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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The echocardiographic manifestations of pulmonic valvular endocarditis in a patient with underlying heart disease consisting of a ventricular septal defect and infundibular stenosis are reported. The abnormal shaggy echoes observed on the pulmonic valve were confirmed to be vegetations based on surgical and pathologic findings. This was further proven by the disappearance of the shaggy echoes after surgical excision of the vegetations. We conclude that echocardiograms can detect the presence and disappearance of pulmonic valvular vegetations, which may be of aid in the diagnosis of pulmonic valvular endocarditis.
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PMID:Preoperative and postoperative echocardiographic studies of pulmonic valvular endocarditis. 724 74

Thirty-two children with both ventricular septal defect (VSD) and aortic insufficiency (AI) were evaluated for progression in degree of AI as well as effectiveness of operation in reducing or eliminating regurgitation. At the time of initial study. AI was mild in 21, moderate in eight, and severe in three patients. Twenty-one patients were followed medically over a 2 year to 19 year period, during which the degree of AI progressed in five. One death occurred during an episode of endocarditis. A total of 24 patients underwent operation at ages ranging from 1 year to 23 years. Postoperative evaluations continued from a minimum of 1 year to 24 years in 19 patients, with residual AI noted in 63% of these. Children less than 5 years of age, even with little valvular involvement, exhibited minimal benefit from attempted correction compared with those in the latter part of the first decade of life (p less than 0.05). Closure of the VSD with associated valvuloplasty resulted in a higher prevalence of elimination or improvement of AI compared with VSD closure alone (p less than 0.01). As AI can progress slowly without compromising the child's development, attempted surgical repair can safely be deferred in children less than 5 years of age with minimal valvular involvement unless careful medical management fails to prevent cardiac decompensation.
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PMID:Ventricular septal defect with associated aortic valve insufficiency. Progression of insufficiency and operative results in young children. 725 82

A case is reported in which acute tricuspid regurgitation developed in a child with a ventricular septal defect resulting in a left ventricular-right atrial shunt. This was successfully treated by closure of the defect and tricuspid valve replacement. The anterior leaflet of the tricuspid valve was almost completely destroyed by endocarditis, though in previous reports of tricuspid valve endocarditis in association with ventricular septal defect in children, it has beem invariably the septal leaflet which is damaged.
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PMID:Severe heart failure in child with ventricular septal defect and acute tricuspid regurgitation. 742 50

A 42-year-old male with pulmonary bioprosthetic valve endocarditis accompanied by residual minor leakage through a previously closed patch for ventricular septal defect (VSD), underwent reoperation with a Carpentier-Edwards bioprosthetic valve. The patient had a history of pulmonary valve replacement and VSD in 1973. A massive vegetation on the pulmonary valve was demonstrated by echocardiography. Five repeated blood cultures yielded Eikenella corrodens. After medical treatment, reoperation was performed. The patient was free of complications after the procedure. Although bioprosthetic valves have potential problems of dysfunction and calcification in long-term use, these problems develop at a significantly slower rate in right-sided positions compared with left-sided positions and bioprosthetic valve thrombosis in the pulmonary position has apparently not been reported. Mechanical prostheses for pulmonary valve replacement have a poor prognosis, with a high incidence of valve thrombosis despite adequate anticoagulant therapy. For the replacement of prosthetic valves in right-sided positions (tricuspid and pulmonary), bioprosthetic valves are now our first choice.
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PMID:[A case of secondary valve replacement caused by pulmonary bioprosthetic valve endocarditis]. 756 25

From March 1992 through March 1995 we have performed 45 Ross procedures for total aortic root replacement in our institution. There were 32 males and 13 females with a mean age of 31 years (range: 3-49 years). Indications for surgery were: aortic stenosis (n = 20), aortic regurgitation (n = 16), native valve endocarditis (n = 6), replacement of prosthetic valve (n = 3). Of these 45 patients 13 (28%) had at least one prior repair. Additional procedures were Dacron graft extension of the autograft (n = 7), enlargement of aortic annulus (n = 3), mitral valve repair (n = 2), CABG (n = 1), closure of VSD (n = 1). The mean cross-clamp time was 132 minutes (76-187 minutes) and the mean bypass time 156 minutes (106-240 minutes). There were two postoperative cardiac deaths, not valve-related, and five non-lethal postoperative complications: right ventricular failure (n = 1), low cardiac output (n = 1), sternal re-entry for bleeding (n = 3). The follow up is complete (1.5-37 months) for the 43 survivors. There was one non-cardiac late death (acute fulminating hepatitis) in an eight years old boy eight months post-operatively. Discharge echo-Doppler studies showed normal autograft and homograft valve function except in one patient who had a grade two aortic regurgitation. Serial echo-Doppler studies showed no significant progression of aortic regurgitation, no significant pulmonary gradients, no dilatation of the autografts during the follow up. It is suggested in conclusion that aortic root replacement with a pulmonary autograft is a safe procedure in selected patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Total aortic root replacement with pulmonary autografts: short term results in 45 consecutive patients. 758 43

Study population involved 21 pts with complex congenital heart disease after corrective surgery using homografts between the years 1986 and 1992. Diagnoses included double outlet right ventricle, tetralogy of Fallot, transposition of great arteries, truncus arteriosus, pulmonary atresia with VSD, corrected transposition with pulmonary stenosis, and absent pulmonary valve. Pts age at surgery ranged from 18 days--to 15 yrs mean, 6.7 yrs. Time interval between surgery and diagnostic procedures was 8 days--6 yrs (mean 11 months). All pts were studied by Echo/Doppler. 2 pts by TEE and 3 pts by MRI. 6 pts had cardiac catheterisation. Distal (5) or proximal (1) stenosis was present in 6 cases. The severity and the type of stenosis was correctly identified by noninvasive technique compared to invasive findings. Homograft valve regurgitation was mild (4) or moderate (3). In two pts severe insufficiency was associated to homograft endocarditis. Postoperative residual shunts were found in 8 pts. Homograft stenosis can correctly be diagnosed using Echo/Doppler technique. Distal stenosis was more frequent than proximal. Homograft tends to become insufficient, but severe incompetence did not occur except in endocarditis.
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PMID:[Non-invasive and invasive assessment of the function of aortic valve homografts in infancy and childhood]. 759 97

To evaluate the outcome of cardiovascular surgery in the Marfan syndrome, the records of 49 patients (median age 35 years) who underwent 60 operations were reviewed. Primary surgery was elective in 39 patients and emergency in ten. Non-dissecting aneurysm with diameter 4-19 cm was present in 34 cases and distal, isolated aneurysm in four. In eight cases there was type A acute aortic dissection with median diameter 5.0 cm. One patient was operated on for mitral valve insufficiency, one for ventricular septal defect and one (acute) for endocarditis. Composite grafts were used for aortic root reconstruction. Operative complications occurred in 24% of the patients. The 30-day survival was 92%. There were five (10%) late deaths. Survival after a median of 8 years postoperatively was 82%. The early and late results of cardiovascular surgery in the Marfan syndrome thus are concluded to be generally favourable. As late reoperation frequently is needed, however, close monitoring is advocated even after successful primary surgery.
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PMID:Results of cardiovascular surgery in the Marfan syndrome. A retrospective study of 49 patients. 764 3

The risk of infective endocarditis after cardiac surgery relates mainly to the risk of infective endocarditis on prosthetic valves. The frequency of prosthetic infective endocarditis varies according to the criteria used in the literature, ranging from 0.4 to 1.3% for early infective endocarditis, with an annual linear risk of late infective endocarditis of 0.5%. This figure seems to be independent of either the type or the location of prostheses, but it does nevertheless increase if more than one valve has been replaced. The most commonly isolated microorganisms in early infective endocarditis are staphylococci. The bacteriological findings in late prosthetic infective endocarditis are similar to those seen in the native disease. The portal of entry is more easily identified in early than in late infective endocarditis (50%). The risk of infective endocarditis in surgically treated congenital heart disease is very low when the patient has a left-to-right shunt or valvar stenosis; it increases amongst patients with tetralogy of Fallot and patients with complex cyanotic congenital heart disease, mainly when there is a residual ventricular septal defect or prior palliative surgery. The risk of infective endocarditis in patients with intracavitary electrodes such as pacemakers and defibrillators, after the interventional procedure itself and after heart transplant, is very low. This leads us to conclude that antibiotic prophylaxis is only warranted in those patients with a prosthetic valve and after surgical treatment of tetralogy of Fallot and other complex cyanotic congenital heart diseases.
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PMID:The risk of infective endocarditis after cardiac surgical and interventional procedures. 767 28

We studied five patients with acquired ventricular septal defect during the course of an infective endocarditis. All patients were male and had a previous aortic valve disease associated with an aortic ring abscess. Clinical examination was useful for the diagnosis of 4 cases, emphasizing the following findings: systolic murmur and/or left paraesternal thrill and right-heart failure. Incidence of congestive heart failure was 60%, while 40% of all patients died during the in-hospital course. No specific etiologic agent was detected. Therefore, acquired ventricular septal defect should be suspected in patients with infective endocarditis of the aortic valve that evolve with a systolic murmur and/or paraesternal thrill and right-heart failure. Immediate surgical treatment is mandatory in these cases.
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PMID:[Acquired ventricular septal defect during infective endocarditis]. 777 92

A successful repair of tricuspid valve insufficiency due to endocarditis related to VSD is reported. Combined quadrangular resection and repair of anterior leaflet, pericardial patch plasty of anterior-septal commissure, Carpentier ring annuloplasty and VSD closure was performed with good clinical results.
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PMID:[A case report of tricuspid valve valvoplasty for tricuspid endocarditis]. 779 23


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