Identification of mechanical prosthetic heart valves based on distinctive cinefluoroscopic and echocardiographic markers

2019 ◽  
Vol 42 (11) ◽  
pp. 603-610 ◽  
Author(s):  
Macit Kalçık ◽  
Ahmet Güner ◽  
Mahmut Yesin ◽  
Emrah Bayam ◽  
Semih Kalkan ◽  
...  
Keyword(s):  
Transesophageal Echocardiography ◽  
Heart Valve ◽  
Prosthetic Valve ◽  
Heart Valves ◽  
Large Body ◽  
Mechanical Heart Valve ◽  
Three Dimensional ◽  
Prosthetic Heart Valves ◽  
Mechanical Prostheses ◽  
Valve Prostheses

The past 65 years have witnessed remarkable progress in the development of safe, hemodynamically favorable mechanical heart valves. Today, there are a large number and variety of prostheses in use and many prostheses have been used for a while and then discontinued. When patients lack reliable information about their heart valve prostheses, identification of valve model becomes difficult even for specialized physicians in this area. A combination of cinefluoroscopy and echocardiography makes it possible to provide accurate and detailed information regarding identification of prosthetic valve models. Fluoroscopic examination is a useful technique to evaluate patients following mechanical heart valve replacement. However, transthoracic echocardiography and transesophageal echocardiography have almost replaced cinefluoroscopy in the evaluation of prosthetic heart valves. Especially, real-time three-dimensional transesophageal echocardiography provides distinctive images of prosthetic heart valves, particularly for those in the mitral position. A large body of literature has been published to familiarize physicians with the radiological appearance of numerous mechanical prostheses. However, there is a lack of data regarding the identification of prosthetic valve models based on echocardiographic appearance. In this review, we aimed to describe distinctive echocardiographic and cinefluoroscopic markers for identifying the type and brand of several commonly used mechanical prosthetic heart valves.

scholarly journals Prophylaxis of thrombotic complications in a pregnant patients with prosthetic heart valves

2012 ◽  
Vol 61 (5) ◽  
pp. 10-24
Author(s):  
Aleksandr Davidovich Makatsariya ◽  
Viktoriya Omarovna Bitsadze ◽  
Dzhamilya Khizriyevna Khizroyeva ◽  
Vyacheslav Borisovich Nemirovskiy ◽  
Svetlana Vladimirovna Akinshina
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Anticoagulation Therapy ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valves ◽  
Dose Selection ◽  
Heart Valve Prostheses ◽  
Adequate Dose ◽  
Thrombotic Complications ◽  
Valve Prostheses

In patients with prosthetic heart valves pregnancy and labor are associated with high risk. There are no established anticoagulation guidelines in pregnant women with mechanical heart valve prostheses. More often physiological hypercoagulable state during pregnancy can reveal acquired and/or inherited hemostasis abnormalities which were asymptotic before pregnancy. The presence in the history of patients the foetal loss syndrome, severe obstetric complications (severe preeclampsia, abruptio placenta, antenatal fetal death, feto-placental insufficiency), thrombosis events is an indication for the screening for genetic thrombophilia and antiphospholipid syndrome. The diagnosis of thrombophilia in patients with mechanical heart valve prostheses can explain the inefficiency of anticoagulation therapy, warfarin resistance, «floating» hemostasis markers and difficulties in adequate dose selection

scholarly journals Hemodynamic Performance of Dysfunctional Prosthetic Heart Valve with the Concomitant Presence of Subaortic Stenosis: In Silico Study

2020 ◽  
Vol 7 (3) ◽  
pp. 90
Author(s):  
Othman Smadi ◽  
Anas Abdelkarim ◽  
Samer Awad ◽  
Thakir D. Almomani
Keyword(s):  
Early Detection ◽  
Heart Valve ◽  
Heart Valves ◽  
Cfd Simulation ◽  
Treatment Plan ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
Subaortic Stenosis ◽  
Prosthetic Heart Valves ◽  
The Impact

The prosthetic heart valve is vulnerable to dysfunction after surgery, thus a frequent assessment is required. Doppler electrocardiography and its quantitative parameters are commonly used to assess the performance of the prosthetic heart valves and provide detailed information on the interaction between the heart chambers and related prosthetic valves, allowing early detection of complications. However, in the case of the presence of subaortic stenosis, the accuracy of Doppler has not been fully investigated in previous studies and guidelines. Therefore, it is important to evaluate the accuracy of the parameters in such cases to get early detection, and a proper treatment plan for the patient, at the right time. In the current study, a CFD simulation was performed for the blood flow through a Bileaflet Mechanical Heart Valve (BMHV) with concomitant obstruction in the Left Ventricle Outflow Tract (LVOT). The current study explores the impact of the presence of the subaortic on flow patterns. It also investigates the accuracy of (BMHV) evaluation using Doppler parameters, as proposed in the American Society of Echocardiography (ASE) guidelines.

scholarly journals Stereoscopic PIV of Steady Flow Through a Bileaflet Mechanical Heart Valve

2008 ◽  
Author(s):  
C. Hutchison ◽  
P. E. Sullivan ◽  
C. R. Ethier
Keyword(s):  
Steady Flow ◽  
Heart Valve ◽  
Heart Valves ◽  
Mechanical Heart Valve ◽  
Three Dimensional ◽  
Flow Characteristics ◽  
Shear Stresses ◽  
Stereoscopic Piv ◽  
Bileaflet Mechanical Heart Valve ◽  
Component Particle

Each year over 180,000 mechanical heart valves are implanted worldwide, with the bileaflet mechanical heart valve (BiMHV) accounting for approximately 85% of all valve replacements [1,2]. Although much improved from previous valve designs, aortic BiMHV design is far from ideal, and serious complications such as thromboembolism and hemolysis often result. Hemolysis and platelet activation are thought to be caused by turbulent Reynolds shear stresses in the flow [1]. Numerous previous studies have examined aortic BiMHV flow using LDA and two component Particle Image Velocimetry (PIV), and have shown the flow to be complex and three-dimensional [3,4]. Stereoscopic PIV (SPIV) can obtain all three velocity components on a flow plane, and hence has the potential to provide better understanding of three dimensional flow characteristics. The objective of the current study was to use SPIV to measure steady flow, including turbulence properties, downstream of a BiMHV in a modeled aorta. The resulting dataset will be useful for CFD model validation, and the intent is to make it publicly available.

TRIZ Based Tool Management Applied in Mechanical Heart Valve Engineering Systems

2012 ◽  
Vol 569 ◽  
pp. 521-524
Author(s):  
Feng Zhou ◽  
Yuan Yuan Cui ◽  
Liang Liang Wu ◽  
Yin Chen ◽  
Jie Yang ◽  
...  
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Production Systems ◽  
Mechanical Heart Valve ◽  
Complex Case ◽  
Evolutionary Development ◽  
Prosthetic Heart Valves ◽  
Engineering Systems ◽  
Device Structure

Artificial mechanical heart valve (MHV) replacement is the common cardiovascular surgical procedure, yet its effect is far from satisfaction. Most important reasons lie in the model design and choice of the materials in the fabrication of the prosthetic heart valves. Based on systematic design methodology of TRIZ theory (Russian acronym for Theory of Solving Inventive Problem), the device structure is analyzed by comparing the past successful designs generated during the evolution of MHV. This paper represents a modeling technique integrating the well-established TRIZ with the conflict and contradiction modeling, substance-field and product functional analysis tools and provides some important trends in evolutionary development of production systems in MHV design. By analyzing the structural behavior and material performance, a complex case study from the research of different structural patterns and characteristics of current tri-leaflet modeling shows the validity of TRIZ theory to guide MHV design.

scholarly journals POLYMERIC HEART VALVE PROSTHESES: CONDITION AND PERSPECTIVES

2018 ◽  
Vol 20 (2) ◽  
pp. 100-111
Author(s):  
M. A. Rezvova ◽  
E. A. Ovcharenko
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Three Dimensional ◽  
High Strength ◽  
Valve Body ◽  
Nanocomposite Polymer ◽  
Valve Stem ◽  
Valve Prostheses ◽  
Number Of Publications

The idea of creating a polymer heart valve, which has high strength and biocompatibility, occurs in the 60’s. Since then, many polymer compounds have been investigated, but no solution has been found for this problem. In recent years, in connection with the development of technologies for the synthesis of high-molecular compounds, new polymers have appeared that can solve this problem, as evidenced by a number of publications describing experimental and clinical data. Nevertheless, the search for a polymer for the valve stem of the valvular valve body does not lose its relevance due to the defi ciencies studied and the lack of evidence confi rming the long-term safety of such products. This review presents the fi rst results of a study of polymer heart valves prostheses based on a nanocomposite polymer from polyhedral oligomeric nanoparticles of silicosioxane and polycarbonate urethane polymer POSS-PCU, polystyrene block-isobutylene-block-styrene SIBS, PTFE polytetrafl uoroethylene, copolymers and composites based on olefi n polymers series and polyesters, the idea of creating a material with a given three-dimensional microarchitecture that determines the anisotropy and the necessary mechanical properties.

scholarly journals P1521 Prosthetic heart valve-related stroke: a single center experience

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Almaghraby ◽  
M Abdelnabi ◽  
Y Saleh ◽  
O Abdelkarim ◽  
O Ozden Tok ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Heart Valve ◽  
Heart Valves ◽  
Hemorrhagic Stroke ◽  
Mechanical Valve ◽  
Prosthetic Heart Valves ◽  
Single Center ◽  
Single Center Experience ◽  
Valve Prostheses

Abstract OnBehalf YIG-CVR Introduction Thromboembolic events or bleeding are by far the most frequent complications of prosthetic heart valves. Cerebrovascular stroke is one of the major thromboembolic complications of anticoagulation-related issues of prosthetic heart valves. Aim of the work To determine the pattern and risk factors of acute stroke in patients with prosthetic heart valves. Methods and Patients A retrospective single-center analysis of the database registry of consecutive acute stroke patients with mitral or aortic heart valve prostheses admitted to a tertiary care stroke specialized center from 01/01/2012 to 01/12/2017. All patients were examined by a certified neurologist and underwent a complete work-up evaluation (Computed Tomography or Magnetic Resonance Imaging, Carotid Doppler ultrasound examination, complete blood tests, and electrocardiogram) and a transthoracic echocardiography (TTE) examination as well as transesophageal echocardiography (TOE) if valve dysfunction or thrombosis were suspected. Results 214 patients with mitral or aortic valve prostheses were admitted by acute stroke in the duration from 01/01/2012 to 01/12/2017 with a mean age of 44 ± 15 years, 132 were males (61.7%) and 178 patients had mechanical valves (83.2%). 135 patients had mitral prosthesis (63.1%) and ischemic stroke was encountered in 151 patients (70.6%). Conclusion In a single center experience, mechanical prosthesis at the mitral valve position was associated with higher incidence of ischemic stroke. Proper close follow-up of INR levels as well as the surgical shift to biological instead of mechanical valve should decrease significantly the incidence of prosthetic valve related strokes. Baseline, clinical and other parameters Patients (n = 214) Age (years) 44 ± 15 Mechanical valve 178 (83.2%) Atrial Fibrillation 101 (47.2%) Rheumatic Heart Disease 175 (81.8%) Left ventricular ejection fraction (%) 54 ±13 Mitral Only 135 (63.1%) Aortic Only 51 (23.8%) Double Valve Prosthesis 28 (13.1%) Ischemic stroke 151 (70.6%) Hemorrhagic stroke 47 (22%) Both ischemic and hemorrhagic stroke 16 (7.4%) Data are represented as mean(±SD) or number (Percentage) Abstract P1521 Figure. Valve sites

Impact of prosthetic heart valves on pregnancy in Bangladeshi women

Perfusion ◽  
2019 ◽  
Vol 34 (6) ◽  
pp. 446-452 ◽  
Author(s):  
Redoy Ranjan ◽  
Dipannita Adhikary ◽  
Sanjoy Kumar Saha ◽  
Sabita Mandal ◽  
Kamrul Hasan ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Heart Valve ◽  
Heart Valves ◽  
Prosthetic Heart Valve ◽  
Study Groups ◽  
Prosthetic Heart Valves ◽  
Group I ◽  
Mechanical Prostheses ◽  
Warfarin Embryopathy ◽  
Group Ii

Background: This study evaluated pregnancy outcome in women with a prosthetic heart valve, especially with the oral anticoagulation therapy that must be weighed against the risk of intracardiac thrombosis. Methods: This multicenter, retrospective, cohort study was undertaken between January 2012 and June 2017. The principal maternal outcome variables included bleeding and thromboembolic complications, infective endocarditis, prosthetic valve thrombosis and heart failure. However, the main foetal outcome variables included miscarriage, mortality, preterm baby, warfarin embryopathy, low birthweight and the mode of delivery. Results: A total of 265 pregnancies in women with prosthetic heart valves were evaluated in two groups: Group I (n = 182) covers a mechanical valve, while Group II (n = 82) covers a bioprosthetic valve. The mean age of the patients was 25.2 ± 2.5 years and 24.5 ± 5.2 years in Group I and Group II, respectively. Approximately 80% of the patients had normal echocardiography findings. However, Group I (mechanical prostheses) has a higher incidence (11.54%) of thrombus formation in comparison with the bioprostheses. Hemorrhagic complications and spontaneous miscarriage were statistically significant (p⩽0.05) between the study groups. However, normal pregnancy outcome (91.57%) was significantly higher (p⩽0.05) in Group II compared to Group I (61.54%). Mean birthweight and mean APGAR score were found normal in both study groups. Only 2.75% of patients have warfarin embryopathy in Group I. Furthermore, comparison of SF-36 scores for HRQOL (Health-Related Quality of Life) before and after pregnancy were statistically insignificant among the study population. Conclusion: Proper antenatal care and early risk stratification are the fundamental measures to improve the maternal and foetal outcomes in a patient with a prosthetic heart valve.

Real Time Three-dimensional Transesophageal Echocardiography: A Novel Approach for the Assessment of Prosthetic Heart Valves

2013 ◽  
Vol 31 (2) ◽  
pp. 188-196 ◽  
Author(s):  
Ashraf M. Anwar ◽  
Youssef F.M. Nosir ◽  
Mirvat Alasnag ◽  
Hassan Chamsi-Pasha
Keyword(s):  
Transesophageal Echocardiography ◽  
Real Time ◽  
Heart Valves ◽  
Three Dimensional ◽  
Prosthetic Heart Valves ◽  
Novel Approach

Simulations of the Hinge Flow Fields of a Bileaflet Mechanical Heart Valve Under Physiologic Pulsatile Aortic Conditions

2008 ◽  
Author(s):  
Hélène A. Simon ◽  
Liang Ge ◽  
Iman Borazjani ◽  
Fotis Sotiropoulos ◽  
Ajit P. Yoganathan
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
Prosthetic Heart Valves ◽  
Valve Design ◽  
Bileaflet Mechanical Heart Valve ◽  
Hinge Flow ◽  
Blood Elements

Native heart valves with limited functionality are commonly replaced by prosthetic heart valves. Since the first heart valve replacement in 1960, more than three million valves have been implanted worldwide. The most widely implanted prosthetic heart valve design is currently the bileaflet mechanical heart valve (BMHV), with more than 130,000 implants every year worldwide. However, studies have shown that this valve design can still cause major complications, including hemolysis, platelet activation, and thromboembolic events. Clinical reports and recent in vitro experiments suggest that these thrombogenic complications are associated with the hemodynamic stresses imposed on blood elements by the complex non-physiologic flow induced by the valve, in particular in the hinge region.

Pharmacogenetic testing in the management of patients with prosthetic heart valves

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E.V Gorbunova ◽  
A.V Ponasenko ◽  
O.L Barbarash
Keyword(s):  
Heart Valve ◽  
Anticoagulant Therapy ◽  
Therapeutic Dose ◽  
Heart Valves ◽  
Warfarin Therapy ◽  
Mechanical Heart Valve ◽  
Early Postoperative Period ◽  
Prosthetic Heart Valves ◽  
Pharmacogenetic Testing ◽  
Polymorphic Variants

Abstract Background This study examined clinical, demographic, anthropometric, and inheritance factors that influence individual sensitivity to warfarin therapy after heart valve surgery. The clinical significance of the pharmacogenetic approach was assessed using the individual time frame and time spent in the INR therapeutic range. Purpose To study the influence of the preemptive panel-based pharmacogenetic testing on the effectiveness and safety of anticoagulant therapy in patients with prosthetic heart valves. Materials and methods The study included 928 patients (519 men and 409 female) (mean age 56±10 years) living in Western Siberia, Russia. Mainly there were patients with rheumatic heart disease, heart failure III NYHA and atrial fibrillation in 35% of cases. Mechanical heart valve prostheses were used in 70% of cardiac surgery cases. Real-time polymerase chain reaction was used for molecular genetic testing for polymorphisms VKORC, CYP2C9*2, CYP2C9*3, and CYP4F2. Results The frequencies of alleles and genotypes of CYP2C9 and VKORC1 in the study population of patients with heart valves prosthetic correspond to the distribution in Caucasian populations. Correlation between the calculated and actual therapeutic doses of warfarin was found according to the B.F Gage algorithm. In analyzing the dependence of the actual therapeutic dose of warfarin on polymorphic variants of the CYP2C9 and VKORC1 genes, it was shown that all the studied variants were associated with a therapeutic dose of warfarin, which was significantly different in carriers of different genotypes. Genotypes A/A CYP2C9*3 and G/G VKORC1 were associated with the largest deviations of the actual therapeutic dose from the calculated one. The clinical effectiveness of the pharmacogenetic approach was assessed according to the prevalence of the studied polymorphic variants of the CYP2C9 and VKORC1 genes in patients with prosthetic heart valves in the Kemerovo region. As a result, two groups of patients were formed using the “copy pair” method, without statistically significant differences in genetic, clinical, demographic, and anthropometric data. Usage of the pharmacogenetic testing at the beginning of warfarin therapy twice reduced time required to select a therapeutic dose of the anticoagulant, while the time within therapeutic INR range was increased by 20.2%. Conclusion The use of the panel-based pharmacogenetic approach at the beginning of warfarin therapy in patients with prosthetic heart valves increases the effectiveness and safety of anticoagulant therapy in the early postoperative period. Funding Acknowledgement Type of funding source: None

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