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Biomedical subjects

Jagdish Butany

Publications and source records attributed to Jagdish Butany.

87 records · Page 5Linked to original sources
PubMedDate not supplied

Mechanical heart valve prostheses: identification and evaluation (erratum).

Mechanical heart value prostheses have been in use since the 1950s. Many prostheses have been used for a while and then discontinued. Today, there are a large number and variety of prostheses in use and an even larger variety that are in place in patients. These may be explanted at any time for a number of reasons. It is essential for the practicing pathologist to be able to identify the prosthesis and be aware of some of its reported complications and modes of failure. This article, and a second one on bioprosthetic heart valves, is designed as a ready reference guide to heart valve prostheses, their important identifying features, their common complications, and modes of failure. It should help in the accurate identification of explanted prosthetic valves and more definitive reports. This accuracy of identification as well as tracking of abnormalities noted will, we hope, permit the identification of new failure modes and the recording of causes of failure of new (or even modified) prosthetic heart valves.

Heart Valve Prosthesis↗
PubMedDate not supplied

Ruptured synthetic expanded polytetrafluoroethylene chordae tendinae.

Synthetic sutures are used for mitral valve repair and as synthetic chordae tendinae to resuspend the mitral valve. The sutures soon get covered with connective tissue and work well for long periods. We report the first instance (in the literature) of rupture of a synthetic (PTFE) chordae tendinae. The synthetic suture (PTFE) was associated with calcification.

Aged↗
PubMedDate not supplied

Papillary fibroelastoma of the interatrial septum: a case report.

Primary cardiac tumors are rare, with benign lesions outnumbering malignant ones by a margin of over four to one. Amongst the benign cardiac neoplasms, papillary fibroelastomas are reported second only to myxomas. Papillary fibroelastomas commonly rise from heart valves and their size ranges from a few millimeters to well over 2.0 cm in diameter. While myxomas commonly arise from the interatrial septum, we present the rare example of a large papillary fibroelastoma arising from the left side of the interatrial septum.

Coronary Angiography↗
PubMedDate not supplied

Artificial chordae tendinae: long-term changes.

BACKGROUND AND AIM: We present the clinical and pathological findings of a patient who underwent mitral valve repair, with synthetic chordae, for rheumatic disease 13 years earlier. METHODS: Echocardiographic, pathologic, and histologic examination of a previously repaired mitral valve using artificial chordae tendinae. RESULTS AND CONCLUSIONS: Extensive fibrosis and thickening, consisting of fibroblasts and mature collagen, in time surrounds the artificial chorda rendering it indistinguishable from its native counterparts on gross examination and even during echocardiography.

Chordae Tendineae↗
PubMedDate not supplied

Thrombosis of mechanical mitral valve prosthesis.

Obstruction of mechanical valve prostheses is a rare but potentially lethal complication following valve replacement surgery. Identifying the etiology and differentiation between thrombus, pannus, and vegetation obstructing the valve prosthesis can pose a diagnostic challenge. We report a patient who had an acute cerebral hemorrhage, developed a progressive mass lesion obstructing his mechanical mitral valve, and discuss contemporary diagnostic and management strategies.

Cerebral Hemorrhage↗
PubMedDate not supplied

A bicuspid pulmonary valve associated with tetralogy of fallot.

Congenitally bicuspid pulmonary valves are uncommon. When they occur, it is usually in association with other congenital cardiac lesions, most often a tetralogy of Fallot. We present a rare case of a patient with a congenitally bicuspid pulmonary valve who had pulmonary valve and RVOT reconstruction. The patient did well for 17 years, but needed further reconstruction when the pulmonary valve started getting stenosed and RV pressures went up significantly. The pulmonary valve showed fibroses, thickening, and focal calcification.

Adult↗
PubMedDate not supplied

Infective endocarditis of the tricuspid valve.

Infective endocarditis (IE) usually involves the left-sided valves, and IE involving the tricuspid valve (TV) is rare, often developing in intravenous drug users (IDU). We present a case of a 32-year-old male, an intravenous drug abuser (IDA), who presented with nonspecific septic symptoms, and was treated with TV conserving surgery. Pathological examination confirmed tissue destruction, friable thrombotic vegetations, and microorganisms in the leaflet tissue.

Adult↗
PubMedDate not supplied

Pathologic analysis of 19 heart valves with silver-coated sewing rings.

OBJECTIVE: The St. Jude Medical Silzone (Silzone) mechanical heart valve was voluntarily recalled (January 2000) due to an unusually high incidence of paravalvular leaks. We present the first series of human morphological data on the failure of these valves. METHODS: Nineteen Silzone valves were evaluated from the 176 Silzone valves implanted in 147 patients at our institution between 1997 and 1999. Explanted prostheses were fixed in 10% formalin, photographed, and X-rayed. Histological sections were collected from the sewing cuff, accompanying tissues, and thrombus. For comparison, six age-matched SJM-standard valves were similarly analyzed. RESULTS: Nineteen Silzone valves from 16 patients (10 male, six female, 52.0 +/- 15.2 years) were examined. Significantly more mitral (15/95) prostheses were removed than aortic (4/81) despite the nearly equal number implanted (p = 0.027). Fifteen of the Silzone valves (13/16 patients) were explanted in the early postoperative period (within six months of implantation), although collection continued for eight years after our institution stopped implanting them. The common indications for surgical explantation were paravalvular leak (8/12) and clinically suspected infective endocarditis (IE) (four patients, five valves). IE was not confirmed by histology or culture in any valve. The sewing cuffs of many Silzone valves showed large regions of pannus, granulation tissue, and purulent exudate. Polymorphonuclear leukocytes were more common in the sewing cuff of Silzone valves; however, the cellular infiltrate was superficial when compared to SJM-standard valves. CONCLUSION: This is the largest morphologically analyzed series of Silzone explants. It demonstrates a consistent pattern of atypical tissue incorporation into the silver-coated sewing ring particularly in the mitral position. Clinical and morphologic features of IE (sterile) are seen in the early postimplant period. Prosthesis-related problems were almost wholly seen at the mitral site, in our group. Our current data indicate that although early failure due to dehiscence and paravalvular leak is a problem, Silzone valves that "survive" past six months will likely function as well as the SJM-standard prosthesis.

Adult↗
PubMedDate not supplied

Radiologic pattern of disease in patients with severe acute respiratory syndrome: the Toronto experience.

Severe acute respiratory syndrome (SARS) is a transmissible febrile respiratory illness caused by a recently discovered coronavirus. Various patterns of disease progression may be observed that have different implications for the prognosis in those affected by SARS. The appearance of the lungs on chest radiographs of patients with this condition may be normal or may include focal airspace opacity or multifocal or diffuse opacities. Thoracic computed tomography (CT) is more sensitive in depicting SARS than is conventional chest radiography, and CT images obtained in patients with normal chest radiographs may show extensive disease and airspace consolidation. However, because the radiologic appearance of SARS is not distinct from that of other diseases that cause lower respiratory tract infection, early identification of SARS will depend in part on the prompt recognition of clusters of cases of febrile respiratory tract illness. To aid in the differential diagnosis and management of SARS, radiologists must be familiar with the typical clinical and histopathologic findings, as well as the radiologic features of the disease.

Adult↗