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

We report here a case of a premature baby with tetralogy of Fallot and bicuspid aortic valve. After the successful completion of the Blalock-Taussig (BT) shunt, severe aortic valve regurgitation (AR) appeared, although it was trivial preoperatively. Severe postoperative heart failure was induced by progression of the AR. Postoperative echocardiography revealed that the progression of the AR was provoked by appearance of prolapse of the cusp as the result of rapid increase of blood flow through the aortic valve after the BT shunt. We propose that, in planning the BT shunt for patients with tetralogy of Fallot, preoperative examinations for a possible bicuspid aortic valve should be done and postoperative precaution considering possible appearances of severe AR and congestive heart failure will be necessary.
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PMID:Symptomatic aortic regurgitation after Blalock-Taussig shunt in tetralogy of Fallot with bicuspid aortic valve. 936 9

From July 1, 1989 to June 30, 1996, a total of six patients, four male and two female, with double aortic arch (DAA) were registered. They aged 16 days to 6.5 years. There were two patients with isolated DAA, and four complicated with intracardiac anomalies. All six patients presented respiratory distress and feeding problem early in life. However, cyanosis, owing to decreased pulmonary blood flow, predominated the clinical picture in each patient having DAA intricated with tetralogy of Fallot (TOF) and pulmonary stenosis, TOF with absent pulmonary valve syndrome, and type II-A tricuspid atresia. DiGeorge syndrome was documented in one patient with TOF and pulmonary stenosis. Expiratory wheezing was remarkable in the patient with TOF and absent pulmonary valve syndrome. Mild cyanosis and heart failure was noted in one patient with ventricular septal defect (VSD), and bicuspid pulmonary valve with mild valvular stenosis. Barium esophagogram showed indentations on esophagus in five patients. Echocardiography was yielding in three infants. Four patients, two isolated and two complex DAA, survived the surgical division of the smaller left aortic arch. One-stage and two-stage operation was performed in patients having DAA intricated with VSD and TOF, respectively. The other two patients with complex DAA remained in close observation owing to the tolerance of symptoms related to intracardiac anomalies.
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PMID:Clinical implications of isolated double aortic arch and its complex with intracardiac anomalies. 957 45

A 70-year-old woman with a bicuspid aortic valve had undergone ascending aorta replacement for acute DeBakey type I dissection. Computed tomography and aortography 2 months after the operation revealed a thrombosed false lumen in the ascending aorta proximal to the prosthetic graft. However, recurrence of dissection was found at the aortic root proximal to the graft 4 years after the initial operation. Significant aortic stenosis was also noted. Despite intensive medical treatment, she had refractory and progressive heart failure. At the second surgery, an aorto-right atrial fistula, which probably was responsible for the severe heart failure was revealed. Closure of the aorto-right atrial fistula, and aortic root replacement were performed using Piehler's method, with a composite graft. The etiology and management of this rare case are discussed.
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PMID:Aorto-atrial fistula associated with recurrent aortic dissection after ascending aorta replacement. 997 7

We analyzed 50 cases of bicuspid aortic valve endocarditis in patients who presented to St. Thomas' Hospital from 1970 through 1998. These represented 12.3% of the 408 cases of native valve endocarditis (NVE). All patients were male, and their mean age was 39 years. Forty-five of the 50 cases were pathologically proven; 47 were clinically definite according to the Duke criteria and 49 according to our modifications of the Duke criteria. Viridans streptococci and staphylococci accounted for 72% of cases. The prevalences of clinical features were similar to those seen in NVE: fever (temperature >/=38 degrees C, 74%) and malaise (70%), although dyspnea was more frequent (36%). There was a high incidence of serious complications (72% heart failure; 30% periannular abscesses). Surgery was required during the initial admission in 82% of cases. Overall mortality was 14%, and surgical mortality was 9%. Few patients knew they had a "heart condition," and a bicuspid aortic valve was detected in only 35% of echocardiograms performed before surgery.
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PMID:Bicuspid aortic valve--A silent danger: analysis of 50 cases of infective endocarditis. 1067 38

Prosthesing the mitral valve with preservation of the posterior cusp was performed in 156 patients. The domestic disk prostheses "Liks", "Emiks" and the bicuspid prosthesis "Medinzh" were used for the implantation. An additional correction of the tricuspid valve was made in 22 patients. The aortal valve needed the correction in 16 patients. The intrahospital lethality was 2.6%. The preservation of the posterior cusp prevents rupture of the posterior wall of the left ventricle, decreases risk of paraprosthetic fistulas and reduces frequency of the development of acute heart failure.
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PMID:[Ways to improve the results of mitral valve prosthesis by preservation of the posterior cusp with the subcuspal structures]. 1098 32

Reports of aortic regurgitation due to rupture of the aortic valve commissures are rare. Prompt surgical intervention is necessary, as the condition results in rapid, progressive heart failure and subsequent death. We report the case of a 78-year-old man who presented with aortic laceration and cardiac tamponade that was probably induced by prolapse of the bicuspid aortic valve. We speculate that prompt initial surgery may have prevented aortic laceration and cardiac tamponade in this patient. Thus, in order to optimize clinical outcome, clinicians must consider early, precautionary surgical management in patients who have sudden cardiac failure due to aortic regurgitation associated with prolapse of the bicuspid aortic valve.
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PMID:Aortic laceration due to prolapse of the bicuspid aortic valve: case report. 1138 Jan 2

Ruptures of sinus of Valsalva aneurysms are a rare complication, and very few cases of rupture in the left atrium have been described. In this clinical case we report the case of a patient hospitalised with a scenario of cardiac insufficiency revealing a very large posterior sinus of Valsalva aneurysm, associated with a bicuspid aortic valve, and rupture in the left atrium. The diagnosis was by transthoracic and transoesophageal multiplan echocardiography, and the treatment surgical, with a good result.
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PMID:[Rupture of a sinus of Valsalva aneurysm in the left atrium]. 1182 27

Although mild proteinuria is commonly observed during the course of brucellosis, biopsy-proven glomerulonephritis (GN) is quite rare. We present the first case of mesangiocapillary glomerulonephritis (MCGN) associated with brucellosis and summarize all cases of Brucella GN published to date. Our patient, who had a congenital bicuspid aortic valve, also had heart failure, fever, urinary abnormalities and proteinuria. Renal biopsy revealed MCGN. Although the clinical features raised the possibility of GN associated with endocarditis, transesophageal echocardiography did not show any vegetations.
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PMID:Brucella glomerulonephritis: review of the literature and report on the first patient with brucellosis and mesangiocapillary glomerulonephritis. 1216 Jan 81

A Japanese man who died at age 85 had been followed since the age of 59, when he first presented. He had hypertension of 162/102 mmHg and a loud systolic murmur on his first visit. He had had an active daily life without any medication for the next 10 years. At the age of 72 he complained of mild chest discomfort on exercise. Although electrocardiography showed no abnormalities, echocardiogram showed calcified bicuspid aortic valve with mild stenosis. At the age of 81 the dyspnea and chest oppression were exacerbated, associated with marked ST depression on exercise electrocardiogram and restriction of aortic valve opening on echocardiograms. In the following years a gradual increase in QRS voltage and ST depression with T wave inversion were recorded on resting electrocardiograms and sharp increases in both left ventricular end-diastolic diameter and flow velocity at the aortic root were observed on echocardiograms. At the age of 85 he died of intractable heart failure with massive pleural effusion. Autopsy revealed marked hypertrophy and moderate dilatation of the heart (weight: 580 g). The bicuspid aortic valve had anterior-posterior cusps with a raphe on the anterior cusp. The mobility of the cusps was almost lost because of severe calcification and thickening. Severe stenosis was found near the orifice of the right coronary artery, but there were no significant ischemic myocardial lesions.
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PMID:[An autopsied case with a bicuspid aortic valve who had progressive angina pectoris and heart failure during follow-up of 27 years]. 1218 11

This case study presents two patients with aortic stenosis and infective endocarditis (IE) who underwent homograft aortic valve replacement. The first patient is a 67 year old practicing surgeon. Twenty one years ago, he was admitted to our department for critical aortic stenosis, infective endocarditis (IE) and heart failure. He underwent homograft aortic valve replacement. After the surgery his condition improved dramatically and he returned to his practice. Current echocardiographic study shows normal function of the left ventricle and normal gradient across homograft aortic valve. The next case, a 33-year old happy mother of 5 children, is particularly interesting. When she was 15 years old, she was referred to surgery, diagnosed with bicuspid aortic valve stenosis, subaortic muscular stenosis and aneurysm of aortic sinus of Valsalva. She underwent homograft aortic valve and root replacement and excision of the sub-aortic muscle bulge. Eleven months later, she required another operation due to active IE. The St. Jude Medical aortic valve was implanted. Two months after the surgery a dysfunction of the implanted artificial valve was diagnosed. She again underwent the homograft aortic valve and root replacement with good long-term results. In the period spanning 1987-1997, she managed to deliver five babies without any complications whatsoever. Seventeen years later, the homograft aortic valve is still functioning fairly well. The homograft aortic valve replacement may be regarded as a viable option for patients with aortic stenosis and IE and for young women suffering from aortic valve disease who intend to be prospective mothers.
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PMID:[Implants with aortic valve homografts in patients with critical left aortic stenosis]. 1263 47


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