International heart journal
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Traumatic tricuspid regurgitation is a rare and progressive disease. Early diagnosis and surgical valve repair are very important. A 57-year-old male was referred to our hospital with a history of blunt chest trauma. ⋯ At 3-month follow-up, the right ventricle was decreased in size with significantly improved right ventricular function. The signs and symptoms of right heart failure were relieved. In this case, 3-dimensional transthoracic echocardiography enabled fast and non-invasive evaluation of the spatial destruction of the tricuspid valve and subvalvular apparatus to assist in the planning of valve repair.
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Previous studies have identified high on treatment platelet reactivity (HTPR) as a potent factor predicting ischemic events for patients with coronary heart disease. We assessed the efficacy and safety of ticagrelor (90 mg twice-daily) and double-dose of clopidogrel (150 mg once-daily) among Chinese patients for elective percutaneous coronary intervention. We enrolled 40 patients with HTPR from among 317 patients with non-ST-segment elevation acute coronary syndromes after a successful elective percutaneous coronary intervention (PCI). ⋯ During the 30-day follow-up, no MACE occurred in any patient, and the overall risk of bleeding showed no difference between the two groups (35% versus 21%, P = 0.48). Our results suggest that ticagrelor may achieve a more rapid and greater platelet inhibition than double-dose clopidogrel. Further studies are still needed to assess the differences in efficacy and safety between ticagrelor and double-dose clopidogrel administration for Chinese patients post elective PCI.
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This study aimed to evaluate the clinical characteristics and surgical treatment of bicuspid aortic valve (BAV) infective endocarditis (IE) compared with tricuspid aortic valve (TAV) IE in China. The relevant pre-, intra- and post-operative materials of all IE patients undergoing cardiac surgery in our center between January 2003 and December 2012 were investigated and analyzed retrospectively. From January 2003 to December 2012, 345 consecutive IE patients received surgery in our center. ⋯ BAV is common in patients with confirmed aortic valve IE. BAV IE patients have a significantly increased risk of perivalvular abscess. Prompt diagnosis and timely surgery for BAV IE patients might be needed to prevent the formation and extension of perivalvular abscess.
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The pathophysiology of congenital heart disease includes aortic dilation and increased stiffness. However, the clinical determinants and significance remain unclear in patients after the Fontan operation. Size and stiffness index (SI) of the ascending and descending aorta (aAO and dAO, respectively) were assessed using angiography in 130 consecutive Fontan patients and 30 age-matched controls. ⋯ Furthermore, in addition to age at Fontan operation and BNP level, the aAO SI independently predicted a lower peak oxygen uptake (P < 0.05). Fontan patients have a stiffer dilated aAO with rapidly tapering smaller dAO that predicts exercise pathophysiology. In addition to intrinsic aortic structural abnormalities, heart failure severities as well as traditional cardiovascular risk factors are also involved in the aortic structural and functional abnormalities.
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Traumatic ventricular septal defect (VSD) resulting from chest trauma, either penetrating or blunt, is a relatively rare occurrence. Herein, we describe the case of a previously healthy 26-year-old man who presented with congestive heart failure, which was secondary to a large traumatic VSD following violent blunt chest trauma. ⋯ Post-device closure, however, the patient developed severe intravascular hemolysis refractory to medical treatment. The patient subsequently underwent surgical removal of the Amplatzer device, with concomitant VSD patch closure.