scholarly journals Challenges in rheumatic valvular disease: Surgical strategies for mitral valve preservation

2015 ◽  
Vol 2015 (1) ◽  
pp. 9 ◽  
Author(s):  
Manuel J Antunes
Keyword(s):  
Mitral Valve ◽  
Valvular Disease ◽  
Surgical Strategies ◽  
Rheumatic Valvular Disease

Mitral Valve Repair Patients with Rheumatic Valvular Disease

2011 ◽  
Vol 20 (1) ◽  
pp. 60
Author(s):  
Rajiv Sharma ◽  
Hemant Sharma ◽  
Dong Kang ◽  
Sumit Yadav ◽  
Robert Tam
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valvular Disease ◽  
Valve Repair ◽  
Rheumatic Valvular Disease

Stroke in Patients with Infective Endocarditis: A 15-Year Single-Center Cohort Study

2018 ◽  
Vol 80 (3-4) ◽  
pp. 171-178 ◽  
Author(s):  
Gui-fang Cao ◽  
Wei Liu ◽  
Qi Bi
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Hemorrhagic Stroke ◽  
Hospital Deaths ◽  
Independent Risk Factors ◽  
The Mean ◽  
Medical University ◽  
The Relationship ◽  
Rheumatic Valvular Disease ◽  
Mitral Valve Vegetation

Objective: To explore the relationship between infective endocarditis (IE) and stroke. Methods: The clinical data of patients diagnosed with IE from January 2003 to December 2017 in Beijing Anzhen Hospital Affiliated to Capital Medical University were retrospectively analyzed. Results: A total of 861 patients (mean age: 40.79 ± 16.27 [SD]) with IE was recruited. Vegetations were confirmed in 97.32% of all the patients, among whom 296 were diagnosed with congenital heart disease and another 53 with rheumatic valvular disease. The most common pathogens were Streptococcus, Staphylococcus, and various types of fungi (13.12, 7.31, and 1.16% respectively). Out of the 138 patients diagnosed with stroke, 101 cases were of ischemic stroke, 23 cases were of hemorrhagic stroke, and 12 cases were of concurrent ischemic and hemorrhagic stroke. There were 31 patients who had infarction lesions in more than 2 vascular systems. The mean age of stroke patients was significantly higher than that of patients without stroke (45.76 ± 17.88 vs. 39.83 ± 15.77, p = 0.000). The incidence of mitral valve vegetation (57.24 vs. 43.01%, p = 0.002), atrial fibrillation (4.34 vs. 1.38%, p = 0.018), fungal infection (2.89 vs. 0.83%, p = 0.038) in patients with stroke was significantly higher than those without stroke. Mitral valve vegetation (OR 1.648; 95% CI 1.113–2.442) and age (OR 1.019; 95% CI 1.007–1.032) were independent risk factors for stroke in IE patients. Stroke increased the risk of hospital deaths (OR 7.673 95%CI 3.634–16.202). Conclusion: Stroke is a common complication of IE. Mitral valve vegetation and old age may incerease the risk of stroke in patients with IE.

Studies on thromboplastic and fibrinolytic activities of valvular tissue in rheumatic valvular disease

1980 ◽  
Vol 176 (3) ◽  
pp. 193-200 ◽  
Author(s):  
Tatsuji Homma ◽  
Sadahide Okudaira ◽  
Yoshinao Iida
Keyword(s):  
Valvular Disease ◽  
Rheumatic Valvular Disease

Rheumatic Valvular Disease

2010 ◽  
pp. 259-266
Author(s):  
Alain Carpentier ◽  
David H. Adams ◽  
Farzan Filsoufi
Keyword(s):  
Valvular Disease ◽  
Rheumatic Valvular Disease

scholarly journals P1304 Is antibiotic profilaxis really not needed in mitral valve prolapse?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Suma ◽  
S Coli ◽  
W Serra ◽  
I Spaggiari ◽  
A Botti ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Antibiotic Therapy ◽  
Mitral Valve Prolapse ◽  
Valvular Disease ◽  
Posterior Leaflet ◽  
Class Iii ◽  
Level Of Evidence ◽  
Native Valve ◽  
Dental Procedures

Abstract Patient Presentation A 54 years old woman with dyslipidemia was admitted to the hospital due to the onset of persistent fever. She had no significant comorbidities and she had a known mitral valve prolapse, which was in clinical and echocardiographic follow-up since more than 15 years before. Two months before the hospitalization she underwent dental hygiene procedure without taking any antibiotic before. The procedure included scaling and polishing of the teeth, and she referred just a mild bleeding. After few days she reported the onset of fever and therefore she started to take amoxicilline/clavulanic acid but without any significant improvement of symptoms. Initial work up At the blood chemistry she had a mild leucocytosis with neutrophilia and a rise in inflammatory indices. The Chest x-ray was normal. A systolic murmur was evident at the physical examination. Therefore, Transthoracic Echocardiogram was performed, followed by Transesophageal Echocardiogram (see Figure). At the Echo there was a significant endocarditic involvement of the mitral valve with multiple vegetations, two on the posterior leaflet (scallop P1 and P3) and one on the anterior one (scallop A3); moreover, there was a flail of the posterior leaflet (scallop P1) with subsequent moderate to severe eccentric valve regurgitation. Diagnosis and management Diagnosis of Endocarditis was made and, thus, antibiotic therapy was started with gentamicin and daptomycin, then switched to ampicillin and ceftriaxone after the isolation at the blood culture of Enterococcus Faecalis sensitive to them. Cerebral CT was performed with no evidence of embolization. Finally, owing to the significant endocarditis of the mitral valve with associate moderate to severe regurgitation, the patient underwent surgical intervention with mitral valve replacement with bioprosthesis. Follow-up The post-operative period was regular with no significant complications. She had no more fever and the antibiotics were stopped after six weeks. Conclusion We reported the case of a severe endocarditic involvement of the mitral valve in a patient with known valvular prolapse, who did not take any antibiotic before a minor dental procedure. 2015 ESC guidelines on Endocarditis recommend to not perform antibiotic prophylaxis in patient with no valvular prosthesis but with other form of valvular disease, including mitral valve prolapse (Class III, level of evidence C). Most of the time, patients with other form of valvular disease (e.g. mitral valve prolapse, bicuspid aortic valve, calcific aortic stenosis) do not experience endocarditis, neither after dental procedures. However, this case shows that sometimes it can happen due to the abnormal conformation of the native valve and, hence, it makes us wonder whether the antibiotic therapy should be indicated before dental procedures in those kind of patients. Abstract P1304 Figure.

Sign in / Sign up

Export Citation Format

Share Document