best predictor of peak VO2 in patients with complex valve disease, while symptoms and ejection fraction are a less reliable guide. Congest Heart Fail. 2010;16:50,54. © 2009 Wiley Periodicals, Inc. [source]

Perioperative Results of the Aortic Root Replacement in Strict Graft Inclusion Technique

JOURNAL OF CARDIAC SURGERY, Issue 5 2008
Niyazi Cebi M.D.
Therefore, the strict graft inclusion technique has been developed to avoid major complications. We present the early results after aortic root replacement in strict graft inclusion technique. Materials and Methods: The strict graft inclusion technique was performed in 28 patients between April 2001 and June 2006 in St-Johannes-Hospital-Dortmund, Dortmund, Germany. There were nine female and 19 male patients. The mean age was 57.78 ± 12.01 years (28 to 77 years). A type A aortic dissection and an ascending aortic aneurysm with aortic valve lesion were the indication to operation in patients. Results: There were no early mortality and postoperative rethoracotomy. The mean postoperative bleeding over mediastinal drains was 565 ± 310 mL. (100,2250 mL). In exception of the patients with preoperative double thrombocyte aggregation inhibitors therapy and postoperative consumption coagulopathy, the mean postoperative bleeding over mediastinal drain was 443.04 ± 171.59 mL (100,1100) in the first 24 hours, the transfusion rate was minimal, mean 0.39 ± 0.64 packed red blood cells (RBC) (0,4) and mean 0.14 ± 0.27 packed fresh frozen plasma (FFP) (0,4), whereas only in 18 patients (78.26%) out of 23 patients was a transfusion not necessary. The intraoperative and postoperative requirement for substitution of erythrocyte concentrate was mean 1 ± 1.28 packed RBC (0,5) and FFP concentrate was mean 1.21 ± 1.90 packed FFP (0,12). Conclusions: The strict graft inclusion technique for aortic root replacement represents a safe and feasible method to avoid bleeding from coronary ostial anastomoses, from aortic annular suture lines, and annular leak. [source]

Lesions of the Mitral Valve as a Cause of Central Retinal Artery Occlusion: Presentation and Discussion of Two Cases

ECHOCARDIOGRAPHY, Issue 1 2010
Maryam Ayati M.D.
We present two cases of mitral valve lesions that manifested with unilateral blindness caused by central retinal artery occlusion (CRAO): Case 1. A 68-year-old woman was admitted to our clinic for sudden blindness. Retinal artery angiogram showed CRAO. Transthoracic and transesophageal echocardiography (TEE) documented a mass attached to the ventricular side of the posterior mitral leaflet, which at pathology was identified as a blood cyst. Case 2. A 67-year-old man was admitted for a sudden unilateral painless loss of vision. Retinal angiogram documented CRAO, and TEE showed a highly mobile, spherical, lesion on the atrial side of anterior mitral leaflet. In this case, the pathological finding was a degenerated calcified thrombosis. We report on two cases of very rare abnormalities of the mitral valve presenting with a very rare embolic complication, i.e., CRAO. Like for cryptogenic stroke, transesophageal echocardiography plays a central role in the diagnosis of cardiogenic embolic sources. (Echocardiography 2010;27:E1-E3) [source]

Aortic Valve Surgery in Congenital Heart Disease: A Single-Center Experience

ARTIFICIAL ORGANS, Issue 3 2010
Kasim Oguz Coskun
Abstract The optimal treatment of congenital aortic valve lesions is a controversial issue. This study was performed to evaluate the outcome after surgical treatment of aortic valve lesions in congenital aortic valve disease. Between the years of 2000 and 2008, 61 patients (mean age: 12.6 ± 9.6 years, range: 1 day to 40 years) underwent aortic valve surgery for congenital aortic valve disease. Twenty-four patients had undergone previous cardiovascular operations. Indications for surgery were aortic regurgitation in 14.7% (n = 9), aortic stenoses in 26.2% (n = 16), and mixed disease in 59.1% (n = 36). The Ross procedure was performed in 37.7% (n = 23), aortic valve replacement with biological or mechanical prostheses in 29.5% (n = 18). Concomitant procedures were performed in 91.8% (n = 56) due to associated congenital cardiac defects. The overall mortality rate was 5%. Six patients needed reoperation. Implantation of permanent pacemakers occurred in six patients for permanent atrioventricular block. At the latest clinical evaluation, all survivors are in New York Heart Association class I,II and are living normal lives. Aortic valve surgeries in patients with congenital heart disease have had low mortality and morbidity rates in our series. Surgical technique as well as timing should be tailored for each patient. Aortic valve replacement should be delayed until the implantation of an adult-sized prosthesis is possible. [source]