An unusual case of central venous catheter (CVC)-related thrombosis during supine surgery in the prone position is presented. A 76-year-old woman was scheduled for elective surgery to repair a broken lumbar instrument. A single-lumen CVC was inserted via the right internal jugular vein. Surgery was performed in the prone position, ...

Cartilaginous metaplasia of superficial veins was found in a 64-year-old woman who underwent surgery for varicose veins. At operation, some varicose veins of the medial thigh were semi-rigid and fibroelastic to the touch. Histology revealed that half the lumen was occupied by chondroid tissue. The other half was obliterated by ...

INTRODUCTION: Treatment of massive pulmonary embolism leading to cardiac arrest is controversial but restitution of circulation within a shorter time is crucial. Cardiopulmonary support and therapeutic hypothermia is an option for cardiac arrest initially of unknown reason. However, hypothermia may influence the effect of the ongoing intrinsic fibrinolysis. OBJECTIVES: To ...

PURPOSE: This study was designed to show the relationship between tricuspid annular plane systolic excursion (TAPSE) and stroke volume (SV) by thermodilution using three different methods and also to assess whether TAPSE can track hemodynamic changes associated with volume loading and ephedrine administration. METHODS: This was an observational study in ...

BACKGROUND: The influence of intraluminal thrombus (ILT) on the proteolytic environment within the wall of an abdominal aortic aneurysm (AAA) is unknown. This is the first study to examine the correlation between ILT thickness and the levels of matrix metalloproteinases (MMPs) and their natural inhibitors (tissue inhibitors of matrix metalloproteinases ...

Despite the rarity of femoral aneurysm and the plethora of other causes of swelling in and around its anatomic location, the possibility of its existence must always be borne in mind. A rare case of metachronously bilateral femoral aneurysms mimicking soft tissue sarcoma in a young Nigerian man is presented. ...

A full-term baby with double-outlet right ventricle and total anomalous pulmonary venous connection (TAPVC) complicated with left main pulmonary artery (PA) stenosis, presented with heart failure caused by increased pulmonary blood flow. Based on significant discrepancies in size and development between the left and right PAs, we performed right PA ...

BACKGROUND/INTRODUCTION: Diseases of the aorta can alter the local mechanical properties of the tissue, leading to aneurysms and plaque instability. Local tissue properties are best evaluated from surgical samples or autopsy tissue using mechanical testing ex vivo. We examined whether formalin-fixed tissues preserve regional and local variations in tissue properties ...

OBJECTIVESImplantation of stents into the ductus arteriosus is an alternative treatment to palliative or corrective cardiac surgery in newborns with duct-dependent pulmonary circulation, although the use of this technique for congenital heart disease is limited.METHODSBetween April 2010 and June 2011, 13 patients underwent patent ductus arteriosus stenting after full assessment ...

To assess the differences in radial force of carotid stents and whether the length of the lesion influences the measurements. Different models of tapered stents of similar size (length, 30 mm) were used. The tapered nitinol Acculink, Protégé, and Cristallo Ideale carotid artery stents and the straight, braided Elgiloy carotid ...

Abstract Purpose: To assess the pullout force (POF) of bridging stent-grafts used in thoracoabdominal stent-grafts and iliac bifurcated grafts. Methods: In an experimental setup, the POFs of Viabahn or Fluency with or without a Zilver stent were measured when deployed into the renal and celiac branches of a Zenith thoracoabdominal ...

We routinely perform a cystourethroscopy 3 months after initial ablation of posterior urethral valves. The aim of this study was to determine the predictive value of the urethral appearance on preoperative micturating cystourethrogram (MCUG) for further valve resection at check cystoscopy. We retrospectively reviewed 31 consecutive boys (aged 4-18 months) ...

Abstract The aim of this project was to investigate the fundamental idea of the possibility of anastomosing small blood vessels in microvascular transplant procedures by an individualized stent known from coronary angioplasty. We investigated the influence of length, dilation and differences in fabrication of the newly developed balloon-expandable stent on ...

BACKGROUND: The absence of incorporation between endoprosthesis (EP) and the arterial wall may lead to device migration and endoleaks around the stent graft. Alternatives have been tested aiming to improve this incorporation. Fibrin glue is used in many operating procedures promoting adhesion and tissue regeneration; however, its use to improve ...

A potential interaction between pulmonary function, abnormal adipose tissue activity, and systemic inflammation has been suggested. This study explores the relationship between circulating soluble TNF-α receptors (sTNF-R1 and sTNF-R2) and respiratory function parameters in obese subjects. Thirty-one non-diabetic morbidly obese women with a history of non-smoking and without prior cardiovascular ...

Focal stenosis or occlusion of the infrarenal aorta is a relatively rare entity. In particular, soft-plaque of atherothrombotic origin in the aortic segment is linked to high-risk for peripheral embolisation. To our knowledge, the present case report describes for first time in the literature successful percutaneous treatment of a symptomatic ...

Few studies have documented the clinicopathological features of prosthetic valve endocarditis independently of native valve endocarditis. Retrospective analysis of patients undergoing cardiac surgery for prosthetic valve endocarditis at our institution (1985-2004). Medical records and microscopic slides were reviewed from 116 patients for demographics, infecting organisms, comorbidities, and pathologic features. Patients ...

A reduced diffusing capacity of the lung for carbon monoxide (DLCO) measured during a pulmonary function test can suggest pulmonary arterial hypertension (PAH). The DLCO has been reported to weakly correlate with pulmonary hemodynamics. To determine whether the relationship between the DLCO and pulmonary arterial pressures can be strengthened by ...

To investigate the impact of selective fetoscopic laser photocoagulation (SFLP) on pre-existing pulmonary valve pathology in the recipient twin in twin-twin transfusion syndrome (TTTS). We evaluated preoperative echocardiograms of all pregnancies with TTTS treated with SFLP at our institution from 2001 to 2009 (n = 76). Sixteen (21%) recipients had ...

An arterial aneurysm is defined as a focal dilation of a blood vessel with respect to the original artery. The risk of abdominal aortic aneurysms (AAAs) increases dramatically in the presence of the following factors: age older than 60 years, smoking, hypertension and Caucasian ethnicity. The likelihood that an aneurysm ...

Endovascular intervention to exclude popliteal artery aneurysms (PAA) achieves results comparable to surgical intervention with less associated morbidity and mortality. However, the biomechanical forces inherent to this region pose unique impediments that can limit successful endovascular exclusion. Herein, we present a case of recurrent thrombotic occlusion of a PAA endoprosthesis ...

Endovascular intervention to exclude popliteal artery aneurysms (PAA) achieves results comparable to surgical intervention with less associated morbidity and mortality. However, the biomechanical forces inherent to this region pose unique impediments that can limit successful endovascular exclusion. Herein, we present a case of recurrent thrombotic occlusion of a PAA endoprosthesis ...

Our objective was to design a new trileaflet aortic valve using computer-aided design (CAD). Quantification of aortic valve geometries is essential in understanding normal and pathological valvular function and eventually in the design of valves. We have designed a new tissue valve model to investigate its suitability in aortic valve ...

The aim of this study was to evaluate whether pulmonary function as assessed by spirometry affects the immediate and late outcome after isolated coronary artery bypass surgery (CABG). Data on preoperative percentages of the predicted forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were retrieved from ...

Objectives: Decellularized porcine heart valves treated with deoxycholic acid (DOA) have demonstrated complete recellularization and absence of calcification when implanted into the pulmonary position in sheep. We studied recellularization and calcification in stented DOA-treated heart valves compared with conventional stented glutaraldehyde-treated valves in the aortic position in juvenile pigs 6 ...

Compared with reoperative aortic valve replacement for nonendocarditic causes, the contemporary risk and long-term outcomes of reoperation for aortic prosthetic valve endocarditis are ill-defined. Between December 1994 and April 2008, 313 patients underwent reoperative aortic valve replacement, of whom 152 (48.6%) had prosthetic valve endocarditis. Mean follow-up was 6.5 ± 0.4 ...

Prosthetic valve thrombosis is a rare but life threatening complication of mechanical heart valve prosthesis. A 44-year-old woman diagnosed with rheumatic heart disease with severe mitral valve stenosis, moderate tricuspid valve insufficiency, and atrial fibrillation underwent transseptal mitral valve replacement and tricuspid valvuloplasty in our department. Heparin and warfarin were ...

BACKGROUND: The purpose of this study is to determine the outcome and performance of bovine pericardial valves in the pulmonary position. METHODS: This is a retrospective review of all patients with congenital heart disease who had pulmonary valve replacement using a bovine pericardial valve from 2002 to 2009 at a ...

Noninvasive assessment of mechanical heart valve function with echocardiography is challenging. There are important safety issues when considering placing a standard catheter across a mechanical valve with for invasive hemodynamic measurements. The feasibility of using a high-fidelity micromanometer coronary pressure guide wire to assess hemodynamics across mechanical valves has been ...

Percutaneous Aortic Valve (PAV) replacement is an attractive alternative to open heart surgery, especially for patients considered to be poor surgical candidates. Despite this, PAV replacement still has its limitations and associated risks. Bioprosthetic heart valves still have poor long-term durability due to calcification and mechanical failure. In addition, the ...

Site-specific biomechanical properties of the aortic valve play an important role in native valve function, and alterations in these properties may reflect mechanisms of degeneration and disease. Small animals such as targeted mutagenesis mice provide a powerful approach to model human valve disease pathogenesis; however, physical mechanical testing in small ...

Congenital cardiac valve disease is common, affecting ∼1% of the population, with substantial morbidity and mortality, but suboptimal treatment options. Characterization of the specific matrix and valve cell phenotypic abnormalities in these valves could lend insight into disease pathogenesis and potentially pave the way for novel therapies. Thirty-five human aortic ...

Glutaraldehyde-preserved bioprosthetic heart valves are non-viable and have a limited durability because of calcification, tissue wear, and inflammation, especially in children. Decellularized porcine heart valves, when treated with deoxycholic acid (DOA), have exhibited complete recellularization and an absence of calcification when implanted into the pulmonary position in juvenile sheep. The ...

Over the past five years, transcatheter valves have stimulated the attention of physicians, engineers, and investors. Transcatheter valve design and implantation techniques depart from the time-proven features of surgical valves, and this has an important impact on the safety and efficacy of prosthetic valve therapy. Herein is reviewed the performance ...

The Codman-Hakim Programmable Valve is widely used in shunting hydrocephalus and other conditions. To establish an accurate valve verification system for the Codman-Hakim programmable valve that does not require radiographic exposure. Prospective clinical trial tested a new valve verification system at 9 research sites. The Valve Programming and Verification System ...

Having passed the 30th anniversary of the first implantation of a Björk-Shiley convexo-concave tilting mechanical valve, recognition of the life-threatening complication of strut fracture is not widespread. The authors report the case of a 48-year-old man with acute-onset chest pain and dyspnea found to have strut fracture and disk embolization ...

Mechanical dysfunction from valve thrombosis is a dreaded complication of valve replacement surgery, usually presenting months to years after the procedure. Here we report acute deterioration of prosthetic valve function due to intraoperative obstruction by a thrombus.

BACKGROUND: Transcatheter pulmonary valve placement is an emerging therapy for pulmonary regurgitation and right ventricular outflow tract obstruction in selected patients. The Melody valve was recently approved in the United States for placement in dysfunctional right ventricular outflow tract conduits. METHODS AND RESULTS: From January 2007 to August 2009, 136 ...

PURPOSE: The objective of this study was to evaluate and compare the relative durability and complications between the proximal valve polyurethane and distal valve silicone peripherally inserted central catheters (PICCs). METHODS: Institutional review board approval was obtained. A total of 326 patients (mean age, 50.4 years) was assigned randomly to ...

Percutaneous implantation has already been used clinically and is a great option for treating young patients. The use of autologous tissue-engineered valved stents might solve the problem of degeneration and limited durability of biological heart valves. Porcine pulmonary heart valves and small intestinal submucosa were obtained from a slaughterhouse. The ...

The Damus-Kaye-Stansel procedure and its modifications have been performed to relieve systemic outflow tract obstruction in patients with a functional single ventricle. However, distortion of the pulmonary valve and sinus in the original procedure may cause pulmonary valve incompetence to develop, and prosthetic material is frequently required due to the ...

The Starr-Edwards valve was the first manufactured valve to be used successfully as a cardiac valve replacement in 1960. Although superseded by newer valves over the decades it has achieved an excellent track record. It has unique features, namely a protective metal casing around the ball poppet and a large ...

Elastin is a ubiquitous extracellular matrix protein that is highly organized in heart valves and arteries. Because elastic fiber abnormalities are a central feature of degenerative valve disease, we hypothesized that elastin-insufficient mice would manifest viable heart valve disease. To analyze valve structure and function in elastin-insufficient mice (Eln(+/-)) at ...

An 83-year-old patient underwent a transapical aortic valve implantation at our institution. Four months later, she was readmitted to our institution because of fever and heart failure. A prosthetic aortic valve endocarditis was diagnosed. Because of the high surgical risk, surgery was refused and the patient died shortly after the ...

We report the findings of voiding cystourethrography in a boy with posterior urethral valves that showed reflux into the epididymis.

We have many choices when selecting artificial valves for valve replacement surgery. It is necessary to know the characteristics of the various prosthetic valves to make an appropriate decision for each valvular heart disease patient. In this review paper, we describe the features and benefits of the artificial valves available ...

Tetralogy of Fallot (TOF) with concomitant absent pulmonary valve syndrome (APVS) constitutes a rare prenatal condition characterized by rudimentary cusps of the pulmonary valve, pulmonary regurgitation, and a variable degree of dilatation of the main and branch pulmonary arteries. Although early prenatal diagnosis of this complex malformation is feasible, the ...

Abstract At birth, the mechanical environment of valves changes radically as fetal shunts close and pulmonary and systemic vascular resistances change. Given that valves are reported to be mechanosensitive, we investigated remodeling induced by perinatal changes by examining compositional and structural differences of aortic and mitral valves (AVs, MVs) between ...

Transapical aortic valve implantation carries some degree of uncertainty regarding the definitive valve position. We added angiographic visualization of the aortic root while the prosthetic valve is being slowly deployed. It enables easy correction of the position of the valve so that perfect alignment can be achieved of the relationships ...

Enhancing the pulmonary annulus renders the pulmonary valve incompetent in cases of tetralogy of Fallot. A pressure-loaded right ventricle may change to a volume-loaded ventricle, which may dilate and eventually dysfunction. This study evaluated a new technique of fashioning a monocusp valve from untreated autologous pericardium suspended on a transannular ...