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At least 19 recordsLinked to original sources
PubMed1979

[Surface changes of the pulmonary valve following pulmonary valve xenotransplantation in the descending aorta. An experimental study in dogs].

Upon implantation in the descending aorta, glutaraldehyde-conditioned pulmonary valves (n = 46) are immediately covered by a protein layer, followed by a fibrinous layer. Two to thirty minutes later platelets, WBCs, macrophages, and microthrombi are incorporated into the valve's surface. After 3 weeks the first collagen fibers appear on the surface and slowly build a collagen layer that grows toward the free edge. These changes are very similar to the surface changes of bioprostheses implanted in humans.

Animals↗
PubMed1975

Echocardiogram and phonocardiogram related to the movement of the pulmonary valve.

Pulmonary valve movement and the related acoustic phenomena were investigated using high speed strip-chart echo- and phonocardiographic recording. The opening of the pulmonary valve had no definite relationship to the acoustic phenomena, whereas the pulmonary ejection sound was closely related in time to the early systolic maximal opening of the valve. The concomitant pulmonary ejection systolic murmur faded away by the time of the mid-systolic semi-closure of the valve, where the tiny extrasound occurred in a half of cases. The pulmonary component of the second heart sound occurred after the valve closure, and the time lag maximally reached up to 50 msec. Pulmonary hypertension tended to minimize this delay, giving the so-called single loud second heart sound. Graham Steell murmur started with the pulmonary component of the second heart sound and reached up to the isometric contaction phase beyond the first heart sound.

Adult↗
PubMed1982

Angio-pathological appearances of pulmonary valve in pulmonary atresia with intact ventricular septum. Interpretation of nature of right ventricle from pulmonary angiography.

Correlative angiographic-anatomical studies in 19 cases of pulmonary atresia with infarct ventricular septum showed the following relations between the angiographic appearance of the pulmonary valve and the morphology of the right ventricle. (1) Doming of the pulmonary valve was associated with a nearly normal-sized right ventricle and a wide infundibulum patent to the level of the pulmonary valve. (2) A fixed valve was associated either with (a) pronounced hypoplasia of the ventricular changer and stenosis of the infundibulum or (b) less commonly, a massive right ventricle and Ebstein's malformation of the tricuspid valve. (3) An intermediate type valve was associated with a small right ventricle and a small infundibulum which was, however, patent to the level of the pulmonary valve. It is suggested that the configuration of the pulmonary valve is a result of haemodynamic stresses placed upon it. These stresses, in turn, are determined by the morphological nature of the right ventricle. Thus, the nature of the pulmonary valve as seen angiographically may ve used as an index of right ventricular morphology.

Heart Defects, Congenital↗
PubMed1989

Therapeutic cardiac catheterization for pulmonary valve and pulmonary artery stenosis.

At C.S. Mott Children's Hospital, percutaneous balloon angioplasty for pulmonary valve or pulmonary artery stenosis accounts for approximately 40 per cent of all therapeutic transcatheter procedures performed in our laboratory. Percutaneous balloon valvuloplasty offers a highly successful nonsurgical approach to the treatment of children with isolated congenital valvar pulmonary stenosis. In these children, balloon valvuloplasty generally reduces the peak systolic pressure gradient by more than 50 per cent and should be considered the treatment of choice. Balloon angioplasty provides substantial anatomic and hemodynamic benefit in approximately 50 to 60 per cent of children with peripheral pulmonary artery stenosis. It is most often successful in treating naturally occurring pulmonary artery stenoses in children with tetralogy of Fallot. Since the surgical alternatives are difficult and often unsuccessful, balloon angioplasty offers a valuable form of treatment for many children with significant pulmonary artery stenosis or hypoplasia.

Adolescent↗
PubMed1995

The use of a glutaraldehyde-preserved ovine pulmonary valve, as a pulmonary valve substitute in infants.

Reconstruction of the right ventricular outflow tract with a valved conduit is often necessary to repair some forms of congenital heart disease. We have used a 12- to 13-mm sized glutaraldehyde-preserved lamb's (ovine) valve for this purpose. The valves were harvested from the local abattoir, dissected, and stored in glutaraldehyde at 4 degrees C for 2 weeks before use. The valve was placed in four infants, two with truncus arteriosus, one with aortic valve atresia and ventricular septal defect, and one with absent pulmonary valve syndrome. In three patients, the valve had to be replaced in the second year of life, and in one patient in the fourth year of life. All patients are alive and well at follow-up. In the short-term, this valve has functioned well and could be considered where commercially available conduits or homografts are not routinely available.

Animals↗
PubMedDate not supplied

Pulmonary valve reconstruction in absent pulmonary valve syndrome: a new technique.

BACKGROUND: In patients with absent pulmonary valve syndrome, the relief of the pulmonary regurgitation at the time of primary repair improves both the early and late results. Though homograft and heterograft valves and conduits have been used for this purpose, both are not easily available and are known for late failure. Monocusp and bicuspid semilunar valves made out of pericardium have their own problems. Hence, a technique of reconstructing an autologous competent 3-cusp valve from the native tissues was developed. METHODS: Two posterolateral semilunar cusps were fashioned from the anterior wall of the main pulmonary artery. The anterior cusp was made from autologous pericardium stitched to the autologous pericardial patch used to widen the right ventricular outflow tract. RESULTS: This method of reconstruction was used in two patients aged 9 and 22 years, respectively. Visual assessment and passive testing after reconstruction revealed well functioning neopulmonary valves in both patients. The second patient, who had an unevenful hospital course, showed only mild pulmonary regurgitation at 5 years postreconstruction. CONCLUSIONS: As 2 of the 3 cusps are fashioned from the pulmonary arterial wall as a pedicled graft, we believe that they will retain their viability and grow with the pulmonary artery. Simultaneous reduction in the size of the pulmonary arteries will relieve bronchial compression when present. The anterior pericardial cusp, even if it eventually shrivels up, is unlikely to produce serious hemodynamic derangements.

Adult↗
PubMed1988

Hour-glass deformity of the pulmonary valve: a third type of pulmonary valve stenosis.

In the 12 years from 1975 to 1987, 55 patients had open pulmonary valve surgery for isolated congenital stenosis of the pulmonary valve. Three types of pulmonary stenosis were seen: (a) dome-shaped pulmonary stenosis (34 patients); (b) dysplastic pulmonary valves with thick cauliflower-like cusps (12 patients), and (c) hour-glass deformity of the pulmonary valve, with "bottle-shaped" sinuses (nine patients). This third type has not been described before. Preoperative identification of the valve structure is important because the choice of treatment (balloon dilatation for some dome-shaped valves and excision for dysplastic and hour-glass valves) depends on the type of stenosis.

Adolescent↗
PubMed1989

Hemodynamic evaluation and morphological changes of right ventricular out-flow tract and pulmonary valve after balloon pulmonary valvuloplasty.

Balloon pulmonary valvuloplasty (BPV) was attempted in 38 cases of congenital pulmonary valve stenosis. It was effective and was done without complication in 36 cases, however it was not effective in two cases of pulmonary valve dysplasia. The balloon used was 20-50% larger in diameter than the pulmonary valve annulus. In the seven cases in which the transvalvular pressure gradient was above 100 mmHg on cardiac catheterization, right ventriculography demonstrated that the functional obstruction of the right ventricular outflow tract increased immediately after BPV, however it subsequently improved at one year after the procedure. At between one and three months after BPV, two-dimensional echocardiography demonstrated that the morphological obstruction to the right ventricular outflow tract had diminished. In two cases, localized right ventricular septal hypertrophy with severe pulmonary valve stenosis was observed by two-dimensional echocardiography and right ventriculography, and persisted at one year. In all cases, two-dimensional echocardiography and angiography demonstrated doming pulmonary valves with valve stenosis, which was diminished by BPV. The pulmonary valve morphology was observed by two-dimensional echocardiography in three cases following BPV. In one case, partial relief of pulmonary valve obstruction was seen to be due to commissural splitting and in the other two, to tearing of cusp tissue. Inspection of the pulmonary valve at operation was made in one case who underwent elective surgery for repair of an atrial septal defect which was associated with pulmonary valve stenosis. It demonstrated partial relief of pulmonary valve stenosis by tearing of cusp tissue. In conclusion, BPV is as effective a treatment for congenital pulmonary valve stenosis as open valvulotomy. In our follow-up study, it has shown no apparent complications. The transient obstruction in the right ventricular outflow tract immediately after BPV improved within one month and improved further after three months and one year. However, in the more long-standing cases the localized right ventricular septal hypertrophy persisted and these cases will require, a long term follow-up.

Blood Pressure↗
PubMed1994

Infective endocarditis of the pulmonary valve following pulmonary artery catheterisation.

The risk of infective endocarditis following pulmonary artery catheterisation in patients with sepsis remains unquantified. Although catheter-induced endocardial and valvular injury are well recognised, valve infection is rare. A case of mixed pulmonary valve endocarditis associated with the use of a pulmonary artery catheter (PAC) in a patient with multisystem failure following liver trauma is described. This illustrates that diagnosis of infective endocarditis in critically ill patients can be difficult because concurrent illness and therapy may mimic or mask the usual presenting signs. The value of transoesophageal echocardiography in this context is emphasised.

Adult↗
PubMed1992

Failure of balloon dilatation of the pulmonary valve in carcinoid pulmonary stenosis.

BACKGROUND: Carcinoid heart disease typically results in pulmonary stenosis and tricuspid incompetence. Percutaneous balloon dilatation is an effective treatment for congenital pulmonary stenosis and has been applied successfully to tricuspid stenosis caused by carcinoid heart disease. The value of balloon dilatation of the pulmonary valve in carcinoid pulmonary stenosis was assessed. METHODS: Two patients with severe congestive heart failure secondary to carcinoid heart disease and with documented pulmonary stenosis had balloon dilatation of the pulmonary valve. In both cases tricuspid regurgitation was also present together with reduced cardiac output. RESULTS: The procedure was technically successful in both patients. One patient experienced symptomatic benefit for two months and the other experienced no improvement. Both patients subsequently required combined tricuspid and pulmonary valve replacement from which good results and symptomatic improvement were obtained. CONCLUSION: Though balloon dilatation of the pulmonary valve is technically feasible it is unlikely to provide useful palliation in carcinoid heart disease. Valve surgery should be considered in patients in whom the malignancy is controlled but carcinoid heart disease is producing drug resistant congestive heart failure.

Carcinoid Heart Disease↗
PubMedDate not supplied

Congenital absence of the pulmonary valve associated with pulmonary stenosis, large ductus arteriosus and intact ventricular septum. Case report.

A six-day-old neonate was diagnosed with a severe form of the syndrome of absent pulmonary valve associated with pulmonary stenosis, aneurysmal dilatation of the pulmonary artery and rare findings including an intact ventricular septum and large ductus arteriosus. The patient underwent surgical repair by closed technique. Cardiac catheterization data, hemodynamic and clinical findings, and surgical technique are reported. Congenital absence of the pulmonary valve is a rare cardiac anomaly. An especially severe form occurs with ventricular septal defect and pulmonary stenosis. The usual findings are respiratory distress, aneurysmal dilatation of the pulmonary arteries and pulmonary stenosis.

Ductus Arteriosus, Patent↗
PubMed1990

[Konno procedure for congenital aortic valve stenosis with pulmonary valve stenosis].

Although aortic and pulmonary valve stenosis are among the most common congenital heart defects, the combination of both aortic and pulmonary valve stenosis in the same patient appears to be very uncommon. Accurate diagnosis of combined valvular stenosis is imperative prior to surgical correction, otherwise surgery of one of the lesions may result in an insufficient hemodynamic improvement. A seven-year-old girl with congenital aortic and pulmonary valve stenosis associated with hypoplastic aortic annulus underwent Konno's operation, pulmonary valvotomy and resection of anomalous muscle of the right ventricular outflow tract simultaneously. The operation was successfully performed and postoperative course was uneventful.

Aortic Valve Stenosis↗