PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “CARDIAC VALVES”

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 361 records · Page 20Linked to original sources
PubMed2001

Fibulin-2 expression marks transformed mesenchymal cells in developing cardiac valves, aortic arch vessels, and coronary vessels.

Previous studies showed that extracellular matrix protein, fibulin-2, is expressed during epithelial-mesenchymal transformation in the endocardial cushion matrix during embryonic heart development. Our current study revealed that, in addition to the cardiac valvuloseptal formation, fibulin-2 is synthesized by the smooth muscle precursor cells of developing aortic arch vessels and the coronary endothelial cells that are originated from neural crest cells and epicardial cells, respectively. In the cardiac valves and the aortic arch vessels, fibulin-2 expression shows robust up-regulation when the transformed mesenchymal cells migrate into the existing extracellular matrix. In the epicardium, epicardial cells produce fibulin-2 upon their migration over the myocardial surface and its expression persists throughout coronary vasculogenesis and angiogenesis. Fibulin-2 is produced by the endothelial cells of coronary arteries and veins but not by the capillary endothelial cells in the myocardium. Thus, fibulin-2 not only uniquely marks the transformed mesenchymal cells during mouse embryonic cardiovascular development, but also indicates vascular endothelial cells of coronary arteries and veins in postnatal life.

Animals↗
PubMed1998

[Influence of isoflurane and sevoflurane on metabolism of oxygen free radicals in cardiac valve replacement].

To investigate effects of isoflurane and sevoflurane on the levels of lipid peroxides (LPO) in plasma and superoxide dismutase (SOD) in red blood cells during myocardial ischemia/reperfusion, and to study myocardial protection of these two volatile anesthetcs, 30 patients undergoing cardiac valve replacement were randomly divided into isoflurane (Group I), sevoflurane (Group S), and controlled group (Group C). Patients of Group I were anesthetized with isoflurane mainly, Group S with sevoflurane, and Group C with fentanyl. LPO and SOD levels were measured at five points before and during the operation. The results were as follows: SOD levels in all groups did not change significantly. LPO levels in Group C increased during the operation, while in other two groups didn't. Rates of automatical rebeating of hearts in Group C were lower than that of hearts in other two groups. It is suggested that isoflurane and sevoflurane can inhibit increasing of LPO levels to attenuate myocardial ischemia/reperfusion injuries mediated by oxygen free radicals during open-heart surgery.

Adult↗
PubMed1992

Cardiac valve replacement in patients infected with the human immunodeficiency virus.

Major surgical procedures, especially when performed under general anesthesia, can depress immunological parameters measured in vitro. Therefore concern has been expressed that operation might have an adverse effect on the immune status of individuals infected with the human immunodeficiency virus (HIV). Four HIV-positive patients without symptoms of HIV disease underwent cardiac valve replacement in consequence of infective endocarditis. After up to 15 months postoperatively, 3 patients are alive and well without signs of progressive immunodeficiency or recurrent endocarditis. One patient died of recurrent endocarditis without evidence of HIV-related disease on autopsy. Cardiac operation does not seem to accelerate HIV-related immunodeficiency.

Adult↗
PubMed1982

Preliminary experience with aspirin for anticoagulation in children with prosthetic cardiac valves.

Twenty-four children (ages 1 to 18 years, mean 12.2 years) underwent 27 operations for aortic, mitral, or combined aortic and mitral valve replacement. There was 1 operative death. Of the 23 operative survivors (12 aortic, 8 mitral, 3 combined valve replacement), only 5 were given warfarin for long-term anticoagulation. The remaining 18 (10 aortic, 8 mitral valve replacement) were given aspirin (plus dipyridamole in 5). Twelve of the 18 had at least one mechanical valve (11 Björk-Shiley and Beall valves; 1 Björk-Shiley valve was replaced with a Beall disc valve as the child grew). These 18 patients were followed for 1 to 59 months (mean, 20.4 months). There was no thrombotic, embolic, or bleeding complications. There were 2 late deaths (one cardiac). Review of the available literature indicates that in children with prosthetic cardiac valves, aspirin (with or without dipyridamole) provides adequate protection against thromboemboli and avoids the hemorrhagic complications associated with warfarin.

Adolescent↗
PubMed1997

[Comparison between intraarterial pulsegraphy and thermodilution method for determination of cardiac output during anesthesia and operation in patients undergoing cardiac valve replacement].

Comparison of intraarterial pulsegraphy and standard thermodilution methods for determination of cardiac output (CO) in 14 patients with poor cardiac function following valve replacement operation was performed. The CO, cardiac index (CI) were moderate to high correlated between the two methods before and after valve replacement respectively. The study indicates that intraarterial pulsegraphy provides a continous method of determining CO in patients with poor cardiac function during operation.

Adult↗
PubMed2006

[Cardiac valve MCSF-1 and its receptor expression changes in Staphylococcus aureus induced infective endocarditis].

OBJECTIVE: To explore the cellular immunology mechanism of infective endocarditis (IE), we investigated the effects of Staphylococcus aureus (S. aureus) on MCSF-1 and its receptor (c-fms) gene expression in cardiac valves. METHODS: Thirty-two rabbits were divided into 4 groups: mitral or tricuspid valve artificial lesions with 5 x 10(4) CFU or 5 x 10(6) CFU S. aureus injection. Control rabbits (n = 7) received 5 x 10(6) CFU S. aureus injection. IE after operation were confirmed by naked eyes and electron microscope observations. MCSF-1, c-fms in mitral and tricuspid valves were detected by RT-PCR. RESULTS: Twenty-six rabbits survived the operation and 14 rabbits developed IE (2 with 5 x 10(4) CFU and 12 with 5 x 10(6) CFU S. aureus injection) one day post operation. S. aureus injection alone did not induce IE. Compared to control rabbits, MCSF-1 mRNA was significantly upregulated and c-fms mRNA significantly downregulated after 5 x 10(4) CFU S. aureus injection with heart valve artificial lesion in mitral valves or tricuspid valves. MCSF-1 expression in mitral valves was further increased while remained unchanged in tricuspid valve after 5 x 10(6) CFU S. aureus injection compared to that in 5 x 10(4) CFU S. aureus injection group. CONCLUSION: High dose bacterial invasion and heart valves lesion were the main factors for inducing infective endocarditis. Development of infective endocarditis was associated with valve MCSF-1/c-fms expression changes in this rabbit model.

Animals↗
PubMed2003

High prevalence of cardiac valve disease in acromegaly: an observational, analytical, case-control study.

To characterize mitral and aortic valve abnormalities we performed M-mode, two-dimensional, and pulsed Doppler echocardiography in 42 patients with active acromegaly, 22 patients cured of acromegaly, and 64 controls pair-matched with the patients for sex and age. The overall prevalence of valve abnormalities was higher in both the active patients (86% vs. 24%; P < 0.0001) and the cured patients (73% vs. 9%; P < 0.0001) than in controls. Left ventricular hypertrophy was higher in active (81% vs. 29%; P < 0.0001), but not in cured (41% vs. 14%; P = 0.09) patients than in controls. Cardiac valve abnormalities were associated with left ventricular hypertrophy in both patients and controls, without any difference between them. Conversely, among subjects without left ventricular hypertrophy, mitral and aortic abnormalities were only present in the patients (75% of active and 54% of cured), but not in controls (3% of active controls and 0% of cured controls). In conclusion, patients with active acromegaly and those cured of the disease have a high prevalence of mitral and aortic abnormalities. The persistence of valve disease in patients with cured acromegaly is likely to be correlated with the persistence of left ventricular hypertrophy, which should be carefully and continuously monitored as an aspect of the risk of cardiac dysfunction in these patients.

Acromegaly↗
PubMed1989

Effects of interleukin-1, lipopolysaccharide, and streptococci on procoagulant activity of cultured human cardiac valve endothelial and stromal cells.

Fibrin is the primary constituent of the vegetation in infective endocarditis, and tissue factor expression is a major mechanism of coagulation activation on infected valves. To determine which cells may participate in coagulation activation in this setting, expression of procoagulant activity (PCA; shown to be tissue factor) was studied in cultured endothelial and stromal cells derived from human cardiac valves. Endothelial cells had negligible PCA (99 +/- 50 mU/10(5) cells, mean +/- 1 standard deviation) unless stimulated by lipopolysaccharide or interleukin-1, which increased PCA to 5,592 +/- 1,482 and 5,901 +/- 1,497 mU/10(5) cells, respectively, in 6 h. Incubation of cells with viable enterococci or viridans streptococci or with an enterococcal cell wall preparation did not induce PCA. Cultured valve stromal cells constitutively expressed high levels of PCA (14,276 +/- 8,738 mU/10(5) cells) which was not changed with exposure to interleukin-1. PCAs of stromal or stimulated endothelial cells from valves of both right and left sides of the heart were comparable. The results suggest that endothelial cells may contribute to fibrin deposition during infection if stimulated, but PCA is not directly induced by bacteria. Stromal cells could contribute PCA if exposed to blood in the course of valve injury.

Blood Coagulation Tests↗
PubMed1996

Type VI collagen in the cardiac valves and connective tissue septa during heart development.

A variety of extracellular matrix (ECM) proteins have been shown to be present in the embryonic heart during the morphogenesis of the valves and membranous septa. It is not known if any specific ECM protein is required for the normal morphogenesis of these tissues, but this is of great interest since there is a high incidence of congenital malformations which affect valvular and septal tissues. Interestingly, the alpha 1 and alpha 2 genes of type VI collagen are located within the region of human chromosome 21 thought to be involved in the congenital heart defect phenotype associated with trisomy 21 (Down's syndrome). In this study we examined the distribution and investigated the function of type VI collagen in the cardiac valves and septa of chicken and mouse embryos during various stages of development. Immunohistochemical and in situ hybridization studies revealed a pattern of cardiac expression of type VI collagen which is present from the earliest stages of valve and septum development through the neonatal period. Results from an in vitro bioassay suggest that type VI collagen may play a role in the formation and migration of specific cells in the forming valves and septa. These data support molecular genetic studies which have indicated that type VI collagen is involved in the heart defect phenotype seen in trisomy 21.

Animals↗
PubMed1993

The St. Jude valve. Thrombolysis as the first line of therapy for cardiac valve thrombosis.

BACKGROUND: Thrombolytic therapy is a promising alternative to valve replacement in the management of prosthetic valve thrombosis. We sought to determine the short- and long-term results of treating thrombosed St. Jude heart valves with thrombolytic therapy as the primary treatment modality. METHODS AND RESULTS: Between March 1978 and December 1991, 988 patients underwent implantation of St. Jude prosthetic valves at our medical center, and all patients with thrombosed valves were identified prospectively. During this period, 17 patients (13 women; mean age, 66.8 +/- 19.0 years) developed prosthetic valve thrombosis (11 aortic, six mitral). In six patients, Coumadin was stopped in preparation for elective surgery. The clinical presentation was congestive heart failure in 13, syncope and fatigue in two, and a cerebrovascular accident in one; one patient was asymptomatic. The average duration of symptoms was 11.7 +/- 12.0 days (range, 1-45 days). Anticoagulation was subtherapeutic in all but one patient at the time of presentation. Cinefluoroscopy was the primary method used for diagnosis and was also used to follow the response to therapy. Twelve patients were treated medically (10 with thrombolytic therapy and two with heparin), three were treated surgically, and two were diagnosed at autopsy. Of the 12 medically treated patients, 10 had marked improvement in leaflet movement and symptoms within 12 hours. Thus, 10 of 12 patients (83%) had a satisfactory response to medical therapy alone. No medically treated patient died or had a major complication resulting in permanent damage. However, four of the 12 medically treated patients had minor complications, including a transient episode of facial weakness in one patient, hematomas in two, and epistaxis in one. Late rethrombosis recurred in two patients in the medically treated group and was successfully retreated with thrombolytic therapy. At 3 months, all patients were alive and well. CONCLUSIONS: Thrombolytic therapy can be used as the first line of therapy for thrombosed St. Jude valves with a low risk of permanent side effects and excellent chances of success. In most cases, surgery can be reserved for patients who do not respond to thrombolytic therapy.

Adolescent↗
PubMedDate not supplied

Antithrombin III in patients with prosthetic cardiac valves.

When compared to 40 control subjects and to 13 patients with mitral stenosis (8 of them commissurotomized) antithrombin III (AT III) activity, assessed by a clotting technique, was found to be slightly but significantly depressed in the 18 patients with prosthetic valves in mitral position. Decrease of AT III level occurred mainly in patients with metallic Björk-Shiley prostheses in whom mitral valve replacement had been performed more than 12 months before the investigation. Particularly low AT III activities were noted in the three patients who developed thromboembolic complications with lethal evolution. Impaired AT III activity in a patient with prosthetic cardiac valves might be considered as a marker of ongoing in vivo activation of coagulation. Such a finding should be a warning and an indication for intensifying the antithrombotic therapy.

Adult↗
PubMed2001

Robotic cardiac valve surgery: transcending the technologic crevasse!

"The man with a new idea is a crank until the idea succeeds."--Mark Twain. With the profound public stress for minimally invasive surgery that guided General Surgery, Cardiothoracic Surgery has progressed with warranted enthusiasm. The explosion of technological advancements in optics, instrumentation and cardiopulmonary bypass has permitted minimally invasive cardiac procedures to be performed with safety, efficiency, and efficacy. In this chapter, we review the evolution of minimally invasive cardiac valve surgery. The articles of leading minimally invasive valve surgeons, both European and American, are reviewed. The indications for minimally invasive surgery are explained. Furthermore, the present day state of "robotic" mitral valve surgery is described.

Heart Valve Diseases↗