PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Aortic Valve Insufficiency”

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 19 recordsLinked to original sources
PubMed1977

[Heart valve prosthesis in children and adolescents with aortic valve insufficiency].

Aortic valve prosthetic replacement in children and adolescents helps to improve their haemodynamics, and favourably affects the course of the rheumatic process. The correction of the defect is indicated in the presence of appropriate subjective and objective symptoms of aortic valve insufficiency. The lumen of the aorta was so large in many children that it permitted the employment of prostheses for adults. Calcification of the aortic valve was found in 9 of the 31 patients, which contradicts the commonly accepted belief of a low incidence of calcification in this disease in children. Hospital mortality and postoperative complications rate did not exceed those in aortic valve replacement in adults. The comparatively fast reduction of the heart size and the positive dynamics of the functional parameters in children and adolescents may be due to the high plasticity of the cardiovascular system in this age-group.

Adolescent↗
PubMed1978

[Indices of left venticular performance and evaluation myocardial quality in mitral valve insufficiency, chronic aortic valve insufficiency and stenosis].

132 patients with pure mono-valvular cardiopathies (mitral incompetence, aortic stenosis and aortic incompetence) were classified into two groups according to the values of the systolic work index/myocardial mass ratio (SWI/MLV). Normal values of the ejection function (EF) and mean velocity of circumferential fibre shortening (VCF) for each cardiopathy were so obtained. Only patients with aortic stenosis of group I (SWI/MLV greater than or equal to 0.75 gm . g-1) had normal EF. All the other patients had EF and VCF values below normal although this did not always imply impaired myocardial function. Therefore the myocardial mass should also be considered in the evaluation of myocardial function and it would seem desirable to take this parameter into account in the management of these patients.

Adult↗
PubMed1992

[Post-traumatic aortic valve insufficiencies].

Aortic regurgitation due to closed chest trauma is rare. It is related either to a valve lesion itself (ruptured cusp) or to trauma of the ascending aorta (subadventitial rupture with prolapse of the underlying aortic valve cusp). Four cases are described, 2 men and 2 women aged 30 to 66 years, after severe injuries in road traffic accidents: three patients had rupture of the aorta and the other had isolated rupture of the non-coronary aortic valve cusp. This pathology is unique due to the pathogenic mechanism associated with multiple thoracic injuries (right costal flap, sternal fracture, pulmonary contusion ...). The polytraumatic context explains the diagnostic difficulties and the secondary importance of the valve problem. Late surgery of these lesions was conservative in 3 cases: valve replacement was necessary in 1 case. If the haemodynamic tolerance of the aortic regurgitation is good, surgery should be deferred until the polytraumatic emergency has been dealt with. Good surgical results, often with conservative procedures, encourage earl operation after the acute polytraumatic period.

Adult↗
PubMed1989

[Course of aortic valve insufficiency in percutaneous aortic valvuloplasty].

The risk of occurrence or aggravation of aortic valve regurgitation after percutaneous aortic valvuloplasty was evaluated by angiography in 50 consecutive patients: 17 men, 33 women, mean age 77.6 years. In all cases angiography was performed with a pigtail catheter, trying to get the catheter in the same position for injections before and after dilatation. Forty-one patients showed no changes from the predilatation situation: aortic regurgitation was absent in 10 cases, minimal in 30 cases and moderate in 1 case. Minute leakage developed in a patient who had no aortic valve regurgitation prior to dilatation. Regurgitation decreased or subsided in 8 patients, i.e.: moderate leakage became minimal in 6 cases and minimal leakage completely disappeared in 2 cases. In the last 8 patients (3 men, 5 women, mean age 76 years) heart rate and transaortic diastolic pressure gradient were identical before and after dilatation, which means that the angiographic reduction of leakage was due to better closure of the valve. Aortic valve dilatation seems to carry a low risk of major aortic regurgitation. In patients who require percutaneous valvuloplasty for tight aortic valve stenosis, the presence of a small or moderate aortic leakage should not preclude the procedure from being performed.

Aged↗
PubMed1996

[Aortic valve reconstruction in ectasia of the aortic root and valve insufficiency].

Aortic valve regurgitation in conjunction with ectasia of the proximal aorta is a common finding. The pathologic mechanism of valve insufficiency is mainly caused by dilatation of the aortic root at the level of the sino-tubular and the aorto-ventricular junction. Total replacement of the proximal aorta with resuspension of the aortic valve within the graft is a new alternative approach. Between July 1993 and March 1995, 17 patients were treated for root ectasia using this approach. The age ranged from 15 to 70 years. Aortic insufficiency (mean grade 3) was present in all patients. The operation consisted of total replacement of the proximal aorta with resuspension of the native valve within the graft. In five patients the aortic arch was replaced as well, one patient underwent mitral reconstruction for severe mitral regurgitation. There was no mortality; postoperative aortic regurgitation was reduced to a mean of 0.7. Aortic valve function has been stabled in 16 instances, in one patient a mild increase in regurgitation was seen. Aortic valve reconstruction in conjunction with total tubular graft replacement of the proximal aorta is a new alternative approach for patients with root ectasia. The disadvantages of mechanical heart valve replacement can be avoided.

Adolescent↗
PubMed1986

[Doppler echocardiography diagnosis and classification of the degree of aortic valve insufficiency in patients with aortic stenoses and mitral valve diseases].

To test the capacity of pulsed Doppler echocardiography in the detection and quantification of aortic regurgitation, 64 consecutive patients with aortic and mitral valve disease were examined clinically and by echocardiography before cardiac catheterization. The severity of aortic regurgitation was determined angiographically (I-IV) and compared with the extent of the regurgitant jet in the left ventricle measured by pulsed Doppler echocardiography. In 15 of 64 patients neither angiography nor pulsed Doppler echocardiography showed aortic regurgitation (specificity 100%). Apart from 3 patients with poor echo quality pulsed Doppler echocardiography correctly detected aortic regurgitation in 46 of 49 patients (sensitivity 94%). Clinical examination (63%) and M-mode echocardiography (63%) were significantly less sensitive than Doppler echocardiography (p less than 0.001). The pulsed Doppler echocardiographic degree of aortic regurgitation correlated strongly with angiography (corrected contingency coefficient 0.91). In patients with severe aortic stenosis (systolic gradient greater than 50 mm Hg) aortic regurgitation I was slightly overestimated by pulsed Doppler echocardiography (p less than 0.003). Differentiation of aortic regurgitation III and IV was not possible. Mitral valve disease did not affect quantification of aortic regurgitation (n = 23).

Adolescent↗
PubMed1986

Aortic valve insufficiency due to aortic dilatation: correction by sinus rim adjustment.

Idiopathic dilatation of the aortic root may commonly cause chronic insufficiency of the aortic valve. In these patients the cusp and sinuses are normal or virtually normal in area and pliability and the coronaries are not displaced. The insufficiency in these patients may be totally corrected by an adjustment of the intercommissural distance at the sinus rim level. The dilated ascending aorta is dealt with separately by whatever technique is appropriate. Five patients with aortic insufficiency due to idiopathic ascending aorta dilatation are described. All underwent successful correction of the insufficiency by adjustment of the intercommissural distance at the sinus rim level and thus far the correction has been maintained for up to 16 months after surgery in each.

Adult↗
PubMed1990

[The role of radionuclide ventriculograms in determining the indications for valve replacement in chronic aortic valve insufficiency].

Timing of aortic valve replacement (AVR) in chronic aortic regurgitation (AR) remains a difficult problem in clinical practice. Radionuclide ventriculography (RNV) yields information on the extent of valvular regurgitation, the enlargement and the systolic function of the left ventricle. A "well-timed" AVR is defined by 1) postoperative improvement of clinical symptoms, decrease in left ventricular end-diastolic volume (EDV) and normalization of ejection fraction (EF) as well as by 2) greater improvement under surgical therapy as compared to conservative management. In "too early" AVR the latter condition is not fulfilled, while in "too late" AVR the first condition is not accomplished. In this study 54 patients with chronic aortic incompetence were evaluated by RNV to see whether these three groups ("too early", "well timed", "too late" AVR, resp.) can be separated by the relation between EDV and regurgitant volume (RV), the level of the EDV and the clinical status. The examination was based on pre- and postoperative RNV studies as well as on follow-up studies. A good postoperative result can be expected in cases with a preoperative EDV/RV-ratio similar to that observed in 30 patients with AR in whom AVR was not indicated. In contrast, in the majority of those cases with an EDV/RV-ratio exceeding this normal range the postoperative outcome will be unsatisfactory. If the EDV/RV-ratio is normal, AVR should be performed in cases with an EDV exceeding 400 ml, while in cases with an EDV between 300-400 ml AVR is only indicated in the presence of additional symptoms (NYHA greater than or equal to II).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Repair of ascending aortic dissection. Influence of associated aortic valve insufficiency on early and late results.

Operative treatment of dissections of the ascending aorta differs from that for the descending aorta, not only because of the need for cardiopulmonary bypass, but also because of the frequent occurrence of aortic valve insufficiency. To determine the early and late results of operative repair, we have reviewed the case histories of 121 consecutive patients who underwent repair of ascending aortic dissections between 1962 and 1985. Ages ranged from 16 to 79 years (mean 56 +/- 14 years); 54 patients had operation within 2 weeks of onset of symptoms (acute), and the remainder had later repair (chronic). Seventy patients (58%) had clinical evidence of aortic insufficiency at the time of admission. During repair of acute dissection, 10 patients (19%) had aortic valve resuspension and 15 patients (28%) had aortic valve replacement. During repair of chronic dissection, eight patients (12%) had resuspension and 43 patients (64%) had replacement. Overall operative mortality was 22%, significantly higher for patients with acute than for those with chronic dissections (39% versus 9%, p less than 0.01). Operative risk was similar for patients who underwent repair of ascending aortic dissections without valve resuspension or replacement (31%) versus those who had repair with aortic valve resuspension (17%) or replacement (17%). During a follow-up period ranging from 1 to 208 months, aortic regurgitation developed in only two patients who did not have aortic insufficiency at the time of repair. Late aortic regurgitation necessitating reoperation developed in one of the 15 survivors who had aortic valve resuspension. Eight patients undergoing aortic valve replacement had complications of their prostheses, including one periprosthetic leak and four mechanical failures. We conclude that resuspension or replacement of the aortic valve does not increase the risk of repair of ascending aortic dissections. Selective management of aortic insufficiency (with valve repair whenever possible) yields satisfactory long-term results.

Aortic Dissection↗
PubMed1987

Aortic valve insufficiency in a one-year-old colt.

Aortic insufficiency was suspected in a thin 1-year-old colt with a grade IV/V decrescendo holodiastolic murmur and a bounding arterial pulse. Echocardiographic findings (diastolic fluttering of the septal leaflet of the mitral valve, left ventricular volume overload, and incomplete aortic valve closure) were diagnostic for aortic valve insufficiency. Moderately thick fibrotic aortic valve leaflets were found at necropsy. Fenestrations were found in the aortic and pulmonic valve cusps. Congenital valvular disease may have led to aortic valvular insufficiency in this horse.

Animals↗
PubMed1988

[The effect of concomitant aortic valve insufficiency on the values of Doppler sonographic gradient determination in patients with aortic stenosis].

We examined the influence of concomitant significant aortic incompetence (AI) on Doppler-gradient measurements in valvular aortic stenosis (AS) by comparing catheter and Doppler gradients of 51 patients with isolated AS and of 24 patients with additional AI. In patients with additional AI there was a significantly greater overestimation of the peak-to-peak gradient by the maximal instantaneous Doppler gradient (AS + AI: overestimation 31.0 +/- 17.6 mm Hg, AS: overestimation 10.5 +/- 20.2 mm Hg; p less than 0.01) and also by the maximal instantaneous catheter gradient (AS + AI: overestimation 32.8 +/- 11.8 mm Hg, AS: overestimation 20.4 +/- 14.0 mm Hg; p less than 0.01). Comparison of the respective catheter-derived and Doppler-sonographically measured instantaneous and mean gradients showed no differences between the two patient subgroups. Higher instantaneous gradients in patients with additional AI are mainly explained by the lower end-diastolic aortic pressure. However, Doppler-sonographic overestimation of the severity of stenosis in patients with combined AS + AI, due to the sole measurement of the instantaneous gradient in clinical practice, should be of limited importance because in these patients significant AI already sufficiently indicates aortic valve replacement.

Adult↗