Document Detail


Noninvasive diagnosis of complications of the mitral bioprosthesis.
MedLine Citation:
PMID:  1249979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The echophonocardiographic diagnoses of valvular and paravalvular insufficiency, calcific stenosis, and thrombolic occlusion of the stent-mounted aortic homograft or heterograft in the mitral position are described. Paravalvular and valvular insufficiency were associated with apical systolic murmurs which decreased in intensity after amyl nitrite inhalation and with echocardiograms which showed initial diastolic slopes of the stents in excess of the normal range (1.9 to 3.3 cm. per second). In clinically improved and stable patients, amyl nitrite inhalation resulted in increased intensity of the commonly heard systolic ejection type murmur at the left sternal border and echocardiographic evidence of further narrowing of the outflow tract measured between the interventricular septum and the anterior portion of the stent. Calcific homograpft stenosis was associated with a decreased diastolic stent slope (0.4 cm. per second) and increased echo density from the tissue leaflets. Thrombus formation on the sewing ring caused fatal inflow occlusion in 2 patients. The condition was characterized by an echocardiogram showing decreased ratio of internal-to-external stent diameter, 0.47 (normal range 0.56 to 0.74), decreased diastolic stent slope, and decreased leaflet excursion.
Authors:
M S Horowitz; D J Goodman; E W Hancock; R L Popp
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  71     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1976 Mar 
Date Detail:
Created Date:  1976-04-27     Completed Date:  1976-04-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  450-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Amyl Nitrite / diagnostic use
Calcinosis / diagnosis
Echocardiography
Electrocardiography
Female
Heart Murmurs
Heart Valve Prosthesis / adverse effects*
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / diagnosis*,  etiology
Mitral Valve Stenosis / diagnosis*,  etiology
Phonocardiography
Thrombosis / diagnosis
Chemical
Reg. No./Substance:
8017-89-8/Amyl Nitrite

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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