scholarly journals Transillumination: No one outwits me

2021 ◽  
Author(s):  
Javier Armenta-Moreno ◽  
Nilda Espinola-Zavaleta ◽  
Joaquin Berarducci
Keyword(s):  
Infective Endocarditis ◽  
Valve Replacement ◽  
Mechanical Valve ◽  
Paravalvular Leak ◽  
Dental Procedure ◽  
Transesophageal Echocardiogram ◽  
Traditional Methods ◽  
Prosthetic Valves ◽  
History Of ◽  
Auricular Surface

A 67-year-old woman with a history of mechanical valve replacement; after the dental procedure, she developed dyspnea, malleolar edema, and fever. The 2D transesophageal echocardiogram (TEE) showed no evidence of valve obstruction, mild paravalvular leak, and no vegetations. In the 3D TEE, the presence of masses suggestive of vegetations on the auricular surface of the prosthesis was suspected which were more precisely defined with transillumination rendering. This technique allowed us to observe with precision the vegetations that were not visualized with traditional methods. This highlights its usefulness in patients with prosthetic valves where infective endocarditis is a serious complication.

Comparison of Bioprosthetic and Mechanical Valve Replacement for Left-sided Infective Endocarditis

2018 ◽  
Vol 27 ◽  
pp. S522
Author(s):  
Sue Hyun Kim ◽  
Jae-Woong Choi ◽  
Hak-Ju Kim ◽  
Hyuk Ahn
Keyword(s):  
Infective Endocarditis ◽  
Valve Replacement ◽  
Mechanical Valve

scholarly journals Quantifying infective endocarditis risk in patients with predisposing cardiac conditions

2017 ◽  
Vol 39 (7) ◽  
pp. 586-595 ◽  
Author(s):  
Martin H Thornhill ◽  
Simon Jones ◽  
Bernard Prendergast ◽  
Larry M Baddour ◽  
John B Chambers ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
High Risk ◽  
Hospital Admissions ◽  
Previous History ◽  
Prosthetic Material ◽  
Moderate Risk ◽  
Prosthetic Valves ◽  
English Population ◽  
Risk Patients ◽  
History Of

Abstract Aims There are scant comparative data quantifying the risk of infective endocarditis (IE) and associated mortality in individuals with predisposing cardiac conditions. Methods and results English hospital admissions for conditions associated with increased IE risk were followed for 5 years to quantify subsequent IE admissions. The 5-year risk of IE or dying during an IE admission was calculated for each condition and compared with the entire English population as a control. Infective endocarditis incidence in the English population was 36.2/million/year. In comparison, patients with a previous history of IE had the highest risk of recurrence or dying during an IE admission [odds ratio (OR) 266 and 215, respectively]. These risks were also high in patients with prosthetic valves (OR 70 and 62) and previous valve repair (OR 77 and 60). Patients with congenital valve anomalies (currently considered ‘moderate risk’) had similar levels of risk (OR 66 and 57) and risks in other ‘moderate-risk’ conditions were not much lower. Congenital heart conditions (CHCs) repaired with prosthetic material (currently considered ‘high risk’ for 6 months following surgery) had lower risk than all ‘moderate-risk’ conditions—even in the first 6 months. Infective endocarditis risk was also significant in patients with cardiovascular implantable electronic devices. Conclusion These data confirm the high IE risk of patients with a history of previous IE, valve replacement, or repair. However, IE risk in some ‘moderate-risk’ patients was similar to that of several ‘high-risk’ conditions and higher than repaired CHC. Guidelines for the risk stratification of conditions predisposing to IE may require re-evaluation.

scholarly journals Catheter-based Closure of a Post-infective Aortic Paravalvular Pseudoaneurysm Fistula With Severe Regurgitation After Two Valve Replacement Surgeries: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Eustaquio Maria Onorato ◽  
Matteo Vercellino ◽  
Giovanni Masoero ◽  
Giovanni Monizzi ◽  
Federico Sanchez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Valve Replacement ◽  
Interventional Procedure ◽  
Multiorgan Failure ◽  
Severe Heart Failure ◽  
Mechanical Valve ◽  
Structural Heart Disease ◽  
Paravalvular Leak ◽  
Interventional Treatment ◽  
Surgical Risk

Backgsround: Infective endocarditis (IE) of prosthetic valves is a dire complication of cardiac valve replacement surgery and is associated with high rates of morbidity and mortality.Case Summary: A 72-year-old woman with multiple comorbidities underwent surgical replacement of the aortic valve with a mechanical prosthetic valve after recurrent IE. After 10 years, IE recurred and the mechanical valve was surgically replaced with a bioprosthetic valve. Ten years later, severe heart failure developed due to severe paravalvular leak (PVL) caused by an aortic annulus abscess complicated by a paravalvular pseudoaneurysm fistula (PPF). The patient was deemed at prohibitive surgical risk and a catheter-based PVL closure procedure was planned. However, the interventional procedure was delayed several months due to the Covid-19 pandemic with progressive heart failure worsening. Despite an acute satisfactory result of the PPF transcatheter closure and a significant clinical improvement, the patient died 10 months later due to multiorgan failure. It is likely that this was due, at least in part, to the long treatment delay caused by the unprecedented strain on the healthcare system.Discussion: In patients at high surgical risk, early diagnosis and prompt interventional treatment of severe PVL are crucial for improving expectancy and quality of life. However, the recent outbreak of COVID-19 caused deferral of elective and semi-elective structural heart disease procedures (SHD) as in our case. Thus, a proactive and vigilant stance on managing SHD should be a priority even in the context of the COVID-19 pandemic.

scholarly journals Supra-Annular Mitral Valve Replacement in Infants with Congenital Mitral Valve Disease

2019 ◽  
Vol 22 (5) ◽  
pp. E315-E316
Author(s):  
Haoyong Yuan ◽  
Zhongshi Wu ◽  
Yifeng Yang ◽  
Can Huang
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Early Death ◽  
Mechanical Valve ◽  
Ptfe Graft ◽  
Prosthetic Valves ◽  
Mechanical Valves ◽  
Neonates And Infants

Mitral valve replacement in infants is rare and causes a relatively high mortality, especially for patients under the age of 1. Supra-annular valve replacement is a viable technique for infants with a small valve annulus. Here, we report two infants who underwent mitral valve replacement via the supra-annular technique. The age and body weight of these babies were 2 months and 3 months and 4.1 kg and 4.7 kg, respectively. Aortic mechanical valves were reversely implanted with a short segment of PTFE graft. The purpose of this strategy was to insert a larger mechanical valve and delay resternotomy. A two-year follow-up exam showed normal ventricular function without mechanical valve-related complications. This method is useful in treating neonates and infants. Although the technique of mitral valve repair has improved over several decades, mitral valve replacement still is necessary at times. In neonates and infants with a small annulus, implantation of commercially available prosthetic valves in the annular position can be a challenge, and an age less than 1 year is a risk factor for early death [Selamet 2008]. Supra-annular mitral valve replacement (SMVR) is an alternative when a traditional annular implantation is not feasible [Sung 2008]. Herein, we report the cases of two patients, who underwent SMVR with a follow-up after two years.

scholarly journals Atypical symptoms with typical signs in a patient with Propionibacterium acnes related mitral valve endocarditis

2021 ◽  
Vol 9 (6) ◽  
pp. 1790
Author(s):  
Rashid Hameed ◽  
Noshine Irrum ◽  
Pankaj Saxena ◽  
Muntaser D. Musameh
Keyword(s):  
Infective Endocarditis ◽  
Propionibacterium Acnes ◽  
Medical Condition ◽  
Previous History ◽  
Causative Organism ◽  
Atypical Symptoms ◽  
Prosthetic Valves ◽  
History Of ◽  
Atypical Presentations ◽  
High Level

Infective endocarditis (IE) is a serious medical condition associated with an increase in morbidity and mortality if not treated promptly and adequately. The clinical outcome depends on the early diagnosis and aggressiveness of the causative organism. Patients usually present with typical features suggestive of Infective endocarditis but in some circumstances the presentations are atypical, and if not diagnosed and treated, may lead to serious consequences. We present a case of atypical presentations of infective endocarditis caused by Propionibacterium acnes organism with no classical features of endocarditis and had symptoms suggestive of urinary tract infection. The diagnosis of IE can be very difficult in patients with atypical clinical presentation, particularly caused by low-pathogenicity organisms. Appropriate clinical assessment and high level of suspicious especially in the patients with previous history of infective endocarditis or having prosthetic valves in situ is crucial.

scholarly journals A fatal case of infective endocarditis complicated by acute COVID-19 pneumonia

2021 ◽  
Vol 2021 (11-12) ◽  
Author(s):  
Anmol Pandey ◽  
William R Davies ◽  
Patrick A Calvert
Keyword(s):  
Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Infective Endocarditis ◽  
Valve Replacement ◽  
Distress Syndrome ◽  
Fatal Case ◽  
Tertiary Hospital ◽  
Optimal Timing ◽  
Intravenous Antibiotic ◽  
History Of

ABSTRACT A 74-year-old man with no co-morbidities presented to hospital with a 3-day history of diarrhoea and vomiting. He met the modified Duke’s criteria for definite infective endocarditis and was immediately started on an intravenous antibiotic. Over Days 1–9, he developed renal failure. On Day 10, he was transferred to a tertiary hospital for mitral valve replacement. However, he tested positive for SARS-CoV-2 on arrival at the tertiary hospital, which delayed his surgery. He underwent bi-weekly nasopharyngeal swabs for SARS-CoV-2 with a plan to operate as soon as he tested negative, or as soon as his incubation period for COVID-19 pneumonia had elapsed. Unfortunately, he died on Day 31 from acute respiratory distress syndrome secondary to COVID-19 pneumonia. We describe the challenges in deciding on the optimal timing for valve replacement. We conclude by suggesting that earlier valve replacement may result in better outcomes.

Abstract 14637: In-hospital Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in Patients With a History of Malignancy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jelani Grant ◽  
Bertrand Ebner ◽  
Louis Vincent ◽  
Jennifer Maning ◽  
neal olarte ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Pacemaker Implantation ◽  
Paravalvular Leak ◽  
Multivariate Logistic Regression Model ◽  
Prior History ◽  
Surgical Aortic Valve Replacement ◽  
Hospital Outcomes ◽  
History Of

Introduction: A history of malignancy is incorporated in the Society of Thoracic Surgeons (STS) Score to assess presurgical risk in patients undergoing surgical aortic valve replacement (SAVR), however data on the prognostic importance in those undergoing TAVR remains limited. Methods: The National Inpatient Sample Database was queried from 2012 to 2017 to identify patients who underwent TAVR using International Classification of Diseases (ICD) 9 and 10 procedure codes. These patients were classified into those who had a history of malignancy or not using ICD 9 and 10 diagnostic codes. Results: There were 24,615 patients who underwent TAVR, of these 4,735 patients had a prior history of malignancy whereas 19,880 patients had no prior history of malignancy. Patients with a history of malignancy were older than those without (81.1±7.9 vs. 80.1± 6.7 years old, p<0.001). Baseline characteristics are shown in Table 1. Patients with a history of malignancy had similar rates of post-TAVR pacemaker implantation (7.6% vs. 6.8%,p=0.05), deep vein thrombosis/pulmonary embolism (2.8% vs.3.1%, p=0.231), paravalvular leak (0.9% vs. 1.1%, p=0.312) and cardiogenic shock (0.3% vs. 0.3%, p=0.828) as those without. The occurrence of post TAVR ischemic strokes were higher in those without a history of malignancy ( 4.8% vs. 3.6%, p<0.001). Using a multivariate logistic regression model to adjust for confounding factors such as age, gender, hypertension, diabetes, heart failure, chronic kidney disease and coronary artery disease, a history of malignancy was predictive of decreased odds of death in patients undergoing TAVR (odds ratio: 0.69, 95% confidence interval 0.53-0.90, p=0.007). Conclusions: In patients with severe symptomatic AS and a history of malignancy, TAVR appears safe with comparable in-hospital outcomes. A history of malignancy should not preclude TAVR in patients with severe symptomatic AS, however larger studies are needed to confirm this finding.

Sign in / Sign up

Export Citation Format

Share Document