scholarly journals THE SURGICAL TREATMENT OF AORTIC INSUFFICIENCY BY CONVERSION OF THE TRICUSPID AORTIC VALVE TO A BICUSPID VALVE

1959 ◽  
Vol 37 (2) ◽  
pp. 177-183
Author(s):  
Joseph J. Garamella ◽  
James G. Andersen ◽  
Reuben Oropeza ◽  
Angelo Veloso ◽  
R. Naidu
Keyword(s):  
Surgical Treatment ◽  
Aortic Valve ◽  
Aortic Insufficiency ◽  
Tricuspid Aortic Valve ◽  
Bicuspid Valve

scholarly journals A Typical Immune T/B Subset Profile Characterizes Bicuspid Aortic Valve: In an Old Status?

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Carmela R. Balistreri ◽  
Silvio Buffa ◽  
Alberto Allegra ◽  
Calogera Pisano ◽  
Giovanni Ruvolo ◽  
...  
Keyword(s):  
B Cells ◽  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Molecular Mechanisms ◽  
B Lymphocyte ◽  
Valve Disease ◽  
Tricuspid Aortic Valve ◽  
Bicuspid Valve ◽  
Circulating Levels

Bicuspid valve disease is associated with the development of thoracic aortic aneurysm. The molecular mechanisms underlying this association still need to be clarified. Here, we evaluated the circulating levels of T and B lymphocyte subsets associated with the development of vascular diseases in patients with bicuspid aortic valve or tricuspid aortic valve with and without thoracic aortic aneurysm. We unveiled that the circulating levels of the MAIT, CD4+IL−17A+, and NKT T cell subsets were significantly reduced in bicuspid valve disease cases, when compared to tricuspid aortic valve cases in either the presence or the absence of thoracic aortic aneurysm. Among patients with tricuspid aortic valve, these cells were higher in those also affected by thoracic aortic aneurysm. Similar data were obtained by examining CD19+ B cells, naïve B cells (IgD+CD27−), memory unswitched B cells (IgD+CD27+), memory switched B cells (IgD−CD27+), and double-negative B cells (DN) (IgD−CD27−). These cells resulted to be lower in subjects with bicuspid valve disease with respect to patients with tricuspid aortic valve. In whole, our data indicate that patients with bicuspid valve disease show a quantitative reduction of T and B lymphocyte cell subsets. Future studies are encouraged to understand the molecular mechanisms underlying this observation and its pathophysiological significance.

scholarly journals Time Course of Aortic Valve Function and Root Dimensions After Subcoronary Ross Procedure for Bicuspid Versus Tricuspid Aortic Valve Disease

Circulation ◽  
2001 ◽  
Vol 104 (suppl_1) ◽  
Author(s):  
Claudia Schmidtke ◽  
Matthias Bechtel ◽  
Michael Hueppe ◽  
Hans-H. Sievers
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Valve Disease ◽  
Time Course ◽  
Aortic Insufficiency ◽  
Valve Disease ◽  
Tricuspid Aortic Valve ◽  
Group A ◽  
Group B

Background The freestanding aortic root, which is the currently preferred operative technique for pulmonary autografts, is reported to dilate and potentially promote aortic insufficiency, which has led to a controversial debate on the appropriate surgical technique, especially for congenital bicuspid aortic valve disease. Desirable data on the time course of valve function and root dimensions for the alternative subcoronary technique comparing bicuspid and tricuspid aortic valve disease are scarce. Methods and Results Echocardiographic examinations of 31 patients with congenital bicuspid aortic valve disease (group A; age 50.5±11.0 years) and 51 patients with acquired tricuspid aortic valve disease (group B; age 48.1±15.7 years) who were operated on between June 1994 and August 1998 were performed twice postoperatively. At first and second follow-up, respectively, maximum (mean) pressure gradients were 6.0±2.0 (3.6±1.0) and 5.1±2.1 (2.9±1.1) mm Hg in group A and 6.5±3.5 (3.9±1.9) and 5.0±1.7 (2.9±1.0) mm Hg in group B ( P >0.05 between groups). In group A, grade 0 aortic insufficiency at first and second follow-up occurred in 8 and 7 patients, respectively, grade 0-I in 12 and 9 patients, grade I in 9 and 11 patients, grade I-II in 1 and 0 patients, and grade II in 1 and 4 patients; in group B, grade 0 aortic insufficiency occurred in 16 and 18 patients, grade 0-I in 16 and 8 patients, grade I in 17 and 21 patients, grade I-II in 0 and 1 patient, and grade II in 0 and 1 patient ( P >0.05). Aortic insufficiency decreased in 10 patients (17%). However, there was an overall tendency for aortic insufficiency to increase over time (n=23, 38%), although it remained subclinical. Aortic root dimensions did not differ between groups and were constant during follow-up. Conclusions This study provides some evidence that the function of the subcoronary pulmonary autograft in bicuspid aortic valve disease is excellent, with stable root dimensions, and is not different from that of tricuspid aortic valves at least up to 5.5 years postoperatively, which suggests the subcoronary technique should be reconsidered.

Abstract 12888: Discrepancy of Aortic Valve Endocarditis in Patients With Bicuspid and Tricuspid Aortic Valve

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Tan Le ◽  
Juan Caceres ◽  
Bailey Brown ◽  
Alexander Makkinejad ◽  
Emma St. Pierre ◽  
...  
Keyword(s):  
Renal Failure ◽  
Surgical Treatment ◽  
Aortic Valve ◽  
Artery Bypass ◽  
Intravenous Drug User ◽  
Significant Risk ◽  
Infectious Endocarditis ◽  
Tricuspid Aortic Valve ◽  
Younger Age ◽  
Short And Long Term

Introduction: It’s unknown if patients with Bicuspid Aortic Valve (BAV) endocarditis behave differently compared to Tricuspid Aortic Valve (TAV), and if BAV patients are more susceptible to aortic valve endocarditis. Hypothesis: We aimed to distinguish BAV and TAV infectious endocarditis, including the short and long-term outcomes after surgical treatment. Methods: From 1997-2017, 336 patients underwent surgical treatment for aortic valve endocarditis, including 63(19%) BAV, which is 10-20 times higher than the BAV incidence in the general population (1-2%), and 273(81%) TAV endocarditis. Results: Postoperatively, the BAV group had significant shorter intubation time, and less renal failure on dialysis compared to TAV group. There was no compelling difference in postoperative stroke, sepsis, pacemaker requirement and in-hospital mortality [3/65(4.6%) vs. 19/283(6.7%)] between groups. The 10-year survival was better in the BAV group than the TAV group (62% vs. 33%, p=0.004) (Figure). The significant risk factors for late mortality were renal failure on dialysis [hazard ratio (HR)=2], intravenous drug user (HR=2.4), congestive heart failure (HR=1.6), previous coronary artery bypass (HR=1.8) and liver disease (HR=2.4), all p<0.05, but not TAV (HR=1.6, p=0.14). Conclusions: In conclusion, BAV patients have a higher likelihood of infectious endocarditis requiring surgery at a younger age than TAV patients, but similar outcomes. Strong consideration of utilizing prophylactic antibiotics and early surgical treatment for BAV patients, to lower the likelihood of aortic valve endocarditis.

Outcomes of Florida Sleeve Procedure in Patients with Bicuspid Versus Tricuspid Aortic Valve

2020 ◽  
Vol 15 (4) ◽  
pp. 361-368
Author(s):  
Seyed Hossein Aalaei-Andabili ◽  
Thomas M. Beaver ◽  
Tomas D. Martin ◽  
Philip J. Hess ◽  
George J. Arnaoutakis
Keyword(s):  
Aortic Valve ◽  
Patient Survival ◽  
Pacemaker Implantation ◽  
Aortic Insufficiency ◽  
Root Diameter ◽  
Perioperative Outcomes ◽  
Tricuspid Aortic Valve ◽  
Kaplan Meier ◽  
Baseline Characteristics ◽  
Patient Survival Rate

Objective Outcomes of the Florida Sleeve (FS) procedure in patients with bicuspid aortic valve (BAV) have not been reported before. We compared outcomes of the FS procedure between patients with BAV and those with tricuspid aortic valve (TAV). Methods From May 1, 2002 to January 1, 2016, 177 patients including 18 BAV and 159 TAV underwent the FS procedure. Baseline characteristics, perioperative outcomes, and echocardiographic measurements were compared between the 2 groups. Kaplan–Meier and life-table analyses were used to evaluate survival and freedom from reintervention rates. Results Mean ± standard deviation age and aortic root diameter were comparable in BAV and TAV groups, 47.83 ± 11.19 versus 49.59 ± 15.79 years ( P = 0.55) and 56.57 ± 6.18 versus 55.17 ± 8.84 mm ( P = 0.46), respectively. The 30-day mortality and stroke rates were zero in the BAV group and 1.88% ( n = 3) in the TAV group ( P = 1.00). One patient (5.55%) in the BAV group and 8 (5.03%) patients in the TAV group needed permanent pacemaker implantation ( P = 0.62). Freedom from reoperation was 93% in the BAV group and 99% in the TAV group at 8 years ( P = 0.041). Patient survival rate was 100% in the BAV group and 91% in the TAV group at 8 years ( P = 0.42). Freedom from aortic insufficiency greater than mild was 93% in the BAV group and 96.5% in the TAV group at 5 years ( P = 0.61). Conclusions This is the first study reporting outcomes of the FS procedure in patients with BAV. This technique is feasible, and the results appear to be durable when compared to patients with TAV.

scholarly journals 696. Bartonella quintana Endocarditis, A Case Series

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S400-S400
Author(s):  
Thomas D Dieringer ◽  
Glen Huang ◽  
Paul R Allyn ◽  
Jeffrey Klausner
Keyword(s):  
Renal Failure ◽  
Infective Endocarditis ◽  
Los Angeles ◽  
Aortic Valve ◽  
Literature Review ◽  
Case Series ◽  
The United States ◽  
Aortic Insufficiency ◽  
Homeless Population ◽  
Bartonella Quintana

Abstract Background Homelessness has been a growing issue in the United States and worldwide. Bartonella quintana, the causative agent of “Trench fever”, is a well known illness among homeless populations in urban centers. While many cases of B. quintana are self limited, the disease can have advanced presentations including endocarditis. We present a short case series of three cases of B. quintana infective endocarditis (IE) in homeless individuals in Los Angeles and review the literature of cases of B. quintana IE in the homeless population. Methods Here we report three cases of B. quintana IE encountered in homeless individuals at the University of California, Los Angeles (UCLA) hospital system. A literature review was also conducted. PubMed was searched for published cases of human IE secondary to B. quintana in homeless individuals. Results All three patients were male with ages ranging from 39 to 57 years old with a history of homelessness and alcohol use. Presentations were subacute to chronic in nature consisting of constitutional symptoms as well as a range of symptoms corresponding with heart and renal failure. Each patient was found to have varying degrees of aortic insufficiency with either identified aortic valve vegetation or valvular thickening. Diagnosis was made with a combination of Bartonella serologies and whole genome sequencing PCR. All three patient’s courses were complicated by renal failure at varying points limiting the use of gentamicin for the full treatment course. Two patients ultimately underwent aortic valve replacement due to severe aortic insufficiency and completed therapy with doxycycline and rifampin. A single patient was discharged with plan to complete doxycycline and rifampin therapy however was lost to follow up. A literature review of 10 manuscripts describing 13 cases of B. quintana IE were identified. All the patients were male and the median age was 45. Six of the cases were in Europe and eight were in North America. All cases had left sided valve involvement (10 aortic, 6 mitral, 3 both valves). No cases of right sided IE were identified. Conclusion B. quintana IE should be considered in homeless patients with a clinical presentation concerning for IE. A combination of serology and PCR testing can be useful in diagnosis of this uncommon cause of infective endocarditis. Disclosures Jeffrey Klausner, MD, MPH, Nothing to disclose

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