Aortico-left ventricular tunnel is a rare congenital cardiac defect, which bypasses the aortic valve via the paravalvar connection from the left ventricle to the aorta. In most of the cases, the tunnel arises from the right aortic sinus. We herein report a case of aortico-left ventricular tunnel, of which the ...

Quadricuspid aortic valve is a rare congenital anomaly. It may present as an isolated anomaly but is occasionally associated with aortic regurgitation. Sinus of Valsalva aneurysm (SVA) is also an infrequent congenital anomaly, typically associated with tricuspid aortic valves. There are only a few reported cases of SVA (ruptured) associated ...

OBJECTIVE: Aortic valve cusp extension and free-hand aortic valve replacement with autologous pericardium has been described. The long-term results were shown to be comparable with commercially available aortic bioprostheses. Nevertheless the relatively demanding surgical technique could not find wide acceptance. We developed a new design of a molded aortic valve, ...

To decrease the morbidity associated with conventional surgery for calcific aortic stenosis, there has been increasing interest in catheter-based treatment using a stent or frame mounted bioprosthetic valve. Critical to its success is knowledge of pathoanatomy, risk of embolization of calcific debris, and issues associated with device anchoring and paravalvular ...

OBJECTIVES: This study was designed to study the behavior of a stent deployed inside human stenotic aortic valves. BACKGROUND: Endovascular valved stent (VS) implantation is a promising new therapy for patients with severe calcific aortic stenosis (AS). The precise characteristics of stent deployment in humans have been poorly studied so ...

The authors present an unusual case of torsades de pointes (Tdp) in an elderly woman with a history of aortic stenosis, status post aortic valve replacement. She was admitted for atrial fibrillation with a slow ventricular response. At the time of admission, the patient was asymptomatic and not taking any ...

Calcification of normal tricuspid and congenital bicuspid valves is the most common cause of aortic stenosis in industrialized countries. There is compelling evidence that thickening and calcification in aortic valve disease is a complex inflammatory process and not simply age-related degeneration. Both aortic sclerosis and stenosis represent phenotypic expressions of ...

OBJECTIVE: Our aim was to determine echocardiographic Doppler predictors of pulmonary artery systolic pressure (PASP) in patients with moderate to severe aortic stenosis (AS). METHODS: In this retrospective study of 50 patients with moderate to severe AS, the determinants of PASP were analyzed. RESULTS: Aortic valve area was 0.84 +/- ...

Transapical aortic valve replacement has been introduced into clinical practice from which also patients with failing biological valves might profit: valve-in-valve procedure. The aim of the study was to determine the fate of biological valves in long-term follow-up (FU) and to evaluate topography and dimensions for transapical access via dual-source ...

AIMS: We analysed the outcome of young adults with congenital aortic valve disease who underwent allograft or autograft aortic valve or root replacement in our institution and evaluated whether there is a preference for either valve substitute. METHODS AND RESULTS: Between 1987 and 2007, 169 consecutive patients with congenital aortic ...

Unicuspid aortic valve with severe aortic stenosis and moderate aortic regurgitation was diagnosed incidentally in an asymptomatic adult male laborer. Unicuspid aortic valve is a rare congenital anomaly of aortic valve. A literature review has suggested that estimated incidence of aortic valve is 0.02%. This case demonstrates incidental diagnosis of ...

AIMS: Among various hypotheses proposed for pathological tissue calcification, recent evidence supports the possibility that self-replicating calcifying nanoparticles (CNPs) can contribute to such calcification. These CNPs have been detected and isolated from calcified human tissues, including blood vessels and kidney stones, and are referred to as nanobacteria. We evaluated calcific ...

<p>From August 1997 to December 2000, 19 patients with aortic regurgitation due to congenital aortic valve underwent aortic valve repair (17 men and 2 women with a mean age of 42 ± 17 years; range, 16 to 70 years). The mean preoperative aortic regurgitation grade was 3.1 ± 0.8 on ...

Thrombosis in a native aortic valve is a rare complication which may lead to systemic embolization. A few cases of aortic thrombosis in previously abnormal valves have been described. In this report, we describe a 42-year-old male who suffered two acute ischaemic attacks, one in the upper right limb and ...

BACKGROUND AND AIM OF THE STUDY: Preservation of the aortic valve during the repair of acute type A aortic dissection (AADA) is a viable option to prevent lifelong oral anticoagulation. The study aim was to assess aortic valve function following resuspension and supracoronary ascending aortic grafting. METHODS: Among a collective ...

Aortic root replacement is the procedure of choice for patients with ascending aortic aneurysms and diseased aortic valve leaflets. The increasing age of patients who undergo aortic root surgery, and data that support the use of a biological aortic valve in the younger population, have significantly increased the need for ...

In tetralogy of Fallot (TOF), the most common form of cyanotic congenital heart disease, only a few patients reach adulthood without surgical correction. We present the case of a man with TOF who survived until the age of 75 years without surgical intervention and had a very unusual combination of ...

The authors present a case of thrombosis on the St. Jude Medical 19 aortic valve prosthesis. The diagnosis was confirmed by transthoracic and transoesofageal echocardiography, cardiac fluoroscopy revealed restricted movement of the aortic valve prosthesis leaflet. Thrombolytic therapy was complicated with brain embolism that was successfully percutaneously removed from the ...

Cardiovascular disease is a less-well appreciated aspect of alkaptonuria. A 69-year-old man presented with shortness of breath and exertional chest pain. He had a previous diagnosis of alkaptonuria (endogenous ochronosis), confirmed on the basis of urine coloration, skin pigmentation and ochronotic arthropathy in the knees. Echocardiography and coronary angiography revealed ...

We report the case of a 54-year-old patient admitted for rehabilitation after implantation of a stentless bioprosthesis due to severe insufficiency of a degenerated bicuspid aortic valve. The patient could fully participate in a standard cardiac rehabilitation program without any signs of haemodynamic instability. Transthoracic echocardiography showed a small mobile ...

We successfully implanted a bioprosthetic aortic valve via the right subclavian artery within the framework of the CoreValve transapical aortic valve replacement (TAVR) ReValving (CoreValve, Irvine, CA, USA) clinical trial on November 20, 2007, at the Clinic for Cardiovascular Surgery at the German Heart Center Munich, Technical University Munich. The ...

Cardiac involvement in Morquio syndrome, mucopolysaccharidosis IV, is characterized by aortic and mitral valve thickening and infiltration of the coronary arteries. There are few reports concerning surgical interventions in patients with mucopolysaccharidoses. We report a case of a patient affected by Morquio syndrome who underwent aortic valve replacement surgery for ...

The frontier of percutaneous aortic valve replacement is challenged by hemodynamic and anatomic obstacles in the precise positioning of the device. With vital structures such as the mitral valve apparatus and the coronary ostia on either side, the margin of error is only within a few millimeters in the placement ...

BACKGROUND: We sought to identify the prevalence of bicuspid pulmonary valve among patients with transposition of the great arteries undergoing the arterial switch operation and evaluate functional integrity of that valve in the neoaortic position. METHODS: Between October 1985 and December 2001, 391 patients had an arterial switch operation for ...

BACKGROUND: The use of a stentless aortic bioprosthesis offers the advantages of a larger effective valve orifice size, reduced transvalvular gradients, and improved hemodynamics versus stented valves. We hypothesized that these features would make the Toronto stentless porcine valve a preferred choice for patients with congenital abnormalities of the right ...

AIM: The present study tests the consistency of echocardiographic criteria for the grading of aortic valve stenosis. METHODS AND RESULTS: Current guidelines/recommendations define severe stenosis as an aortic valve area (AVA) <1 cm2 (or <0.6 cm2 adjusted for body surface area), mean pressure gradient (DeltaPm) >40 mmHg, or peak flow ...

OBJECTIVES: The purpose of this study was to determine trends of growth of left heart structures after intervention for neonatal aortic valve stenosis. BACKGROUND: The growth potential of left heart structures in neonatal aortic valve stenosis after relief of obstruction might influence risk for subsequent outcomes. METHODS: From 1994 to ...

Aortic valve stenosis (AVS), including a range of disorder severities, from mild leaflet thickening without valve obstruction, 'aortic sclerosis', to severe calcific aortic stenosis, is a progressive, active process of valve modification, mediating by chronic inflammation (similar to atherosclerosis for cardiovascular risk factors) and biological features. AVS is the expression ...

The USCOM (Ultrasonic Cardiac Output Monitors) device is a non-invasive cardiac output monitor, which utilises transaortic or transpulmonary Doppler flow tracing and valve area estimated using patient height to determine cardiac output. We evaluated USCOM against thermodilution cardiac outputs and transoesophageal echocardiography valve area measurements in 22 ASA PS4 cardiac ...

A bicuspid aortic valve is found in approximately 2 % of the population. The data in the literature concerning the incidence of clinical manifestations are inconsistent, and a detailed comparison with patients with tricuspid aortic valve is not yet available. We analyzed the clinical manifestations and demographic data of patients ...

Aortic valve pathology is the most common acquired valvular heart disease in the adults of western countries, and mitral regurgitation (MR) is often clinically present in patients with degenerative aortic stenosis or insufficiency. Many studies report an incidence of MR between 65-75% in patients evaluated for aortic valve replacement. Severe ...

The aortic valve is part of the aortic root which is wedged between the heart and the ascending aorta, maintaining a directional flow throughout life-span. Beside different types of aortic valve replacements, reconstructive techniques are increasingly performed to restore normal aortic valve function. To apply these operations, understanding of normal ...

Angina pectoris, syncope or near-syncope, and congestive heart failure (CHF) are the 3 cardinal manifestations of aortic stenosis (AS) in the elderly. Prolonged duration and late peaking of the aortic systolic ejection murmur best differentiate severe from mild AS. The agreement in quantitation of AS severity between Doppler echocardiography and ...

Aortic valve disease manifests in the form of stenosis, regurgitation, or some combination, yielding either excessive afterload and/or excessive preload on the left ventricle. Aortic root disease may affect valvular function, causing regurgitation; may simply be coexistent with stenotic aortic valvular disease; or may exist despite normal aortic valve function. ...

We present a report of a postoperative left ventricular-right atrial (LV-RA) communication after aortic valve replacement. Such intracardiac defects are rare but encountered occasionally after valve surgery. The diagnosis was made by use of transesophageal echocardiography with echo-Doppler and color-flow imaging. Complications of LV-RA shunts and differential diagnosis are discussed.

This case report presents a rare clinical finding of an isolated quadricuspid aortic valve in an otherwise healthy 24-year-old female who was referred for cardiac evaluation due to newly identified murmur. A transthoracic echocardiogram suggested an unusual case of a bicuspid aortic valve with two raphes with normal opening and ...

The purpose of this study was to determine the effect of simultaneous coronary artery bypass grafting (CABG) and the influence of valve structure on both early and late survival in quinquagenarians having aortic valve replacement (AVR) for aortic stenosis (AS) (with or without aortic regurgitation). We analyzed survival and valve ...

OBJECTIVE: In patients with severe aortic stenosis (AS), we examine the association between: (1) the content of oxidized LDL (oxLDL) in the aortic valve and the degree of inflammation and remodeling; (2) The proportion of small dense LDL particles in the plasma and the presence of oxLDL in the valve ...

Supravalvular aortic stenosis is a rare congenital cardiac anomaly occurring mainly as a part of Williams-Beuren syndrome. Aortic narrowing above the level of the aortic valve causes obstruction of the left ventricular outflow tract, and a pressure gradient between the left ventricle and the aorta causes left ventricle hypertrophy. We ...

The case is reported of a 72-year-old patient with a mobile aortic valve lesion discovered incidentally by echocardiography performed in the setting of coronary artery bypass graft (CABG) surgery. Definitive identification of this lesion was not possible by transthoracic echocardiography or transesophageal echocardiography alone. Pathological examination of the excised aortic ...

Calcific aortic stenosis is now the main cause of aortic stenosis in the majority of patients, due to declining incidence of rheumatic fever. Risk factors such as hyperlipidemia play an important role in the progression of aortic stenosis. According to the most recent American College of Cardiology/American Heart Association guidelines, ...

OBJECTIVES: Aortic stenosis is one of the most common forms of acquired valvular heart disease in adults, and the proportion of patients unsuitable for conventional surgery is increasing. Consequently, the development of new less-invasive techniques to treat severe aortic stenosis is crucially important. Current experience in percutaneous aortic valve replacement ...

PURPOSE OF REVIEW: Techniques of aortic root replacement have been developed that preserve the native aortic valve. These techniques avoid anticoagulation in patients who would otherwise receive a composite valve graft with a mechanical valve. RECENT FINDINGS: Longer-term data on the longevity of the main two techniques of aortic valve-sparing ...

OBJECTIVES: The purpose of this study was to examine the relationship between C-reactive protein (CRP) and calcific aortic valve disease in a large, randomly selected, population-based cohort. BACKGROUND: The pathobiology of calcific aortic stenosis involves an active inflammatory, atheromatous, osteogenic process. Elevations in CRP, a measure of systemic inflammation, have ...

BACKGROUND: An increasing proportion of patients with congenitally abnormal aortic valves (AV) present for AV replacement. AIMS: To review morphological changes in a large contemporary patient population undergoing AV replacement. METHODS: A detailed review was conducted for all 1025 patients who underwent AV replacement from 2002 to 2005, including the ...

Congenital quadricuspid aortic valves (QAVs) are rare phenomena. They are often associated with aortic insufficiency and significant morbidity. A QAV with an associated ascending aortic aneurysm is extremely rare, and these conditions might have a shared embryonic etiology. We describe the case of a patient with a QAV associated with ...

BACKGROUND: Ascending aortic aneurysms (AA) are a common, though poorly understood medical condition. AIMS: To document the histological changes in a large series of human ascending AA, and to correlate these changes with clinical variables. METHODS: 111 ascending AA were excised at surgery over a 3 year period. Each aneurysm ...

The purpose of this study was to determine the effect of simultaneous coronary artery bypass grafting (CABG) and the influence of valve structure on both early and late survival in quadragenarians having aortic valve replacement (AVR) for aortic stenosis (AS) (with or without aortic regurgitation). We analyzed survival and valve ...

The patient was a 28-year-old man referred to our center because of presence of a cardiac murmur and persistence of fever for 3 weeks. A harsh, loud systolic murmur in the left sternal border without radiation to the neck and an early diastolic murmur in the right second intercostal space ...

Calcific aortic stenosis (AS) has been considered a degenerative and unmodifiable process resulting from aging and 'wear and tear' of the aortic valve. Over the past decade, studies in the field of epidemiology, molecular biology and lipid metabolism have highlighted similarities between vascular atherosclerosis and calcific AS. In particular, work ...