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

The Toronto SPV bioprosthesis for aortic valve replacement has been prospectively evaluated in 100 patients, since March 1993. Intraoperative transoesophageal and postoperative transthoracic echocardiography were used to assess valve function. Follow-up was complete in 74 patients at 6 months and in 38 patients at 1 year. The average valve size implanted was 26.5 mm. Some 37 patients had additional coronary artery bypass grafting surgery. The hospital mortality rate was 4%. Non-structural valve dysfunction occurred in one patient and late endocarditis in another patient required operation. There were no other valve complications. None of the patients developed clinically relevant aortic valve incompetence during follow-up and there was a significant decrease in pressure gradients, increase in valve orifice areas and decrease in left ventricular hypertrophy.
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PMID:The stentless Toronto SPV bioprosthesis for aortic valve replacement. 886 97

Mitral annular calcification (MAC) is a degenerative process associated with left ventricular hypertrophy (HLV) and progressive atherosclerosis, characteristic of the older age groups. Numerous investigations point to significantly earlier onset of atherosclerosis process in patients in final stage of chronic renal insufficiency. The aim of investigation was to determinate the MAC frequency in patients on hemodialysis and to try to find the correlation between MAC intensity and the duration of hemodialysis, age, sex, Ca/P, metabolism, level of parathormone and atherogenic factors. A group of 40 patients on hemodialysis (aged 20 to 67, 26 men and 24 women) were divided int two groups; group 1 without MAC, N = 17 (42.5%), X = 3.5, SD = 3.1; and group 2 with MAC, N = 23 (57.5%), X = 6.2, SD = 2.4. M-mode and 2-D echocardiography were performed in all patients. Group 2 was divided into three subgroups according to MAC quantitation: mild N = 16 (70%), severe, N = 4 (17%), moderate, N = 3 (13%). Study results showed positive correlation between MAC and serum values of Ca and P (p < 0.05). Increased values of HDL cholesterol, statistically significant at the level p < 0.05 were observed. Study results showed the correlation between MAC and time factor, i.e. duration of dialysis treatment to be statistically significant (p < 0.05). Cardiac calcified syndrome could be a sequela of MAC causing conduction disturbances, valvular stenosis or insufficiency, and arterial emboli or endocarditis.
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PMID:Frequency of mitral annular calcification in patients on hemodialysis estimated by 2-dimensional echocardiography. 904 15

The marked increase in cocaine consumption observed in recent decades, has led to the identification of previously unknown multiple medical problems. Cardiovascular complications related to cocaine abuse include myocardial ischemia and infarction, myocarditis, cardiomyopathy, rhythm disturbances and sudden death, endocarditis, pneumopericardium and left ventricular hypertrophy. Although the mechanisms involved in cocaine-related cardiac diseases are multiple, many cardiac complications in these patients are caused in part or totally by an increase in adrenergic activity due to the blockade of catecholamine reuptake induced by the drug.
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PMID:[Pathology of the heart of noncardiac origin. VIII. Cocaine and the heart]. 964 64

A 49-year-old black man with hypertension-induced chronic renal failure requiring hemodialysis and a history of arteriovenous access graft infection was admitted with Staphylococcus aureus sepsis, dyspnea, and peri-incisional erythema over his arteriovenous graft fistula. Results of a transthoracic echo demonstrated aortic sclerosis and concentric left ventricular hypertrophy. Results of a whole-body In-111 white cell (WBC) scan were negative over the arteriovenous graft site; however, an intense abnormal focus of labeled WBCs was evident to the left of the sternum. A subsequent transesophageal echocardiogram showed a mixed cystic-solid calcified mass adjacent the left aortic cusp. Surgery confirmed a perivalvular abscess. As a whole-body imaging modality, the In-111 WBC scintigram indicated the true location of the infectious process responsible for the patient's sepsis. The combination of echocardiography and radiolabeled WBC imaging increases sensitivity for detection of endocarditis/perivalvular abscess. Radiolabeled WBC imaging is more efficacious for monitoring therapy because the echocardiogram often does not change with treatment of endocarditis/perivalvular abscess.
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PMID:Perivalvular abscess complicating infective endocarditis: complementary role of echocardiography and indium-111-labeled leukocytes. 973 77

A 70-year-old patient with a history of hypertension and hypercholesterolemia was referred for evaluation of necrotic toes. The patient had a history of several cerebrovascular accidents during the previous month. Initially, she developed sudden-onset left upper extremity weakness which, over the ensuing 4 days, progressed to complete left-sided weakness. This was followed by the development of acute dysarthria. A transesophageal echocardiogram revealed moderate left ventricular hypertrophy, several vegetations on her tri-leaflet aortic valve associated with moderate aortic regurgitation, and a large right atrial thrombus with a mobile component. Bubble studies failed to reveal any septal defects. The patient's electrocardiogram was nonspecific. As serial blood cultures were negative despite fevers of up to 39.8 degrees C, the patient was treated with a 6-week course of intravenous ceftriaxone, ampicillin, gentamicin, and ciprofloxacin for a presumed diagnosis of culture-negative endocarditis. Fungal cultures of the blood were negative. The patient, however, progressed and developed several necrotic toes. Physical examination was significant for ischemic changes of the left first, second, third, and fifth toes, as well as the right first and second toes. Diffuse subungual splinter hemorrhages in the toenails, numerous 2-4-mm palpable purpuric papules on the lower extremities, and nontender hemorrhagic lesions of the soles were also noted. Peripheral and carotid pulses were intact and no carotid bruits were heard. Cardiopulmonary and abdominal examinations were unremarkable. Neurologic examination revealed a disoriented, dysarthric patient with left central facial nerve paralysis, as well as spasticity, hyperactive reflexes, and diminished strength and sensation in the left upper and lower extremities. A left visual field defect and left hemineglect were also present. The patient's last brain computerized tomogram revealed areas of low attenuation consistent with cerebral infarctions in three distinct areas of the brain. These included the left occipitotemporal area, the right parieto-occipital area, and the right posterior frontal region. The regions affected were in the distribution of both the anterior and posterior circulation. No evidence of hemorrhage was noted. The patient subsequently complained of abdominal discomfort. A computerized tomogram of the abdomen with oral and intravenous contrast revealed a 4-cm x 3-cm irregular mass in the tail of the pancreas with several low-attenuation lesions throughout the liver which were consistent with infarctions or metastases. Several splenic infarctions were also present. A biopsy of the tumor revealed pancreatic adenocarcinoma. The patient's carcinoembryonic antigen level was 18. 4 ng/mL (0-3) and the CA 19-9 antigen level was 207,000 U/mL (0-36). The alpha-fetoprotein level was normal. Other significant laboratory findings included a prothrombin time of 16.7 (international normalized ratio, 1.4), an activated partial thromboplastin time of 32 (ratio, 1.3), and a platelet count of 85,000/mm3. The Russell viper venom time, sedimentation rate, and C3 levels were normal, and the patient was negative for antinuclear antibodies, anticardiolipin antibodies, and antibodies to extractable nuclear antigens. Of note, the patient was not receiving any anticoagulation. Blood cultures for mycobacteria and fungi, human immunodeficiency virus serology, and urinalysis and culture were negative. The patient subsequently developed an inferior wall myocardial infarction and was transferred to the coronary care unit. In line with the family's request, aggressive care was ceased and the patient expired. The patient's family refused an autopsy.
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PMID:Cutaneous manifestations of marantic endocarditis. 1080 80

The superior performance of stentless aortic valves with improved left ventricular hypertrophy regression and greater effective orifice area is proven. The Aortech Elan stentless valve (AESV) is a glutraldehyde preserved porcine valve with a pericardial reinforced inflow tract and a scalloped outflow to reduce bulk. We present the early results of AESV implantation at our institution. The first 41 consecutive recipients of the AESV at our unit, between November 1999 and December 2000, were studied. Mean preoperative New York Heart Association functional class (NYHA) status was 3.00 +/- 0.1. Patients requiring a bioprosthesis with suitable anatomy routinely received this implant. The AESV was implanted, either with an interrupted or continuous suture to the inflow tract and a continuous suture to the outflow tract. Transthoracic echocardiography was performed at 6 to 9 weeks after surgery, and aortic transvalvular gradients, flow velocities, and effective orifice areas (EOA) were calculated. In the early postoperative period, two patients with coronary artery disease died of low cardiac output. Echocardiography demonstrated competent valves. At follow-up, one patient was shown to have mild to moderate perivalvular leak with minimal symptoms. Two patients with aortic regurgitation secondary to bacterial endocarditis had no evidence of infection at 3 months after surgery. Mean transvalvular gradient was 6.91 +/- 0.87 mm Hg and mean effective orifice area was 1.18 +/- 0.04 cm(2)/m(2) at a mean of 8.4 weeks after surgery. AESV recipients for native aortic endocarditis were free from infection and regurgitation. The Elan stentless aortic valve demonstrates excellent early hemodynamic results, with very low transvalvular gradients, good flow characteristics and low regurgitation incidence. Ease of implantation is evidenced by favorable ischemic times. This valve may offer an option to homograft in acute aortic endocarditis. Long-term results are awaited.
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PMID:The aortic Elan stentless aortic valve: excellent hemodynamics and ease of implantation. 1180 49

Stentless aortic xenografts were introduced into clinical practice as aortic valve substitutes over a decade ago. Stentless prosthetic valves were expected to provide enhanced durability and more physiologic hemodynamic behavior when compared with stented bioprostheses. Whilst the former expectation has not been fulfilled, partly due to concomitantly improved durability of second-generation stented bioprostheses, the latter has consistently been satisfied in early and late clinical observation. Evidence is accumulating suggesting improved long-term survival due to more timely and thorough regression of ventricular hypertrophy. In addition, stentless xenografts have shown extreme versatility when adopted in a variety of complex clinical conditions associated with aortic valve disease, including small aortic anulus, ascending aortic aneurysm, endocarditis and left ventricular dysfunction. Future research in the form of prospective, multicenter, randomized trials must address the issues of very long-term durability and survival, while simplification in valve design is required to promote wider use of stentless valves.
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PMID:Stentless aortic valve replacement: current status and future trends. 1503 20

A 68-year-old woman with concentric left ventricular hypertrophy, prosthetic valve endocarditis with aortic root abscess, and sepsis had aortic root replacement with an aortic allograft. On weaning from cardiopulmonary bypass, she had hemodynamic instability caused by systolic anterior motion of the mitral valve, which resulted in a left ventricular outflow tract obstruction; the peak pressure gradient across the left ventricular outflow tract was 130 mm Hg, and there was moderately severe (3+) mitral regurgitation. After reinstitution of cardiopulmonary bypass, a central Alfieri edge-to-edge stitch was placed between the anterior and posterior leaflets of the mitral valve. This reduced the gradient across the left ventricular outflow tract to 10 mm Hg and eliminated the mitral regurgitation, which enabled successful separation from cardiopulmonary bypass.
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PMID:Use of the Alfieri edge-to-edge technique to eliminate left ventricular outflow tract obstruction caused by mitral systolic anterior motion. 1556 Sep 93

The objective of this study was to determine the outcome of neglected minimal or moderate aortic regurgitation during mitral or mitro-tricuspid valve surgery. 42 patients were included in this survey between 1985 and 2002. There were 17 men and 25 women aged 9-54 years (mean age: 22 +/- 10 years). Etiology was dominated by acute rheumatic fever (91%). Associated lesions were observed: mitral valve incompetence 11 cases, mitral valve stenosis 9 cases, mitral valve incompetence plus mitral valve stenosis in 8 pateints and mitro-tricuspid valve disease in 14 others. All the patients were symptomatic (NYHA class II 79%, NYHA class III or IV 20%). 90% of patients had a radiological cardiomegaly: mean cardio-thoracic was 0.62. At electrocardiogram, 79% of patients were in sinus rhythm and 57% presented a left ventricular hypertrophy. Minimal or moderate aortic regurgitation has been confirmed by echocardiography and angiocardiography in all patients. Surgical treatment was a mitral valve replacement (n = 35.83%), a mitral valvuloplasty (n = 5.12%), a mitral valve replacement and a tricuspid valve annuloplasty according to DE VEGA technique (n = 2.5%). The operative mortality was 4.7% (2 deaths) due to an acute cardiac failure (1 case) and prosthetic valve endocarditis (1 case). 19 patients have been followed up from a mean 1 month to13 years (mean follow-up: 5 years). The follow-up has been marked by a regression or a stability of the neglected aortic incompetence , a regression of the mean cardio-thoracic ratio from 0.62 preoperatively to 0.56 postoperatively, an improvement of the functional status (84% of cases). We conclude that the neglected aortic incompetence during mitral or mitro-tricuspid valve surgery do not tend to aggravate during follow-up.
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PMID:[Aortic failure neglected in surgery of mitral or mitro-tricuspid valve diseases]. 1943 61

A 56-year old man was referred because of heart failure. Staphylococcus aureus grew in the blood cultures. Echocardiography disclosed an 18 mm vegetation on the aortic valve and left ventricular noncompaction. Unfortunately he died 24 h later due to intractable heart failure. Autopsy confirmed aortic valve endocarditis, severe left ventricular hypertrophy and fibrosis, and noncompaction of the apical and lateral walls.
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PMID:Fatal outcome of aortic-valve endocarditis in noncompaction/hypertrabeculation. 1973 6


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