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PubMed1988

[Narrow and calcified aortic valve stenosis in subjects in their 8th and 9th decades. An anatomic study of 64 cases].

Anatomical data obtained from 64 patients aged from 70 to 86 years with calcified and tight aortic orifice stenosis (functional area less than 1 cm2) were divided into three types according to the macroscopic appearance of the aortic valve: (1) tricuspid valve without commissural fusion: 44 cases (18 men, 26 women, mean age 76 years); (2) tricuspid valve with commissural fusion: 12 cases (8 men, 4 women, mean age 72 years); (3) calcified congenital bicuspid valve: 8 cases (6 men, 2 women, mean age 73 years). Thus, the distribution of patients by sex became the same starting from the eighth decade of life. Calcified aortic orifice stenosis (CAOS) of degenerative origin was the most common lesion (69 p. 100), with a strong female predominance. There were several differences between degenerative CAOS and bicuspid valve stenosis on the one hand and aortic orifice stenosis with commissural fusion on the other hand. In the first group, calcification did not involve the free edge of the aortic cusps, large calcifications of the mitral ring were extremely frequent, and there was little or no aortic regurgitation. Moreover, the aortic ring clearly was wider in cases with bicuspid valve. In patients with degenerative CAOS and bicuspid valve, attempts at digital dilatation by the left ventricular route succeeded in most cases in obtaining a fairly important widening of the aortic orifice by compression and/or disruption of the valvular calcium deposits, without causing significant regurgitation of injuring the valve; the cusps recovered some mobility.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Noninvasive assessment of valve lesions with Doppler ultrasound.

Noninvasive assessment of valvular lesions with Doppler echocardiography is based on determination of velocities of blood flow in the region of cardiac valves, adjacent cardiac chambers and in the large vessels. Obstructions lead to an increase in the velocity of flow in the region of the stenosis which can be registered with the Doppler technique. Through application of the Bernoulli equation, from the maximal velocity, the pressure gradient across the stenotic valve can be calculated. Additionally, the severity of the stenosis is reflected in the temporal course of the velocity curve of the jet through the stenosed valve. For this purpose, in mitral stenosis, the pressure half-time is employed and, in aortic stenosis, the peak of the velocity curve during systole is used. The severity of tricuspid and pulmonic stenosis can also be classified with a method analogous to that used in obstruction of the left heart. The diagnosis of valvular incompetence is based on the detection of regurgitant flow. The extent of regurgitant flow into the proximal cardiac chamber enables semiquantitative classification of severity. The intensity of the jet through the incompetent valve is also indicative of the size of the regurgitant volume. Similar to that in obstructive lesions, the temporal course of the velocity curve is also related to the severity. In association with high-grade regurgitant lesions, there is a premature decrease in the velocity curve. Additionally, the severity of aortic regurgitation can be assessed on the basis of the extent of regurgitant flow in the descending aorta or the subclavian arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1979

Right atrial myxoma: unusual clinical presentation and atypical glandular histology.

A 57-year-old black female presented with a 1-month of right-sided congestive heart failure and clinical evidence of pulmonic and tricuspid valvular stenosis and insufficiency. The echocardiographic examination and ventriculography demonstrated a large right atrial tumor interfering with the function of both right-sided valves. The patient underwent successful surgical resection of the tumor. Histologically, the tumor had cellular areas typical of myxoma, as well as glandular areas, a feature which has been described very rarely in this lesion. Electron microscopy of the glandular zones, which has never been reported previously, shown cells having essential homology with the usual myxoma elements. The atypical histopathology of this lesion supports the theory that atrial myxomas are true neoplasms, and are not derived from unusually organized mural thrombi.

Collagen↗