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Journal of Artificial Organs : the... Jun 2012Based on a single hospital experience of heart valve implantation from 1965 to 2009, the superiority of prosthetic heart valves including Starr-Edwards caged ball... (Review)
Review
Based on a single hospital experience of heart valve implantation from 1965 to 2009, the superiority of prosthetic heart valves including Starr-Edwards caged ball valves, Omniscience aortic tilting disc valves, and St. Jude Medical bileaflet valves are reviewed. This review discusses the prominent antithrombogenicity of the Starr-Edwards model 1200 aortic prosthesis under selected conditions, the relatively rarely thrombosed (despite its decreased opening angle) Omniscience aortic valve, the long-term outcomes 10 as well as 30 years after St. Jude Medical valve replacement, and finally the latest results on the significance of patient-aortic prosthesis mismatch in relation to myocardial hypertrophy. The findings described here should be considered in further investigations of cardiac valve prostheses.
Topics: Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Heart Valves; Humans; Japan; Prosthesis Design
PubMed: 22527975
DOI: 10.1007/s10047-012-0637-5 -
Anatolian Journal of Cardiology Dec 2016Prosthetic valve thrombosis is one of the major causes of primary valve failure, which can be life-threatening. Multimodality imaging is necessary for determination of... (Review)
Review
Prosthetic valve thrombosis is one of the major causes of primary valve failure, which can be life-threatening. Multimodality imaging is necessary for determination of leaflet immobilization, cause of underlying pathology (thrombus versus pannus or both), and whether thrombolytic therapy attempt in the patient would be successful or surgery is needed. Current guidelines for the management of prosthetic valve thrombosis lack definitive class I recommendations due to lack of randomized controlled trials, and usually leave the choice of treatment to the clinician's experience. In this review, we aimed to summarize the pathogenesis, diagnosis, and management of mechanical prosthetic valve thrombosis.
Topics: Heart Valve Diseases; Heart Valve Prosthesis; Heart Valves; Humans; Mitral Valve; Thrombolytic Therapy; Thrombosis
PubMed: 28005024
DOI: 10.14744/AnatolJCardiol.2016.7486 -
Neurology India 2023
Topics: Humans; Heart Valve Prosthesis; Anticoagulants; Heart Valves
PubMed: 38174484
DOI: 10.4103/0028-3886.391345 -
EuroIntervention : Journal of EuroPCR... Apr 2020
Topics: Cardiovascular System; Heart Valve Diseases; Heart Valve Prosthesis; Heart Valves; Humans
PubMed: 32301712
DOI: 10.4244/EIJV15I17A272 -
Current Problems in Cardiology Jun 1992
Review
Topics: Bioprosthesis; Follow-Up Studies; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Postoperative Complications; Prosthesis Design; Prosthesis Failure; Survival Rate
PubMed: 1499328
DOI: No ID Found -
Circulation Jan 2008
Review
Topics: Algorithms; Bioprosthesis; Heart Valve Prosthesis; Humans; Practice Guidelines as Topic; Reoperation; Societies, Medical; Survival Rate
PubMed: 18195186
DOI: 10.1161/CIRCULATIONAHA.107.736819 -
Clinical Imaging Aug 2023Prosthetic heart valve (PHV) dysfunction is a serious complication. Echocardiography remains the first-line imaging investigation to assess PHV dysfunction. However, the...
BACKGROUND
Prosthetic heart valve (PHV) dysfunction is a serious complication. Echocardiography remains the first-line imaging investigation to assess PHV dysfunction. However, the role of Computed Tomography (CT) scanning in this type of case has not been thoroughly studied yet. The objective of our study was to determine if cardiac Computed Tomography (CT) had a potentially complementary role to play alongside echocardiography in diagnosing the mechanism of prosthetic valve dysfunction.
METHODS AND RESULTS
This prospective cohort study was conducted on 54 patients with suspected PHV dysfunction. All patients underwent routine diagnosis work-up (transthoracic and transesophageal echocardiography) and additional cardiac CT. Cardiac CT showed findings that were not detected by echocardiography in seven patients (12%) namely aortic pannus (5) and pseudoaneurysm (2). An underlying thrombus was detected by echocardiography and missed by cardiac CT in 15 patients (27%). However, in these thrombotic cases, cardiac CT contributed to the functional evaluation of leaflets.
CONCLUSION
This study demonstrates that an integrated approach including transthoracic, transesophageal echocardiography and computed tomography is useful in patients with suspected PHV dysfunction. While computed tomography is more accurate in the diagnosis of pannus formation and periannular complications, echocardiography is superior at detecting thrombus.
Topics: Humans; Heart Valve Prosthesis; Prospective Studies; Tomography; Echocardiography, Transesophageal; Thrombosis; Heart Valves; Prosthesis Failure
PubMed: 37146521
DOI: 10.1016/j.clinimag.2023.02.011 -
American Heart Journal Feb 1994
Review
Topics: Fibrinolytic Agents; Heart Valve Prosthesis; Heart Valves; Humans; Thromboembolism
PubMed: 8296709
DOI: 10.1016/0002-8703(94)90131-7 -
Journal of Thrombosis and Thrombolysis Apr 2006Valvular thrombosis is a serious complication in patients with prosthetic heart valves. Traditional treatment is emergency surgery, but thrombolysis provides a non... (Review)
Review
BACKGROUND AND OBJECTIVES
Valvular thrombosis is a serious complication in patients with prosthetic heart valves. Traditional treatment is emergency surgery, but thrombolysis provides a non invasive alternative. In this paper we evaluate the efficacy and safety of thrombolysis in prosthetic heart valve thrombosis.
METHODS
Data of 68 patients diagnosed of prosthetic valve thrombosis, treated at the Institute of Cardiology and Cardiovascular Surgery, Havana during a 6-years period were analyzed. They received thrombolysis with a recombinant streptokinase infusion at 250,000 IU in 30 minutes followed by 100,000 IU/hour during 72 hours or less if the thrombosis resolved before. The evaluation was based on clinical and echocardiographic findings.
RESULTS
Affected sites were mitral (50 cases), tricuspid (9), and aortic (9). Mean time of prosthesis implantation was 6.8 years. The presentation form was generally heart failure (NYHA functional class III-IV) in 64 (94.1%) patients. Mean time interval between onset of symptoms and diagnosis was 10.6 days. There was total response to treatment in 58 (85.3%) patients, partial in 4 (5.9%) and failure in 6 (8.8%). Recombinant streptokinase overall dose was 5.1 x 10(6) IU and mean infusion time 50 hours. Major hemorrhagic complications were observed in two patients. Five embolic events occurred during thrombolysis. Four patients died. Rethrombosis was noted in 11 patients; 10 were retreated successfully with thrombolysis.
CONCLUSIONS
Thrombolysis with recombinant streptokinase is efficacious and safe for the treatment of prosthetic heart valve thrombosis. It does not contraindicate surgical treatment if there is no total response, because patient goes to surgery in better hemodynamic conditions with lower risk. Nowadays it can be considered as first-line treatment in all patients with prosthetic heart valve thrombosis regardless of functional class unless specific contraindications exist.
Topics: Adolescent; Adult; Aged; Female; Fibrinolytic Agents; Heart Valve Prosthesis; Humans; Male; Middle Aged; Streptokinase; Thrombolytic Therapy; Thrombosis
PubMed: 16622616
DOI: 10.1007/s11239-006-4969-y -
Journal of Medical Engineering &... Feb 2020In this study, we describe the design, fabrication and computational testing of a new prosthetic device for aortic valve replacement. The device is an active stent...
In this study, we describe the design, fabrication and computational testing of a new prosthetic device for aortic valve replacement. The device is an active stent composed of a silicone rubber during initial prototyping, with adaptation towards a hydrogel, poly-vinyl alcohol reinforced with bacterial cellulose nanofibres underway. The nature of the stent is soft robotic (SR), where an increase in internal pressure of the pneumatic network causes an increase in the internal diameter of the device. When working in tandem with the SR heart valve, described briefly, pulsations of the blood and the energy gained from ventricular pressure actuates the valve-and-stent combination. This increases the effective orifice area of the entire device and addresses an issue with small sized heart valves facing prosthesis-patient mismatch.
Topics: Aortic Valve; Female; Heart Valve Prosthesis; Humans; Male; Prosthesis Design; Robotics; Stents
PubMed: 32090661
DOI: 10.1080/03091902.2020.1723728