Journal of cardiology
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Journal of cardiology · Jan 1997
Comparative Study[Mitral valve remodeling using valvuloplasty, chordoplasty and ring annuloplasty].
Degenerative mitral valve disease is a major cause of mitral regurgitation and mitral valve repair has acquired greater importance as a surgical treatment of mitral regurgitation. Since 1991 we have used mitral valve repair to remodel the mitral valve leaflet, chordae tendineae and annulus. The final aim of our mitral valve remodeling technique is to correct the coaptation line of both leaflets. ⋯ Left ventricular and mitral valvular function is well preserved after mitral valve remodeling. Mitral valvular function after mitral repair exceeds that of the mitral valve replacement. Mitral valve remodeling procedures are very useful for patients with mitral regurgitation due to mitral valve prolapse.
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Journal of cardiology · Jan 1997
Case Reports[Mitral prosthetic valve replaced twice due to repeated prosthetic valve endocarditis: a case report].
A 38-year-old man was admitted to our hospital for detailed examination of fever, cough and yellow sputum. At the age of 32, be had mitral prosthesis for the first time, because of mitral regurgitation due to mitral valve prolapse. Four years previously, he had again undergone mitral prosthetic valve replacement due to prosthetic valve endocarditis due to staphylococcus epidemidis. ⋯ The diagnosis was prosthetic valve endocarditis. He underwent a third mitral prosthetic valve replacement. Detection of the source of infection was difficult only by transthoracic echocardiography, and immediate transesophageal echocardiography seemed mandatory to diagnose bacterial endocarditis.
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Journal of cardiology · Jan 1997
Case Reports[Right atrial thrombus recognized 18 years after tricuspid valve replacement: a case report].
A 53-year-old man, who had undergone tricuspid valve replacement with Hancock valve and direct closure of a ventricular septal defect when aged 34 years, was admitted with signs of right heart failure. Two-dimensional echocardiography showed bioprosthetic tricuspid valve malfunction with right atrial thrombus. He was treated by tricuspid valve replacement using a Hancock II valve and removal of the right atrial thrombus with remarkable improvement. Transesophageal echocardiography was the most useful method for recognizing the presence of right atrial thrombus and assessing its actual or potential hemodynamic effects.
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Journal of cardiology · Jan 1997
[Echocardiographic prediction of risk for embolism in patients with infective endocarditis].
The relationship between two-dimensional echocardiographic findings of vegetation and embolic events was investigated in 26 patients with infective endocarditis (17 males and 9 females, mean [+/-SD] age 51 +/- 17 years). The size and the other morphologic characteristics of vegetation (mobility, extent and consistency) were analyzed retrospectively according to the criteria by Sanfilippo, et al., and parameters were assigned scores from 1 to 4 to provide a total score. Patients with a maximum vegetation diameter > 10 min had a significantly higher incidence of embolic events than those with < or = 10 mm (p < 0.05). ⋯ There were no significant differences in the frequency of emergent valve replacement between patients with aortic value and mitral valve endocarditis. However, the incidence of heart failure was higher, but not significantly, in patients with aortic valve (67%) and combined valve endocarditis (67%) than in those with mitral valve endocarditis (36%). The maximum size and total score reflecting mobility, extent and consistency of vegetation using two-dimensional echocardiography provide useful information to predict the occurrence of embolic events in patients with infective endocarditis.
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Journal of cardiology · Jan 1997
Case Reports[A patient with mitral stenosis due to infective endocarditis].
A 51-year-old woman presented with mild stenosis of the mitral valve which had become thickened and rigid due to infective endocarditis, manifesting as persistent fever of up to 40 degrees C and general fatigue of a few days' duration. A harsh systolic murmur was heard. Multiple blood cultures revealed alpha-streptococcus. ⋯ Based on these findings, the diagnosis was hypertrophic obstructive cardiomyopathy complicated by infective endocarditis and "mitral stenosis". Valvular regurgitation is a common complication of active and healed infective endocarditis. In contrast, infective endocarditis rarely causes valvular stenosis except for stenosis caused by large fungus vegetation.