Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0232605 (regurgitation)
 8,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between June 1975 and August 1978, 22 cases of anatomically and functionally severe tetralogy of Fallot were corrected with a valve bearing ventriculo-pulmonary Hancock conduit. The indication for use of the Hancock conduit was atresia of the pulmonary valve ring and main pulmonary artery (classified according to Sommerville and Jefferson as types I and II respectively) in 5 patients, severe hypoplasia of the pulmonary valve ring, the right ventricular outflow tract (RVOT) and the main pulmonary artery in 10, 1 patient with an abnormal right coronary artery and an acquired obstruction of the infundibulum subsequent to Waterston-Cooley anastomosis in 4 patients. Hancock conduits (KHP) were also employed in two patients with severe pulmonary insufficiency after patch insertion across the pulmonary valve ring. Early mortality was 9%. Very good hemodynamic results were achieved in 15 patients (with pRV/pLV ratios less than 0.4 in 8 and between 0.4 and 0.5 in 5 patients). Good results (as indicated by pRV/pLV ratios between 0.5 and 0.7) were found in 7 patients, while only in 2 patients a ratio greater than 0.7 indicated an insufficient hemodynamic result. The valve bearing ventriculo-pulmonary Hancock conduit is the surgical method of choice for various types of atresia of the RVOT. As opposed to transanular reconstruction of the RVOT which, dependent on the extent of hypoplasia, consistently leads to some degree of pulmonary insufficiency, the use of the Hancock conduit can prevent pulmonary regurgitation.
 ...
PMID:[Reconstruction of the right ventricular outflow tract in tetralogy of Fallot with a Hancock valve containing ventriculo-pulmonary conduit (author's transl)]. 45 28

Seven patients with pulmonary regurgitation (PR), normal pulmonary artery (PA) pressures and large left-to-right atrial shunts are reported. Six had secundum atrial septal defects (ASD) and one had anomalous pulmonary venous drainage. These comprised 4% of 180 patients with atrial shunts and normal PA pressures. Pulmonary regurgitation was diagnosed clinically by mid-frequency diastolic decrescendo murmurs beginning after the pulmonic component of the second heart sound, and diagnoses were confirmed by catheterization. In two patients who had serial preoperative catheterizations over 8 and 16 years, PR progressed in one and was present only on the second study in the other. All patients underwent shunt correction, at which time the pulmonic anulus and artery appeared dilated, but the pulmonic valves were normal and did not require revision. In all patients the PR murmur disappeared after shunt correction alone, and on chest X-ray both PA and overall heart size decreased. Although it is known that pulmonary regurgitation occurs with atrial septal defects and pulmonary hypertension, the present study demonstrates that it also occurs with high flow atrial shunts, in which setting it has different implications and is reversible with shunt correction alone.
 ...
PMID:Pulmonary regurgitation in large atrial shunts without pulmonary hypertension. 99 12

To determine the prevalence of valvular regurgitation in children (from birth to 14 years old) with structurally normal hearts, the records of 1360 consecutive patients referred for echocardiographic and Doppler examination were analyzed. A total of 461 (33.9%) patients were found to have structurally normal hearts. Flow patterns across the four valves were examined by pulsed, continuous-wave, and color Doppler imaging techniques. Regurgitation was detected in 124 (26.9%). Pulmonic regurgitation was most commonly found and was detected in 101 (21.9%) patients, tricuspid regurgitation in 29 (6.3%), and mitral regurgitation in 11 (2.4%). Aortic regurgitation was not found. Regurgitation of one valve occurred in 106 (23.0%) patients and of two valves in 18 (3.9%) patients. No patient had regurgitation of more than two valves. The prevalence of pulmonic regurgitation increased significantly with age (p less than 0.0001), whereas the prevalence of mitral, tricuspid, and bivalvular regurgitation did not change with age. Valvular regurgitation was trivial or mild in 87% of patients. Thus mild valvular regurgitation is commonly found in children with structurally normal hearts.
 ...
PMID:The prevalence of valvular regurgitation in children with structurally normal hearts: a color Doppler echocardiographic study. 172 23

Echo Doppler makes a fundamental contribution to the non-invasive quantification of mitral valve disease. It enables calculation of gradients and of orifice surface area in mitral stenosis. The quantification of mitral insufficiency is also possible though more difficult: it is based upon the combination of semi-quantitative and quantitative methods, in particular the calculation of regurgitation fraction obtained by comparison of flow rates at different orifices in cases of pure regurgitation. Finally, the calculation of pulmonary artery pressures from a Doppler record in tricuspid and pulmonary insufficiency can be used to assess the effects of mitral valve disease on the pulmonary circulation. Echo Doppler thus provides a reliable non-invasive hemodynamic assessment of mitral valve disease and should lead to a reduction in the number of invasive investigations in this type of valve disease.
 ...
PMID:[Quantification of mitral valve diseases by Doppler]. 177 2

A total of 20 patients (mean age 8.9 months) were examined after total correction of Fallot's tetralogy, 9 of them underwent transannular plasty and 11, separate right ventricular outflow tract plasty. Two-dimensional and Doppler echocardiographies were used to measure cardiac index, end-diastolic and end-systolic volumes, ejection fraction of the left and right ventricles, regurgitation fraction on the pulmonary and tricuspid valves, right ventricular-pulmonary artery pressure gradient. The study of the immediate postoperative period indicated that the pattern of its course was affected by the type of right ventricular outflow tract plasty, however, its function (ejection fraction) remained diminished in the periods up to 12 months of the operation. Pulmonary valve regurgitation was found to be one of the factors contributing to its diminution.
 ...
PMID:[Cardiac function after radical correction of tetralogy of Fallot in infants]. 189 54

Fifty-five patients with repair of tetralogy of Fallot were evaluated with treadmill exercise, pulmonary function testing and rest two-dimensional and Doppler echocardiography to determine the relation among cardiopulmonary function, exercise capacity and ventricular arrhythmias. The mean age at repair was 8.1 +/- 2.1 years; age at the time of study ranged from 15 to 37 years (mean follow-up time after repair 18 +/- 5 years). Exercise duration was 92 +/- 17% of predicted. Maximal heart rate was 94 +/- 7% of predicted. No exercise test was stopped because of an arrhythmia. Thirty patients had oxygen consumption and ventilation measured during their final minute of exercise. Peak oxygen consumption was 31 +/- 8 ml/kg per min (86 +/- 18% of predicted). Twenty-five patients (45%) had low vital capacity at rest (less than 80% of predicted). Pulmonary regurgitation was identified in 42 (75%) of the patients and judged to be moderate in 10 (18%). Mild tricuspid valve regurgitation was identified in 64%. Doppler estimated right ventricular outflow gradient was greater than 15 mm Hg in 15% of the patients (mean gradient 24 mm Hg [range 16 to 56]). Age at repair, duration of follow-up and type of repair did not correlate with echocardiographic variables, ventilatory data, exercise performance or arrhythmias. Moderate pulmonary regurgitation was associated with increased right ventricular diastolic area and both were inversely related to exercise duration and vital capacity. Decreased breathing reserve during maximal exercise was associated with moderate pulmonary regurgitation and decreased vital capacity. The results indicate that exercise capacity in these patients is in general good; however, right ventricular volume loading and ventilatory dysfunction may produce exercise limitation.
 ...
PMID:Lung function and pulmonary regurgitation limit exercise capacity in postoperative tetralogy of Fallot. 199 5

The feasibility, reproducibility and reliability of Doppler echocardiography in evaluation of pulmonary artery pressure in patients with chronic obstructive pulmonary disease (COPD) were determined in a multicentre study. In 100 COPD patients with mean pulmonary artery pressure ranging from 10 to 62 mmHg at cardiac catheterization, pulmonary pressure estimation was attempted by four Doppler echocardiographic methods. These methods comprised the calculation of transtricuspid and transpulmonary pressure gradients from Doppler-detected tricuspid or pulmonary regurgitation, the evaluation of right ventricular outflow tract velocity profiles with the measurement of right ventricular systolic time intervals and the measurement of the right ventricular isovolumic relaxation time. In 98 (98%) patients at least one of the methods could be employed. A tricuspid regurgitation jet was detected in 47 (47%) patients but its quality was adequate for measurement in 30 (30%). Pulmonary regurgitation jet velocity was measured only in five cases. The standard error of estimate in testing intra- and interobserver reproducibility of Doppler systolic time intervals was less than 5%. The predictive value of right ventricular outflow tract acceleration time less than 90 ms in the identification of patients with mean pulmonary artery pressure greater than 20 mmHg was 80%. Of Doppler echocardiographic data, best correlations with mean pulmonary artery pressure were found for the transtricupid gradient (r = 0.73, SEE = 7.4 mmHg), for the right ventricular acceleration time (r = 0.65, SEE = 8 mmHg) and right ventricular isovolumic relaxation time (r = 0.61, SEE = 8.5 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Doppler echocardiographic evaluation of pulmonary artery pressure in chronic obstructive pulmonary disease. A European multicentre study. Working Group on Noninvasive Evaluation of Pulmonary Artery Pressure. European Office of the World Health Organization, Copenhagen. 204 42

430 apparently healthy subjects were studied with color Doppler flow imaging system. There were 216 females and 214 males, their age ranged from 4-80 years (mean 41.2 years). They were divided into 6 groups by every ten years of age, with group I having age below 19 and group VI age above 70. None of the subjects had previous diagnosis of cardiovascular diseases. Mitral regurgitation was detected in 30.9-52.8% in all the groups except group I, in which it was found in 20.0% only. The prevalence rate of tricuspid regurgitation was 9.8-36% in the six groups. Pulmonary regurgitation signals were detected in 43.8-4.8% in these groups with a tendency of lower incidence in the elderly. Aortic regurgitation were detected only in the three elder groups with an incidence of 5.5% in group 4 and 13.6% in group 6. The reason for that may be the degeneration of aortic valve with aging. Our study showed that in a large proportion of normal persons color Doppler echocardiography allows recording of regurgitation signals behind cardiac valves except for aortic valve. The regurgitation volume was small and there was no significant hemodynamic effect. The size and diameter of the heart chambers were normal when compared with other studies.
 ...
PMID:[Color Doppler evaluation of valvular regurgitation in normal subjects]. 208 99

The article deals with the results of complex study of the effect of pulmonary insufficiency on intracardiac hemodynamics and function of the heart in the immediate and late-term periods after radical correction of Fallot's tetralogy. Answers are also given to questions concerning the expediency of the use and functional adequacy of a xeno-pericardial monocusp in the closure mechanism of the pulmonary artery valve. The study showed that massive pulmonary regurgitation has a negative effect on the functional condition of the right ventricle in late-term postoperative periods. Convincing data were obtained which allow a graft with a monocusp of a bull's pericardium to be recommended for further clinical use to prevent insufficiency of the pulmonary artery valve after radical correction of Fallot's tetralogy.
 ...
PMID:[Results of the use of a graft with a monocusp in radical correction of Fallot's tetrad]. 226 Dec 47

We studied valvular regurgitation (pulmonary, aortic, tricuspid and mitral regurgitation) in 30 patients with complete heart block by color Doppler echocardiography, pulse Doppler and continuous wave Doppler echocardiography. The prevalence rate of multivalvular regurgitation of these subjects was 83.3%. Regurgitation involving all four valves appeared in 30.0% of these patients. The prevalence rate of pulmonary, aortic, tricuspid and mitral regurgitation was 56.7%, 33.3%, 100%, and 76.7% respectively. Pulmonary regurgitation (PR) was observed in patients with complete heart block without pulmonary hypertension. PR velocity was slow and interrupted by atrial contraction. It might be possible to evaluate atrial pressure from the interruption of PR. Tricuspid regurgitation (TR) during systole was often present in patients with right ventricular endocardial pacing. Systolic TR was influenced by atrial contraction. When atrial contraction occurred during systole, TR was interrupted, or shortened. Diastolic TR and MR were easily detected by M mode color Doppler echocardiography. The diastolic TR and MR were of slow velocity and appeared 240-290 msec after P wave. These atypical valvular regurgitation in patients with complete heart block reflect of the inverse atrial-ventricular pressure gradient across the atrio-ventricular valve.
 ...
PMID:[Valvular regurgitation in patients with complete heart block by color Doppler echocardiography]. 230 27


1 2 3 4 5 6 7 Next >>