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Query: UMLS:C0232605 (regurgitation)
 8,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Abscesses in the aortic root are a serious complication of infective endocarditis and require accurate diagnosis for antibiotic and surgical management. Nineteen cases of endocarditis of a native valve or prosthetic valve and adjacent abscess cavities were identified with angiography. Of 6 patients with endocarditis of a native valve, 5 had bicuspid aortic valves and all had severe aortic regurgitation. Of 13 patients with endocarditis of a prosthetic aortic valve, all had paravalvular regurgitation. Abscesses in the aortic root were saccular, ranged from 1 to 3 cm in diameter, and, depending on sinus of origin, extended beneath the main and right pulmonary arteries or into the interventricular septum or mitral anulus. Fistulas were detected into the mitral anulus in 8 patients, and into the right ventricle in 3 patients. No complications from the catheterization were recorded during the 48-hour follow-up.
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PMID:Aortic root abscess resulting from endocarditis: spectrum of angiographic findings. 648 67

Seven out of 348 cases of Fallot's tetralogy (2 %) referred over an eight year period were complicated by aortic incompetence (AI). The incidence of AI was much lower than in VSD (7.6 %), probably because of the prevailing haemodynamics: in high VSD, the left-to-right shunt may damage the aortic cusps whilst in Fallot's tetralogy the output of both ventricles is ejected directly into the aorta with no alteration of aortic valve function. In this series, infective endocarditis was the predominant cause of AI (3 cases); surgery had to be undertaken in the infectious phase in 2 cases. AI was coincidental in two other cases (rheumatic valvular disease and calcified bicuspid valve). In the remaining two cases, the role of increased aortic flow in late distension of the aortic valve ring is discussed. AI should be corrected in the same operative time as the Fallot's tetralogy. Late onset AI occurring after repair of Fallot's tetralogy should also be corrected; in this situation, it is often difficult to diagnose the origin of the diastolic murmur. Without surgery the prognosis is poor as the diastolic regurgitation occurs in a ventricle whose function is often already compromised.
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PMID:[Tetralogy of Fallot and aortic insufficiency]. 679 83

In this report, a rare case of tricuspid stenosis uncomplicated by other valve lesions is presented, with clinical, hemodynamic, echocardiographic, and angiographic studies. The patient was markedly incapacitated, mostly as a result of a restricted cardiac output. Tricuspid commissurotomy was performed, with a stenotic deformity of a bicuspid atrioventricular valve, probably of congenital origin, found at surgery. Considerable improvement was observed, notwithstanding the persistence of some signs of residual tricuspid obstruction as a result of an incomplete commissurotomy, to avoid increasing the slight degree of preexistent valvular regurgitation.
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PMID:Isolated tricuspid stenosis: report of a case submitted to valvular commissurotomy. 683 70

This study compares the role of M-mode and two-dimensional echocardiography in the evaluation of the nonstenotic, congenitally bicuspid aortic valve. Ten asymptomatic healthy subjects (age 20-35 years) with a systolic ejection click and short systolic murmur were evaluated. M-mode echocardiograms were entirely normal. The aortic root, diastolic closure line, eccentricity index of the aortic valve, and left ventricular size and function were normal in every subject. The two-dimensional parasternal long axis view of the aortic root was also normal in all patients with bicuspid aortic valves; there were no abnormalities of systolic excursion of the aortic cusps and doming of the aortic valve was absent. Images obtained in the two-dimensional parasternal short axis view of the aortic root at the level of the aortic valve revealed only two cusps, anterior and posterior, in all patients. The classic closure pattern of the normal tricuspid aortic valve forming a "Y" was absent in every subject. Instead, a horizontal closure line along the "X" axis was demonstrated in all patients; changing the angulation of the transducer in various positions did not alter this pattern. All subjects had increased reflectance of echoes along the line of diastolic closure, probably resulting from redundancy of the aortic cusp tissue. We conclude that because of the inability of the M-mode echocardiographic technique to accurately diagnose this condition in the study group, two-dimensional echocardiography should be the technique of choice in the evaluation of patients with a suspected bicuspid aortic valve. Recognition of this condition is important in view of its susceptibility to subacute bacterial endocarditis, aortic stenosis, and regurgitation.
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PMID:Superiority of two-dimensional echocardiography in the diagnosis of congenitally bicuspid aortic valve. 709 96

Cardiovascular manifestations of Lobstein's disease are rare, probably unrecognized, and determining factors for the final prognosis, the most frequent lesion being aortic incompetence. The eleventh case to be reported with pathological findings in the literature is described. This complication is usually found in men, blood regurgitation being large in amount, symptomatic, and progressive. Its mechanism is related less to dilatation of the aorta and its ring than to valvular changes, they being frequently bicuspid and dysplasic. Histological findings, not however pathognomonic, are myxoid degeneration in the valves and parietal cystic necrosis in the aortic wall. Apart from the absence of an aneurysm and aortic dissection, macro- and microscopic lesions are similar to those observed in Marfan's syndrome and osteogenesis imperfecta. Operative therapy was employed in all eleven cases, with three postoperative deaths and three later deaths. Certain complications arise from uncontrollable severe hemorrhage, which justifies the use of valve heterografts not requiring antivitamin K administration.
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PMID:[Osteogenesis imperfecta and aortic incompetence. One case with pathological findings. Review of the literature (author's transl)]. 722 62

Nineteen patients with types I and III Ehlers-Danlos syndrome were hospitalized at our institution between 1973 and 1978. Chest roentgenogram, electrocardiogram, and echocardiogram were done; 11 patients underwent cardiac catheterization. Thirty-five cardiac or great vessel abnormalities were detected. Fifteen patients had nitral valve prolapse; six also had tricuspid valve prolapse. Dilatation of the aortic root or extasia of the sinuses of Valsalva, or both, occurred in six patients. Dilatation of the pulmonary artery and annulus caused pulmonary regurgitation in one patient. Congenital heart defects included bicuspid aortic valve (two), pulmonary valvular stenosis (one), ventricular septal defect (two), and an atrial septal defect (one). The apparent high prevalence of cardiovascular abnormalities in hospitalized patients with types I and III Ehlers-Danlos syndrome necessitates a careful cardiovascular evaluation. Conversely, Ehlers-Danlos syndrome types I and III should be excluded in patients with mitral or tricuspid valve prolapse, great vessel dilatation, and congenital heart defects.
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PMID:The spectrum of cardiac defects in the Ehlers-Danlos syndrome, types I and III. 735 21

Valvuloannuloplasty for atrioventricular (AV) valvular regurgitation was performed in 13 patients with univentricular AV connection and double outlet right ventricle. The suturing-up of free margins of the anterior and posterior common leaflets, which divides the common orifice into two parts, was performed in 4 children with quadricuspid or quintacuspid common AV valve and effectively reduced the regurgitation. The semicircular annuloplasty with a thin GORE-TEX graft was carried out in two patients having tricuspid AV valve, and a favourable result was obtained. In bicuspid AV valvular regurgitation, two patients received the suturing-up of free margins of prolapsed leaflets, and the results were satisfactory. From these results we consider that the semicircular annuloplasty for dilated tricuspid AV valve and the suturing-up of free margins of dilated or prolapsing leaflets in quadricuspid or quintacuspid and bicuspid AV valves are the recommendable procedures. If more than mild AV valvular regurgitation remained after these valvuloplasties, the Kay's and/or DeVega's annuloplasties should be added for eliminating the regurgitation.
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PMID:[Valvuloannuloplasty for atrioventricular valvular regurgitation in complicated cyanotic cardiac anomalies]. 764 93

Cryopreserved pulmonary allografts harvested from adults at the time of kidney donation were size reduced and used in two children with pulmonary atresia and ventricular septal defect. A technical modification for the creation of size-reduced pulmonary allograft conduits is described. Postoperative ultrasonic and cineangiographic assessments revealed excellent function of the pulmonary bicuspid valved conduit with a minimal pressure gradient and essentially no regurgitation. Although the long-term fate of cryopreserved bicuspid pulmonary valve and conduit is unknown, this conduit provides excellent handling characteristics that render allograft conduits preferable to synthetic conduits. In addition, the remodeled bicuspid pulmonary allograft conduits have exhibited excellent hemodynamic characteristics and are a reasonable alternative to other types of conduits when an appropriate size allograft is not available.
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PMID:Size-reduced cryopreserved pulmonary valve allograft for an RV-PA conduit: technical modification and functional evaluation. 769 84

The congenital bicuspid aortic valve functions almost normally provided degeneration does not occur, but complications of infective endocarditis and calcification of the cusps with aging are indications for surgical intervention. We compared 22 cases with an incompetent bicuspid aortic valve (14 cases with stenosis and eight with regurgitation) with 96 cases of acquired tricuspid aortic valve (30 cases with stenosis and 66 with regurgitation) who were treated by aortic valve replacement (AVR) during the same period. Compared with the stenotic tricuspid aortic valve cases, the stenotic bicuspid aortic valve cases: 1) were older at AVR (59.3: 51.7 years, P < 0.05), 2) had a smaller diameter of preoperative valve orifice (6.9: 9.2 mm, P < 0.05), 3) had a smaller valve ring diameter (23.0: 24.3 mm, P < 0.05), 4) used artificial valves of almost identical size (22.0: 22.5), and 5) included no operative deaths (0: 10%). In contrast, compared with the tricuspid aortic valve cases with regurgitation, the bicuspid aortic valve cases with regurgitation: 1) were younger at AVR (39.5: 45.8 years), 2) had a higher incidence of infective endocarditis (62.5: 19.6%, P < 0.02) as a complication, and 3) showed a higher operative death rate (25.0: 6.1%), although this difference was not statistically significant. Suture repair of the incised portion of the aorta must be performed meticulously in patients with prominent poststenotic dilatation of the ascending aorta.
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PMID:Artificial valve replacement for congenital bicuspid aortic valves. 770 29

Little morphologic information is available on operatively excised pulmonic valves. The causes of pulmonic stenosis are limited to a few conditions: (1) rheumatic and (2) nonrheumatic (congenital, carcinoid, infective endocarditis). Congenital causes of pulmonic stenosis constitute well over 95% of these conditions. Congenital types of pulmonic stenosis include acommissural dome-shaped, dysplastic, and bicuspid. Rare acquired causes of pulmonic stenosis include carcinoid, rheumatic, and infective endocarditis. Of the acquired causes of pulmonic stenosis, carcinoid is the most common condition. In contrast, causes of pure pulmonic regurgitation are multiple. Two major categories of pure pulmonic regurgitation include (1) conditions associated with anatomically abnormal valve cusps (congenital, rheumatic, carcinoid, trauma, and infective endocarditis) and (2) conditions associated with anatomically normal cusps (elevated pulmonary artery systolic pressures, idiopathic dilated pulmonary trunk, and Marfan's syndrome).
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PMID:Pathology of pulmonic valve stenosis and pure regurgitation. 770 86


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