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At least 649 records · Page 36Linked to original sources
PubMed2000

[Preliminary echocardiographic evaluation on prosthetic valve replacement of preserving the subvalvular apparatus with artificial chorade for mitral stenosis].

The purpose of this study was to evaluate the preliminary results after prosthetic valve replacement of preserving the subvalvular apparatus with artificial chorade for mitral stenosis. 20 patients had received operation with expanded polytetrafluoroethylene(e-PTFE) as artificial chordade. The patients were followed up by means of echocardiography. The time of follow-up study varied from 4 to 18 months with a mean of 6 months. The left atrial, ventricular dimension as well as ventricular function were assessed. In addition, the length of artificial chorade and obstruction of left ventricular outflow track were observed. The results showed that left atrial diameter (LAD, from 57.59 +/- 13.51 mm to 47.05 +/- 9.55 mm), left ventricular end-diastolic dimension (LVEDD, from 46.23 +/- 12.56 mm to 42.41 +/- 10.86 mm), left ventricular end-systolic dimension (LVESD, from 33.50 +/- 10.20 mm to 29.68 +/- 8.40 mm) decreased (P < 0.01), and ejection fraction (EF, from 52.59 +/- 11.89% to 58.36 +/- 8.03%) increased (P < 0.05) after operation. There were no significant changes of fractional shortening (FS, from 29.23 +/- 8.99% to 31.05 +/- 6.08%). The length of artificial chorade ranged from 2.6 cm to 4.3 cm (the mean, 3.2 cm). There was no case of obstruction of left ventricular outflow track. It is believed that the result of preliminary echocardiographic observation on prosthetic valve replacement of preserving the subvalvular apparatus with artificial chorade for mitral stenosis is satisfactory.

Adult↗
PubMed2003

Improvement in mitral regurgitation after aortic valve replacement.

BACKGROUND: Concomitant mitral valve regurgitation is often present in patients with aortic stenosis. The additional MV replacement is associated with high operative risk. Previous studies have shown an amelioration of MV regurgitation after aortic valve replacement but most of the patient groups were heterogenous. OBJECTIVES: To determine whether AV replacement for aortic stenosis has any effect on MV regurgitation. METHODS: We reviewed two-dimensional echocardiography and color flow Doppler assessment of both aortic stenosis and MV regurgitation severity in 30 patients. Patients with previous MV surgery, organic MV disease, occlusive carotid artery disease, ejection fraction < 50%, and coexisting significant AV regurgitation were excluded. Preoperatively, MV regurgitation was mild in 23 patients (77%) and moderate in 7 (23%); in no patient was the condition severe. All patients had severe atrial stenosis (peak average aortic gradient 86 +/- 22 mmHg in the mild MV regurgitation group and 83 +/- 26 mmHg in the moderate group). The patients were divided into two groups according to the severity of MV regurgitation (associated mild, and moderate). Group 2, with moderate MV regurgitation, was the most problematic in terms of decision making for concomitant MV surgery. Therefore, additional assessment of several parameters was required. RESULTS: There was a significant decrease in MV regurgitation area (7.6 +/- 1.9 vs. 3.0 +/- 1.2 cm2, P < or = 0.012) and percent (28 +/- 5% vs. 12 +/- 6%, P < or = 0.001) between pre- and postoperative evaluation. Thus, the severity of the condition in all patients with moderate MV regurgitation decreased after AV replacement; in the mild group it remained unchanged in 53% or improved in 47%. There was no association between the preoperative gradient on the aortic valve and the degree of MV regurgitation. CONCLUSIONS: In our population of patients with severe atrial stenosis there were no patients with coexisting severe MV regurgitation. The decision to repair or replace a severely leaking mitral valve is an easy one, as in mild MV regurgitation. The clinical problem often presents in patients with severe aortic stenosis and moderate MV regurgitation. We believe that additional MV surgery is not necessary, at least in patients with preserved left ventricular function and without organic MV disease.

Aged↗
PubMed2003

Hypertrophic non-obstructive cardiomyopathy with aortic and mitral regurgitation: an unusual presentation for surgical option.

The case is described of a pediatric patient with hypertrophic non-obstructive cardiomyopathy (HNCM) presenting with aortic and mitral regurgitation. This 17-year-old boy had been followed for HNCM since he was aged 4 years. Serial echocardiography had been showing the emergence and progression of aortic regurgitation and mitral regurgitation since the patient was aged 6 years. He started to have syncope attacks at 16 years of age and fell into congestive heart failure at 17 years. He underwent successful mitral valve repair by means of double-orifice technique, and aortic valve repair with raphe triangular resection, cusp plication and subvalvular annuloplasty.

Adolescent↗
PubMed2003

[The apply of Cosmopost ceramic posts in clinic].

OBJECTIVE: To investigate the manufacture method and the effects of Cosmopost ceramic posts, to summarize the indications of Cosmopost ceramic post in clinic. METHODS: 228 pieces Cosmopost ceramic posts and cores were made for 96 patients. 2l7 pieces full ceramic crowns and 8 pieces full ceramic bridgs for Cosmopost ceramic posts and cores were made. The fitness of Cosmopost ceramic post were checked, and the color of all full ceramic crowns and full ceramic bridgs were checked in clinic. The amount of loosening and broken in all restorations were checked every year in clinic. follow up 2 - 3 years. RESULTS: 1 Cosmopost ceramic post was fracture about 1.5 mm before the full ceramic crown was worn. 227 pieces Cosmopost ceramic posts were perfect. All of the full ceramic crowns and bridgs for full ceramic posts were excellent in color. No loosening and broken cases were checked in 0.5 - 3 years. But the indications of Cosmopost ceramic posts were strict in clinic. CONCLUSION: Cosmopost ceramic post has natural aesthetic effect and good strength. it can be used in clinic.

Adolescent↗
PubMed2005

[Biostability and calcification resistance of valved bovine jugular veins stabilized by dye-mediated photooxidation].

This study was conducted to make an in vitro evaluation of the biological characteristic of valved bovine jugular veins stabilized by dye-mediated photooxidation. The fresh valved bovine jugular veins were stabilized by dye-mediated photooxidation. The glutaraldehyde-treated veins and fresh veins served as controls. The samples were subjected to protein extraction assay and pepsin digestion assay, and were analyzed by polyacrylamide gel electrophoresis. The rat subcutaneous model for assessment of tissue calcification and immunologic properties was used. Calcium levels were determined by elemental analysis on dried samples and von Kossa staining. Both photooxidized and glutaraldehyde-treated tissues were resistant to protein extraction and pepsin digestion, compared to fresh tissue. Calcification levels were much lower for photooxidized tissues when compared with those for both glutaraldehyde-treated and fresh tissues. The perigraft infiltrate was lower in the photooxidized tissues than in the fresh and glutaraldehyde-treated tissues. Valved bovine jugular veins stabilized by dye-mediated photooxidation were biostable and resistant to calcification, and the immunologic property was well.

Animals↗
PubMed2006

Left ventricular outflow tract obstruction after bioprosthetic mitral valve replacement with posterior mitral leaflet preservation.

We present a case of transient left ventricular outflow tract obstruction after mitral valve replacement with a high-profile bioprosthesis; only the posterior native mitral valve leaflet was preserved. A 76-year-old woman was admitted to our institution with pulmonary edema. Two weeks earlier, she had undergone mitral valve replacement at our hospital due to severe mitral stenosis and 2+ mitral regurgitation complicated by cardiac failure and atrial fibrillation. The patient was taking digoxin, furosemide, and warfarin at the time of readmission. Echocardiography showed a narrowed left ventricular outflow tract. Doppler echocardiography revealed a peak 64-mmHg gradient between the septum and the strut of the bioprosthesis. The patient was successfully treated medically. This case indicates that the risk of left ventricular outflow tract obstruction after bioprosthetic mitral valve replacement is not always eliminated by removal of the anterior mitral valve leaflet when the posterior mitral leaflet is preserved.

Aged↗
PubMed1996

A hemodynamic comparison of Omniscience and Medtronic Hall aortic prostheses.

BACKGROUND AND AIMS OF THE STUDY: Preliminary reports have suggested hemodynamic disparities between single leaflet tilting disc prostheses. We tested the hypothesis that similarities in prosthetic design may not necessarily indicate hemodynamic equivalence. MATERIALS AND METHODS: In a retrospective analysis, we compared the functional characteristics of two single tilting disc (Omniscience and Medtronic Hall) prostheses implanted in the aortic position in 30 patients matched for valve size and left ventricular systolic function. RESULTS: Echocardiographic and Doppler analysis blinded to patient and valve type indicated similar quantitative left ventricular ejection fractions (64% +/- 6% for both) and cardiac outputs (4.8 +/- 1.2 vs. 4.6 +/- 1.2 l/min, p = 0.65) in the Onmiscience and Medtronic Hall groups, respectively. Transprosthetic instantaneous peak gradients were greater for Omniscience than for Medtronic Hall valves (44 +/- 8 vs. 35 +/- 11 mmHg, p < or = 0.02), as were the mean values (24 +/- 6 vs. 18 +/- 6 mmHg, p = 0.01). Even when 21 and 23 mm prostheses were analyzed separately to allow for unequal sewing ring diameters in the smallest valve sizes (Omniscience = 19 mm, Medtronic Hall = 20 mm), higher gradients were noted in the Omniscience prostheses. Effective orifice areas were smaller in the Omniscience than Medtronic Hall prostheses whether data from all prostheses (0.92 +/- 0.11 cm2 vs. 1.09 +/- 0.18 cm2, p < or = 0.05), or only data from 21 and 23 mm valves (0.94 +/- 0.11 cm2 vs. 1.10 +/- 0.18 cm2, p < 0.05) were included. Similarly, the dimensionless obstructive index, a parameter independent of left ventricular flow and annular size, was reduced in the Omniscience valves, indicating greater obstruction, whether all valves (0.31 +/- 0.04 vs. 0.36 +/- 0.07, p < or = 0.01) or only 21 and 23 mm valves (0.31 +/- 0.04 vs. 0.36 +/- .04, p < 0.001) were analyzed. CONCLUSION: Despite prosthetic design similarities, resting hemodynamic assessment indicates greater stenosis in Omniscience than Medtronic Hall valves when placed in the aortic position. The long term effects of these differences in terms of ventricular diastolic and systolic function and mass regression requires further evaluation.

Aortic Valve Insufficiency↗
PubMed1997

Tricuspid inflow and regurgitant flow dynamics after mitral valve replacement: differences relating to surgical repair of the tricuspid valve.

BACKGROUND AND AIMS OF THE STUDY: Changes in tricuspid inflow and regurgitant flow dynamics were evaluated in patients with functional tricuspid regurgitation (TR) who underwent mitral valve replacement (MVR) with and without tricuspid annuloplasty (TAP). METHODS: In a group of 30 patients, all with atrial fibrillation, 15 underwent TAP performed according to the modified De Vega technique; the remaining 15 did not undergo TAP. Patients were studied before and serially after surgery, using pulsed and color Doppler echocardiography. The mean follow up was 4.7 years in the TAP group and 5.1 years in the non-TAP group. RESULTS: In the TAP group, immediately after surgery, the area of the TR jet decreased markedly, and the deceleration time of the tricuspid inflow velocity wave was significantly prolonged compared with that before surgery. By contrast, in the non-TAP group, both the area of the TR jet and deceleration time of tricuspid inflow velocity were virtually unchanged. The area of the TR jet remained small for a long period in the TAP group, but in non-TAP patients was increased in four cases over seven years, with two patients developing right-sided heart failure. Recent data showed the area of the TR jet to be significantly smaller, with maximum tricuspid inflow velocity significantly increased, and deceleration time of the tricuspid inflow velocity wave significantly prolonged in the TAP group compared with the non-TAP group. CONCLUSIONS: In patients with functional tricuspid regurgitation undergoing MVR, concomitant TAP may cause mild tricuspid stenosis, but produces sustained preventive effects against TR. Careful follow up is needed in patients who have not undergone TAP, as TR is not markedly decreased and may even be exacerbated. Aggressive TAP is recommended in patients showing dilatation of the tricuspid annulus, even if TR is mild.

Adult↗
PubMed1997

[Reconstructive surgery in a case of aneurysm of the ascending aorta and aortic valve insufficiency].

The authors report the case of a young patient with an aneurysm of the ascending aorta and moderate aortic incompetence, who underwent a conservative operation at our institution. Dilatation of the sinotubular junction, particularly at the level of the non-coronary sinus of the aortic valve with loss of coaptation between the corresponding leaflet and the two coronary leaflets, was identified at the time of surgery as major cause of valve insufficiency. During surgery, the dilated ascending aorta and pathologic aortic sinus were replaced with a 26 Hemashield prosthesis tailored according to the David guidelines. An intraoperative post-repair transesophageal echo exam showed that the aortic valve appeared to be working competently. The post-operative course was uneventful and at one year, an echographic check of the aortic valve showed that it was fully competent, with normal leaflet motion. Conservative surgery can be a good option in selected patients with ascending aortic aneurysm and aortic valve insufficiency.

Adult↗
PubMedDate not supplied

Color change and fracture resistance of two preveneered stainless-steel crowns after sterilization.

PURPOSE: This study compared the fracture resistance and color stability of two commercially available, preveneered stainless-steel crowns before and after four sterilization techniques. METHODS: Thirty-five crowns from each of two manufacturers were divided into five groups. Four groups were sterilized twice using one of the following techniques: steam autoclave at both 121 degrees C (15 PSI) for 20 min and 132 degrees C (30 PSI) for 8 min; Chemiclave with formaldehyde at 132 degrees C for 20 min; and 2% gluteraldehyde for 10 h. The fifth group from each manufacturer was the control. Color of facings was measured before and after each sterilization in triplicate using a colorimeter, and the variance of each color parameter was analyzed for significance. Fracture resistance was measured for each group and differences between the control and experimental groups analyzed for significance. RESULTS: The results of this study show that high heat and chemical sterilizations have little effect on color and fracture resistance of the preveneered stainless-steel crowns. Student's t test analysis revealed a significantly decreased resistance to fracture with Kinder Krowns sterilized in 2% gluteraldehyde. Chemiclave sterilization caused the most negative color change in all three color parameters measured for both types of crowns. CONCLUSIONS: As neither steam technique produced significant changes in fracture resistance or color changes that were clinically detectable, the results of this study indicate that the two steam techniques tested can be used by clinicians to sterilize either Kinder Krowns or Nu Smile preveneered stainless-steel crowns.

Color↗