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Results for “HEART VALVE DISEASES”

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At least 487 records · Page 27Linked to original sources
PubMed1989

[A ten years' experience with 613 mitral valve replacements].

This study was performed to assess the effect of factors on early and late mortality of isolated MVR in 613 patients. The tilting disc valve was used in 480 and the porcine xenograft bioprosthesis in 133 patients between Sep. 1978 and Nov. 1987. The overall early mortality rate was 4.89%. A comparative analysis showed that five factors (emergency operation, biventricular hypertrophy with serain, pulmonary hypertension, function class IV, and reoperation) significantly increased the early mortality rates (P less than 0.01). A 10-year follow-up study showed that the late mortality rate was significantly higher in patients with mitral insufficiency, function class IV and left ventricular hypertrophy with strain (P less than 0.01). The authors emphasize that the MVR must be performed early before the factors affecting the operative outcome are fully developed. Successive treatment with digitalis and/or diuretics should be continued in early postoperative period for 6-12 months to improve the cardiac function. Owing to the well-known durability of the bioprosthesis the authors prefer the use of mechanical valve.

Adolescent↗
PubMed1983

[Surgical treatment of valvular lesions of the heart in septic endocarditis].

Surgical interventions for valvular septic lesions of the heart were performed in 21 patients. Total surgical mortality reached 53%. The mortality rate was smaller in the patients with primary septic endocarditis, in spite of their poorer initial condition, as compared to the patients with secondary septic endocarditis coupled with rheumatic process (33 and 75%, respectively). A classification of septic endocarditis is proposed, based on their etiology, pathogenesis and clinical course, the type of affected valve, the extent of circulatory disturbance and prospective complications. Correct diagnosis and identification of indications for surgery with the help of this classification, timely surgical treatment, improved surgical techniques and accumulated clinical experience have all contributed to reducing the mortality rate to 12.5%.

Adolescent↗
PubMed1994

Transthoracic and transesophageal echocardiography for the evaluation of cardiac tumors, thrombi, and valvular vegetations.

Echocardiography is commonly used for the detection, assessment, and diagnosis of intracardiac masses. Since the introduction of M-Mode ultrasound in 1954, the subsequent development of two-dimensional Doppler, and transesophageal echocardiographic techniques have shown clinical efficacy in the evaluation of intracardiac pathology. The various presentations of cardiac tumors, thrombi, and valvular vegetations can pose a diagnostic challenge. In addition, once a diagnosis is established, data regarding risk stratification and prognosis are often required for further management. Echocardiography can serve these clinical needs.

Echocardiography↗
PubMed2002

Long-term survival of dialysis patients in the United States with prosthetic heart valves: should ACC/AHA practice guidelines on valve selection be modified?

BACKGROUND: Minimal data exist on the long-term survival of dialysis patients after cardiac valve surgery. Current practice guidelines of the American College of Cardiology/American Heart Association Task Force on the management of patients with valvular heart disease proscribe the use of bioprosthetic (tissue) valves in hemodialysis patients. METHODS AND RESULTS: Dialysis patients hospitalized for heart valve replacement surgery from 1978 to 1998 were retrospectively identified from the US Renal Data System database. Long-term survival was estimated by the life-table method. The impact of demographic differences and comorbidity on outcome were examined in a Cox proportional hazards model. The in-hospital mortality of 5858 dialysis patients undergoing valve surgery was 20.7%. Aortic valve replacement was performed in 3415 patients (58%), mitral valve replacement in 1848 patients (32%), and combined aortic and mitral valve replacement in 562 patients (10%). Tissue valves were used in 881 patients. There was no significant difference in survival related to type of prosthetic valve. The 2-year survival rate was 39.7+/-3.5% with tissue valves versus 39.7+/-1.4% for nontissue valves. Compared with nontissue prosthetic valves, the use of tissue valves was not predictive of death (RR 0.98; 95% CI 0.90 to 1.07). CONCLUSIONS: There is no significant difference in survival of dialysis patients after cardiac valve replacement with tissue versus nontissue prosthetic valves. Current practice guidelines proscribing the use of bioprosthetic heart valves in hemodialysis patients should be rescinded.

Adult↗
PubMed1991

Doppler echocardiographic evaluation of streptokinase lysis of thrombosed right-sided St. Jude Medical valves in patients with congenital heart defects.

Four episodes of St. Jude Medical prosthesis leaflet thrombosis were serially evaluated by two-dimensional and Doppler echocardiography during treatment with streptokinase. Three patients aged 4, 11, and 24 years with congenital heart disease had St. Jude Medical valves in pulmonary positions (two cases) for tetralogy of Fallot and in the tricuspid position (one case). The duration of thrombosis was not known in any patient. Leaflet immobility and its resolution were demonstrated by echocardiography and were confirmed fluoroscopically. Continuous wave Doppler echocardiography showed abnormal stenotic gradients in thrombosed valves that were reduced after thrombolysis. These studies demonstrate the utility of two-dimensional and Doppler echocardiography in serial evaluation of prosthetic pulmonary and tricuspid valve thrombosis during thrombolysis.

Adult↗