Heart Valve Disease

Valve Repair ◽

Embolic Risk

Echocardiography plays a major role in the evaluation, monitoring and decision making of patients with valvular heart disease. This chapter examines the aetiologies, haemodynamic measurements, and various consequences in aortic, mitral and pulmonary valve stenosis. It also describes how to assess patients with valvular regurgitation (mitral, aortic and pulmonary), valvular prosthesis and definite or suspected infective endocarditis. For each condition, echocardiographic features of poor prognosis, including complications, embolic risk, and the timing for surgery are discussed. Indications for transoesophageal echocardiography and 3D echocardiography are highlighted, especially when a decision of valve repair is envisioned. The timing echocardiographic monitoring of patients with valvular heart disease is also described.

Case of calcific tricuspid and pulmonary valve stenosis

BMJ Case Reports ◽

10.1136/bcr-2020-235190 ◽

2020 ◽

Vol 13 (9) ◽

pp. e235190

Author(s):

Yash Paul Sharma ◽

Prashant Kumar Panda ◽

Lipi Uppal ◽

Uma Debi

Keyword(s):

Heart Disease ◽

Tricuspid Valve ◽

Valvular Heart Disease ◽

Pulmonary Valve ◽

Carcinoid Heart Disease ◽

Almost All ◽

Unusual Finding ◽

Severe Calcification ◽

Tricuspid Valve Stenosis

Isolated right-sided valvular disease is a much less recognised entity when compared with left-sided valvular heart disease. Almost all the cases of combined pulmonary valve with tricuspid valve involvement are a consequence of underlying carcinoid heart disease. Moreover, severe calcification of tricuspid valve is an extremely unusual finding. We report a case of a severe calcific tricuspid valve stenosis along with severe pulmonary valve stenosis where the exact aetiology could not be established. On reviewing the literature, we did not find any reports describing such a morphology.

Cine MR imaging of valvular heart disease: display and imaging parameters affect the size of the signal void caused by valvular regurgitation.

American Journal of Roentgenology ◽

10.2214/ajr.155.4.2119099 ◽

1990 ◽

Vol 155 (4) ◽

pp. 723-727 ◽

Cited By ~ 78

Author(s):

J Suzuki ◽

G R Caputo ◽

C Kondo ◽

C B Higgins

Keyword(s):

Heart Disease ◽

Mr Imaging ◽

Valvular Heart Disease ◽

Valvular Regurgitation ◽

Imaging Parameters ◽

Cine Mr ◽

Signal Void

Natriuretic Peptide Release during Exercise in Patients with Valvular Heart Disease: a Systematic Review.

10.22541/au.160828574.45595077/v1 ◽

2020 ◽

Author(s):

Sveeta Badiani ◽

Jet van Zalen ◽

Aeshah Althunayyan ◽

Sahar Al-borikan ◽

Thomas Treibel ◽

...

Keyword(s):

Systematic Review ◽

Heart Disease ◽

Mitral Regurgitation ◽

Aortic Stenosis ◽

Natriuretic Peptide ◽

Valvular Heart Disease ◽

Blood Pressure Response ◽

Heart Valve Disease ◽

Optimal Timing ◽

The Relationship

Aims Serum biomarkers have a potential role in the risk stratification of patients with heart valve disease and may help determine the optimal timing of intervention. Much of the published literature relates to biomarker sampling in a resting state, but the relationship of exercise biomarkers is less well described. We performed a systematic review to examine the significance of exercise natriuretic peptides on echocardiographic variables and cardiovascular events, in valvular heart disease. Methods A search for studies that assessed exercise biomarkers in patients with moderate to severe valve lesions was performed. We examined the relationship between rest and exercise BNP and also the endpoints of symptoms, haemodynamic or echocardiographic variables and clinical outcomes. Results 11 prospective studies were identified (844 participants). 61% were male and the mean age was 55.2 ± 9.6 years. The majority of the blood samples were taken at baseline and within 3 minutes of stopping exercise. There was a significant increase in exercise BNP compared with rest, in patients with aortic stenosis, mitral regurgitation and mitral stenosis. Elevated exercise BNP levels correlated with mean gradient and left atrial area, and there was a relationship between a higher exercise BNP and a blunted blood pressure response, in aortic stenosis. Furthermore, exercise BNP was independently associated with cardiac events, over and above resting values, in patients with mitral regurgitation and aortic stenosis. Conclusions The results suggesting that exercise natriuretic peptide levels may have additive prognostic importance over resting levels, as well as demographic and echocardiographic data.

Long-term survival in patients with isolated pulmonary valve stenosis: a not so benign disease?

Open Heart ◽

10.1136/openhrt-2021-001836 ◽

2021 ◽

Vol 8 (2) ◽

pp. e001836

Author(s):

Kristofer Skoglund ◽

Annika Rosengren ◽

Georgios Lappas ◽

Maria Fedchenko ◽

Zacharias Mandalenakis

Keyword(s):

Heart Disease ◽

Early Diagnosis ◽

Congenital Heart ◽

Pulmonary Valve ◽

Survival Rates ◽

Term Survival ◽

Risk Of Mortality

Background and objectivesDuring the last decades, the survival rates in patients with congenital heart disease have increased dramatically, particularly in patients with complex heart malformations. However, the survival in patients with simple defects is still unknown. We aimed to determine the characteristics and the risk of mortality in patients with isolated pulmonary valve stenosis (PS).MethodsSwedish inpatient, outpatient and cause of death registries were used to identify patients born between 1970 and 2017 with a diagnosis of PS, without any other concomitant congenital heart lesion. For each patient with PS, 10 control individuals without congenital heart disease were matched by birth year and sex from the total population registry. We used median-unbiased method and Kaplan-Meier survival analysis to examine the risk of mortality.ResultsWe included 3910 patients with PS and 38 770 matched controls. The median age of diagnosis of PS was 0.7 years (IQR 0.3–7.0). During a median follow-up of 13.5 years (IQR 6.5–23.5), 88 patients with PS and 192 controls died; 500 patients with PS (12%) underwent at least one transcatheter or surgical valve intervention. The overall mortality rate was significantly higher in patients with PS compared with matched controls (HR 4.67, 95% CI 3.61 to 5.99, p=0.001). Patients with an early diagnosis of PS (0–1 year) had the highest risk of mortality (HR 10.99, 95% CI 7.84 to 15.45).ConclusionsIn this nationwide, register-based cohort study, we found that the risk of mortality in patients with PS is almost five times higher compared with matched controls. Patients with an early diagnosis of PS appears to be the most vulnerable group and the regular follow-up in tertiary congenital heart units may be the key to prevention.

Severe Pulmonary Valvular Stenosis and Balloon Pulmonary Valvuloplasty (BPV): A Case Report

Ibrahim Cardiac Medical Journal ◽

10.3329/icmj.v3i1-2.52864 ◽

2015 ◽

Vol 3 (1-2) ◽

pp. 53-58

Author(s):

Tahera Nazrin ◽

CM Shaheen Kabir ◽

Sahela Nasrin ◽

Md Rokonujjaman ◽

M Maksumul Huq ◽

...

Keyword(s):

Heart Disease ◽

Congenital Heart ◽

Pulmonary Valve ◽

Excellent Result ◽

Pulmonary Stenosis ◽

Short Term ◽

Valvular Stenosis ◽

Congenital Cyanotic Heart Disease

Congenital pulmonary valve stenosis is a common congenital heart disease andIsolated pulmonary valve stenosis comprises 8-10% of all congenital heart disease. It is an acyanotic heart disease,but can present with severe cyanosis if it is associated with patent foramen ovale (PFO). Severe pulmonary stenosis with cyanosis can be misdiagnosed clinically. Proper evaluation and modern technique of treatment modality can save a life easily. We report a 5 years old boy with severe pulmonary valvular stenosis with PFO who was clinically misdiagnosed as a case of congenital cyanotic heart disease (Tetralogy of Fallot). After taking proper history, clinical examination and investigations we treated the baby by balloon pulmonary valvuloplasty (BPV) successfully without any complication. The short term (6 months) outcome of BPV showed excellent result. Ibrahim Cardiac Med J 2013; 3(1&2): 53-58

Transcatheter Pulmonary Valve Replacement in a Carcinoid Heart

Texas Heart Institute Journal ◽

10.14503/thij-15-5310 ◽

2016 ◽

Vol 43 (4) ◽

pp. 341-344 ◽

Cited By ~ 13

Author(s):

Pranav Loyalka ◽

Michael Schechter ◽

Angelo Nascimbene ◽

Ajay Sundara Raman ◽

Cezar A. Ilieascu ◽

...

Keyword(s):

Heart Disease ◽

Valve Replacement ◽

Pulmonary Valve ◽

Open Heart Surgery ◽

Pulmonary Valve Replacement ◽

Carcinoid Heart Disease ◽

Percutaneous Valve Replacement ◽

Surgical Valve Replacement ◽

Percutaneous Valve

Carcinoid heart disease presents as right-sided heart failure attributable to the dysfunction of the tricuspid and pulmonary valves. Although surgical valve replacement is the mainstay of treatment when patients become symptomatic, it is associated with substantial perioperative mortality rates. We present a case of severe pulmonary valve stenosis secondary to carcinoid heart disease, treated successfully with percutaneous valve replacement. A 67-year-old man with severe pulmonary valve stenosis was referred to our center for pulmonary valve replacement. The patient had a history of metastatic neuroendocrine tumor of the small bowel with carcinoid syndrome, carcinoid heart disease, and tricuspid valve regurgitation previously treated with surgical valve replacement. Because of the patient's severe chronic obstructive pulmonary disease and hostile chest anatomy seen on a computed tomographic scan dating from previous cardiothoracic surgery, we considered off-label percutaneous valve replacement a viable alternative to open-heart surgery. A 29-mm Edwards Sapien XT valve was successfully deployed over the native pulmonary valve. There were no adverse sequelae after the procedure, and the patient was discharged from the hospital the next day. This case report shows that percutaneous valve replacement can be a valid option in carcinoid heart disease patients who are not amenable to surgical valve replacement.

Adult Congenital Heart Disease Investigated with Cardiac Catheterization Over A 20-Year Period

The Open Cardiovascular Medicine Journal ◽

10.2174/1874192400903010124 ◽

2009 ◽

Vol 3 (1) ◽

pp. 124-127 ◽

Cited By ~ 5

Author(s):

George D Giannoglou ◽

Antonios P Antoniadis ◽

Yiannis S Chatzizisis ◽

George E Louridas

Keyword(s):

Heart Disease ◽

Atrial Septal Defect ◽

Cardiac Catheterization ◽

Congenital Heart ◽

Septal Defect ◽

Pulmonary Valve ◽

Adult Congenital Heart Disease ◽

Adult Congenital

Background: Recent advances in diagnosis and treatment have increased the life expectancy of patients with congenital heart disease. Methods: To investigate the prevalence of adult congenital heart disease (ACHD) in a large registry of patients over a 20-year period, we retrospectively assessed data of 14,012 males and 4,461 females who underwent clinically indicated cardiac catheterization from 1984 to 2003. Results: ACHD was recorded in 234 subjects aged from 18 to 66 years, [95 males (40.7%) and 139 females (59.3%)]. Females were more likely to present with ACHD than males (p<0.001). Atrial septal defect was the most common defect (43.3%) followed by partial anomalous pulmonary venous return (12.0%), pulmonary valve stenosis (11.3%) ventricular septal defect (8.0%), coarctation of aorta (5.5%) patent ductus arteriosus (4.0%) and Fallot’s tetralogy (3.3%). Atrial septal defect was more common in females (p<0.01), while pulmonary valve stenosis was more frequent in males (p<0.05). No difference across sexes was found in the other forms of ACHD. Females with ACHD were significantly older than males at the time of catheterization (median age 41 years, interquartile range 26 to 53 years vs. median age 35 years, interquartile range 22 to 48 years, p<0.05). Conclusions: In adulthood ACHD is found more commonly in females and is diagnosed later in life than in males. Atrial septal defect is the most prevalent form of ACHD and occurs most commonly in females.

The diagnosis and treatment of pulmonary valve stenosis in children

Asian Journal of Medical Sciences ◽

10.3126/ajms.v6i6.12017 ◽

2015 ◽

Vol 6 (6) ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Shiv Kumar Yadav

Keyword(s):

Heart Disease ◽

Congenital Heart ◽

Recent Progress ◽

Pulmonary Valve ◽

Diagnosis And Treatment ◽

Medical Sciences ◽

Percutaneous Balloon ◽

First Choice

Pulmonary valve stenosis (PS) is a common congenital heart disease, its early diagnosis and treatment can improve growth and prognosis in children with pulmonary valve stenosis. With the development of the diagnostics and treatment, percutaneous balloon pulmonary valvuloplasty (PBPV) has replaced surgery as the first choice for isolated pulmonary valve stenosis. The article reviews the recent progress in diagnosis and treatment of pulmonary valve stenosis.DOI: http://dx.doi.org/10.3126/ajms.v6i6.12017Asian Journal of Medical Sciences Vol.6(6) 2015 1-5

Prevalence, Type, and Molecular Spectrum of NF1 Mutations in Patients with Neurofibromatosis Type 1 and Congenital Heart Disease

Genes ◽

10.3390/genes10090675 ◽

2019 ◽

Vol 10 (9) ◽

pp. 675 ◽

Cited By ~ 1

Author(s):

Pinna ◽

Daniele ◽

Calcagni ◽

Mariniello ◽

Criscione ◽

...

Keyword(s):

Heart Disease ◽

Neurofibromatosis Type 1 ◽

Odds Ratio ◽

Congenital Heart ◽

Pulmonary Valve ◽

Neurofibromatosis Type ◽

Study Cohort ◽

Pulmonary Valve Stenosis

The aim of this study was to assess the prevalence and type of congenital heart disease (CHD) and the associated mutation spectrum in a large series of patients with neurofibromatosis type 1 (NF1), and correlate the mutation type with the presence and subgroups of cardiac defects. The study cohort included 493 individuals with molecularly confirmed diagnosis of NF1 for whom cardiac evaluation data were available. CHD was reported in 62/493 (12.6%) patients. Among these patients, 23/62 (37.1%) had pulmonary valve stenosis/dysplasia, 20/62 (32.3%) had mitral valve anomalies, and 10/62 (16.1%) had septal defects. Other defects occurred as rare events. In this NF1 subcohort, three subjects carried a whole-gene deletion, while 59 were heterozygous for an intragenic mutation. A significantly increased prevalence of non-truncating intragenic mutations was either observed in individuals with CHD (22/59, 37.3%) or with pulmonary valve stenosis (13/20, 65.0%), when compared to individuals without CHD (89/420, 21.2%) (p = 0.038) or pulmonary valve stenosis (98/459, 21.4%) (p = 0.002). Similarly, patients with non-truncating NF1 mutations displayed two- and six-fold higher risk of developing CHD (odds ratio = 1.9713, 95% confidence interval (CI): 1.1162–3.4814, p = 0.0193) and pulmonary valve stenosis (odds ratio = 6.8411, 95% CI: 2.6574–17.6114, p = 0.0001), respectively. Noteworthy, all but one patient (19/20, 95.0%) with pulmonary valve stenosis, and 18/35 (51.4%) patients with other CHDs displayed Noonan syndrome (NS)-like features. Present data confirm the significant frequency of CHD in patients with NF1, and provide further evidence for a higher than expected prevalence of NF1 in-frame variants and NS-like characteristics in NF1 patients with CHD, particularly with pulmonary valve stenosis.

Frequency of obstructive coronary artery disease in patients undergoing valvular heart disease surgery.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.4675 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1297-1303

Author(s):

Munir Ahmad ◽

Muhammad Yasir ◽

Muhammad Hamid Saeed ◽

Muhammad Saeed Ali Khan ◽

Qasim Rauf ◽

...

Keyword(s):

Coronary Artery Disease ◽

Heart Disease ◽

Coronary Artery ◽

Valvular Heart Disease ◽

Heart Surgery ◽

Obstructive Coronary Artery Disease ◽

Heart Valve Disease ◽

Cross Sectional ◽

History Of ◽

Artery Disease

Objectives: To determine the frequency of obstructive coronary artery disease in patients undergoing valvular heart disease surgery. Study Design: Cross-sectional study. Setting: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad. Period: Six months, from 02 February, 2017 to 01 August, 2017. Material & Methods: After taking approval from hospital ethical committee, patients coming through outpatient department who fulfilled the inclusion criteria were enrolled and informed consent was taken from them. History of smoking, diabetes mellitus, renal dysfunction, dyslipidemia, hypertension and family history of coronary artery disease was assessed. Coronary angiography was performed by senior consultant interventional cardiologist for assessing obstructive coronary artery disease as per operational definition. All the information was collected on prespecified Performa. Results: In this study, out of 140 cases of valvular heart disease (VHD), 47.14%(n=66) were between 30-50 years of age whereas 52.86%(n=74) were between 51-70 years of age, mean ±sd was calculated as 51.71+9.09 years, 57.14%(n=80) were male while 42.86%(n=60) were female, frequency of obstructive coronary artery disease in patients undergoing valvular heart surgery was recorded as 29.3% (n=41) whereas 70.7% (n=99) had no such finding. Conclusion: The frequency of obstructive coronary artery disease was (29.3%) in patients undergoing valvular heart disease surgery. However, coronary artery disease was less frequent in rheumatic as compared to degenerative heart valve disease.