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JACC. Cardiovascular Interventions Jan 2024
Topics: Humans; Pulmonary Valve; Treatment Outcome
PubMed: 38267138
DOI: 10.1016/j.jcin.2023.12.002 -
The American Journal of Cardiology Nov 2023
Topics: Humans; Pulmonary Valve; Magnetic Resonance Angiography; Cardiovascular System; Cardiac Surgical Procedures; Transcatheter Aortic Valve Replacement; Aortic Valve; Aortic Valve Stenosis; Treatment Outcome; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation
PubMed: 37802700
DOI: 10.1016/j.amjcard.2023.09.028 -
Journal of Thoracic Imaging Jan 2016Given its inconspicuous appearance on radiography, computed tomography (CT), and magnetic resonance imaging (MRI) the pulmonary valve (PV) is often overlooked as an... (Review)
Review
Given its inconspicuous appearance on radiography, computed tomography (CT), and magnetic resonance imaging (MRI) the pulmonary valve (PV) is often overlooked as an important cause of both cardiac and pulmonary disease. In this pictorial essay, we review the normal appearance of the PV as well as various congenital anomalies including pulmonary atresia, pulmonary stenosis, and valvular fusion anomalies. Infectious entities, degenerative conditions, and malignant lesions are also depicted. We discuss surgical techniques used to repair both congenital and acquired pulmonary valvular diseases and describe postoperative appearances of the PV on imaging.
Topics: Heart Valve Diseases; Humans; Magnetic Resonance Imaging; Pulmonary Valve; Tomography, X-Ray Computed
PubMed: 26656195
DOI: 10.1097/RTI.0000000000000182 -
JACC. Cardiovascular Interventions Jan 2022
Topics: Cardiac Surgical Procedures; Heart Valve Prosthesis Implantation; Humans; Longitudinal Studies; Pulmonary Valve; Treatment Outcome
PubMed: 35057988
DOI: 10.1016/j.jcin.2021.12.001 -
Cardiovascular Pathology : the Official... 2023Fenestrations in semilunar valves of human hearts have been incidentally described during autopsies since the 1800s, and were thought to be a degenerative process of the...
Fenestrations in semilunar valves of human hearts have been incidentally described during autopsies since the 1800s, and were thought to be a degenerative process of the valve cusps. Due to the nature of autopsy, prior literature has primarily examined these fenestrations in pathologic hearts, and has implicated them in leading to valve insufficiency, regurgitation, and cusp rupture. More recent studies have predicted an increase in fenestration prevalence in the rapidly aging United States and have warned of a potential increase in fenestration-related valvular pathology. Herein, we analyze fenestration prevalence in 403 healthy human hearts and report findings that differ from these prior reports, and emphasize that fenestrations may not necessarily portend significant valvular dysfunction.
Topics: Humans; Pulmonary Valve; Aortic Valve; Heart Valve Diseases; Aorta; Autopsy; Aortic Valve Insufficiency
PubMed: 37393965
DOI: 10.1016/j.carpath.2023.107557 -
Seminars in Thoracic and Cardiovascular... 2020Valve-sparing techniques for the treatment of Tetralogy of Fallot with pulmonary stenosis have evolved over the past few decades. This article will discuss the rationale... (Review)
Review
Valve-sparing techniques for the treatment of Tetralogy of Fallot with pulmonary stenosis have evolved over the past few decades. This article will discuss the rationale for a more aggressive approach to sparing the pulmonary valve, the various techniques available (including commissurotomy, leaflet thinning and debridement, balloon dilation, and finally modified monocusp repair), as well as a systematic approach for employing these techniques based on individual patient anatomy in a manner that takes full advantages of the benefits of the valve-sparing approach while mitigating the risks involved.
Topics: Angioplasty, Balloon, Coronary; Cardiac Surgical Procedures; Cardiac Valve Annuloplasty; Child; Debridement; Echocardiography; Humans; Pulmonary Valve; Pulmonary Valve Stenosis; Tetralogy of Fallot
PubMed: 32354543
DOI: 10.1053/j.pcsu.2020.02.005 -
Journal of the American College of... Jan 2022
Topics: Cardiac Surgical Procedures; Humans; Pulmonary Valve; Tetralogy of Fallot
PubMed: 34991786
DOI: 10.1016/j.jacc.2021.10.032 -
Journal of Visualized Experiments : JoVE Aug 2021The underlying causes of heart valve related-disease (HVD) are elusive. Murine animal models provide an excellent tool for studying HVD, however, the surgical and...
The underlying causes of heart valve related-disease (HVD) are elusive. Murine animal models provide an excellent tool for studying HVD, however, the surgical and instrumental expertise required to accurately quantify the structure and organization across multiple length scales have stunted its advancement. This work provides a detailed description of the murine dissection, en bloc staining, sample processing, and correlative imaging procedures for depicting the heart valve at different length scales. Hydrostatic transvalvular pressure was used to control the temporal heterogeneity by chemically fixing the heart valve conformation. Micro-computed tomography (µCT) was used to confirm the geometry of the heart valve and provide a reference for the downstream sample processing needed for the serial block face scanning electron microscopy (SBF-SEM). High-resolution serial SEM images of the extracellular matrix (ECM) were taken and reconstructed to provide a local 3D representation of its organization. µCT and SBF-SEM imaging methods were then correlated to overcome the spatial variation across the pulmonary valve. Though the work presented is exclusively on the pulmonary valve, this methodology could be adopted for describing the hierarchical organization in biological systems and is pivotal for the structural characterization across multiple length scales.
Topics: Animals; Imaging, Three-Dimensional; Mice; Microscopy, Electron, Scanning; Pulmonary Valve; Specimen Handling; X-Ray Microtomography
PubMed: 34424247
DOI: 10.3791/62581 -
The Journal of Thoracic and... Dec 2022The Ross procedure is an excellent option for children or young adults who need aortic valve replacement because it can restore survival to that of the normal...
OBJECTIVE
The Ross procedure is an excellent option for children or young adults who need aortic valve replacement because it can restore survival to that of the normal aged-matched population. However, autograft remodeling can lead to aneurysmal formation and reoperation, and the biomechanics of this process is unknown. This study investigated postoperative autograft remodeling after the Ross procedure by examining patient-specific autograft wall stresses.
METHODS
Patients who have undergone the Ross procedure who had intraoperative pulmonary root and aortic specimens collected were recruited. Patient-specific models (n = 16) were developed using patient-specific material property and their corresponding geometry from cine magnetic resonance imaging at 1-year follow-up. Autograft ± Dacron for aneurysm repair and ascending aortic geometries were reconstructed to develop patient-specific finite element models, which incorporated material properties and wall thickness experimentally measured from biaxial stretching. A multiplicative approach was used to account for prestress geometry from in vivo magnetic resonance imaging. Pressure loading to systemic pressure (120/80) was performed using LS-DYNA software (LSTC Inc, Livermore, Calif).
RESULTS
At systole, first principal stresses were 809 kPa (25%-75% interquartile range, 691-1219 kPa), 567 kPa (485-675 kPa), 637 kPa (555-755 kPa), and 382 kPa (334-413 kPa) at the autograft sinotubular junction, sinuses, annulus, and ascending aorta, respectively. Second principal stresses were 360 kPa (310-426 kPa), 355 kPa (320-394 kPa), 272 kPa (252-319 kPa), and 184 kPa (147-222 kPa) at the autograft sinotubular junction, sinuses, annulus, and ascending aorta, respectively. Mean autograft diameters were 29.9 ± 2.7 mm, 38.3 ± 5.3 mm, and 26.6 ± 4.0 mm at the sinotubular junction, sinuses, and annulus, respectively.
CONCLUSIONS
Peak first principal stresses were mainly located at the sinotubular junction, particularly when Dacron reinforcement was used. Patient-specific simulations lay the foundation for predicting autograft dilatation in the future after understanding biomechanical behavior during long-term follow-up.
Topics: Humans; Child; Young Adult; Aged; Autografts; Transplantation, Autologous; Polyethylene Terephthalates; Aortic Valve; Aortic Valve Insufficiency; Pulmonary Valve
PubMed: 34538420
DOI: 10.1016/j.jtcvs.2021.08.058 -
The American Journal of Case Reports Feb 2019BACKGROUND Infective endocarditis (IE) has a high mortality rate, even when treated with appropriate antibiotic therapy and surgical intervention. Right-sided...
BACKGROUND Infective endocarditis (IE) has a high mortality rate, even when treated with appropriate antibiotic therapy and surgical intervention. Right-sided endocarditis is in itself rare, with some studies reporting an incidence of 5-10%. The majority of these cases involve the tricuspid valve, and isolated pulmonary valve endocarditis (PVE) is an extremely rare entity affecting less than 2% of patients with infective endocarditis. Identification and early management are crucial to prevent long-term complications and reduce mortality. CASE REPORT We present a patient with a history of essential hypertension and no underlying valvular disease, who underwent dental cleaning and subsequently developed low-grade fever, myalgia, and malaise. This occurred during the flu season, and was initially diagnosed and treated as flu, without any improvement. The patient was later found to be bacteremic with S. mitis, with no identifiable source, and a normal transthoracic echocardiogram (TTE). He was later hospitalized, had a transesophageal echocardiogram, and was found to have a large pulmonic valve vegetation. CONCLUSIONS This case presents an interesting and rare finding of endocarditis, isolated to the pulmonic valve, in an otherwise healthy individual with no predisposing risk factors. The lack of peripheral stigmata, as well as an unremarkable initial outpatient TTE, made the diagnosis more difficult. It should also be noted that current guidelines do not specifically address right-sided endocarditis, and do not specify the role of surgical intervention.
Topics: Dental Prophylaxis; Echocardiography; Endocarditis, Bacterial; Humans; Male; Middle Aged; Pulmonary Valve; Streptococcal Infections; Streptococcus mitis
PubMed: 30713335
DOI: 10.12659/AJCR.913041