Document Detail


Ultrasound detection of cerebral emboli in patients with prosthetic heart valves.
MedLine Citation:
PMID:  7912147     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study was undertaken in 64 patients, 50 with mechanical and 14 with porcine prosthetic valves, to evaluate the incidence of intracranial emboli and their distribution in the basal cerebral arteries. The patients were studied using transcranial Doppler (EME TC2-64B, Uberlingen, Germany), with a monitoring time of two minutes over each of the internal carotid arteries, middle and anterior cerebral arteries, vertebral arteries and the basilar artery. Sixty-three of the 64 patients were stabilized on warfarin at the time of the study. The incidence of emboli signals was significantly higher in patients with mechanical compared to porcine cardiac valves (88% versus 14%, p < 0.01). The number of emboli signals was significantly higher in the anterior compared with the posterior circulation, with a median of eight signals in the internal carotid arteries (95% confidence interval 5-15), 2.5 in the vertebral arteries (95% confidence interval 1-5.5)(p < 0.03). It was also significantly higher in those patients who had undergone double (aortic and mitral) as opposed to those who had undergone single aortic valve replacement: 18 versus two signals per minute (confidence intervals 5-30.5 versus 0.5-3.5) (p < 0.01). It is concluded that subclinical emboli signals are readily detectable using transcranial Doppler and are common in patients with prosthetic heart valves. Their number depends on both the type and the number of the prosthesis, while their distribution in the basal cerebral arteries is consistent with their cardiac source.
Authors:
D G Grosset; P Cowburn; D Georgiadis; H J Dargie; A Faichney; K R Lee
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  3     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-07-22     Completed Date:  1994-07-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  128-32     Citation Subset:  IM    
Affiliation:
University Department of Medicine and Therapeutics, Western Infirmary, Glasgow.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Bioprosthesis*
Cerebral Arteries / ultrasonography
Female
Heart Valve Prosthesis / adverse effects*
Humans
Intracranial Embolism and Thrombosis / ultrasonography*
Male
Middle Aged
Ultrasonography, Doppler, Transcranial*
Warfarin / administration & dosage
Chemical
Reg. No./Substance:
81-81-2/Warfarin

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


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