scholarly journals A Rare Case of Aortic Valve Thrombosis in Patient with Idiopathic Hypereosinophilic Syndrome

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Elisabetta Grolla ◽  
Michele Dalla Vestra ◽  
Luca Bonanni ◽  
Ada Cutolo ◽  
Fausto Rigo
Keyword(s):  
Aortic Valve ◽  
Hypereosinophilic Syndrome ◽  
Organ System ◽  
Idiopathic Hypereosinophilic Syndrome ◽  
Thromboembolic Complications ◽  
Native Valve ◽  
Prosthetic Valves ◽  
Common Causes ◽  
Valve Thrombosis ◽  
Cardiac Ventricles

Idiopathic hypereosinophilic syndrome (HES) is characterized by persistent eosinophilia and eosinophil-mediated organ-system damage. Cardiac thrombosis and thromboembolic complications represent common causes of morbidity and mortality and usually involve cardiac ventricles or mitral and prosthetic valves, while the involvement of the aortic valve is extremely rare in HES. Here we report peculiar multimodality images of an atypical case of extended thrombosis of the aortic valve, complicated by myocardial ischemia and asymptomatic cerebral ischemia, likely due to thrombus embolization, occurring in a 48-year-old man with HES. Prompt anticoagulant and steroid therapy lead to rapid and complete resolution of the thrombotic lesions, allowing preserving the native valve and preventing further embolic events.

scholarly journals 501 A common finding with an atypical (rare) presentation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J Rigueira ◽  
N Cunha ◽  
R Ferreira ◽  
M Rodrigues ◽  
J Silva ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Left Ventricle ◽  
Cardiac Involvement ◽  
Hypereosinophilic Syndrome ◽  
Previous History ◽  
Common Finding ◽  
Normal Range ◽  
Native Aortic Valve ◽  
Valve Thrombosis ◽  
Intracardiac Masses

Abstract Introduction Hypereosinophilic syndrome (HES) is characterized by persistent eosinophilia and eosinophil-mediated organ damage. Cardiac thrombosis and thromboembolic complications are common causes of morbidity and mortality in these patients. The echocardiogram is the first method of image in the assessment of cardiac involvement by HES. Clinical Case An 81 year-old male, with previous history of hypereosinophilia under investigation without specific treatment, presented to the emergency department after several episodes of syncope and exertional dyspnea. The patient denied fever. He was hemodynamically stable and had a holosystolic murmur (III/VI) audible in the entire precordium. The ECG was normal. The blood tests showed leukocytosis (26.69 x10^9/L) mainly related to hypereosinophilia (17.5 x10^9/L), thrombocytopenia (134.000/uL), elevation of troponin (hsTnT= 276 ng/L, normal range <14) and reactive C-protein (3.27mg/dL, normal range <0.5). The transthoracic echocardiogram (limited for the acoustic window) showed a mass in the aortic valve with obstruction of the left ventricle outflow tract (LVOT) during systole (maximum velocity= 3.85m/s, maximum gradient = 59mmHg, mean gradient = 31mmHg), moderate mitral regurgitation, left ventricle hypertrophy with normal ejection fraction and mild pericardial effusion. A transesophageal echo (TEE) was performed confirming the presence of a hyperechogenic sessile mass, with irregular contours, measuring 23x30 mm, attached to the aortic valve causing obstruction of the LVOT (Figure 1 A and B – TEE midesophageal long axis in diastole and systole, respectively; C and D - TEE midesophageal short axis in diastole and systole, respectively). The patient was submitted to emergent cardiac surgery for excision of the mass and aortic valve replacement (Figure 1E and F- intraoperative and macroscopic views of the mass, respectively). The anatomopathological diagnosis confirmed an aortic valve thrombus. Discussion/Conclusion: Native aortic valve thrombosis is a rare situation with severe complications like acute myocardial infarction, peripheral ischemia, stroke, cardiogenic shock and sudden death. In HES, cardiac involvement is present in up to 40-50% of patients, mainly with endomyocardial fibrosis and mural thrombus formation. Native and prosthetic mitral valve thrombosis has also been described, but aortic valve involvement is very unusual. Thrombi are one of the most common intracardiac masses, but here we present a rare case of native aortic valve thrombosis with high risk of sudden cardiac death, possibly related to HES. The echocardiogram, particularly the transesophageal echo was essential for the identification of the mass and surgical planning, but as usual in intracardiac masses, the final diagnosis was histological. Abstract 501 Figure.

scholarly journals 1075. A Retrospective Comparison of Native Valve Endocarditis and Prosthetic Valve Endocarditis in a Large Tertiary Care Teaching Hospital From 2007 to 2015

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S322-S322
Author(s):  
Hoi Yee Annie Lo ◽  
Anahita Mostaghim ◽  
Nancy Khardori
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Aortic Valve ◽  
Teaching Hospital ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Native Valve ◽  
Prosthetic Valves ◽  
Dental Procedures ◽  
History Of

Abstract Background Studies comparing native valve and prosthetic valve endocarditis (NVE and PVE) have mixed findings on the risk factors and outcomes between the two cohorts. This retrospective review of infective endocarditis (IE) at a teaching hospital in the United States aims to compare the clinical and microbiological features between NVE and PVE. Methods Patients were retrospectively identified from 2007 to 2015 using appropriate IE-related ICD-9 codes. Cases that met definite Modified Duke Criteria for IE were further classified as either PVE or NVE, and were reviewed for epidemiology, causative organism(s), affected valves and associations, risk factors, dental procedures in the past 6 months, and 30-day mortality. Results A total of 363 admissions met criteria for definite endocarditis, with 261 NVE cases and 59 PVE cases. Forty-three cases that were either associated with an infection involving both native and prosthetic valves or intracardiac devices were omitted from this study. Most risk factors, such as hemodialysis and intravenous drug use, did not show any significant difference amongst the two groups. IE involving the aortic valve as well as a previous history of IE were more likely to be seen in PVE (both P < 0.0001). Dental procedures done in the preceding 6 months before IE admission were more likely to be associated with PVE than NVE (P = 0.0043). PVE showed a higher likelihood of 30-day mortality compared with NVE (P = 0.067). The causative organisms of PVE were more likely to be caused by common gut pathogens such as Klebsiella and Enterobacter species. Conclusion PVE cases had a significantly higher chance of involving the aortic valve as well as having a history of IE. PVE cases were also significantly more likely to be associated with a dental procedure done in the preceding 6 months than with the NVE cases. This implies that patients with prosthetic valves, who are currently covered under the 2007 AHA guidelines to receive prophylaxis prior to dental procedures, are still at a high risk of developing PVE. It may be prudent to reconsider adding a post-procedure dose of antibiotics, instead of a single preprocedure dose, to extend the protection of this high-risk population with prosthetic valves. Furthermore, PVE cases showed higher rates of 30-day mortality compared with NVE with near significance, which is likely multifactorial. Disclosures All authors: No reported disclosures.

Regressive Aortic Valve and Infundibular Tumors During Idiopathic Hypereosinophilic Syndrome

2005 ◽  
Vol 18 (7) ◽  
pp. 772a ◽  
Author(s):  
Claire Dauphin ◽  
Pascal Motreff ◽  
Marc Ruivard ◽  
Virginie Rieu ◽  
Jean-Jacques Cloix ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Hypereosinophilic Syndrome ◽  
Idiopathic Hypereosinophilic Syndrome

Early Postoperative Thrombosis of Pericardial Xenograft Aortic Valve

2000 ◽  
Vol 8 (1) ◽  
pp. 50-51 ◽  
Author(s):  
Carlos-A Mestres ◽  
F Javier García-Real ◽  
Manuel Fuentes
Keyword(s):  
Aortic Valve ◽  
Thromboembolic Complications ◽  
Valve Thrombosis ◽  
Postoperative Thrombosis

Thromboembolic complications and valve thrombosis in pericardial xenografts are rare. A case of early postoperative thrombosis of a pericardial xenograft is described.

INVESTIGATION OF LEAFLET GEOMETRY IN A PERCUTANEOUS AORTIC VALVE WITH THE USE OF FLUID-STRUCTURE INTERACTION SIMULATION

2012 ◽  
Vol 12 (01) ◽  
pp. 1250003 ◽  
Author(s):  
K. H. J. VAN ASWEGEN ◽  
A. N. SMUTS ◽  
C. SCHEFFER ◽  
H. S. VH. WEICH ◽  
A. F. DOUBELL
Keyword(s):  
Aortic Valve ◽  
Fluid Structure Interaction ◽  
Von Mises Stress ◽  
Aortic Valves ◽  
Native Valve ◽  
Fluid Structure ◽  
Structure Interaction ◽  
Prosthetic Valves ◽  
Significant Difference ◽  
Von Mises

Prosthetic aortic valves have been used for the replacement of dysfunctional native aortic valves in humans for more than fifty years. Current prosthetic valves have significant limitations and the development of improved aortic valve prostheses remains an important research focus area. This paper investigates one of the newer additions to the family of replacement valves, namely the stented percutaneous valve. An important design aspect of stented percutaneous valves, is the configuration of the leaflet's attachment to the surrounding stent. There are essentially two possible configurations: The first method is attaching the leaflets in a straight configuration, and the second method is to attach the leaflets in a curved configuration. Finite element models of both configurations were created, and the behavior of these configurations was then studied using a fluid-structure interaction (FSI) simulation. The FSI simulation was validated by means of comparing simulation results to actual measurements from a pulse duplicator using prototype valves of both configurations. The FSI results showed no significant difference between the valves' opening and closing behaviors. The von Mises stress distributions proved to be the largest differentiating and decisive factor between the two valves. The FSI simulations did however show that the leaflets that are attached in the straight configuration form folds that resembles that of the curved configuration as well as the native valve, but to a larger scale. The effect that these folds might have on valve tissue fatigue leaves room for future investigation.

Idiopathic Hypereosinophilic Syndrome Involving the Liver: CT Features vs. Peripheral Eosinophilia

1997 ◽  
Vol 37 (4) ◽  
pp. 673 ◽  
Author(s):  
Kyung Sook Kim ◽  
Moon Gyu Lee ◽  
Young Chul Won ◽  
Eun Hye Lee ◽  
Han Na Noh ◽  
...  
Keyword(s):  
Hypereosinophilic Syndrome ◽  
Idiopathic Hypereosinophilic Syndrome ◽  
Peripheral Eosinophilia ◽  
Liver Ct ◽  
Ct Features

scholarly journals Corynebacterium jeikeium native valve infective endocarditis case report: a confirmed microbiological and pathological diagnosis from heart valvular tissue

2020 ◽  
Author(s):  
Wentzel Bruce Dowling ◽  
Johan Koen
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Penicillin G ◽  
Peripheral Vascular ◽  
Native Valve ◽  
Valve Tissue ◽  
Case Summary ◽  
Duke Criteria ◽  
G Prior ◽  
Initial Blood

Abstract Background The Modified Duke criteria is an important structured schematic for the diagnosis of infective endocarditis (IE). Corynebacterium jeikeium is a rare cause of IE that is often resistant to standard IE anti-microbials. We present a case of C. jeikeium IE, fulfilling the Modified Duke pathological criteria. Case summary A 50-year-old male presented with left leg peripheral vascular disease with septic changes requiring amputation. Routine echocardiography post-amputation demonstrated severe aortic valve regurgitation with vegetations that required valve replacement. Two initial blood cultures from a single venepuncture showed Streptococcus mitis which was treated with penicillin G prior to surgery. Subsequent aortic valve tissue cultured C. jeikeium with suggestive IE histological valvular changes and was successfully treated on a prolonged course of vancomycin. Discussion This is the first C. jeikeium IE case diagnosed on heart valvular tissue culture and highlights the importance for the fulfilment of the Modified Duke criteria in diagnosing left-sided IE. Mixed infection IE is rare, and this case possibly represents an unmasking of resistant C. jeikeium IE following initial treatment of penicillin G.

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