OBJECTIVES: The major problem with heart valve bioprostheses made from chemically treated porcine aortic valves is their limited longevity caused by gradual deterioration, which has a causal link with valve tissue mechanical properties. To our best knowledge, there are no published studies on the mechanical properties of modern, commercially available ...

Obstructive prosthetic valve thrombosis is a serious complication in patients with prosthetic heart valves. It should be suspected in patients with worsening functional class, embolic phenomena, and inadequate anticoagulation. TTE is very informative and the most frequent modality to begin with. TEE is extremely important, with its unique role in ...

Advanced prosthetic valve endocarditis is often associated with substantial destruction of the tissues adjacent to the prosthesis. Removal of the infected prosthesis and débridement of the infected tissues make implantation of a new prosthesis challenging. Herein, we discuss successful surgical aortic valve translocation in a 50-year-old man who had advanced ...

Dual antiplatelet therapy is currently recommended for all patients with acute coronary syndromes, independent of whether they receive pharmacological treatment or undergo percutaneous coronary intervention. Antiplatelet agents are the cornerstone of pharmacological treatment in interventional cardiology. However, there is a clear need for randomized trials to assess the treatment strategy ...

Bileaflet mechanical heart valves, which exhibit hemodynamic performance fairly similar to that of native valves, can be investigated by the analysis of their closing sounds. Signal spectra calculated from the closing sounds are characterized by specific features that are suitable for the functional evaluation of the valves. Five commercial bileaflet ...

Percutaneous pulmonary valve implantation is a potential treatment for right ventricular outflow tract (RVOT) dysfunction. However, RVOT implantation site varies among subjects and the success of the procedure depends on RVOT morphology selection. The aim of this study was to use in vitro testing to establish percutaneous valve competency in ...

We present a case of infective endocarditis associated with community-acquired Streptococcus agalactiae in an immune competent patient. The endocarditis affected the native aortic valve with perforation of the coronary cusp and was complicated by a cerebral embolism. The use of intravenous ampicillin produced a satisfactory clinical and echocardiographic recovery despite ...

There are many difficulties for young women with a Starr-Edwards ball valve who want to attempt pregnancy. There is no consensus regarding whether they should maintain anticoagulation therapy throughout pregnancy with the risk of a thromboembolism or to undergo a reoperation with bioprosthetic heart valves, followed by a third operation ...

Prosthetic aortic valve dysfunction presenting as aortic regurgitation is a complication of mechanical valve replacement. We describe a case of late valve dysfunction caused by an annular suture of excessive length obstructing the closure mechanism of a bileaflet prosthetic valve.We present this rare cause of valve dysfunction in an 80-year-old ...

Percutaneous pulmonary valve implantation is a new treatment option in patients with dysfunctional conduits. The aim of percutaneous pulmonary valve implantation is to prolong the lifespan of right ventricle to pulmonary artery conduits and thereby postponing open-heart surgery. Early results have shown a significant reduction in right ventricular pressure and ...

A Gunther tulip vena cava filter was implanted in a patient with pulmonary embolism from deep venous thrombosis. The filter became unnecessary after therapy. However, retrieval by the standard method employing a vascular sheath placed via the transjugular approach in combination with a snare device was impossible. A thrombus occupying ...

BACKGROUND AND AIM OF THE STUDY: Calcification of the cardiac valves occurs more frequently on the left side, most commonly involving the aortic and mitral valves. The differences in hemodynamics and blood pressure between the right and left sides have been considered as possible causes. However, the reason for this ...

A 48-year-old man with a history of infective endocarditis and severe aortic regurgitation had undergone prosthetic aortic valve replacement at another institution. Two months later, the patient developed prosthetic valve endocarditis with an aortic root abscess and an aorto-left atrial periprosthetic valvular fistula through the detached posterior annulus of the ...

OBJECTIVES: Pulmonary valve insufficiency remains a leading cause for reoperations in congenital cardiac surgery. The current percutaneous approach is limited by the size of the access vessel and variable right ventricular outflow tract morphology. This study assesses the feasibility of transapical pulmonary valve replacement based on a new valved stent ...

Intermittent aortic regurgitation (AR) is an unusual complication after a mechanical prosthetic replacement. We describe a rare case of intermittent dysfunction of a bileaflet mechanical aortic prosthetic valve in a 41-year-old man with a 21 mm Tri-technologies prosthetic valve implanted 4 years before. Transthoracic echocardiography (TTE) before discharge was normal ...

Congenital absence of the pulmonary valve appears to have a prolonged fate, despite substantial regurgitation, thus the optimal timing of surgical correction remains unclear. A 53-year-old man with isolated pulmonary regurgitation accompanied by obstructive sleep apnea developed progressive heart failure after reopening of the foramen ovale. Closure of the interatrial ...

Valved conduits are frequently used in congenital heart surgery to establish continuity between the right ventricle and the pulmonary arteries. The Contegra bovine jugular vein (Medtronic Inc, Minneapolis, MN) is a conduit that incorporates a tri-leaflet valve and affords off-the-shelf availability, good handling characteristics, and excellent hemodynamics. However, complications related ...

The valve-on-valve (VOV) technique is that a mechanical valve is implanted on the sewing cuff of the previous bioprosthesis after removing degenerated leaflets. We conducted an in vitro study to determine the size-match of the valves for VOV technique. The Carpentier-Edwards pericardial (CEP) valve and Mosaic valve were used. We ...

OBJECTIVE: The aim of the study was to evaluate the use of a decellularised scaffold and its re-endothelialisation in vitro in order to create human vascular substitutes containing venous valves. This research is clinically relevant particularly with regard to the development of venous (valve containing) transplants to replace a diseased ...

Prosthetic valve dysfunction is a rare but life-threatening condition. A 66-year-old woman presented with shock 15 years after aortic valve replacement with a tilting-disc valve. Imaging demonstrated severe aortic insufficiency and a fixed-open prosthetic valve. Reoperation revealed pannus ingrowth from the aortic aspect, resulting in immobility of the occluder. A ...

BACKGROUND: Pulmonary regurgitation (PR) occurs frequently after tetralogy of Fallot (TOF) repair, impairing long-term prognosis and necessitating reinterventions. Myocardial damage, invasiveness, and the risks of pulmonary valve replacement (PVR) therefore need to be minimized. The new Shelhigh Injectable Stented Pulmonic Valve (Shelhigh Inc, Union, NJ) allows implantation without cardiopulmonary bypass ...

Epididymo-orchitis is an uncommon complication of posterior urethral valve. A four-year-old boy was admitted because of right-sided epididymo-orchitis. Scintigraphy of the scrotum showed increased uptake of radiotracer on the right side. The posterior urethral valve was disclosed by voiding cystourethrography. Ablation of the valve and antibiotic therapy made the patient ...

Considerable progress has been made in recent years toward elucidating a conceptual framework that integrates the dynamic functional structure, mechanical properties, and pathobiological behavior of the cardiac valves. This communication reviews the evolving paradigm of a continuum of heart valve structure, function, and pathobiology and explores its implications. Specifically, we ...

This paper describes a method for prefabricating screw, pneumatic, and solenoid valves and embedding them in microfluidic devices. This method of prefabrication and embedding is simple, requires no advanced fabrication, and is compatible with soft lithography. Because prefabrication allows many identical valves to be made at one time, the performance ...

BACKGROUND AND AIM OF THE STUDY: The closing 'click' sounds from mechanical heart valve prostheses are often clearly audible for patients and their relatives. These sounds have been recognized as a disturbing factor causing sleeping disturbances or social embarrassment, which patients must endure for the rest of their lives. The ...

The relevance of venous valves in varicose veins is still discussed controversially as, among others, the veins' wall weakness is accused to be the initial trigger of varicose veins. Thorough knowledge of their positions and frequencies will support understanding the pathogenesis of varices. Contrary to the incidences of valves in ...

The most common fungal organism to cause endocarditis is Candida which is followed by Aspergillus. Aspergillus endocarditis can occur in either the native or prosthetic heart valves, usually occurs post-operative after cardiac valve surgery. This case is illustrative of a 49-year-old man with previous history of coronary artery bypass grafting ...

BACKGROUND AND AIM OF THE STUDY: The St. Jude Medical Epic Supra (ES) valve is a new porcine bioprosthesis designed for complete supra-annular implantation. To date, no in-vivo data regarding the hemodynamic and clinical performance of this valve are available. The study aim was to compare the hemodynamic performance of ...

Minimally invasive valve replacement is now a clinical reality. A number of ingenious techniques have been described for percutaneous aortic and pulmonary valve replacement as well as transventricular aortic valve replacement. We describe a technique for transventricular pulmonary valve replacement utilizing off-the-shelf bovine tissue valve, vascular stents, and simplified delivery ...

PURPOSE: Biologic valved-conduit grafts avoid the need for anticoagulation and can exploit the excellent hemodynamic performance of stentless valves. Incorporation of sinuses of Valsalva into the neoaortic root can improve the function of the stentless valves. DESCRIPTION: Here we present a novel prefabricated stentless valved conduit incorporating sinuses of Valsalva ...

BACKGROUND AND AIM OF THE STUDY: Growth factor-dependent cell proliferation can cause in-stent neointimal hyperplasia. The study aim was to evaluate whether oral everolimus inhibits the intimal proliferation associated with the implantation of prosthetic pulmonary valved stents. METHODS: Prosthetic pulmonary valves were implanted in 12 pigs (mean bodyweight 25 kg) ...

OBJECTIVE: The objective of our study was to evaluate the role of ECG-gated MDCT in the functional evaluation of mechanical prosthetic aortic and mitral valves. MATERIALS AND METHODS: Twenty sequential patients with 23 mechanical prosthetic valves were evaluated with an ECG-gated 40- or 64-MDCT scanner. Multiplanar reformation, maximal-intensity-projection, volume-rendering, and ...

Bag-valve-mask ventilation is generally a safe, and often a life-saving procedure for children who are unable to oxygenate or ventilate by themselves. A case is presented which describes a malfunctioning expiratory valve in a disposable manual bag-valve-mask device resulting in a pneumomediastinum in a child. This is a rare cause ...

OBJECTIVE: The objective was to compare the medium- and long-term outcomes for pericardial monocusp valves, polytetrafluoroethylene (Gore-Tex, WL Gore and Associates Inc, Flagstaff, Ariz) 0.1-mm monocusp valves, and bileaflet 0.l-mm polytetrafluoroethylene valves and their efficiency in the right ventricular outlet. METHODS: We reviewed all hand-sewn right ventricular outlet valves created ...

Infective endocarditis of pulmonary valve requiring surgery is rare. We report a case of 80-year-old woman with a permanent pacemaker implanted 14 years ago. She had signs of infection resistant to antibiotic therapy, secondary cachexia, and dyspnea. Echocardiography examination revealed an infectious mass on pacing electrodes in the right atrium, ...

AIMS: Ventricular assist devices (VADs) are now a mainstay in the management of patients with end-stage heart failure. An important consideration in the long-term durability of these devices is the structural integrity of the prosthetic valves. Herein, we report the morphological findings in inflow and outflow explanted bioprostheses from seven ...

Stentless valve continence is affected by the implantation technique, annular symmetry and dilatation of the sinotubular junction. We tested in vitro how the Sorin Solo stentless pericardial valve adapts to a slightly dilated sinotubular junction. Stentless Sorin Solo aortic valves (25 mm) were sutured into a 32-mm Valsalva graft suspending ...

In this two-part series, we discuss the anatomical basis for arrhythmias arising above the semilunar valves. In this part (part I), we describe the relevant anatomy and technique for mapping and ablation of ventricular arrhythmias arising above either the pulmonic or the aortic valve. After an initial discussion of the ...

BACKGROUND: Selection of the best tissue valve is an essential step before percutaneous aortic valve replacement (PAVR) becomes a clinical reality. The aim of this study was to evaluate in vitro three different tissue valves mounted within the same endovascular stent. METHODS: Thirty stented valves (10 aortic porcine, 10 pulmonary ...

We report the case of a 21-year-old woman with a severely stenotic pulmonary homograft who underwent percutaneous pulmonary valve implantation, with no significant change in transvalvular gradient within the 24 hours after the procedure. Major improvement in hemodynamic valve performance of more than 60% decrease in transvalvular gradient and more ...

Percutaneous pulmonary valve perforation in selected neonates with pulmonary valve atresia and intact ventricular septum has been well established as a therapeutic option. Pulmonary valve perforation is associated with significant risks including perforation of the right ventricle. Optimal catheter positioning is crucial to the success of the procedure. This report ...

We report a case of prosthetic valve infective endocarditis and aortic root abscesses caused by Achromobacter xylosoxidans subsp. xylosoxidans. The patient was an intravenous drug user and had injected amphetamines using 'duck pond water' as a diluent. After surgical intervention and 6 weeks of intravenous meropenem therapy, the patient made ...

Annular abscesses are serious complications of infectious native and prosthetic valve endocarditis. In this patient, we isolated Stenotrophomonas maltophilia, a rare cause of subaortic abscess with high mortality/morbidity rates although virulent gram-positive cocci, S. Aureus in particular, have been the most commonly isolated agents. We treated this case of endocarditis ...

The epicardium is embryologically formed by outgrowth of proepicardial cells over the naked heart tube. Epicardium-derived cells (EPDCs) migrate into the myocardium, contributing to myocardial architecture, valve development, and the coronary vasculature. Defective EPDC formation causes valve malformations, myocardial thinning, and coronary defects. In the atrioventricular (AV) valves and the ...

BACKGROUND: We assessed the hemodynamic performance and calcification potential of a new design of bovine pericardial valve, the Trilogy valve (Arbor Surgical Technologies Inc, Irvine, CA). We compared this new valve with the Perimount valve (Edwards Lifesciences, Irvine, CA) in a randomized prospective study in adolescent sheep. METHODS: Nine Trilogy ...

An anterior urethral valve is uncommon compared to a posterior urethral valve as a cause of lower obstructive uropathy. Furthermore, an anterior urethral valve in the fossa navicularis is extremely rare. We describe the case in a 6-year-old boy who presented with a split urinary stream. Endoscopy revealed an anterior ...

Bioprosthetic valves are used in thousands of heart valve replacement surgeries. Existing glutaraldehyde-crosslinked bioprosthetic valves fail due to either calcification or degeneration. Glutaraldehyde crosslinking does not stabilize valvular glycosaminoglycans (GAGs). GAGs, predominantly present in the medial spongiosa layer of native heart valve cusps, play an important role in regulating physico-mechanical ...

Propionibacterium acnes is an anaerobic, non-spore forming, gram-positive bacillus, and is often part of the normal flora of human skin. It usually has relatively low virulence. However, it can rarely cause serious infections including infections of prosthetic valves, native valves, and annuloplasty rings. We describe a rare case of late ...

Two severely symptomatic infants of tetralogy of Fallot with absent pulmonary valve successfully repaired by a modified Kreutzer's technique are described. In addition to the standard repair of tetralogy of Fallot, our surgical technique consists of extensive pulmonary reduction arterioplasty, which allows tracheobronchial decompression. Both patients tolerated surgery and showed ...

Abiotrophia defectiva is a rare cause of infective endocarditis. Besides an association with often negative blood cultures and difficult treatment, high rates of relapse and higher mortality than endocarditis caused by other viridans streptococci are known features of this entity. We report on the surgical and medical management of the ...