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

Colour Doppler echocardiographic (CDE) assessment of tricuspid regurgitation (TR) has been limited by the lack of an accepted model against which it can be compared. Angiography is said to be inadequate because catheter placement across the tricuspid valve could induce artifactual TR. Thirty-five consecutive patients with left-sided valvulopathy and recent heart failure were studied. Angiography was validated by CDE, which demonstrated that catheter placement across the tricuspid valve did not increase the size of the regurgitant jet in the first 30 cases. All the patients were studied with CDE immediately before performing the angiography in order to compare the findings of both techniques. From all the CDE parameters measured among the angiographic groups, the jet area overlapped the least (P = 0.024). The diameters of the right cardiac chambers were larger in angiographically severe cases (P = < 0.003 to 0.041), and a scale of severity that combined jet area and right atrium area showed an excellent correlation with angiography (r = 0.924; P < 0.001). Furthermore, maximal instant systolic gradients between the right cavities, estimated by catheterization, were lower in severe cases (P = 0.038). Assessment of these gradients by continuous Doppler can enhance recognition of severe TR. The analysis of jet area, right atrium area and regurgitant gradient by CDE can provide excellent assessment of TR.
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PMID:Assessment of chronic tricuspid regurgitation by colour Doppler echocardiography: a comparison with angiography in the catheterization room. 798 99

A successful case of left heart bypass (LHB) for severe heart failure after mitral commissurotomy is presented. A 44-year-old woman underwent surgery for mitral and tricuspid regurgitation, then could not be weaned from cardiopulmonary bypass because of low cardiac output and intractable ventricular arrhythmia. The LHB from right-sided left atrium to ascending aorta was instituted with anti-thrombogenic centrifugal pump system (Carmeda). During initial 6 hours of LHB, any anticoagulant drugs were not employed, thereafter the local administration of heparin into left ventricle was started with a dose of 200 unit per hour. The LHB was successfully weaned at 26 hours after institution. Her postoperative course was uneventful. The left heart bypass without systemic heparinization utilizing anti-thrombogenic material might be a safe and useful method for postcardiotomy cardiogenic shock.
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PMID:[A successful case of left heart bypass with biocompatible bypass circuit and minimal heparin for severe heart failure after open mitral commissurotomy]. 808 85

The authors report their experience of the clinical and echocardiographic aspects and course of tricuspid infectious endocarditis, based upon 12 cases collected between September 1985 and December 1992. The diagnosis was confirmed on the basis of the association of signs of septicemia (12 cases), at least two positive blood cultures for the same organism (9 cases) and well-defined vegetations seen by trans-thoracic echocardiography (12 cases). All patients were young women: mean age = 21.8 +/- 4.7. None were heroin addicts but one was positive for human immune deficiency virus. Tricuspid infectious endocarditis was most often acute (9 cases), primary (10 cases, post-abortum (11 cases), due to Staphylococcus aureus (5 cases), and complicated by cardiac failure (12 cases) and lung abscess (4 cases). Four patients died of septicemia (2 cases), of cardiac failure and lung abscess (2 cases). One had severe tricuspid incompetence requiring surgery. It has not yet been possible to operate on this patient because of the lack of cardiac surgery facilities in Congo. The prevention of tricuspid infectious endocarditis depends above all on the fight against clandestine abortions and against the development of intravenous drug abuse.
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PMID:[Tricuspid infectious endocarditis in Brazzaville. Apropos of 12 cases]. 811 50

Chylothorax associated with right-sided congestive heart failure was diagnosed in 5 cats. One cat had restrictive pericardial disease, with mild pericardial effusion, and a heart-base chemodectoma. Two other cats had congestive cardiac disease (tetralogy of Fallot and tricuspid regurgitation in 1 cat, and endocardial cushion defect and tricuspid dysplasia in the other), and 2 cats had idiopathic cardiomyopathy. All cats had jugular venous distention, and echocardiographic evaluation helped define the nature of the cardiac disease in these cats. Subtotal pericardiectomy resulted in resolution of the chylothorax in the cat with the heart-base tumor, whereas medical management of the right-sided heart failure temporarily decreased pleural effusion in the cat with tetralogy of Fallot and in the 2 cats with cardiomyopathy.
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PMID:Chylothorax associated with right-sided heart failure in five cats. 812 26

In the period between January 1979 and January 1989, 72 patients (46 women and 26 men, average age 46 years) out of 697 patients undergoing a tricuspid valve procedure, underwent prosthetic valve replacement for organic tricuspid valve disease. Sixteen patients had pure tricuspid regurgitation (Group I). The causal pathology was essentially traumatic (6 cases) and infections (endocarditis) (5 cases). Fifty-six patients (Group II) had organic tricuspid valve disease associated with a left-heart valvular lesion. The causal pathology was rheumatic fever in 52 cases and endocarditis in 4 cases. In 40 patients (71.5%) the procedure was a reoperation of a mitral and/or aortic and/or tricuspid valve prosthesis. In 21 cases, the initial operation had involved the tricuspid valve. All patients in Group I underwent valvular replacement with a bioprosthesis. In Group II, 40 patients were implanted with a bioprosthesis and 16 with a mechanical valve prosthesis. The follow-up was complete for an average period of 7 years (range 2 to 12 years) for a total of 295 patient-year. The hospital mortality was nil in patients with isolated tricuspid valve disease. Reoperation for deterioration of a porcine bioprosthesis was required after 4 years in 1 case. Terminal cardiac failure was responsible for one late death 7 years after surgery. The hospital mortality was 26.7% (15 patients) in Group II. The actuarial rate of patients free of reoperation at 7 years was 80 +/- 8%. The actual rate of patients free of any prosthetic valve related complication was 78 +/- 2%. The 7 year survival rate excluding operative mortality was 65 +/- 8%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Tricuspid valve replacements in adults. Long-term results]. 812 49

In 31 patients who had undergone cardiac orthotopic transplantation, valvular regurgitation was studied by echocardiographic and pulsed Doppler over 2 years. The first week after cardiac transplantation, transplant recipients had an increase in the severity of tricuspid, mitral (group II), and aortic regurgitation, as well as a greater number of simultaneously regurgitating valves when compared with those in a group of 60 normal subjects of similar age to heart donors: transplant recipients, trivalvular regurgitation 48% (95% confidence interval [CI] 30 to 66) vs control group, 5% (CI 1 to 13; p < 0.001). Moderate-severe tricuspid regurgitation (TR) was the most frequent occurrence (55%, CI 36 to 73) followed by pulmonary (PR) (42%, CI 25 to 61), moderate mitral (MR) (32%, CI 15 to 51), and mild aortic (AR) (23%, CI 10 to 43) regurgitation. These regurgitations were asymptomatic at rest except for TR. TR was associated with right-sided heart failure in 76% of patients in the early postoperative period and controlled with diuretic drugs. This regurgitation correlated with persistence of post-transplant pulmonary hypertension (r = 0.6) and was not related to pulmonary hypertension before cardiac transplant. There was also no relation found between donor ischemia time or episodes of cardiac rejection.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Quantitative assessment of valvular function after cardiac transplantation by pulsed Doppler echocardiography. 820 38

We report a patient of ventricular septal defect associated with a vegetations on the tricuspid valve and a perforation of the aortic cusp caused by infective endocarditis. Antibiotics could not relieve the high fever of this patient, and disseminated intravascular coagulation caused by sepsis and two-sided heart failure developed. She underwent extended tricuspid valve excision, aortic valve replacement and VSD closure during the active stage. Post-operative antibiotic therapy was continued intravenously for 6 weeks, and orally for 3 more weeks. Although post-operative right ventriculography indicated tricuspid regurgitation and right atrium enlargement, pressure study of the right side of the heart revealed normal hemodynamics.
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PMID:[Extended tricuspid valve excision for active infective endocarditis associated with ventricular septal defect]. 828 5

Between 1975 and 1991, 97 consecutive patients underwent De Vega tricuspid annuloplasty either isolated or in combination with mitral, aortic, or mitral and aortic valve procedures. Preoperatively 96.9% of the patients were in New York Heart Association functional class III or IV. Causes of tricuspid insufficiency were functional tricuspid ring dilatation and a combination of dilatation and different organic tricuspid valve lesions. There were 17 early deaths (17.5%), primarily due to cardiac failure, none was related to the tricuspid annuloplasty. 80 perioperative survivors have been followed up for a mean of 4.7 +/- 4.1 years with a total of 462 cumulative patient-years. Actuarial 5-, 10-, and 15-year survival rates, including early deaths, were 64% +/- 5%, 48 +/- 6%, and 26% +/- 10%. Recurrence of tricuspid regurgitation was rated as moderate in 15% and severe in 18.8%. Ten patients required reoperation (2.2%/patient-year), of whom 8 were associated with tricuspid regurgitation (1.7%/patient-year). Although in all patients but one the De Vega annuloplasty was intact, the tricuspid ring was dilated; 4 patients had additional tricuspid organic valve lesions. 6 of the 8 patients had concomitant mitral valve or mitral prosthesis dysfunction. 26 patients died late (5.6%/patient-year) due to chronic cardiac failure in 50% and after reoperation in 7% of the patients. 4 patients had implantation of a permanent pacemaker (0.9%/patient-year). 54 patients (67.5%) are still alive, with 43% having no and 17.5% having only mild residual tricuspid regurgitation. De Vega annuloplasty is indicated with tricuspid insufficiency due to functional ring dilatation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgery for tricuspid insufficiency: long-term follow-up after De Vega annuloplasty. 836 51

We reported a 64-year-old woman with frequent cardiac failure due to unroofed coronary sinus complicated with tricuspid regurgitation (TR). We performed direct suture closure of unroofed coronary sinus and tricuspid annuloplasty with a Carpentier ring (34 T). Immediately after the operation, large amount of pleural effusion accumulated owing to acute left ventricular failure. That cause consists in the scarcity of the left ventricular volume, which was depending on the much left-to-right shunt volume through the unroofed coronary sinus. But her general condition was recovered from acute left ventricular failure for administration of catecholamine, digitalization, and urinative. We think that the echocardiography is valuable to investigation of the existence of unroofed coronary sinus, especially complicated with TR.
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PMID:[A case report of unroofed coronary sinus with repeated congestive cardiac failure]. 837 17

Among 21 patients with left atrial myxoma treated during the past 11 years in our institute, 3 patients had associated acquired heart disease which required concomitant cardiac surgery. Two patients had atherosclerotic coronary arterial disease, and underwent single coronary artery bypass grafting (CABG) and 4 CABGs in addition to removal of myxoma, respectively. Both of them received CABGs after removal of myxoma, because the intraoperative heart protection using retrograde coronary perfusion could afford the situation. Another patient had a huge left atrial myxoma associated with mitral and tricuspid regurgitation. She suffered from sudden heart failure caused by tumor obstruction of blood flow across the mitral valve, and an emergency surgery was performed. She underwent mitral valve replacement for annular dilatation with prolapse of both leaflets and tricuspid annuloplasty for annular dilatation, in addition to removal of myxoma. All of these 3 patients went a good postoperative course and are doing well now with no local recurrence. In this paper, preoperative and intraoperative evaluation, and surgical treatment of associated heart disease with left atrial myxoma were discussed.
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PMID:[Surgical treatment of left atrial myxoma with concomitant acquired heart disease]. 851 67


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