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Valve Stenosis (valve + stenosis)

Distribution by Scientific Domains
Medical Sciences92%

Kinds of Valve Stenosis

  • pulmonary valve stenosis
    		•

    Selected Abstracts

    Late Presentation of Pulmonary Valve Stenosis Confirmed by Cardiovascular Magnetic Resonance

    CONGENITAL HEART DISEASE, Issue 3 2008
    Didier Locca MD
    ABSTRACT We describe the case of a 70-year-old man who presented with increasing exertional dyspnea. He was found to have an ejection systolic murmur and evidence of right ventricular outflow tract obstruction, with a peak velocity of 4.5 m/s recorded by transthoracic Doppler echocardiography. Cardiovascular magnetic resonance showed right ventricular hypertrophy, pulmonary valve stenosis, peak recorded velocity 4.2 m/s, with thickened pulmonary valve leaflets of reduced mobility, and poststenotic dilatation of the main pulmonary artery. The case illustrates that severe pulmonary valve stenosis can present late in life and that cardiovascular magnetic resonance can be useful in clarifying nature and level of right ventricular outflow tract obstruction in an adult. [source]

    Echo-Tracking Assessment of Carotid Artery Stiffness in Patients with Aortic Valve Stenosis

    ECHOCARDIOGRAPHY, Issue 7 2009
    Francesco Antonini-Canterin M.D.
    Background: There is little information about mechanical properties of large arteries in patients (pts) with aortic stenosis (AS). Methods: Nineteen patients with AS (aortic valve area: 0.88 ± 0.29 cm2) and 24 control subjects without AS but with a similar distribution of risk factors were recruited. , index, pressure-strain elastic modulus (Ep), arterial compliance (AC), augmentation index (AIx), and local pulse-wave velocity (PWV) were obtained at the level of right common carotid artery (CCA) by a real time echo-tracking system. Time to dominant peak of carotid diameter change waveform, corrected for heart rate (tDPc), and maximum rate of rise of carotid diameter (dD/dt) were measured. Systemic arterial compliance (SAC) was also calculated. Parameters of AS severity (mean gradient, valve area, stroke work loss [SWL]) were determined. Results: tDPc was higher in patients with AS than in controls (7.9 ± 0.6 vs. 6.6 ± 0.7, P < 0.0001) while dD/dt was lower (5.3 ± 3.6 mm/s vs. 7.8 ± 2.8 mm/s, P = 0.01). AIx was significantly higher in AS group (32.5 ± 13.6% vs. 20.6 ± 12.2%, P = 0.005) and had a linear correlation both with tDPc (r = 0.63, P < 0.0001) and with dD/dt (r =,0.38, P = 0.01). There was a significant correlation between carotid AC and SAC (r = 0.49, P = 0.03), but only carotid AC was related to SWL (r = 0.51, P = 0.02), while SAC was not (P = 0.26).Conclusions: AIx was the only parameter of arterial rigidity found to be higher in patients with AS than in controls. Carotid AC showed a significant correlation with SAC and it seemed to be more closely related to AS severity than to SAC. [source]

    Primary Pulmonary Artery Sarcoma: Surgical Management and Differential Diagnosis with Pulmonary Embolism and Pulmonary Valve Stenosis

    JOURNAL OF CARDIAC SURGERY, Issue 6 2009
    Xiao-Peng Hu M.D.
    We present six cases of primary pulmonary artery sarcomas and discuss clinical features, differential diagnosis, surgical treatment, and outcome of the tumors. Methods: Between January 1994 and July 2008, six patients were identified with the disease during operation. Three patients were initially diagnosed with pulmonary valve stenosis, and two patients had a presumptive diagnosis of chronic pulmonary embolism. Two patients had simple or partial tumor resection. Four patients had radical tumor resection and homograft reconstruction of the pulmonary arteries. Results: Histological examinations showed five malignant mesenchymomas and one fibrosarcoma. One patient died of refractory pulmonary hypertension during operation. Two patients died 4 months postoperatively because of brain metastases. Two patients were alive for 3 and 9 months, respectively after the operation with recurrent tumor. One patient is alive even 2 years after resection with no signs of recurrence or metastasis. Conclusions: Because of similar clinical features, pulmonary artery sarcomas are often confused with other pulmonary vascular obstructive diseases. Computed tomography scanning and gadolinium-enhanced magnetic resonance imaging could be useful methods for differential diagnosis. The prognosis is very poor. The survival time after resection varies from several months to several years depending on the presence of recurrence or metastasis. Early diagnosis and radical surgical resection presents the only opportunity for a potential cure. [source]

    Right Ventricular Function in Congenital Heart Defects Assessed by Regional Wall Motion

    CONGENITAL HEART DISEASE, Issue 3 2010
    FSCAI, Michael R. Nihill MB
    ABSTRACT Objectives., To develop a simple method to assess right ventricular function by angiography. Background., Conventional methods of evaluating right ventricular function are inaccurate, cumbersome, and expensive. Methods., We analyzed biplane right ventricular angiograms taken in the posterior,anterior and lateral projections using software to measure right ventricular volumes and regional wall motion in 78 patients with normal hearts (n = 29), atrial septal defects (ASD n = 13), pulmonary valve stenosis (PVS n = 21), and postoperative atrial switch patients (n = 15). We also measured the shortening fraction (SF) from the midtricuspid annulus to the septum and correlated various angiographic measurements with the right ventricular (RV) ejection fraction. Results., The volume-overloaded patients (ASD) had larger end diastolic volumes and increased SF compared with normal patients, while the pressure-loaded patients (PVS) had normal volumes and SF. The postoperative atrial switch patients had decreased systolic function and increased end diastolic volume. The SF for all of the patients correlated with the ejection fraction (r= 0.785, P, .0001). Conclusions., A simple measurement of the end diastolic and end systolic distance from the midtricuspid annulus to the septum (SF) provides a good index of RV function by angiography and correlates well with RV ejection fraction. [source]

    Late Presentation of Pulmonary Valve Stenosis Confirmed by Cardiovascular Magnetic Resonance

    CONGENITAL HEART DISEASE, Issue 3 2008
    Didier Locca MD
    ABSTRACT We describe the case of a 70-year-old man who presented with increasing exertional dyspnea. He was found to have an ejection systolic murmur and evidence of right ventricular outflow tract obstruction, with a peak velocity of 4.5 m/s recorded by transthoracic Doppler echocardiography. Cardiovascular magnetic resonance showed right ventricular hypertrophy, pulmonary valve stenosis, peak recorded velocity 4.2 m/s, with thickened pulmonary valve leaflets of reduced mobility, and poststenotic dilatation of the main pulmonary artery. The case illustrates that severe pulmonary valve stenosis can present late in life and that cardiovascular magnetic resonance can be useful in clarifying nature and level of right ventricular outflow tract obstruction in an adult. [source]

    Primary Pulmonary Artery Sarcoma: Surgical Management and Differential Diagnosis with Pulmonary Embolism and Pulmonary Valve Stenosis

    JOURNAL OF CARDIAC SURGERY, Issue 6 2009
    Xiao-Peng Hu M.D.
    We present six cases of primary pulmonary artery sarcomas and discuss clinical features, differential diagnosis, surgical treatment, and outcome of the tumors. Methods: Between January 1994 and July 2008, six patients were identified with the disease during operation. Three patients were initially diagnosed with pulmonary valve stenosis, and two patients had a presumptive diagnosis of chronic pulmonary embolism. Two patients had simple or partial tumor resection. Four patients had radical tumor resection and homograft reconstruction of the pulmonary arteries. Results: Histological examinations showed five malignant mesenchymomas and one fibrosarcoma. One patient died of refractory pulmonary hypertension during operation. Two patients died 4 months postoperatively because of brain metastases. Two patients were alive for 3 and 9 months, respectively after the operation with recurrent tumor. One patient is alive even 2 years after resection with no signs of recurrence or metastasis. Conclusions: Because of similar clinical features, pulmonary artery sarcomas are often confused with other pulmonary vascular obstructive diseases. Computed tomography scanning and gadolinium-enhanced magnetic resonance imaging could be useful methods for differential diagnosis. The prognosis is very poor. The survival time after resection varies from several months to several years depending on the presence of recurrence or metastasis. Early diagnosis and radical surgical resection presents the only opportunity for a potential cure. [source]

    Does Aortic Root Enlargement Impair the Outcome of Patients With Small Aortic Root?

    JOURNAL OF CARDIAC SURGERY, Issue 5 2006
    Hasan Ardal
    The aim of this study was to evaluate long-term results of the posterior root enlargement. Methods: Between 1985 and 2002, 124 patients underwent aortic valve replacement with a posterior root enlargement. The main indication was a small aortic valve orifice area to patient body surface area (indexed valve area < 0.85 cm2/m2). Fifty-four (44%) patients were male, and 70 (56%) were female with a mean age 39.1 ± 14.3 years. Indications for operation were severe calcified aortic valve stenosis (37.1%), severe aortic insufficiency (25.8%), or combination (37.1%). Seventy-five (60%) patients received double-valve replacement. A pericardial patch was used in 100 patients (80.6%) and a Dacron patch was used in 24 patients. Results: Operative mortality was 6.4% (8 patients). The causes of hospital mortality were low cardiac output syndrome (LCOS) (in 6 patients), cerebrovascular events (in 1 patient) and multiple organ failure (in 1 patient). Multivariate analysis demonstrated concomitant coronary revascularization to be a significant (p = 0.03) predictor for early mortality. There were six (5.4%) late deaths. Cox proportional hazards regression analysis demonstrated LCOS (p = 0.013) and infective endocarditis (p = 0.003) to be significant predictors for late mortality. Atrioventricular block required a permanent pacemaker was observed in 4 patients (3.2%). Conclusions: Posterior aortic root enlargement techniques can be easily applied without additional risks. Long-term survival and freedoms from valve-related complications are satisfactory. [source]

    Predictors of Failure to Cure Atrial Fibrillation with the Mini-Maze Operation

    JOURNAL OF CARDIAC SURGERY, Issue 1 2004
    Zoltan A. Szalay M.D.
    A reduction in the number of right and left atrial incisions could decrease the operative time. The aim of this study was to assess the results of a mini-maze operation and to define predictors of its failure. Methods: Between 1995 and 2000, 72 patients (mean age 64 ± 9 years) undergoing cardiac surgery had a concomitant mini-maze operation for symptomatic chronic atrial fibrillation. Three and 12 months postoperatively, heart rhythm and left atrial transport functions were assessed by electrophysiology, echocardiography, and magnetic resonance imaging. Multivariate analysis was performed to identify predictors of failure of the mini-maze operation. Results: Operative mortality was 1.4% (1/72). Death during follow-up occurred in 5.6% of patients (4/71), in one due to chronic heart failure. After 1 year, 80% of patients (48/60) were either in sinus rhythm (n = 43; 72%) or had a pacemaker (n = 5; 8%) implanted due to sick sinus syndrome. Intermittent and chronic atrial fibrillation was found in 20% of patients (12/60). Preoperative duration of atrial fibrillation (p = 0.05), preoperative left atrial diameter (p = 0.001), preoperative right atrial diameter (p = 0.02), a reduced left ventricular ejection fraction (p = 0.03), an increased left ventricular end-diastolic diameter (p = 0.04), and the presence of mitral valve stenosis (p = 0.001) were found to be univariate predictors of failure of the mini-maze operation 1 year postoperatively. Multivariate analysis defined preoperative diagnosis of mitral valve stenosis (p = 0.005; OR 117.5), longer duration of preoperative atrial fibrillation (p = 0.01; OR 1.33), and increased preoperative left ventricular end-systolic diameter (p = 0.02; OR 1.2) as incremental independent risk factors for failure of the mini-maze operation to cure chronic atrial fibrillation. Conclusion: The mini-maze operation is a safe procedure with similar results to that of Cox's Maze-III operation. The less-invasive mini-maze operation could be applicable even to patients with severely reduced left ventricular function, in whom complex cardiac surgery has to be performed concomitantly as well as in those presenting severe comorbidities. (J Card Surg 2004;19:1-6) [source]

    Occlusion of an Aberrant Artery to a Pulmonary Sequestration Using a Duct Occluder

    JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2002
    D.C.H., ELLEN CRUSHELL M.D., M.R.C.P.I.
    This report describes a female infant with a rare chromosome defect, del. 12 (q22-24.1), who has severe pulmonary valve stenosis, an atrial septal defect, and a small muscular ventricular septal defect. At 4 months of age a balloon pulmonary valvuloplasty was performed in the cardiac catheterization laboratory. During the procedure, a large aberrant artery from the aorta to a sequestration of the right lower lobe of lung was found. The flow-off from the sequestration was into a dilated left atrium. The single artery supplying the sequestration was successfully occluded using an Amplatzer Duct Occluder device. There were no complications and the infant remains well at 1-yearfollow-up. [source]

    Prospective Evaluation of the Balloon-to-Annulus Ratio for Valvuloplasty in the Treatment of Pulmonic Stenosis in the Dog

    JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 4 2006
    Amara Estrada
    Background: In dogs, treatment of pulmonic valve stenosis (PS) with pulmonary balloon valvuloplasty (PBV) is a viable method to decrease the pressure gradient across the valve. However, to the authors' knowledge, the variables that influence the selection of the correct balloon size for the procedure have not been explored. Moreover, the lesions caused by the procedure have not been detailed. Hypothesis: Variables that influence the measurement of the annulus could affect selection of the balloon size. We sought to determine the effects of treatment when the balloon-to-annulus ratio (BAR) was or > 1.3, but within the recommended range of 1.2,1.5, regardless of whether dilation was performed with single or double balloon technique. Animals: Twenty-five Beagles with PS were studied. Methods: Inter-and intra-observer variability, echocardiography versus angiocardiography, and systolic versus diastolic timing were evaluated for the BAR. Assessment of right ventricular (RV) pressure, Doppler gradient, stenotic valve area, and RV wall thickness were compared before and 1, 90, and 180 days after treatment. Postmortem examination of the heart was done. Results: Significant correlations existed in measurement of the annulus; however, variation existed that would change balloon size. Improvement in the degree of PS was significant regardless of the BAR or single or double ballooning. In the most severely affected dogs, continued improvement was noted on day 90. Postmortem examination revealed tears in the commissures and the valve leaflets. Conclusions: Multiple factors influenced determination of the BAR and a range of 1.2,1.5 was effective without detrimental consequences. Dogs with severe PS had continued decrease in RV pressure 3 months after treatment. [source]

    First-year survival of infants born with congenital heart defects in Arkansas (1993-1998): A survival analysis using registry data

    BIRTH DEFECTS RESEARCH, Issue 9 2003
    Mario A. Cleves
    BACKGROUND In the United States and other developed nations, birth defects are the leading cause of infant mortality. Congenital heart defects (CHDs) are among the most prevalent and fatal of all birth defects. Here we report the survival probability of infants born with CHDs in Arkansas and examine the impact of multiple malformations on survival. METHODS Birth and death certificate records were linked to birth defects registry data for infants born with CHDs from January 1993 through December 1998 in Arkansas. Both neonatal and first-year survival probabilities were estimated. These were computed non-parametrically using Kaplan-Meier's product limit method. A Cox proportional-hazards model was used to evaluate the relative importance of additional malformations on survival. RESULTS A total of 1,983 infants with CHDs were included in this study. The neonatal survival probability for this cohort was 94.0% (95% CI: 93.0%, 95.1%), and the first-year survival probability was 88.2% (95% CI: 86.8%, 89.6%). The presence of hypoplastic left heart syndrome conferred the greatest reduction in survival, whereas infants with pulmonic valve stenosis and infants with ventricular septal defects had the highest first-year survival. Infants with multiple CHDs had decreased survival compared to those with isolated heart defects. Survival was also adversely affected by the presence of congenital abnormalities in other body systems. CONCLUSIONS Neonatal and first-year survival of infants with CHDs varies by both the type of cardiac malformation and the presence of additional cardiac and non-cardiac malformations. Further work will focus on the effects of maternal and infant characteristics on survival. Birth Defects Research (Part A) 67:662,668, 2003. © 2003 Wiley-Liss, Inc. [source]

    Transcatheter aortic valve implantation through the left subclavian artery with a patent LIMA graft,

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 1 2010
    Maurizio Taramasso MD
    Abstract We report the case of an 80-year-old male with severe aortic valve stenosis previously submitted to surgical myocardial revascularization with patent mammary graft treated by TAVI through left-transaxillary approach because of unsuitable transfemoral and transapical approaches.© 2010 Wiley-Liss, Inc. [source]

    Critical stenosis of aortic and mitral valves after mediastinal irradiation

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2004
    A. Selcuk Adabag MD
    Abstract Radiotherapy is used widely in cancer treatment. Mediastinal irradiation is associated with valvular regurgitation; however, stenosis is rare. We present a patient with critical aortic and mitral valve stenosis after mediastinal irradiation and discuss the natural history, treatment, and prognosis of radiation-associated valvular heart disease. Catheter Cardiovasc Interv 2004;63:247,250. © 2004 Wiley-Liss, Inc. [source]

    Outcome of pulmonary and aortic stenosis in Williams-Beuren syndrome in an Asian cohort

    ACTA PAEDIATRICA, Issue 6 2007
    Ching-Chia Wang
    Abstract Aims: To define the cardiovascular anomalies and the long-term outcomes in an Asian cohort with Williams-Beuren syndrome (WBS). Methods: Data were retrieved from a retrospective chart review of patients who had a definitive diagnosis of WBS by fluorescence in situ hybridization between 1995 and 2005. All patients underwent echocardiography every 3,9 months. Ten patients underwent cardiac catheterization. Results: Twenty-one patients with a total follow-up of 134 patient-years (median: 72 months) were enrolled. Characteristic dysmorphic facial features were noted in 19 patients (n = 19, 90%). All except one had associated cardiac anomalies, accounting for 0.3% (20/6640) of the patients with congenital heart disease. The spectrum of cardiac anomalies included supravalvular aortic stenosis (SVAS) (n = 15, 71%), peripheral pulmonary stenosis (PPS) (n = 12, 57%), pulmonary valve stenosis (PS) (n = 10, 47%), mitral valve prolapse (MVP) (n = 9, 43%), coarcation of the aorta (n = 4, 19%), ventricular septal defect (n = 2, 10%) and atrial septal defect (n = 1, 5%). Concurrent SVAS and PS/PPS were found in 14 (70%) patients. Only one patient required balloon dilation of PS, which improved. Regression of the stenoses occurred with a probability of 31, 90 and 71% at the age of 10 years for SAVS, PS and PPS, respectively. Conclusions: Among our WBS patients, SVAS, PPS and PS were common, and were associated with probability of spontaneous regression, especially of right-sided lesions. [source]