Mitral stenosis and hockey stick, do not always mean rheumatic valve disease

We report a 52-year-old and weight of 79.36 lbs female patient with Thrombocytopenia induced by giant atrial thrombus in rheumatic mitral stenosis. The patient underwent bioprosthetic mitral valve implantation and removal of the giant thrombus. The platelet count progressively increased achieving normal levels one week after surgery. Cardiovasc. j. 2020; 13(1): 95-96

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Valvular heart disease

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0352 ◽

2020 ◽

pp. 3436-3458

Author(s):

Michael Henein

Keyword(s):

Lupus Erythematosus ◽

Mitral Stenosis ◽

Valve Disease ◽

Pulmonary Vasculature ◽

First Heart Sound ◽

Rheumatic Valve Disease ◽

Congenital Mitral Stenosis ◽

Valve Pathology ◽

Apex Beat ◽

Diastolic Murmur

Rheumatic valve disease remains prevalent in developing countries, but over the last 50 years there has been a decline in the incidence of rheumatic valve disease and an increase in the prevalence of degenerative valve pathology in northern Europe and North America. In all forms of valve disease, the most appropriate initial diagnostic investigation is almost always the echocardiogram. The most common cause is rheumatic valve disease. Other causes include mitral annular calcification, congenital mitral stenosis, infective endocarditis (very rarely), and systemic lupus erythematosus (Liebman–Sachs endocarditis). The important consequences of mitral stenosis are its effect on left atrial pressure, size, and the pulmonary vasculature; it commonly causes atrial fibrillation. Presenting symptoms are typically exertional fatigue and breathlessness; systemic embolism can occur. Characteristic physical signs are irregular pulse, tapping apex beat, loud first heart sound, opening snap, and an apical low-pitched rumbling mid-diastolic murmur.

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Faculty Opinions recommendation of Clinical outcomes in 1731 patients undergoing mitral valve surgery for rheumatic valve disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.732126028.793564329 ◽

2019 ◽

Author(s):

Wendy Tsang

Keyword(s):

Mitral Valve ◽

Clinical Outcomes ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Valve Disease ◽

Rheumatic Valve Disease

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P24: MANAGEMENT OF RHEUMATIC VALVE DISEASE OF THE AORTIC VALVE USING THE OZAKI PROCEDURE WITH AUTOLOGOUS PERICARDIUM

British Journal of Surgery ◽

10.1093/bjs/znab117.109 ◽

2021 ◽

Vol 108 (Supplement_1) ◽

Author(s):

A Asif ◽

M Caputo

Keyword(s):

Aortic Valve ◽

Intraoperative Complications ◽

Valve Disease ◽

Severe Aortic Regurgitation ◽

Autologous Pericardium ◽

End Diastolic Volume ◽

Rheumatic Valve Disease ◽

Coronary Cusp ◽

Valve Pathology ◽

Diastolic Murmur

Abstract Case-Study A 15-year-old boy was referred to our tertiary centre from his local paediatric services with a background of rheumatic fever, severe aortic regurgitation (AR) and mild to moderate mitral regurgitation. He had a history of angina and dyspnoea on exertion, a 2/6 ejection systolic murmur and 2/4 end diastolic murmur. Transthoracic echocardiography showed severe aortic valve insufficiency (with flow reversal seen in the descending aorta and an LV end diastolic volume of 173 ml/m2) and trivial pulmonary valve regurgitation. Autograft failure following the favoured Ross procedure deemed the patient as a candidate for an Ozaki procedure. Autologous pericardium was used to replace the diseased aortic valve. Intraoperative transoesophageal echocardiography showed a deficient left coronary cusp leaflet and a retracted right coronary cusp leaflet. The patient was under cardiopulmonary bypass for 124 minutes and on cross-clamping for 99 minutes with no intraoperative complications. Histological examination of the aortic valve leaflets showed neovascularisation, myxoid changes and disarray of the fibrous stroma. Postoperative recovery was uneventful. The postoperative echocardiogram showed trivial AR, end diastolic volume 217ml, end systolic volume 12 ml and 40% ejection fraction. There was full resolution of the dyspnoea, angina and diastolic murmur on follow-up 4-months postoperatively as supported by healthy valve function on echocardiography. This case highlights that in those of risk of multiple valve pathology, such as in rheumatic valve disease, an Ozaki procedure using autologous pericardium is a viable surgical option for paediatric aortic valve repair with good outcomes. Take-home message In cases of systemic conditions affecting the heart valves where there is multiple valve pathology and risk of autograft failure, such as rheumatic valve disease, the use of autologous pericardium to replace these valves has shown to be a viable option in this paediatric case.

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Perioperative Management of Sectio Caesarea Surgery in Patient With Heart Valve Disorders

Solo Journal of Anesthesi, Pain and Critical Care (SOJA) ◽

10.20961/soja.v1i1.49474 ◽

2021 ◽

Vol 1 (1) ◽

pp. 1

Author(s):

Purwoko Purwoko ◽

Zidni Afrokhul Athir

Keyword(s):

Mitral Regurgitation ◽

Cesarean Section ◽

Maternal Mortality ◽

Pulmonary Edema ◽

Heart Valve ◽

Mitral Stenosis ◽

Valve Disease ◽

Heart Valve Disease ◽

Normal Limits ◽

In Pregnancy

<div class="WordSection1">Cardiovascular disease in pregnancy is common range from 1% to 3 and contributes to 10-15% of maternal mortality. Valvular heart disease accounts for about 25% of cases of cardiac complications in pregnancy and important cause of maternal mortality, some of which are mitral stenosis and mitral regurgitation. Cesarean delivery remains the preferred choice, as it reduces the hemodynamic changes that can occur in normal delivery and allows for better monitoring and hemodynamic management. Our paper provide in-depth information regarding the pathophysiology of heart valve disease in pregnant women and an appropriate perianesthesia approach to obtain a good prognosis. We report a case of a 26-year-old pregnant woman, with obstetric status G1P0A0, 36 weeks’ gestation, body weight 61 kg accompanied by severe mitral regurgitation and moderate mitral stenosis. This patient was planned to undergo elective cesarean section. The patient's condition in the perioperative examination was: GCS E4V5M6, other vital signs within normal limits, SpO2 98-99% in supine position. Other physical and laboratory examinations were also within normal limits. The goal of anesthesia during surgery in patients with heart valve disease undergoing cesarean section maintain pulmonary capillary pressure to prevent acute pulmonary edema. In this case, regional anesthesia of epidural anesthesia was chosen because it can reduce systemic vascular resistance and provide better post-cesarean section pain. The patient's hemodynamics perianesthesia tended to be stable without any complications such as pulmonary edema. </div>

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Heart valve disease

Oxford Textbook of Medicine ◽

10.1093/med/9780199204854.003.1606_update_002 ◽

2010 ◽

pp. 2736-2757

Author(s):

Michael Henein

Keyword(s):

Developing Countries ◽

North America ◽

Heart Valve ◽

Valve Disease ◽

Heart Valve Disease ◽

Northern Europe ◽

Diagnostic Investigation ◽

Rheumatic Valve Disease ◽

Valve Pathology

Rheumatic valve disease remains prevalent in developing countries, but over the last 50 years there has been a decline in the incidence of rheumatic valve disease and an increase in the prevalence of degenerative valve pathology in northern Europe and North America. In all forms of valve disease, the most appropriate initial diagnostic investigation is almost always the echocardiogram....

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