scholarly journals Valvular heart diseases. (2). Mitral valve plasty for infective endocarditis. Especially in active stage.

1990 ◽  
Vol 19 (4) ◽  
pp. 696-697
Author(s):  
H. Ohuchi
2016 ◽  
pp. 20-24
Author(s):  
Bang Giap Vo ◽  
Anh Binh Ho ◽  
Van Minh Huynh

Objectives: To investigate the features of coronary artery lesions in patients over 50 with heart valve diseases and to find out the relationship between the levels of coronary artery lesions and heart valve diseases. Results: In patients over 50 year old with heart valve diseases, the rate of significant coronary artery lesions is 55.5%. In which, significant lesions in the group of both mitral and aorta valve diseases is 44.19%, only mitral valve diseases is of 70%, only aortic valve diseases is of 51.85%. There is a relationship between the severity of mitral valve diseases and right coronary artery lesions (OR 3.74: 1.64 to 8.5, p = 0.0017) and circumflex coronary artery lesions (OR 2.59: 1.16 to 5.75, p = 0.0192). The severity of heart valve lesions in significant coronary artery lesions group is higher than insignificant coronary artery lesions group or normal group. Conclusion: Coronary artery lesions is common in patients > 50 years old with heart valve diseases, there is a relationship between the severity of mitral valve diseases and and right coronary artery lesions and circumflex coronary artery lesions. Key words: coronary artery lesions, mitral valvediseases


2021 ◽  
Vol 22 (22) ◽  
pp. 12132
Author(s):  
Francesco Nappi ◽  
Adelaide Iervolino ◽  
Sanjeet Singh Avtaar Singh ◽  
Massimo Chello

miRNAs have recently attracted investigators’ interest as regulators of valvular diseases pathogenesis, diagnostic biomarkers, and therapeutical targets. Evidence from in-vivo and in-vitro studies demonstrated stimulatory or inhibitory roles in mitral valve prolapse development, aortic leaflet fusion, and calcification pathways, specifically osteoblastic differentiation and transcription factors modulation. Tissue expression assessment and comparison between physiological and pathological phenotypes of different disease entities, including mitral valve prolapse and mitral chordae tendineae rupture, emerged as the best strategies to address miRNAs over or under-representation and thus, their impact on pathogeneses. In this review, we discuss the fundamental intra- and intercellular signals regulated by miRNAs leading to defects in mitral and aortic valves, congenital heart diseases, and the possible therapeutic strategies targeting them. These miRNAs inhibitors are comprised of antisense oligonucleotides and sponge vectors. The miRNA mimics, miRNA expression vectors, and small molecules are instead possible practical strategies to increase specific miRNA activity. Advantages and technical limitations of these new drugs, including instability and complex pharmacokinetics, are also presented. Novel delivery strategies, such as nanoparticles and liposomes, are described to improve knowledge on future personalized treatment directions.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Saif Al-Chalabi ◽  
Tricia Tay ◽  
Rajkumar Chinnadurai ◽  
Philip A Kalra

Abstract Background and Aims Infective endocarditis (IE) is a serious infective complication that usually results in prolonged hospitalisation and is associated with high morbidity and mortality. It is sometimes difficult to promptly diagnose infective endocarditis when a patient receiving hemodialysis presents with signs and symptoms of bacteremia, a delay which can lead to worse outcomes. In this study, we aimed to identify the risk factors that can predict infective endocarditis in haemodialysis patients with bacteremia. Method This retrospective observational study was conducted on all patients diagnosed with infective endocarditis (IE) and receiving maintenance hemodialysis between 2005 and 2018 in Salford Royal Hospital and its satellite dialysis units (catchment population of 1.5 million). The IE patients were propensity score matched in a 1:2 ratio with similar hemodialysis patients without IE but with bacteremia between 2011 and 2015. Propensity scores were generated by using binary logistic regression analysis incorporating age, gender, diabetes status, and dialysis vintage as variables. Logistic regression analysis was used to predict the risk factors associated with developing IE. Statistics were performed using SPSS version-24. Results We had a sample of 105 patients (35 IE vs 70 bacteremia). The median age of the patients was 65 years with a predominance of males (60%). 43% were diabetic, 11.5% were receiving immunosuppression and 72% had a catheter for dialysis access. IE patients had higher peak C-reactive protein (CRP) during admission compared to patients with bacteremia and no IE (253 mg/l vs 152 mg/l, p=0.001). Patients who developed IE had a longer duration of dialysis catheter use than the bacteremia group (150 vs 19 days; p<0.001) (table 1). There was no significant difference between causative microorganisms in both groups. Staphylococcus aureus caused most cases (54% in IE and 47% in bacteremia). Our study showed clearly that patients who had IE had longer hospital stay (45 vs 18 days, p=0.001) with a far higher 30-day mortality rate (54.3% vs 17.1%, p<0.001). Logistic regression analysis showed previous valvular heart diseases (OR: 20.1; p<0.001), a higher peak CRP (OR:1.01; p=0.001), and a longer duration of catheter use (OR: 1.01; p=0.035) as significant predictors for infective endocarditis (table 2). Conclusion Bacteremia in patients receiving hemodialysis through a catheter as access should be actively investigated with a high index of suspicion for IE particularly those having valvular heart diseases, hypertension, higher peak CRP, and those with a longer duration of dialysis catheter usage. Work up may need to include invasive investigations such as transesophageal echocardiogram to confirm or reliably rule out this devastating condition.


2012 ◽  
Vol 6 ◽  
pp. CMC.S8580 ◽  
Author(s):  
Seyfollah Abdi ◽  
Negar Salehi ◽  
Babak Ghodsi ◽  
Hossein Ali Basiri ◽  
Mahmoud Momtahen ◽  
...  

Background Valvular heart diseases and mainly rheumatic heart diseases complicate about 1% of pregnancies. During pregnancy physiological hemodynamic changes of the circulation are the main cause of mitral stenosis (MS) decompensation. Prior to introduction of percutaneous mitral balloon commissuroplasty (PTMC), surgical comissurotomy was the preferred method of treatment in patients with refractory symptoms. PTMC is an established non-surgical treatment of rheumatic mitral stenosis. The study aimed to assess the safety and efficacy of PTMC in pregnant women with severs mitral stenosis. Material and Method Thirty three consecutive patients undergoing PTMC during pregnancy enrolled in this prospective study. Mitral valve area (MVA), transmitral valve gradient (MVG), and severity of mitral regurgitation (MR) were assessed before and 24 hour after the procedure by transthoracic and transesophageal echocardiography. Mitral valve morphology was evaluated before the procedure using Wilkin's criteria. Patient followed for one month and neonates monitored for weight and height and adverse effect of radiation. Result Mitral valve area increased from 0.83 ± 0.13 cm2 to 1.38 ± 0.29 cm2 ( P = 0.007). Mean gradient of mitral valve decreased from 15.5 ± 7.4 mmHg to 2.3 ± 2.3 mmHg ( P = <0.001). Pulmonary artery pressure decreased from 65.24 ± 17.9 to 50.45 ± 15.33 ( P = 0.012). No maternal death, abortion, intrauterine growth restriction was observed and only one stillbirth occurred. Conclusion PTMC in pregnant women has favorable outcome and no harmful effect on children noted.


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