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Anatolian Journal of Cardiology Apr 2020
Topics: Aneurysm; Computed Tomography Angiography; Diagnosis, Differential; Dyspnea; Humans; Male; Middle Aged; Pulmonary Artery; Pulmonary Valve Stenosis
PubMed: 32352412
DOI: 10.14744/AnatolJCardiol.2020.57598 -
Journal of Veterinary Internal Medicine 2023Pulmonary stenosis (PS) usually is evaluated using echocardiography. A multiparametric approach, in addition to the maximum pressure gradient (PG), might be indicated to...
BACKGROUND
Pulmonary stenosis (PS) usually is evaluated using echocardiography. A multiparametric approach, in addition to the maximum pressure gradient (PG), might be indicated to better characterize PS severity and address its management.
HYPOTHESIS/OBJECTIVES
Our hypothesis was that right heart size and function are associated with echocardiographic and clinical severity of pulmonary stenosis in dogs.
ANIMALS
Client-owned dogs with PS.
METHODS
Prospective, multicenter, observational study. Enrolled dogs underwent complete echocardiographic examination. Associations among right heart echocardiographic variables, PS transvalvular PG >80 mm Hg and presence of clinical signs (exercise intolerance, syncope, right-sided congestive failure, or some combination of these) were assessed using logistic regression analysis.
RESULTS
Eighty-eight dogs with PS. Twenty-eight dogs were symptomatic. Increased right ventricular end-diastolic free wall thickness (odds ratio [OR] > 100; 95% confidence interval [95%CI], 50- > 100; P = .01) and decreased aorta-to-pulmonary artery velocity time integral ratio (OR, < 0.001; 95%CI, 0.0-0.001; P = .005) were independently associated with PS PG >80 mm Hg. Decreased tricuspid annular plane systolic excursion (OR, 0.35; 95%CI, 0.15-0.77; P = .01) and increased right ventricular end-diastolic area (OR, 1.4; 95%CI, 1.08-2.02; P = .01) were independently associated with clinical severity.
CONCLUSION AND CLINICAL IMPORTANCE
Structural and functional right heart echocardiographic variables are associated with echocardiographic and clinical severity in dogs with PS. A multiparametric approach is advised to better assess PS severity.
Topics: Dogs; Animals; Prospective Studies; Echocardiography; Pulmonary Valve Stenosis; Heart Ventricles; Pulmonary Artery; Ventricular Function, Right; Dog Diseases
PubMed: 37038627
DOI: 10.1111/jvim.16679 -
BMC Veterinary Research Jul 2020Left ventricular noncompaction (LVNC) is a rare form of cardiomyopathy currently described in humans and cats. It consists of a spongy myocardium characterized by...
BACKGROUND
Left ventricular noncompaction (LVNC) is a rare form of cardiomyopathy currently described in humans and cats. It consists of a spongy myocardium characterized by prominent trabeculation and deep recesses involving more than 50% of the ventricular thickness. We describe the clinical and pathological features of LVNC combined with tricuspid valve dysplasia, double-orifice tricuspid valve and severe pulmonary stenosis in a puppy. In addition, we briefly review the LVNC causes, pathogenesis, forms and current diagnostic criteria.
CASE PRESENTATION
A seven-week-old intact German Shorthaired Pointer-cross male was presented with a poor body condition, exercise intolerance and dyspnea. Clinical exam identified a bilateral systolic murmur (grade IV/VI over the right heart base and grade III/VI over the left heart base). Echocardiography identified tricuspid valve dysplasia, mild mitral regurgitation, and severe pulmonic stenosis with a trans-valvar systolic pressure gradient of 106 mmHg. Left ventricular noncompaction was diagnosed by necropsy and further confirmed histopathologically by the presence of two distinct myocardial layers: an inner noncompacted zone covering more than 50% of ventricular thickness containing prominent trabeculation and deep recesses, and an outer zone of compact myocardium.
CONCLUSIONS
This is the first case describing LVNC in a canine patient, supporting the introduction of this form of heart disease as a differential diagnosis for cardiomyopathies in juvenile and adult dogs.
Topics: Animals; Cardiomyopathies; Dog Diseases; Dogs; Echocardiography; Heart Defects, Congenital; Heart Ventricles; Male; Pulmonary Valve Stenosis; Tricuspid Valve
PubMed: 32703195
DOI: 10.1186/s12917-020-02480-7 -
Cardiovascular Journal of Africa 2016This prospective study was planned to investigate the frequency and relationship of acquired von Willebrand syndrome (AVWS) with aortic and pulmonary stenosis in...
INTRODUCTION
This prospective study was planned to investigate the frequency and relationship of acquired von Willebrand syndrome (AVWS) with aortic and pulmonary stenosis in patients.
METHODS
A total of 84 children, ranging from two to 18 years of age, were enrolled in this study. Of these, 28 had isolated aortic stenosis, 32 had isolated pulmonary stenosis and 24 were healthy. Children with aortic and pulmonary stenosis associated with other congenital heart diseases were excluded. Children with hypothyroidism, renal or liver disease, malignancy or autoimmune disease were also excluded. Wholeblood count, blood group, factor VIII level, prothrombin time (PT), activated partial thromboplastin time (aPTT), von Willebrand factor antigen (VWF:Ag), ristocetin co-factor (VWF:RCo), and bleeding time using a platelet-function analyser (PFA-100) were performed in all patients. All of the children in the study underwent a detailed physical examination and echocardiographic evaluation.
RESULTS
A history of bleeding was positive in 18% of the aortic stenosis group, 9% of the pulmonary stenosis group, and 4% of the control group. Seven of 60 (12%) patients had laboratory findings that implied a diagnosis of AVWS, and two of these (28%) had a history of bleeding. The frequency of AVWS was 14% in patients with aortic stenosis and 9% in those with pulmonary stenosis.
CONCLUSION
AVWS is not rare in stenotic obstructive cardiac diseases. A detailed history of bleeding should be taken from patients with valvular disease. Even if the history is negative, whole blood count, PT and aPTT should be performed. If necessary, PFA-100 closure time and further tests should be planned for the diagnosis of AVWS.
Topics: Adolescent; Age Factors; Aortic Valve Stenosis; Blood Coagulation; Blood Coagulation Tests; Case-Control Studies; Child; Child, Preschool; Female; Humans; Male; Platelet Function Tests; Prognosis; Prospective Studies; Pulmonary Valve Stenosis; Turkey; von Willebrand Diseases
PubMed: 27841910
DOI: 10.5830/CVJA-2015-093 -
Journal of the American College of... Mar 2010
Topics: Adolescent; Cardiac Volume; Catheterization; Child; Child, Preschool; Exercise Test; Female; Follow-Up Studies; Humans; Hypertrophy, Right Ventricular; Infant; Male; Prospective Studies; Pulmonary Valve Insufficiency; Pulmonary Valve Stenosis; Risk Factors; Stroke Volume; Young Adult
PubMed: 20202523
DOI: 10.1016/j.jacc.2010.01.017 -
Clinical Cardiology Jan 1995Little morphologic information is available on operatively excised pulmonic valves. The causes of pulmonic stenosis are limited to a few conditions: (1) rheumatic and... (Review)
Review
Little morphologic information is available on operatively excised pulmonic valves. The causes of pulmonic stenosis are limited to a few conditions: (1) rheumatic and (2) nonrheumatic (congenital, carcinoid, infective endocarditis). Congenital causes of pulmonic stenosis constitute well over 95% of these conditions. Congenital types of pulmonic stenosis include acommissural dome-shaped, dysplastic, and bicuspid. Rare acquired causes of pulmonic stenosis include carcinoid, rheumatic, and infective endocarditis. Of the acquired causes of pulmonic stenosis, carcinoid is the most common condition. In contrast, causes of pure pulmonic regurgitation are multiple. Two major categories of pure pulmonic regurgitation include (1) conditions associated with anatomically abnormal valve cusps (congenital, rheumatic, carcinoid, trauma, and infective endocarditis) and (2) conditions associated with anatomically normal cusps (elevated pulmonary artery systolic pressures, idiopathic dilated pulmonary trunk, and Marfan's syndrome).
Topics: Humans; Pulmonary Valve; Pulmonary Valve Insufficiency; Pulmonary Valve Stenosis
PubMed: 7704986
DOI: 10.1002/clc.4960180112 -
La Tunisie Medicale Feb 2021Balloon Valvuloplasty is the first-line treatment for congenital valve pulmonary stenosis (PS) in children and adults.
INTRODUCTION
Balloon Valvuloplasty is the first-line treatment for congenital valve pulmonary stenosis (PS) in children and adults.
METHODS
We reported immediate results of balloon valvuloplasty in congenital pulmonary stenosis from 2014 to 2019.
RESULTS
BPV was performed in 40 patients, the diagnosis was based on cardiac ultrasound data showing valvular dysplasia in 92% of cases, the main associated anomaly is FOP in 22.5% of cases, immediate success (defined by a peak-to-peak gradient after the DPPC of less than 50mmHg) was found in 88% of cases, allowing a significant reduction in mean peak to peak pressure among pulmonary valve from 69.65mmHg to 30.19mmHg. After BV 11% of patients maintained a high gradient, the independent predictive factors were valvular dysplasia and the small diameter of the ring an immediate post procedural infundibular reaction was noted in 25% of cases mainly related to valvular dysplasia. The mortality of the procedure was zero and morbidity was low. mild pulmonary regurgitation was found in all patients.
CONCLUSION
PV has been established as the treatment of choice for valvular PR with few complications. Following its satisfactory immediate results, the indications quickly extended to critical pulmonary stenosis in newborns and late discovery forms in adults.
Topics: Adult; Balloon Valvuloplasty; Child; Follow-Up Studies; Humans; Infant, Newborn; Pulmonary Valve; Pulmonary Valve Stenosis; Treatment Outcome
PubMed: 33899201
DOI: No ID Found -
Thorax Jul 1970Four cases of pulmonary artery stenosis resulting from extrinsic pressure are presented. All of these cases presented with the triad of chest pain, dyspnoea, and a...
Four cases of pulmonary artery stenosis resulting from extrinsic pressure are presented. All of these cases presented with the triad of chest pain, dyspnoea, and a pulmonary systolic murmur. Respiratory variation of this murmur was noted in three of the patients, the murmur increasing during expiration and diminishing or disappearing during inspiration. It is suggested that this may be a useful sign in diagnosing this syndrome. The tumour in these four cases was an intrapericardial sarcoma, a benign teratoma, Hodgkin's disease, and a malignant thymoma respectively.
Topics: Adult; Angiocardiography; Dyspnea; Female; Heart Neoplasms; Hodgkin Disease; Humans; Male; Mediastinal Neoplasms; Phonocardiography; Pressure; Pulmonary Valve Stenosis; Sarcoma; Teratoma; Thymoma; Thymus Neoplasms
PubMed: 5485008
DOI: 10.1136/thx.25.4.465 -
Multimedia Manual of Cardiothoracic... Aug 2023Left transposition of the great arteries with inlet ventricular septal defect and pulmonary stenosis is a relatively uncommon cardiac malformation. Two surgical...
Triple switch' aortic and pulmonary root inversion and modified Senning procedure for anatomically complex left transposition of the great arteries with inlet ventricular septal defect and pulmonary stenosis.
Left transposition of the great arteries with inlet ventricular septal defect and pulmonary stenosis is a relatively uncommon cardiac malformation. Two surgical treatments are available: double switch or physiological correction. The choice of surgical technique depends on the results of a discussion between the family and the surgeon. Choosing the appropriate technique is challenging because all options present various complications and benefits. We present a 'triple switch' aortic and pulmonary root inversion and modified Senning procedure for an anatomically complex left transposition of the great arteries with an inlet ventricular septal defect and pulmonary stenosis.
Topics: Humans; Infant; Arterial Switch Operation; Transposition of Great Vessels; Bays; Aorta; Pulmonary Valve Stenosis; Heart Septal Defects, Ventricular
PubMed: 37584208
DOI: 10.1510/mmcts.2023.060 -
Archives of Cardiovascular Diseases Apr 2017The Ross procedure is used in the treatment of selected patients with aortic valve disease. Pulmonary graft stenosis can appear in the long-term follow-up after the Ross... (Observational Study)
Observational Study
BACKGROUND
The Ross procedure is used in the treatment of selected patients with aortic valve disease. Pulmonary graft stenosis can appear in the long-term follow-up after the Ross intervention, but the factors involved and its clinical implications are not fully known.
AIM
To describe the incidence, clinical impact and predictors of homograft stenosis and reintervention after the Ross procedure in a prospective series in a tertiary referral hospital.
METHODS
From 1997 to 2009, 107 patients underwent the Ross procedure (mean age: 30±11 years; 69% men; 21 aged<18 years), and were followed for echocardiographic homograft stenosis (peak gradient>36mmHg) and surgical or percutaneous homograft reintervention.
RESULTS
After 15 years of follow-up (median: 11 years), echocardiographic and clinical data were available in 91 (85%) and 104 (98%) patients, respectively: 26/91 (29%) patients developed homograft stenosis; 10/104 (10%) patients underwent 13 homograft reintervention procedures (three patients underwent surgical replacement, three received a percutaneous pulmonary valve and one needed stent implantation). The other three patients underwent two consecutive procedures in follow-up; one died because of a procedure-related myocardial infarction. Rates of survival free from homograft stenosis and reintervention at 1, 5 and 10 years were 96%, 82% and 75% and 99%, 94% and 91%, respectively. Paediatric patients had worse survival free from homograft stenosis (hazard ratio [HR] 3.50, 95% confidence interval [CI]: 1.56-7.90; P=0.002), although there were no significant differences regarding reintervention (HR: 2.01, 95% CI: 0.52-7.78; P=0.31). Younger age of homograft donor was also a stenosis predictor (HR: 0.97, 95% CI: 0.94-0.99; P=0.046).
CONCLUSIONS
The probabilities of homograft stenosis and reintervention 10 years after the Ross procedure were 29% and 10%, respectively; only one patient had a reintervention-related death. Younger donor and recipient age were associated with a higher rate of stenosis.
Topics: Adolescent; Adult; Age Factors; Allografts; Aortic Valve; Aortic Valve Stenosis; Child; Child, Preschool; Disease-Free Survival; Echocardiography; Female; Heart Valve Prosthesis Implantation; Humans; Incidence; Kaplan-Meier Estimate; Longitudinal Studies; Male; Middle Aged; Multivariate Analysis; Proportional Hazards Models; Prospective Studies; Pulmonary Valve; Pulmonary Valve Stenosis; Risk Factors; Severity of Illness Index; Spain; Tertiary Care Centers; Time Factors; Treatment Outcome; Young Adult
PubMed: 28043783
DOI: 10.1016/j.acvd.2016.09.008