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

Valvulo-annuloplasty for atrioventricular (AV) valvular regurgitation was performed in 10 patients with univentricular heart and double outlet right ventricle. Kay annuloplasty alone was employed in three patients with a quadricuspid or tricuspid common AV valve. Two of them died after the operation and the remaining one is waiting for reoperation because of recurrence of severe AV valve regurgitation. The suturing-up of free margins of the anterior and posterior common leaflets was performed in 3 children with quadricuspid common AV valve and effectively reduced the regurgitation. The semicircular annuloplasty with a thin Gore-tex graft or the suturing-up of floppy leaflets combined with plasty of the chordae and papillary muscle was carried out in two patients having tricuspid AV valve, and a favourable result was obtained in the semicircular annuloplasty. In mitral 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 floppy leaflets in quadricuspid and bicuspid AV valves are the recommendable procedures. If more than mild AV valvular regurgitation remains after these valvuloplasties, the Kay and/or DeVega annuloplasties should be added for eliminating the regurgitation.
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PMID:[Valvulo-annuloplasty for atrioventricular valvular regurgitation in univentricular heart and double outlet right ventricle]. 783 19

There are no obvious criteria concerning the optimal repair for complete transposition with bicuspid pulmonary valve if neither the organic changes in the valve nor the pressure gradient between the left ventricle and the pulmonary trunk are severe. Instead of intraatrial switching or intraventricular rerouting in such circumstances, we have proceeded to the arterial switch procedure in 6 patients with an adequate diameter of the pulmonary valve (greater than 100% of the calculated normal aortic orifice). Postoperative catheterization (at approximately 8 months after the procedures) showed no pressure gradient between the left ventricle and the neoaorta except for a finding of 34 mm Hg difference in 1 patient who had undergone simultaneous subpulmonary myotomy. Echocardiography (7 years later in the longest follow-up) has shown no more than slight regurgitation across the bicuspid neoaortic valve, with no progressive increase of blood velocity across the valve. From these results in the middle term, we conclude that the arterial switch procedure remains an option of choice for patients with initially bicuspid pulmonary valve, providing there is no severe subpulmonary stenosis.
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PMID:A bicuspid pulmonary valve is not a contraindication for the arterial switch operation. 784 69

During the period 1968-1985, aortic valve replacement was performed in 871 patients, 617 males and 254 females aged 49.6 years in mean (15 to 75). Up to the end of 1988, 42 patients (4.8%) were reoperated on because of periprosthetic leakage. In primary surgery, annular calcification was found in 27 of these patients (64%), 17 patients (40%) had a bicuspid valve, and a positive culture from the excised valve was diagnosed in one of three patients with active native endocarditis. Two patients had Marfan's syndrome and two others postendocardial regurgitation. At primary surgery, mechanical prostheses were inserted in every case. Differences between the prosthetic models used could not be shown as regards to the occurrence of periprosthetic leakage. To implant the valve, interrupted everted U-mattress sutures with pledgets appeared to be the best method. Leakage occurred in 21 patients (50%) during their hospital stay and in 18 patients (43%) during the follow-up period of four months. Three others developed leakage two to four years from primary surgery. The main indication for reoperation was congestive heart failure alone or combined with heamolytic anaemia in 37 (88%) of cases. Four patients required the reoperation due to infectious dehiscence. Preoperatively, 34 patients (81%) were in NYHA (The New York Heart Association) Class III-IV. A new prosthetic valve was implanted in 23 cases, a composite graft once and in 18 cases refixation was performed. Two patients died in association with surgery, both due to the low output syndrome. During the follow-up time of 6.4 years, eight patients developed recurrent leakage. Four of them were found during their hospital stay and four others later. The role of prosthetic infection was remarkable in these eight cases; three patients with preoperative infectious dehiscence of the prosthesis had recurrence and one patient developed prosthetic endocarditis with leakage later. Three patients required more reoperations. At follow-up study, leakage was diagnosed in five of 28 living patients. Three of them were not significant and two moderate. 24 patients (86%) were in NYHA Class I-II.
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PMID:Periprosthetic leakage after aortic valve replacement. 785 65

A 57-year-old man with a cough and increasing exertional dyspnoea for the past 6 weeks was found on examination to have a loud systolic murmur and cardiomegaly with pulmonary congestion. Echocardiography revealed congenitally corrected transposition of the great arteries (cTGA: atrioventricular and ventriculoarterial discordance): a morphologically right ventricle with a tricuspid valve on the left, a morphologically left ventricle with bicuspid a-v valve on the right, the aorta arising ventrally from the left-sided (morphologically right) ventricle. The tricuspid valve showed an Ebstein-like anomaly with obvious regurgitation. Transoesophageal and contrast echocardiography defined valvar anatomy, attachment of the great arteries and cardiac chambers to the venous and arterial circulations, as well as absence of a left to right shunt. Angiography revealed a coronary anatomy typical for cTGA. The exertional dyspnoea responded to diuretics and low doses of ACE inhibitor. Follow-up monitoring of the valvar regurgitation and appropriate endocarditis prophylaxis were recommended. As the haemodynamics in cTGA is normal, in the absence of additional anomalies, it is a congenital cardiac defect which can, though rarely, present first in adulthood. Life expectancy depends on the nature of any additional defects and the degree of commonly associated tricuspid valve regurgitation. As this case demonstrates, echocardiography can largely define the anomalies.
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PMID:[Congenitally corrected transposition of the great vessels in adulthood. The value of noninvasive study methods]. 807 3

This two-part article examines the histologic and morphologic basis for stenotic and purely regurgitant aortic valves. Part I discusses stenotic aortic valves and Part II will discuss causes of purely regurgitant aortic valves. In over 95% of stenotic aortic valves, the etiology is one of three types: congenital (primarily bicuspid), degenerative, or rheumatic. Other rare causes of stenotic aortic valves include active infective endocarditis, homozygous type II hyperlipoproteinemia, and systemic lupus erythematosis. The causes of pure aortic regurgitation are multiple but can be separated into diseases affecting the valve (normal aorta) (infective endocarditis, congenital bicuspid, rheumatic, floppy), diseases affecting the walls of aorta (normal valve) (syphilis, Marfan's, dissection), disease affecting both aorta and valve (abnormal aorta, abnormal valve) (ankylosing spondylitis), and diseases affecting neither aorta nor valve (normal aorta, normal valve) (ventricular septal defect, systemic hypertension). Diseases affecting the aortic valve alone are the most common subgroup of conditions producing pure aortic valve regurgitation.
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PMID:Pathology of aortic valve stenosis and pure aortic regurgitation. A clinical morphologic assessment--Part I. 816 31

It is quite unusual that the congenital bicuspid aortic valve shows aortic valve regurgitation except postinflammatory event. In a case of aortic regurgitation with bicuspid valve, a fibrous band was recognized between the conjoined cusp and the ascending aorta at the operation. Since a degenerative change alone was discerned histologically in the resected specimen, this abnormal band was supposed to be an embryogenic remnant of the aortic valve. Six cases were reported previously and all of them were male, and five were Japanese.
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PMID:[Congenital bicuspid aortic valve with regurgitation--a rare case showing a fibrous band between the conjoined cusp and the ascending aorta]. 822 26

The right ventricular outflow tract was reconstructed in patients with tetralogy of Fallot using a wide transannular patch bearing a large unicuspid or bicuspid valve. The shape of the valve was designed to limit the degree of pulmonary regurgitation. The characteristics of the valve and the water-repellent nature of the polytetrafluoroethylene sheet make calcification and pseudointimal formation less common than with traditional bioprosthetic valves.
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PMID:Outflow reconstruction of tetralogy of Fallot using a Gore-Tex valve. 826 54

We reported a case of pseudocoarctation of the aorta associated with severe aortic regurgitation. A 63-year-old male admitted with congestive heart failure due to aortic regurgitation. The blood pressure was 170/60 mmHg in the right arm and the systolic pressure was 132 mmHg in the right leg. To and fro murmur and diastolic grade IV/VI blowing murmur was heard along the lower left sternal border. Aortogram demonstrated marked buckling of the descending aorta at the origin of the left subclavian artery without collateral circulation and bicuspid aortic valve with severe aortic regurgitation. His pressure gradient across the pseudocoarctation was 40 mmHg in the preoperative catheterization. We performed an aortic valve replacement (AVR) without further surgical treatment. The pressure gradient was reduced to 10 mmHg and his symptom improved after AVR. These results suggested that pseudocoarctation of the aorta may require no surgical treatment in some case associated with aortic valve regurgitation because of improvement of high pressure gradient across it by AVR alone.
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PMID:[Pseudocoarctation of the aorta associated with aortic valve regurgitation: a case report]. 827 36

Open valvotomy was successfully performed in neonate with critical aortic stenosis using cardiopulmonary bypass. The baby was referred to our hospital at the age of 24 days with very grave state, and needed intensive care including endotracheal intubation and inotropic support. Critical valvular aortic stenosis was confirmed by echocardiography. Poststenotic dilatation and enough size of short axis LV dimension were reported, and aortic annulus was measured 6 mm in diameter. Without catheterization and angiography, open valvotomy was performed with moderate hypothermia and ischemic arrest using single dose of cold cardioplegia at the age of 29 days. Bicuspid aortic valve was thick and dysplastic with thick gelatinous cusp edge, however commissurotomy was applicable in two direction. The diameter of aortic opening was enlarged from 2 mm to 7 mm. Total bypass and aortic cross clamp time were 78 and 28 minutes respectively. The baby recovered uneventfully and there was no evidence of significant AS or aortic regurgitation in echocardiography 7 months after surgery. Sorts of reoperation for restenosis or regurgitation were reported. The results of reoperation for regurgitation were reported to be poor, especially in young infants who should be performed aortic valve replacement. However, residual AS could be manipulated with re-valvotomy, PVB, apico-aortic conduit or AVR. As the choice of first relief of critical AS without other anatomical disadvantages including hypoplastic left ventricle, endocardial fibroelastosis, and mitral stenosis, it would be crucial for late results to prevent progression of aortic regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case report of successful open valvotomy in neonate with critical aortic stenosis]. 830 70

In a survey using colour-flow echocardiography and a portable generator, of one thousand one hundred fifteen children, three had clinical and echocardiographic evidence of rheumatic heart disease giving a prevalence rate of 27/1000. Sixty nine (6.2%) of the children examined had trivial mitral regurgitation (TMR). Of these, three had associated trivial aortic regurgitation. Isolated trivial aortic regurgitation was not seen. Four children had isolated mild-moderate regurgitation of the pulmonary valve. Congenital heart disease (CHD) was found in two children-one with secundum atrial septal defect and one with a ventricular septal defect and pulmonary stenosis, giving a prevalence of 1.8/1000. One child had a bicuspid aortic valve and two persistent left superior vena cava. It is feasible to carry out an echocardiographic survey using a portable generator in schools where electricity is not available. The prevalence of rheumatic heart disease (RHD) is higher than previously found in Kenya. The prevalence of TMR is surprisingly high. This was associated with familial clustering reminiscent of RHD. The importance of these findings must await the results of further investigation.
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PMID:Prevalence of heart disease in school children in rural Kenya using colour-flow echocardiography. 870 1


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