Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although no epidemiological studies are available to evaluate the exact risk of infective endocarditis complicating native cardiac disease, analysis of data in the literature shows that cardiac disease can be classified into three groups of decreasing risk: (1) high risk disease includes cyanotic congenital heart lesions, previous bacterial endocarditis, aortic valve disease, mitral regurgitation and uncorrected left-to-right shunt, but not atrial septal defect; (2) cardiac conditions of moderate risk include mitral valve prolapse with valvar regurgitation or leaflet thickening, isolated mitral stenosis, tricuspid valve disease, pulmonary stenosis and hypertrophic cardiomyopathy; (3) conditions of low or no risk include isolated atrial septal defect, ischaemic heart disease and/or previous coronary artery bypass graft surgery, surgically corrected left-to-right shunt with no residual shunt, mitral valve prolapse with thin leaflets in the absence of regurgitation, and calcification of the mitral annulus.
 ...
PMID:Native cardiac disease predisposing to infective endocarditis. 767 19

A 51-year-old woman was referred to our institute for surgical treatment from an other hospital where she was diagnosed as having a mycotic aneurysm located at the aortic annulus due to infective endocarditis. The aneurysm communicated with the left ventricle, with aortic stenosis and regurgitation, mitral stenosis and tricuspid regurgitation caused by rheumatic fever. On admission to our institute, the infective endocarditis was at the healed stage. The mycotic aneurysm was located at the aortic annulus of the right coronary cusp, and was closed using a prosthetic patch with mattress sutures. Aortic valve replacement with a 19-mm St. Jude Medical prosthesis was then performed on this patch. The mitral and tricuspid valves were also replaced with 27-mm and 29-mm St. Jude Medical prostheses, respectively. The patient is doing well 1 year after surgery.
 ...
PMID:[Surgical treatment of aortico-left ventricular communication due to infective endocarditis]. 776 44

The prevalence of left atrial spontaneous echo contrast (SEC) and the occurrence of systemic embolism were prospectively studied in 176 consecutive patients. All had significant mitral regurgitation (MR) and underwent transesophageal echocardiographic (TEE) studies. Left ventriculography was performed in all patients to document the severity of MR. The underlying causes of MR included rheumatic heart disease in 84 patients, ruptured chordae tendineae in 37, mitral valve prolapse in 18, infective endocarditis in 20, coronary artery disease in 8, congenital heart disease in 5, and dilated cardiomyopathy in 4. No patient was found to have left atrial thrombus. Left atrial SEC was observed in three patients (1.7 percent), all of whom had atrial fibrillation, concomitant mitral stenosis, and huge left atria. Color flow mapping revealed that left atrial SEC was prominent in regions where the turbulent flow of MR was not present. Systemic embolism occurred in ten patients (5.7 percent). The underlying disease was infective endocarditis, rheumatic heart disease, and dilated cardiomyopathy in 6, 3, and 1 patient, respectively. The sites of embolization involved the central nervous system in eight patients and the spleen in the remaining two. Three patients with rheumatic heart disease and the one with dilated cardiomyopathy were in atrial fibrillation and had dilated left atria (diameter > 45 mm) when systemic embolism occurred. Only one patient with rheumatic heart disease was found to have left atrial SEC. The remaining six, with infective endocarditis, all had sinus rhythm. In conclusion, left atrial SEC or thrombus detected by TEE is uncommon in patients with significant MR. Clinical conditions may be of help to identify the subsets of patients at higher risk for systemic embolism.
 ...
PMID:Significant mitral regurgitation is protective against left atrial spontaneous echo contrast formation, but not against systemic embolism. 802 Mar 25

Although there are no epidemiological studies allowing precise evaluation of the risk of infective endocarditis in given cardiac pathologies, a review of the literature allows classification of different conditions in three groups of decreasing risk: 1: high risk group: cyanotic, congenital heart disease, patients with previous infective endocarditis, aortic valve disease, mitral regurgitation and unoperated left-to-right shunts apart from atrial septal defects; 2: moderate risk group: mitral valve prolapse with myxoid valves or a systolic murmur, mitral stenosis, tricuspid valve disease, pulmonary stenosis, hypertrophic obstructive cardiomyopathy; 3: low or negligible risk: isolated atrial septal defect, operated or unoperated (bypass graft) ischaemic heart disease, operated left-to-right shunts without residual shunt, mitral valve prolapse with normal valve thickness and without a murmur, mitral ring calcification without regurgitation.
 ...
PMID:[Risk of bacterial endocarditis and native heart diseases]. 802 94

For the determination of the risk factors associated with the development of and death caused by prosthetic valve endocarditis, data were reviewed from 66 patients who were prospectively entered into the Veterans Affairs Cooperative Study on Valvular Heart Disease and in whom prosthetic valve endocarditis subsequently developed. Data were recorded at 13 medical centers between October 1977 and September 1982 in patients randomized to receive a mechanical valve (Bjork-Shiley spherical disc, n = 510 patients) or a bioprosthetic valve (Hancock porcine heterograft, n = 522 patients). The average rate of prosthetic valve endocarditis development was 0.8% per year over an average follow-up period of 7.7 years. Of the 66 patients in whom prosthetic valve endocarditis developed (5.8%), 15 cases occurred within 2 months of operation (early) and 51 occurred after operation (late). The most significant preoperative predictor of prosthetic valve endocarditis was active endocarditis at the time of operation (7.4% versus 0.9%) (p = 0.001). Early prosthetic valve endocarditis occurred more frequently in patients who underwent operation for multivalvular disease (p = 0.023). Significantly related perioperative variables were coma, prolonged mechanical ventilation, deep postoperative wound infection, postoperative jaundice, ventricular tachycardia, ventricular fibrillation, and replacement of more than one valve (p < 0.05). Multivariate predictors were hypoxia (p = 0.001), preoperative endocarditis (p = 0.003), preoperative valve lesion (p = 0.020), and resident surgeon (p = 0.05). Significant preoperative variables predictive of late prosthetic valve endocarditis were mitral stenosis and mixed mitral stenosis-regurgitation. The only multivariate predictor of late prosthetic valve endocarditis was superficial wound infection (p = 0.004). Of deaths attributable to prosthetic valve endocarditis, 41% occurred in patients treated with antibiotics alone, 48% occurred in patients treated with surgical intervention and antibiotics, and death resulted in both patients who received no treatment. No difference was found in the risk of early or late postoperative prosthetic valve endocarditis developing in patients receiving the mechanical valve versus those receiving the bioprosthetic valve.
 ...
PMID:Determinants of the occurrence of and survival from prosthetic valve endocarditis. Experience of the Veterans Affairs Cooperative Study on Valvular Heart Disease. 804 Nov 68

This two-part article examines the histologic and morphologic basis for stenotic and purely regurgitant mitral valves. In Part I, conditions producing mitral valve stenosis are reviewed. In over 99% of stenotic mitral valves, the etiology is rheumatic disease. Other rare causes of mitral stenosis include congenital malformed valves, active infective endocarditis, massive annular calcium, and metabolic or enzymatic abnormalities. In Part II, conditions producing pure mitral regurgitation will be discussed. In contrast to the few causes of mitral stenosis, the causes of pure (no element of stenosis) mitral regurgitation are multiple. Some of the conditions producing pure regurgitation include floppy mitral valves, infective endocarditis, papillary muscle dysfunction, rheumatic disease, and ruptured chordae tendinae.
 ...
PMID:Pathology of mitral valve stenosis and pure mitral regurgitation--Part I. 807 Jan 51

This two-part article examines the histologic and morphologic basis for stenotic and purely regurgitant mitral valves. In Part I, conditions producing mitral valve stenosis were reviewed. In over 99% of stenotic mitral valves, the etiology is rheumatic disease. Other rare causes of mitral stenosis include congenitally malformed valves, active infective endocarditis, massive annular calcium, and metabolic or enzymatic abnormalities. In Part II, conditions producing pure mitral regurgitation are discussed. In contrast to the few causes of mitral stenosis, the causes of pure (no element of stenosis) mitral regurgitation are multiple. Some of the conditions producing pure regurgitation include floppy mitral valves, infective endocarditis, papillary muscle dysfunction, rheumatic disease, and ruptured chordae tendineae.
 ...
PMID:Pathology of mitral valve stenosis and pure mitral regurgitation--Part II. 808 26

We report a case of myocardial infarction with normal coronary arteriography in a 39-year-old woman presenting with tight mitral stenosis complicated by atrial extrasystoles and spontaneous atrial contrast at echocardiography. The diagnosis of coronary embolism was most probable. Coronary embolism is a rare disease, usually due to a blood clot or, less frequently, to a vegetation of endocarditis starting in a heart valve. The left network is usually involved, with typical myocardial necrosis. Coronary arteriography is sufficient to make the diagnosis. Preventive treatment is essential.
 ...
PMID:[Coronary embolism revealing mitral valve stenosis]. 812 13

Since September 1991, 20 patients with mitral stenosis underwent mitral valve replacement and chordal replacement with expanded polytetrafluoroethylene (ePTFE) sutures. The continuity between the papillary muscles and the mitral annulus was maintained by four mattress sutures of ePTFE, which connected the stumps of the papillary muscle heads to the mitral annulus at the 2, 4, 8, and 10 o'clock positions. Low profile bileaflet prosthetic valves were inserted. There was no mortality either in-hospital or during follow-up. There was no valve related morbidity, such as valve structural failure, thromboembolism, anticoagulant related hemorrhage, prosthetic valve endocarditis, or posterior left ventricular rupture. The technique of replacing chordae tendineae is described in detail.
 ...
PMID:Replacement of chordae tendineae using expanded polytetrafluoroethylene (ePTFE) sutures during mitral valve replacement in patients with severe mitral stenosis. 821 39

In 1990, 95 mitral valves from 54 women and 41 men (mean age, 61 years; age range, 8 to 85 years) were replaced (76%) or repaired (24%) at the Mayo Clinic. Functionally, 58% of the valves were purely regurgitant (MR), 25% were stenotic and regurgitant (MS-MR), and 17% were purely stenotic (MS). Postinflammatory (presumably rheumatic) disease accounted for 100% of MS cases, 92% of MS-MR cases, and 16% of MR cases. Other causes of pure MR included floppy valves (49%), ischemic heart disease (13%), infective endocarditis (9%), miscellaneous (9%), and indeterminate (4%). Thus, postinflammatory disease represented the major cause of both mitral stenosis (MS and MS-MR) and overall mitral valve disease in our surgical population. In contrast, floppy valves were the most commonly observed cause of pure MR. Among postinflammatory valves, 55% were completely excised and 45% had only the anterior leaflet removed; all were replaced. In contrast, floppy valves were incompletely excised in 96%; 67% were repaired and only 33% were replaced. Because mitral valves frequently are incompletely excised, rendering an accurate etiologic diagnosis requires not only a morphologic assessment of resected tissues but also a knowledge of the clinical history, operative details, and functional state of the valve.
 ...
PMID:Evaluation of surgically excised mitral valves: revised recommendations based on changing operative procedures in the 1990s. 827 75


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>