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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of 196 isolated aortic valve replacements in patients older than 65 years were analyzed. Eighty-four percent of patients were in New York Heart Association (NYHA) functional class III or IV preoperatively. The operative mortality was 12% for all cases and 9% for elective cases. Actuarial probability of five-year survival was 55% for the entire group and 61% for discharged patients. Myocardial failure and congestive heart failure were the most common causes of early and late postoperative death, respectively. Embolic strokes occurred in 16% of discharged patients and caused substantial disability in 9%. At the termination of the study, 94% of surviving patients were in NYHA class I or II, and none were in class IV. Aortic valve replacement in elderly patients entails reasonable operative risk, and results in satisfactory postoperative rehabilitation.
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PMID:Isolated aortic valve replacement in patients older than 65 years. 30 Apr 38

The long term results of 95 left ventricular aneurysmectomies are presented. In 47 patients simultaneous aorto-coronary bypass surgery was performed. 53 patients presented preoperatively with congestive heart failure; 8 out of these died within the first postoperative month, while 5-year survival rate (actuarial method) was 52%. Two thirds of this patient group improved. None of the 42 patients without preoperative congestive heart failure died early. 5-year survival rate was 93% and subjective improvement was recorded in one half of this subgroup. Comparison of pre- and postoperative angiograms (40 patients) revealed an increase in left ventricular ejection fraction reflecting the removal of the non-contracting segment. The ejection fraction of the contracting segment of the left ventricle improved after aneurysmectomy, especially in patients with preoperative congestive heart failure. In conclusion, aneurysmectomy improves left ventricular function and the symptoms of heart failure; moreover, it prevents perforation of false aneurysms. Its effect on arrhythmias could not be determined conclusively. Angina may be improved by simultaneous aorto-coronary bypass surgery.
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PMID:[Surgical treatment of myocardial aneurysms. Indications and results]. 30 76

The case files of 4,456 medical admissions in 1975--1976 at Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria, included 354 cardiovascular patients. The most common causes were hypertension (45.5%), cardiomyopathy (20.6%) and chronic rheumatic heart disease (14.4%). The mean age of hypertensive and cardiovascular patients was lower than in Europe. The majority of hypertensive patients suffer from essential hypertension. Congestive cardiac failure is the commonest complication of hypertension and cardiomyopathy. Rheumatic valvular disease with mitral incompetence is frequent and sometimes severe in young people. Other cardiovascular diseases included pericardial disease, bacterial endocarditis, cor pulmonale, anaemic heart failure, congenital and syphilitic heart disease. Coronary heart disease was only encountered in non-Africans. Cardiovascular mortality in hospital was high (20%).
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PMID:Cardiovascular disease in Northern Nigeria. 31 94

Cardiovascular disease is the chief cause of death in technologically advanced countries and accounts for more than 50% of all deaths in the USA. For a patient with end-stage cardiac failure the only treatment presently available is organ replacement, either by transplantation or by the use of a mechanical heart. Transplantation has demonstrated its value: survival of more than 8 years and restoration of a normal quality of life to patients who were in end-stage cardiac decompensation. However, the prospect of routine clinical application of an artificial heart remains distant. The development of a totally implantable artificial heart still presents a series of challenging engineering problems with regard to strict constraints of size, weight, blood-material compatibility, adaptability of output to demand, efficiency and reliability of the power supply, and safety if nuclear fuel is used. The totally artificial heart is presently not an alternative to the cardiac allograft, but could provide short-term support for patients awaiting cardiac transplantation.
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PMID:Human technology after cardiac epigenesis. Artificial heart versus cardiac transplantation. 33 21

In a prospective study 31 cases of proved and 10 of highly suspected bacterial endocarditis were analysed. Valve incompetence was the usual consequence but stenosis occurred in 3 cases, all fatal. Congestive heart failure developed in two-thirds. Secondary manifestations were common and as often caused by alpha-streptococci as by other bacteria. Initial antibiotic treatment was mainly applied according to a fixed schedule, generally with continuous intravenous infusion, followed by oral therapy. In 10 patients, the infection was still active after 6 weeks of therapy. Therefore, we now use intermittent injections or infusions for at least 4--6 weeks. Within a year, 9 patients died from uncontrolled infection together with congestive heart failure, and 1 from heart failure and active chronic endocarditis. In 4, myocardial abscesses or inflammations were found. All 10 had underlying factors or advanced stages of the disease. Of 18 patients with alpha-streptococci or enterococci none died from endocarditis, as against 10 of 23 with other or unknown bacteria. Follow-up yielded valuable information on one-third of the patients. The mortality during the initial hospital stay was 22%, after 1 year 24% and after 5 years 39%.
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PMID:Bacterial endocarditis. II. A prospective study with clinical, laboratory and therapeutic observations. 41 66

Necropsy findings in 10 dogs with naturally occurring cardiac disease closely resembled hypertrophic cardiomyopathy in human beings and cats. Each dog had marked cardiac hypertrophy, and 8 dogs had disproportionate thickening of the ventricular septum with respect to the left ventricular free wall (compared with dogs with normal hearts or with cardiac hypertrophy due to acquired or congenital heart disease). Ratios of septum to free wall thickness in the 10 dogs ranged from 1.1 to 1.5, and 6 had ratios greater than or equal to 1.3. Marked cardiac muscle cell disorganization in the ventricular septum, characteristic of human patients with hypertrophic cardiomyopathy, was found in only 2 of the 10 dogs. Death occurred while the dogs were under anesthesia during the course of operative procedures (5 dogs) or unexpectedly in animals without previous manifestations of cardiac disease (3 dogs). Four dogs had clinical signs of congestive heart failure, including 2 with marked cardiac decompensation. Two of these 4 dogs with heart failure and 1 dog that died during unrelated surgery, but without prior signs of heart disease, had electrocardiographic evidence of complete heart block.
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PMID:Canine hypertrophic cardiomyopathy. 42 33

The Authors consider the global evaluation of clinical and functional data in patients with the following radiological features: 1) X-ray thoracic aspects characterized by marked broncho-vascular bundles and diffusion of reticular nodulation as in diffuse interstitial pulmonary fibrosis; 2) lack of ECG and clinical signs of heart failure. Since a reversibility of radiological alterations was considered a favourable reply to bleeding and diuretic acute and long term therapy the Authors suggest that these patterns should be related to a different distribution of hydric and haematic masses with a decreasing of interstitial pulmonary oedema which contributes to a full interlobar septa like "D" lines shadows, according to Kreel, (1975). The Authors, moreover, relate these clinical, functional and radiological aspects to the patterns of "wet lung" distinguished from the cardiac lung caused by congestive heart failure and from interstitial lung fibrosis.
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PMID:[Contribution to the study of "wet lung". Radiological and clinico-functional changes induced by depletion therapy in 5 patients with chronic bronchopulmonary disease]. 43 31

In a prospective study, 44 children receiving Adriamycin (ADR) for various neoplastic diseases underwent serial estimations of the systolic time intervals (STI) for the noninvasive assessment of left ventricular myocardial performance. Five of the 44 children developed clinical signs of ADR-related congestive heart failure at a cumulative dose of less than 550 mg/m2 body surface area. Clinical symptoms, changes in the electrocardiogram and in the chest X-ray were preceded in every case by changes of the STI, mainly a prolongation of the left ventricular pre-ejection period (PEP), or a decrease of the ejection time (ET)/pre-ejection period (PEP) ratio (ET/PEP). A continous increase of the PEP and a decrease of the ET/PEP-ratio also gave an indication of myocardial dysfunction during ADR treatment in the other children without clinical signs of congestive heart failure. This subclinical cardiotoxic effect of ADR below the critical cumulative dose of 550 mg/m2 was observed in children with pre-existent myocardial damage, with preceding thoracic irradiation, or during concurrent chemotherapy, of which cyclophosphamide seemed to be most important. Thus, the estimation of the STI proved helpful and reliable in the early detection of incipient heart failure and in the selection of high risk patients in children receiving ADR treatment.
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PMID:Assessment of adriamycin cardiotoxicity in children by systolic time intervals. 43 54

False aneurysms of the left ventricle were repaired in four patients (average age, 61 years). The etiology was myocardial infarction in three patients and disruption of an apical left ventricular cannulation site in the fourth. The interval from initiating event to surgery averaged 11 months. One patient was in cardiogenic shock and succumbed in the operating room from myocardial failure. The other three patients, in functional class III at the time of surgery, survived and are currently asymptomatic. The literature records 43 patients who have undergone surgical repair of a false aneurysm of the left ventricle. The causes were myocardial infarction (12 patients), operative injury (13 patients), penetrating trauma (11 patients), and blunt trauma (seven patients). Twenty-seven (63%) were under the age of 50 years. In those who were limited by symptoms, congestive heart failure predominated. Forty seven per cent of the patients were operated upon in the first five months following the initiating event; 61% within the first year. Only four patients underwent surgery more than 48 months after the myocardial insult. Thrombus was present in 28% of the aneurysms. Morbidity was recorded in nine patients, and six patients (14%) died. This study documents the necessity for early surgical repair and the relatively low operative mortality obtained with this lethal lesion.
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PMID:False aneurysm of the left ventricle. Report of four cases and review of surgical management. 44 96

Controversy persists concerning the role of early surgical intervention in severe infective endocarditis (IE). We therefore reviewed 163 episodes of well-documented IE in which 32 cardiac operations were performed during the active phase of IE. Congestive heart failure (CHF) was the principal indication for surgery in 88% (28/32); systemic emboli, 1/32; and persisting sepsis, 3/32. Staphylococcus and enterococcus were the most common infecting organisms in the operative group (44% and 16% respectively). Surgical mortality (11/32,37%) did not differ (p greater than 0.05) from medical mortality (26/131,20%). All 11 operative deaths occurred in patients moribund prior to surgery, including three with preoperative cardiac arrest. Surgical patients undergoing preoperative cardiac catheterization demonstrated marked CHF: a mean left ventricular end-diastolic pressure of 25.3 mm Hg. The mean cardiac index in 8/11 surgical deaths was lower (p less than 0.05) vs surgical survivors: 2.21/min/m2 vs. 3.21/min/m2. Postoperative complications were rare in the 21 surgical survivors. There were no episodes of continued infection, prosthetic dehiscence, or advanced heart block; only one paravalvular leak; and one systemic embolus. These findings emphasize the high medical and surgical mortality in patients with IE, suggest that delayed operative intervention may be a major causative factor resulting in a high surgical mortality, and justify an aggressive surgical approach in patients with valve dysfunction and heart failure. These data indicate that survivors of surgical intervention during active IE have eradication of infection and few postoperative complications.
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PMID:Surgery in active infective endocarditis. 44 78


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