- Valve-sparing reimplantation for neoaortic root dilatation and regurgitation with an unbalanced cusp after the arterial switch operation. [Journal Article]
- JCJ Card Surg 2018; 33(2):122-125
- A 13-year-old male presented with neoaortic root dilatation and severe aortic valve regurgitation 13 years following an arterial switch operation. The valve cusps were unbalanced due to an enlarged n...
A 13-year-old male presented with neoaortic root dilatation and severe aortic valve regurgitation 13 years following an arterial switch operation. The valve cusps were unbalanced due to an enlarged non-coronary cusp. A valve-sparing reimplantation with a cusp plication was performed which resulted in a competent valve with trivial regurgitation. Thus, even in an unbalanced cusp, valve-sparing reimplantation can be used for neoaortic root dilatation and valve regurgitation after an arterial switch operation.
- Concomitant mitral regurgitation: an insidious cause of lowflow, low-gradient severe aortic stenosis. [Journal Article]
- EEuroIntervention 2018 Feb 20; 13(14):1622-1625
- Left heart pressures can be the key to know the limitation of left ventricular assist device support against progression of aortic insufficiency. [Journal Article]
- JAJ Artif Organs 2018 Feb 20
- Aortic insufficiency (AI) is a worrisome complication under left ventricular assist device (LVAD) support. AI progression causes LVAD-left ventricular (LV) recirculation and can require surgical inte...
Aortic insufficiency (AI) is a worrisome complication under left ventricular assist device (LVAD) support. AI progression causes LVAD-left ventricular (LV) recirculation and can require surgical intervention to the aortic valve. However, the limitations of LVAD support are not well known. Using an animal model of LVAD with AI, the effect of AI progression on hemodynamics and myocardial oxygen metabolism were investigated. Five goats (Saanen 48 ± 2 kg) underwent centrifugal type LVAD, EVAHEART, implantation. The AI model was established by placing a vena cava filter in the aortic valve. Cardiac dysfunction was induced by continuous beta-blockade (esmolol) infusion. Hemodynamic values and myocardial oxygen extraction ratio (O2ER) were evaluated while changing the degree of AI which was expressed as the flow rate of LVAD-LV recirculation (recirculation rate). Diastolic aortic pressure was decreased with AI progression and correlated negatively with the recirculation rate (p = 0.00055). Systolic left ventricular pressure (LVP) and mean left atrial pressure (LAP) were increased with AI progression and correlated positively with the recirculation rate (p = 0.010, 0.023, respectively). LVP and LAP showed marked exponential increases when the recirculation rate surpassed 40%. O2ER was also increased with AI progression and had a significant positive correlation with the recirculation rate (p = 0.000043). O2ER was increased linearly, with no exponential increase. AI progression made it difficult to reduce the cardiac pressure load, worsening myocardial oxygen metabolism. The exponential increase of left heart pressures could be the key to know the limitation of LVAD support against AI progression.
- Transcatheter Aortic Valve Replacement as a Bridge to Left Ventricular Assist Device Implantation. [Journal Article]
- IInnovations (Phila) 2018 Feb 14
- We describe a case of the pre-emptive use of transcatheter aortic valve replacement in a patient with end-stage ischemic cardiomyopathy and native aortic stenosis/aortic insufficiency as a bridge to ...
We describe a case of the pre-emptive use of transcatheter aortic valve replacement in a patient with end-stage ischemic cardiomyopathy and native aortic stenosis/aortic insufficiency as a bridge to left ventricular assist device implantation. The use of this strategy can not only medically optimize patients before left ventricular assist device implantation but also provide a minimally invasive bridge to left ventricular assist device support, avoiding concomitant surgical aortic valve replacement or closure.
- [Robot-assisted atrial septal defect closure in adults: first experience in Russia]. [Journal Article]
- KKhirurgiia (Mosk) 2018; (2):4-20
- CONCLUSIONS: In view of favorable course of postoperative period, no significant specific complications and encouraging immediate results we can talk about endoscopic robot-assisted ASD closure in adults as a safe and effective alternative to surgical treatment.
- Pattern and Extent of Tricuspid Valve Involvement in Chronic Rheumatic Heart Disease. [Journal Article]
- MMMymensingh Med J 2018; 27(1):120-125
- Rheumatic heart disease causes a significant number of morbidity and mortality in Bangladesh. Although the mitral and the aortic valve are the two most involved valves in rheumatic heart disease, the...
Rheumatic heart disease causes a significant number of morbidity and mortality in Bangladesh. Although the mitral and the aortic valve are the two most involved valves in rheumatic heart disease, the tricuspid valve disease is not uncommon secondary to, or in association with, mitral or aortic valve disease, but receives less attention as compared to the primary left-sided valve disease. Appropriate treatment of the tricuspid valve disease may improve long-term functional outcome. But the pattern and extent of the tricuspid valve involvement was not studied recently. This study was carried out to observe the pattern and extent of tricuspid valve involvement in Rheumatic Heart Disease patients. This observational analytical study was undertaken in the department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from December 2010 to September 2011. Considering all ethical issues, data were collected from 173 subjects who underwent Echocardiography for their Chronic Rheumatic heart disease. Pattern of tricuspid valve involvement was observed by using Transthoracic Echocardiography by 2D, M mode and Doppler assessment. One hundred seventy three (173) patients with Rheumatic Heart disease was studied, out of these, 36 patients had evidence of tricuspid valve involvement based on echocardiographic findings. Fifteen (15) patients had Tricuspid stenosis and 36 patients had Tricuspid Regurgitation in the patients with TV involvement. All the patients with TV involvement had thickened leaflets. Doming, restriction of motion and calcification were present in different proportions. From this study, it can be concluded that organic tricuspid valve involvement in RHD is not uncommon in our country.
- Percutaneous Pulmonary Valve Implantation Contraindicated by Severe Aortic Regurgitation Due to Left Coronary Sinus Deformation. [Journal Article]
- CJCirc J 2018 Feb 16
- Pregnancy Outcomes in Women With Rheumatic Mitral Valve Disease: Results From the Registry of Pregnancy and Cardiac Disease. [Journal Article]
- CircCirculation 2018 Feb 20; 137(8):806-816
- CONCLUSIONS: Although mortality was only 1.9% during pregnancy, ≈50% of the patients with severe rheumatic MS and 23% of those with significant MR developed heart failure during pregnancy. Prepregnancy counseling and considering mitral valve interventions in selected patients are important to prevent these complications.
- Severe aortic regurgitation caused by unicuspid aortic valve. [Journal Article]
- KPKardiol Pol 2018; 76(2):478
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- Dilated aortic root influences pulmonary artery catheter placement in anesthetized patients. [Journal Article]
- JCJA Clin Rep 2018; 4(1):15
- CONCLUSIONS: The present study showed that enlargement of the aortic root is associated with long placement time of the catheter.