PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “HEART VALVE DISEASES”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed1981

Porcine heterograft valve replacement in carcinoid heart disease.

A 53-year-old man with a pancreatic carcinoid tumor and liver metastases had the carcinoid syndrome with involvement of the tricuspid valve by carcinoid plaque. The mitral valve was involved by unrelated myxomatous degeneration (floppy valve). Each valve was replaced by a Hancock glutaraldehyde-prepared porcine heterograft prosthesis. When the patient died of complications of the tumor 8 months postoperatively, both valves had clinically normal function. Nevertheless, the carcinoid plaque, which was present in all four cardiac chambers and almost completely covered the endocardial surfaces of both atria, extended onto both prostheses. This eventually might have interfered with prosthetic valve function.

Bioprosthesis↗
PubMedDate not supplied

The unnatural history of valvular heart disease: late results with silastic ball valve prostheses.

The development of prosthetic heart valves successfully arrested the dismal natural history of valvular heart disease for thousands of patients. The experiences of numerous investigators provided a setting wherein the design and implantation of the silastic ball valves led to improved survival with both aortic and mitral valve replacement. Refinement of the caged-ball design was based on clinical and laboratory findings. In the mitral position, valve related thromboembolism was reduced from 38% to 3%. With the aortic prostheses the problem of ball variance was overcome by reducing trauma to the poppet and altering its heat curing process. In 1967 a completely cloth covered valve was introduced to reduce further the thromboembolic rate. Significant improvement in the embolus-free rate was ultimately found to be dependent on the year of operation with introduction of the time-frame concept. The current mitral silastic ball valve, Model 6120, yields an actuarial survival of 72 (+/- 3%), 54 (+/- 5%), and 37 (+/- 5%) for five, ten and fifteen years respectively. For aortic valve replacement, current Model 1260, the actuarial survival is 71 (+/- 2%), 58 (+/- 3%) and 48 (+/- 4%) for five, ten and fifteen years respectively. Late results are compared to other valvular prostheses.

Aortic Valve↗
PubMed1994

[Transesophageal echocardiography: indications and findings. Experiences from 3 centers].

The introduction of transoesophageal echocardiography has greatly enhanced the noninvasive diagnostic possibilities in cardiology. This multicentre report analyses the findings in different indications as well as the rate of complications in 335 consecutive patients on whom transoesophageal echocardiography was performed. The most frequent indication was the search for a cardiac source of embolism (36%). Compared to patients with other indications, thrombi in the left atrial appendage, atrial septal aneurysms and protruding aortic atheromas were significantly more frequent in this group. Transoesophageal echocardiography was performed in 20% for the diagnosis of suspected endocarditis and vegetations and/or paravalvular abscesses could be demonstrated in 46% of these patients. Other important indications included the assessment of mitral valve disease, congenital heart disease, valve prosthesis dysfunction and aortic dissection. Clinically relevant complications occurred in 1.8% and were spontaneously reversible in all cases. Transoesophageal echocardiography is an extremely valuable and safe diagnostic tool in cardiology.

Adolescent↗
PubMed1984

[Reconstructive valve surgery in congenital heart disease].

As part of various defects in congenital heart disease, valvular lesions are frequently encountered and remain as one of the difficult subjects. Recent advances in the management of valvular lesions and late results of repair and replacement were reported. In congenital aortic stenosis, most of patients have obtained satisfactory results with valvotomy, but some required reoperation with valve replacement even during childhood. In supracristed VSD associated with aortic regurgitation, late recurrence of regurgitation was found in some, but 70% of the patients showed free of diastolic murmur after 10 years. In tetralogy of Fallot, definitive repair of pulmonary valve was performed in last 5 years with composite patch with patient's own pericardium to reduce postoperative pulmonary regurgitation. Recently, pericardium is treated with glutaraldehyde on the operating table to prevent late shrinkage. As external conduit, homograft aorta, which had been utilized previously, showed good late results comparable to xenograft in terms of free from reoperation. Xenograft has been frequently utilized without significant late obstruction so far. In atrioventricular canal, endocardial cushion prosthesis technique has been utilized satisfactory with recent modification of the wings made by glutaraldehyde treated patient's own pericardium as well as in tetralogy.

Follow-Up Studies↗
PubMed2006

Percutaneous valve replacement: weird or wonderful?

Percutaneous treatment of valve diseases has proven to be an effective alternative to open surgery since the early 1980's. For most patients with rheumatic mitral stenosis, use of percutaneous catheter-based techniques as balloon valvuloplasty for the treatment of both congenital pulmonary stenosis as well as trans-septal commissurotomy has become a good therapeutic option. Furthermore in the mid 1990's in vitro studies demonstrated the feasibility of percutaneous catheter-based valve implantation first in pulmonary and subsequently in aortic position. Afterwards initial in vivo implantations were successfully undertaken. Limitations of this new branch of transcatheter-based techniques are: risk of embolization due to pre-dilatation; difficult deployment; migration of valved stent; paravalvular leakage and limited durability of the implanted valve. Hence, many advances and improvements are necessary prior to pronouncing a new real alternative and safe therapeutic option. Up to now the gold standard for the treatment of heart valve disease is still open surgical valve repair and replacement. Percutaneous valve replacement procedures offer substantial advantages both to patients and medical care providers. From a medical point of view, they may help reduce surgical risks, offer a less invasive procedure, lower complication rates and shorten rehabilitation times in future. From an economic standpoint, shorter hospital stays result in overall cost reduction.

Animals↗
PubMed1995

Mechanical valve replacement under 12 years of age: 15 years of experience.

Despite improving surgical techniques, treatment of heart valve disease in children remains controversial. Growth of the child and adequate anticoagulation level are the main concerns when valve replacement is performed in the pediatric age. We reviewed the case histories of 29 children who underwent valve replacement with mechanical prosthesis from 1979 to 1994 in order to evaluate the performance of mechanical valves in this age group. Age ranged from two years to 12 years (mean 8.97 +/- 3.7 years). A total of 31 valves were implanted; 17 children had atrioventricular (Av) valve replacement (15 mitral, one common Av (heterotaxia), one tricuspid (systemic ventricle)), 11 children had aortic valve replacement (one redo), and one child had double mitral and aortic valves implanted. The etiology of valvular disease was congenital in 34.5%, degenerative in 17.2%, rheumatic in 24%, infective in 13.8%, and prosthetic dysfunction in 10.3%. Of the 29 patients, eight had undergone previous procedures and eight required simultaneous repair of associated lesions. There were three hospital deaths (10.3%). The mean follow up was 5.79 +/- 5.36 years. There were four late deaths (2.66%/patient-year) at a mean of 37 months from surgery. All operative survivors received oral anticoagulation with sodium warfarin. No thromboembolic event or bleeding occurred, no endocarditis developed in any patient; one reoperation was performed for patient/prosthesis mismatch. Mechanical valves offer excellent hemodynamic performances and a low rate of thromboembolism and/or bleeding in our experience, and are our first choice for heart valve replacement in children when reparative surgery is not feasible.

Aortic Valve↗
PubMed2006

Valve surgery in octogenarians: a safe option with good medium-term results.

BACKGROUND AND AIM OF THE STUDY: The number of octogenarians is increasing in industrialized societies, and many patients aged over 80 years have heart valve disease which is amenable to surgical treatment. The perioperative outcomes and long-term results in very elderly patients undergoing valve surgery were evaluated. METHODS: A retrospective analysis was conducted of 2,791 patients with long-term follow up, who underwent valve surgery between 1990 and 2002. Of these patients, 132 (68 males, 64 females) were aged over 80 years (mean age 82 +/- 2 years; range: 80-94 years). RESULTS: Ninety-five patients (71.9%) underwent aortic valve replacement, 36 (27.3%) mitral surgery, and one patient had double-valve surgery. Sixty-five patients (49.2%) required concomitant coronary artery bypass grafting. There were 11 (8.3%) redo procedures. Patients aged over 80 years were significantly more symptomatic preoperatively than their younger counterparts (NYHA class III-IV 90.9% versus 69.0%, p < 0.001), with more congestive cardiac failure, hypertension, peripheral vascular disease, obstructive pulmonary disease, and renal failure (all p < 0.05). Perioperative mortality did not, however, differ significantly between groups (< 80 years versus > or = 80 years, 2.9% versus 4.6%, p = 0.10). There was also no difference in the composite end point of in-hospital death, renal failure, stroke, low output state, myocardial infarction, or sternal wound infection (< 80 years versus > or = 80 years, 10.5% versus 11.4%, p = 0.8). The mean follow up period was 66 +/- 44 months (< 80 years) versus 61 +/- 37 (> or = 80 years). Late mortality was higher in the elderly group (10-year survival 37.9% versus 68.2%, p < 0.001) and preoperative atrial fibrillation (RR 2.75; CI: 1.44-5.23), coronary artery disease (RR 1.98; CI 1.12-3.52) and congestive cardiac failure (RR 2.13; CI: 1.10-4.11) were independent predictors of late mortality. The groups did not differ with respect to long-term valve-related events, with the exception of fewer reoperations among elderly patients. CONCLUSION: Valve surgery in selected octogenarians is associated with low morbidity and mortality. The outlook after surgery is very good, and surgery should not be denied to this group on the basis of age alone.

Age Factors↗