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Results for “PULMONARY VALVE STENOSIS”

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At least 757 records · Page 42Linked to original sources
PubMed1996

Idiopathic pulmonary artery aneurysm.

The purpose of this article is to report two cases of pulmonary artery (PA) aneurysm in patients who had no evidence of left-to-right intracardiac shunting or other known relevant etiologies. One patient, a 52-year-old woman, was admitted to the hospital due to exertional palpitation, while the other patient, a 73-year-old woman, came to the hospital because of fever and cough. In both women, chest radiographic findings of a hugely dilated PA were confirmed by computed tomography (CT). In both cases, a ventriculogram showed fusiform dilatation of the main PA without evidence of pulmonary valve stenosis. The results of chest radiography, two-dimensional echocardiography, CT of the thorax, including pulmonary angiography in one patient, were compatible with the diagnosis of PA aneurysm. No specific drug regimen was administered nor was any surgical intervention performed in either patient. Both patients were asymptomatic as of the last telephone follow-up. Idiopathic PA aneurysm is a benign condition with better survival than PA aneurysms of other etiologies, because of the absence of left-to-right intracardiac shunting and significant pulmonary hypertension. PA aneurysm must be considered as part of the differential diagnosis in an enlarged pulmonary trunk seen on chest radiogram, and two-dimensional echocardiography should be performed initially.

Aged↗
PubMed1983

Hemodynamic function after the Mustard operation for transposition of the great arteries.

Pre- and postoperative cardiac catheterization data and cinenangiocardiograms of 82 patients who survived the Mustard operation for transposition of the great arteries (TGA) were reviewed. The post-operative catheterizations were performed 20 days to 10 years after operation (mean 2.5 years). Forty-six patients (56%) had no or insignificant associated cardiac lesions, whereas 36 (44%) had ventricular septal defect, pulmonary stenosis, or both, and required surgical intervention at the time of the Mustard operation. Postoperatively, 11 patients (13%) had significant systemic venous obstruction. Of the 11 patients, 6 required reoperation, and 2 patients had evidence of restenosis or complete obstruction in the superior vena cava after reoperation. In most patients, superior vena caval obstruction was well tolerated even in the presence of high pressure in the superior vena cava. Pulmonary venous obstruction occurred in 5 patients (6%), 3 of whom had no clinical symptoms despite severe pulmonary venous obstruction, although all had radiographic evidence of pulmonary venous congestion. The incidence of obstruction was drastically reduced after the Mustard operation was modified to include routine enlargement of the pulmonary venous atrium. Tricuspid regurgitation was uncommon (10%), but did occur in patients who had transatrial closure of a ventricular septal defect. Preoperatively, left ventricular outflow obstruction occurred in 38%. In 12 patients an attempt was made to relieve the obstruction at surgery. The 6 patients who had localized obstruction had a good result, but patients with more diffuse narrowing of left ventricular outflow had little or no relief of obstruction. Mild to moderate left ventricular outflow gradients regressed spontaneously in most patients after the Mustard operation.

Adolescent↗
PubMed1979

Pulmonary valve motion in valvular pulmonary stenosis in childhood.

Echocardiography tracings of the pulmonary valve was recorded in 16 patients with pulmonic stenosis (PS) ranging in ages from 6 to 14 years (average 10 years). 11 patients had an isolated PS and 5 had a PS associated with atrial septal defect. In 2 patients with mild PS (gradient 15 mm Hg) the depth of the "a" wave was normal: 3 and 4 mm. In 14 patients with moderate or severe PS (gradient 40 mm to 200 mm Hg), the maximal depth of the "a" wave was less than 6 mm in 2 patients, and more than 6 mm in 12 patients (range 7 to 15 mm, average 10 mm). The motion of both anterior and posterior pulmonary valve leaflets was well recorded in 3 patients with severe PS. The "a" wave showed a posterior motion of the posterior leaflets and an anterior motion of the anterior leaflet. This motion is due to the premature pulmonary valve opening.

Adolescent↗
PubMed1975

Anomalous pulmonary venous return in a Great Dane.

A five-month-old male Great Dane dog was clinically diagnosed as having a complex cardiac anomaly, including anomalous drainage of pulmonary veins. Thoracic radiographs were indicative of this condition, but cineangiocardiography was required for confirmation. At necropsy, examination of the heart revealed that all pulmonary veins entered the right atrium rather than the left atrium as in a normal animal. In addition, a large ostium secundum-type interatrial septal defect and stenosis of the pulmonic valve were demonstrated.

Animals↗
PubMed1990

[Pulmonary annuloplasty in functional pulmonary regurgitation associated with mitral stenosis: a case report].

In order to prevent disadvantage of pulmonary regurgitation (PR) on cardiac function, pulmonary annuloplasty (PAP) was performed in a 58-year-old female. She suffered from severe mitral stenosis with right heart failure, and was in a state of cardiac cachexia. She was associated with PR due to pulmonary annular dilatation secondary to severe pulmonary hypertension. She underwent mitral valve replacement, tricuspid annuloplasty and PAP around the pulmonary annulus using a Teflon tape. No PR was observed by postoperative angiograms, and the operative method was proved to be effective on the treatment for PR. The PAP is recommended for patients with functional PR secondary to severe pulmonary hypertension.

Female↗
PubMed2000

[The correction of pulmonary insufficiency with a cryopreserved homograft: an optimal solution to a postoperative problem not rare].

Although the results of surgical repair for congenital pulmonary stenosis are generally good, some patients develop progressive symptoms related to pulmonary regurgitation and right ventricular dilation. Pulmonary homograft implantation may have a beneficial effect on these symptoms, due to a reduction in the volume overload of the right ventricle and hemodynamic improvement. We describe our experience of one patient with severe pulmonary regurgitation following pulmonary valvotomy performed with the Brock technique during childhood because of pulmonary valve stenosis. The patient was admitted to our Institution because of dyspnea on exertion (NYHA functional class II-III) and paroxysmal episodes of supraventricular arrhythmias. Echocardiography showed severe pulmonary regurgitation, an important right ventricular dilation associated with severe tricuspid insufficiency and a patent foramen ovale without any significant shunts. Surgical repair was performed through a median sternotomy with cardiopulmonary bypass and moderate hypothermia. The right ventricular infundibulum was opened and a cryopreserved pulmonary homograft was implanted with continuous sutures. De Vega annuloplasty was performed on the tricuspid valve and the patent foramen ovale was closed with a running suture. Postoperative course was uneventful and the patient was discharged on the seventh postoperative day. Three months after surgery the patient is asymptomatic and echocardiographic evaluation shows no evidence of pulmonary or tricuspid regurgitation, a decrease in right ventricular dilation and a significant improvement in biventricular systolic and diastolic function. In conclusion, pulmonary regurgitation after surgical valvotomy can be treated with the implantation of a cryopreserved pulmonary homograft with satisfactory results. It would appear advisable to perform surgical repair of concomitant right heart anomalies, such as secondary tricuspid insufficiency, to obtain both a decrease in right ventricular overload and a regression of its preoperative dilation.

Adult↗
PubMed2003

Initial diagnostic errors in children suspected of having heart disease: prevalence and long-term consequences.

OBJECTIVE: To access the incidence of diagnostic errors in the initial evaluation of children with cardiac murmurs. METHODS: We evaluated our 7-years of experience in a public pediatric cardiology outpatient clinic. Of 3692 patients who were sent to the hospital, 2603 presented with a heart murmur and were investigated. Patients for whom a disagreement existed between the initial and final diagnoses were divided into the following 2 groups: G1 (n=17) with an initial diagnosis of an innocent murmur and a final diagnosis of cardiopathy, and G2 (n=161) with an initial diagnosis of cardiopathy and a final diagnosis of a normal heart. RESULTS: In G1, the great majority of patients had cardiac defects with mild hemodynamic repercussions, such as small ventricular septal defect and mild pulmonary stenosis. In G2, the great majority of structural defects were interventricular communication, atrial septal defect and pulmonary valve stenosis. CONCLUSION: A global analysis demonstrated that diagnostic error in the initial evaluation of children with cardiac murmurs is real, reaching approximately 6% of cases. The majority of these misdiagnoses were in patients with an initial diagnosis of cardiopathy, which was not confirmed through later complementary examinations. Clinical cardiovascular examination is an excellent resource in the evaluation of children suspected of having cardiopathy. Immediate outpatient discharge of children with an initial diagnosis of an innocent heart murmur seems to be a suitable approach.

Brazil↗