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At least 901 records · Page 50Linked to original sources
PubMed1995

[Surgical treatment of aortico-left ventricular communication due to infective endocarditis].

A 51-year-old woman was referred to our institute for surgical treatment from an other hospital where she was diagnosed as having a mycotic aneurysm located at the aortic annulus due to infective endocarditis. The aneurysm communicated with the left ventricle, with aortic stenosis and regurgitation, mitral stenosis and tricuspid regurgitation caused by rheumatic fever. On admission to our institute, the infective endocarditis was at the healed stage. The mycotic aneurysm was located at the aortic annulus of the right coronary cusp, and was closed using a prosthetic patch with mattress sutures. Aortic valve replacement with a 19-mm St. Jude Medical prosthesis was then performed on this patch. The mitral and tricuspid valves were also replaced with 27-mm and 29-mm St. Jude Medical prostheses, respectively. The patient is doing well 1 year after surgery.

Aneurysm, Infected↗
PubMed1975

[Surgical treatment of a single ventricle. Apropos of 4 operated cases].

A surgical operation with a "curative" aim has been performed on four patients with a lone ventricle. It consisted of a IA type in 3 cases and IC type in one. There were one operative death and three long-term survivals. The operation consisted essentially in: a delicate step of partition of the lone cavity and the treatment of the often combined, and sometimes complex, heart malformation. The trauma to the conduction pathways is one of the major dangers of this type of operation and should be avoided or decreased by the detection during operation of the His bundle. Operation should be indicated in badly tolerated forms. Stenosis of the infundibulo-pulmonary pathway interferes with the development of a hypertensive pulmonary arteriolitis, seems to be a favourable element for surgical correction. In the absence of such stenosis, one should perform a banding early enough or discuss the indication for an intracardiac operation in relation with the pulmonary artery resistance.

Adult↗
PubMed1994

[Changes in left ventricular pressure volume loop of Lutembacher syndrome].

A 49-year-old woman with Lutembacher syndrome, atrial septal defect (ASD), mitral stenosis (MS), tricuspid regurgitation and cardiac cachexia underwent a mitral valve replacement with a 27 mm CarboMedics valve, patch closure of ASD and tricuspid annuloplasty to 29 mm by DeVega's method. The pressure volume loop (PV loop) was measured, both preoperatively and postoperatively (immediately and two months after the operation) by a Miller catheter and echocardiogram. The left ventricular stroke work (LVSW), left ventricular end diastolic volume (LVEDV) and left ventricular end diastolic pressure (LVEDP) markedly increased immediately after the operation. LVSW and LVEDV further increased, whereas LVEDP decreased with improvements in diastolic compliance two months after the operation. It was likely that those change of LV function was a sum of simple ASD and MS both of which have similar but less significant characters than Lutembacher syndrome.

Cachexia↗
PubMed1993

[Surgical treatment of secondary atrial septal defect associated with mitral valve disease].

From March 1965 through August 1991, 703 patients with secondary atrial septal defect were treated surgically in our hospital. Among them, 32 cases (4.6%) were associated with mitral valve disease. The mitral valve lesion was repaired at the same time of closure of the atrial septal defect. The operative mortality was 6.3% and there was no late death. Follow-up study showed that heart function of the patients was improved obviously and most of them have resumed work or study. The clinical features, incidence, etiology, pathology and surgical techniques of secondary atrial septal defect associated with mitral valve disease were discussed.

Adolescent↗
PubMed1993

Second natural history study of congenital heart defects. Pulmonary stenosis: echocardiography.

BACKGROUND: Two-dimensional and Doppler echocardiography can provide information about valve morphology, right ventricular size and function, and hemodynamics in patients with pulmonary stenosis. Therefore, two-dimensional and Doppler echocardiographic examinations were performed on patients with pulmonary stenosis returning for the Second Natural History Study of Congenital Heart Defects. METHODS AND RESULTS: Three hundred twenty-five patients with pulmonary stenosis underwent two-dimensional and Doppler echocardiographic examinations. Of these, 115 were in the medically treated group, and 210 had undergone a previous operation. Patients in the valvotomy group had a higher incidence of right ventricular dysfunction and a larger right ventricular diastolic dimension. The valvotomy group had a lower pulmonary valve mean gradient and a lower right ventricular systolic pressure than the medically treated group. For all patients, there was no significant correlation of the echocardiographic variables with the presence or absence of symptoms, reflecting the low incidence of patients with cardiac decompensation. CONCLUSIONS: These observations provide an objective measurement for assessing the status of the pulmonary valve and right ventricular response in patients with pulmonary stenosis. Limitations of echocardiography in this study are discussed.

Adolescent↗
PubMed1996

[Double outlet left ventricle: a rare and unusual cardiopathy. Apropos of 7 new cases].

Double outlet left ventricle is a very rare condition due to an abnormality of conotruncal morphogenesis. The authors report 7 new cases to the 119 already published, one with an anatomical variation not previously described. Three of the cases reported were of the most usual type similating tetralogy of Fallot. Two of these cases underwent complete correction with excellent results 13 months and 2 years after surgery. The third patient aged 6 months is well after initial palliative neonatal surgery. A case with an L-malposition pedicle with subpulmonary ventricular septal defect and pulmonary outflow tract obstruction died after early palliative surgery (Blalock-Taussig). A case with subaortic ventricular septal defect, pulmonary stenosis, and tricuspid atresia, underwent physiopathological correction (Fontan procedure) after a Waterston shunt and is well at 19 years of age. The other two cases presented more unusual anatomical forms aortic outflow obstruction: one had hypoplasia of the aortic arch with an isthmic coarctation requiring a Crafoord procedure in the neonatal period associating with banding followed by complete correction at 19 months of age. After 3 years, the patient is asymptomatic. The last case with atresia of the aortic valve and severe hypoplasia of the ascending aorta died after corrective surgery of first intent. Other cases have been described in the literature with different clinical presentations: absence of pulmonary or aortic obstruction; intact interventricular septum. The anatomical variability is due to the complex embryogenesis of the conotruncal region and explains the clinical diversity of this congenital cardiac malformation.

Aortic Valve↗
PubMed1990

[The relationship between preoperative status and postoperative exercise tolerance after mitral valve replacement].

Treadmill exercise test was performed for the evaluation of exercise tolerance after mitral valve replacement. The duration of maximum exercise tolerance in TR free group had no significant difference as compared with TR combined group. Preoperative RV function in TR combined group was kept relatively good as shown in cardiac index, pulmonary arterial and right atrial pressure. As hemodynamics was improved by TAP (TVR), it may not occur the difference in exercise tolerance between the groups. The duration of maximum exercise tolerance with MS group showed shorter tolerance than that of MR group. This difference in MS group might be considered due to the limitation of LV dilatation by rheumatic cardiac damage. Exercise tolerance after MVR was significantly lowered by atrial fibrillation, cardio-thoracic ratio over 60% and pulmonary vascular resistance over 3.0 Runits.m2.

Exercise Tolerance↗
PubMed1997

[A surgical case report--combined valvular disease in a 77-year-old woman with multi-organ dysfunction].

A 77-year-old woman was admitted to our hospital with congestive hepatic dysfunction and combined valvular disease. In addition to aortic stenosis, mitral stenosis, and tricuspid regurgitation, multi-organ dysfunction consisting of hepatic cirrhosis, pulmonary dysfunction and renal dysfunction were found. In consideration of the patient's anxiety for surgical treatment, we performed aortic valve replacement, open mitral commissurotomy and tricuspid annuloplasty. Although the patient required hemofiltration for 2 days and an assist of catecholamines for 1 month, she improved better and was discharged at 2 months after surgery. As preoperative assessment of preliminary function of other organs is difficult in the elderly, indications for surgery and optimal surgical procedures must be investigated in each case.

Aged↗
PubMed1976

Coronary arterial fistula.

We report two cases of coronary arterial fistula communicating with the right ventricle. It was noted that the coronary arteries did not spring from the aorta in the normal way. Proximal connections between the coronary arteries and the aorta absent. The lesions were associated with pulmonary valvular atresia, tricuspid valvular stenosis, and intact ventricular septum. We describe the clinical and autopsy findings and discuss the possible pathogenesis.

Coronary Vessel Anomalies↗
PubMed1990

[Percutaneous balloon valvuloplasty of a stenosed bioprosthesis (Carpentier-Edwards xenograft) in the tricuspid valve position].

Two patients with increasing stenosis of a bioprosthesis in the tricuspid valve position were treated by percutaneous balloon valvuloplasty (PBV). Tricuspid valve replacement with a Carpentier-Edwards xenograft and mitral valve replacement with a Duromedics mechanical valve had been performed in both of them 2 to 3 years prior to PBV. Echocardiographic studies revealed tricuspid bioprosthetic stenosis with a prolonged pressure half time. After PBV, the calculated valve area and cardiac index increased and the pressure half time was shortened, although improvement of clinical symptoms was not apparent. Complications related to the procedure did not occur. Further studies are required to determine the indications and to see the long term results of PBV on stenosed bioprosthesis in the tricuspid valve position, but for the moment, we consider PBV be tried with caution for a stenosed bioprosthesis in the tricuspid valve position before the decision for re-replacement of the prosthesis.

Bioprosthesis↗
PubMed1981

[Calcification of the tricuspid annulus].

Tricuspid annular calcification was observed on cardiac screening of a 50 year old woman with congenital valvular pulmonary stenosis and confirmed by angiography. At operation, the tricuspid annular calcification was palpable but there was no interference with valvular function. There was no associated disease process in this patient. Phosphate and calcium metabolism was normal. Tricuspid annular calcification is very rare: 7 other reported cases, aged 42 to 51 years old. All patients had right ventricular hypertension usually caused by pulmonary stenosis. Tricuspid valve function was normal in all cases. The pathogenesis is discussed: a premature degenerative process favored by right ventricular hypertension may be responsible. This would appear to be the first case to be published in France.

Calcinosis↗
PubMed1989

[Incidence and concomitant factors of tricuspid valve insufficiency in patients with aortic and mitral valve diseases].

Invasive data about the frequency and associated factors of tricuspid regurgitation in normals and in patients with aortic and mitral valve disease are still rare. Thus, right ventricular biplane angiograms (RAO/LAO projection), the mean pulmonary artery pressure and the presence of atrial fibrillation were analyzed with regard to tricuspid regurgitation in 30 normals and 165 patients with pure mitral regurgitation, mitral stenosis, aortic regurgitation, aortic stenosis, combined mitral valve disease or combined aortic valve disease. Patients with tricuspid stenosis or coronary artery disease were excluded. In 52 of the 195 patients tricuspid regurgitation was present. Tricuspid regurgitation occurred statistically more often in patients with mitral stenosis (33%), mitral regurgitation (48%) or combined mitral valve disease (68%) than in patients with aortic regurgitation (4%) or combined aortic valve disease (3%). In patients with aortic stenosis and in normals tricuspid regurgitation was not present. In patients with combined mitral valve disease, tricuspid regurgitation was more often present than in patients with pure mitral stenosis (p less than 0.002), despite comparable values of the mean pulmonary artery pressure, the right ventricular enddiastolic and endsystolic volume indexes, the right ventricular ejection fraction and the frequency of atrial fibrillation. Only in patients with pure mitral regurgitation tricuspid regurgitation was associated with an elevated mean pulmonary artery pressure (p less than 0.02). Differences in the right ventricular size and function did not occur between normals and patients with mitral or aortic valve disease. Therefore, the mean pulmonary artery pressure, atrial fibrillation and the size and function of the right ventricle are not major determinants for the occurrence of tricuspid regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗