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Query: UNIPROT:Q86TM3 (cage)
 29,987 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prosthetic shadowing of the left atrium may prevent detection of mitral regurgitation during transthoracic echocardiography. In 60 patients with mitral valves, Carpentier-Edwards (n = 20), St. Jude (n = 22), and cage-ball (n = 18), we blindly evaluated the accuracy of three transthoracic Doppler signs of significant (> 2+) mitral regurgitation: (1) color Doppler flow convergence, (2) a color Doppler jet of significant regurgitation in the left atrium, and (3) an intense continuous wave Doppler signal. All 60 patients had transesophageal echocardiography, 26 had cardiac catheterization, and 28 had surgery. The sensitivity and specificity of flow convergence for significant regurgitation by transesophageal echocardiography was 73% and 70%, respectively, compared with 33% and 93% for left atrial color Doppler, and 15% and 97% for continuous wave Doppler. The sensitivity of flow convergence in Carpentier-Edwards, St. Jude, and cage-ball valves was 80%, 73%, and 67%, respectively; whereas the sensitivity of left atrial color Doppler was 70%, 27%, and 0%, and the sensitivity of continuous wave Doppler was 33%, 0%, and 13%. Flow convergence was the only sign of significant regurgitation in 12 of 30 patients (40%); 10 of these patients had mechanical valves. We conclude flow convergence is a more sensitive, though less specific, predictor of significant mitral regurgitation than color Doppler, spatial mapping of the left atrium, and continuous wave Doppler, especially when a mechanical valve is present.
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PMID:A comparison of flow convergence with other transthoracic echocardiographic indexes of prosthetic mitral regurgitation. 146 87

The Marfan syndrome is an autosomal dominant disorder of connective tissue with manifestations throughout the body. Diagnosis is based on the cardinal effects on the skeletal, ocular, and cardiovascular systems. Long limbs and digits, thoracic cage deformity, dislocation of the ocular lens, mitral valve prolapse, and dilatation of the aortic root are typical signs. Before recent advances in management, valvular regurgitation and aortic dissection accounted for over 90 percent of deaths, often in the third through fifth decades of life. Echocardiography, introduced nearly 2 decades ago, and the recent enhancements of cardiovascular Doppler techniques have greatly improved the ability of identifying patients with Marfan syndrome and following their clinical courses. Cardiovascular surgery has progressed over the same period to provide Marfan patients relatively safe approaches to repair of the life-threatening complications, and surgery should be offered prophylactically. The ability to intervene effectively in the Marfan syndrome requires a clear understanding of its natural history throughout life. This review discusses the clinical course and current management of the cardiovascular complications of the Marfan syndrome in children, young adults, and women considering pregnancy. These approaches have relevance to valvular and aortic problems found in the general population.
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PMID:Clinical management of the cardiovascular complications of the Marfan syndrome. 202 28

Transthoracic two-dimensional echocardiography (TTE) has been an accepted noninvasive procedure used to diagnose infective endocarditis by demonstrating the presence of vegetations and other complications such as ring abcess, mycotic lesions or sinus of valsalva aneurysm. Moreover, complementary Doppler and Color Flow imaging are very useful in detecting early valvular regurgitation and in evaluating the severity of such regurgitant lesions. Occasionally, TTE fails to provide an adequate quality of imaging because of the patient's obesity, chest deformity or emphysema. Transesophageal echocardiography (TEE) on the other hand, a relatively new technique, allows ultrasonic imaging of the heart through the esophagus and provides a clear visualization of all cardiac structures without any interference from the lungs, chest wall or rib cage. We present a case of aortic valve endocarditis diagnosed by TEE.
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PMID:Transesophageal echocardiography (TEE): its diagnostic value in endocarditis. 227 24

The Marfan syndrome is frequently complicated by cardiovascular abnormalities. Of these, aortic dissection and aortic valve regurgitation are the most life-threatening. The most noticeable abnormalities of the Marfan syndrome--the skeletal abnormalities--may be subtle and limited. Presented here are five reports of cases of the Marfan syndrome. All patients had potentially lethal cardiovascular complications. Either the syndrome had not been previously diagnosed or the patient had not been adequately monitored despite the the presence of thoracic cage deformities present from youth. The purpose of this report is to heighten recognition of the association of thoracic cage deformities with the Marfan syndrome to permit early diagnosis of the associated cardiovascular complications. Surgical management of these complications can favorably alter the natural history of the Marfan syndrome.
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PMID:Thoracic cage deformities in the early diagnosis of the Marfan syndrome and cardiovascular disease. 235 66

Three patients who underwent aortic valve replacement had dissection of the ascending aorta 7 months, 2 years and 15 years after surgery. This is a rare complication of aortic valve replacement (11 reported cases). Its incidence estimated from the literature would appear to be less than 1% of all aortic valve replacements. It occurs in both cases of stenosis and regurgitation (4 aortic regurgitations, 2 aortic stenosis, 5 mixed aortic valve disease) and is seen in ball and cage (7 cases), tilting disc (3 cases) and bioprosthesis (1 case). Six of these patients had hypertension. The role of the initial surgery for valve replacement in secondary aortic dissection is discussed. Aortic clamping and cannulation can cause immediate dissection but may also damage the aortic wall, leading to the risk of secondary dissection. An aneurysm of the ascending aorta was observed in 5 Cases at surgery; in 3 cases, the aorta was dilated without true aneurysm; in 3 other cases the aorta was considered to be macroscopically normal. The integrity aorta is sometimes difficult to confirm and a macroscopically normal of the aorta may have fragile aortic walls, especially in cases of aortic regurgitation due to valvular dysplasia and forms frustres of Marfan's syndrome, and are associated with a risk of secondary dissection. The appearances of the aorta at aortic valve replacement influence the choice of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Dissection of the ascending aorta after aortic valve replacement]. 641 4

Esophagogastrostomy is a satisfactory method of restoring continuity of the esophagus with minimal long-term effects on growth and development. Anemia or reflux oesophagitis is not a complication of the operation provided the anastomosis is high in the thoracic cage, i.e., above the level of the aortic arch. Postural gastritis secondary to regurgitation of bile was not seen in our patients. The mortality of the operation is high (33%) but this is due to the small number of patients in whom it is indicated. This contrasts markedly with the results in adults where the mortality in large series has fallen to low levels (13%). Thus, esophagogastrostomy should retain a place in selected patients for the primary treatment of esophageal atresia and the high esophageal stricture.
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PMID:Observations on the role of esophagogastrostomy in infancy and childhood with particular reference to the long-term results and operative mortality. 738 64

The development of lesser invasive transcatheter techniques for aortic valve replacement (AVR) to treat high surgical risk patients with severe aortic stenosis (AS) has engendered controversy among traditional cardiovascular therapists. Presently, there are two catheter-based treatment systems (the Cribier-Edwards Aortic Bioprosthesis and the CoreValve Revalving System) utilizing either a balloon-expandable or a self-expanding stent (or cage) platform which unfolds a pericardial tissue valve within the displaced diseased aortic valve. After ex vivo durability testing and animal studies, several clinical registries with these transcatheter AVR systems in almost 300 patients worldwide have demonstrated the following: (1) good acute hemodynamic performance with reduction in mean aortic valve gradients to <10 mm Hg; (2) frequent para-valvular regurgitation, which has improved with self-expanding devices and the use of larger (26 mm) valve sizes; (3) acceptable periprocedural (30-day) mortality (<10%) with the newest generation devices and improved operator techniques. Enlightened interdisciplinary treatment teams incorporating surgeons, interventionalists, and medical therapists as well as rigorously conducted randomized clinical trials will be required to determine if these innovative transcatheter AVR approaches will represent a viable therapy for high-risk patients with severe AS in the future.
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PMID:Transcatheter aortic valve replacement in patients with critical aortic stenosis: rationale, device descriptions, early clinical experiences, and perspectives. 1715 38

Anomalous union of the pancreaticobiliary duct (AUPBD) is a congenital anomaly that is defined as a junction of the bile duct and pancreatic duct outside the duodenal wall. This anomaly results in a loss of normal sphincteric mechanisms at the pancreaticobiliary junction. As a result, regurgitation of pancreatic juice into the biliary system develops and causes choledochal cysts, choledocholithiasis, cholangitis, pancreatitis and malignancy of the biliary tract. Gallbladder cancer or common bile duct cancer associated with AUPBD and choledochal cysts have been frequently reported. But, intrahepatic cholangiocarcinoma associated with this condition has been only rarely reported. Here, we report a case of intrahepatic cholangiocarcinoma associated with AUPBD and choledochal cyst.
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PMID:[A case of intrahepatic cholangiocarcinoma associated with Type IV choledochal cyst]. 2292 25

Many problems in poultry production are caused by a combination of interrelated factors such as management, stress, nutrition, and exposure to pathogens. Saprophagous flies that develop in poultry manure are a potential route of pathogen transmission. Besides being a nuisance, defecation and regurgitation of flies soil equipment and structures and can reduce light levels of lighting fixtures. These effects clearly affect management and may contribute to reductions in poultry egg production, health, and welfare. Many essential oils or their main components have bioactive effects such as natural repellents and insecticides, antioxidants, anticholesterolemics, and antimicrobials. This study evaluated if supplementing quail feed with thymol or isoeugenol as functional food could alter the production of flies from manure. Dropping samples deposited by quail fed with a supplementation of 2,000 mg of thymol or isoeugenol per kg of feed or no supplement (control) were collected. Each sample was incubated inside an emergence cage that was inspected daily to collect emerging adult flies. Fewer flies emerged from droppings of quail fed a thymol-supplemented diet (P = 0.01) and there was a tendency to a lower emergence from droppings of isoeugenol-fed quail (P = 0.09). The number of positive containers for Musca domestica was smaller from quail droppings of thymol- (P = 0.02) or isoeugenol- (P = 0.01) supplemented feed than from the control counterparts, suggesting an oviposition repellent effect. Supplementing quail feed with thymol or isoeugenol has an overall moderate effect against flies, reducing M. domestica emergence.
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PMID:Fly emergence from manure of Japanese quail fed thymol- or isoeugenol-supplemented diets. 2510 67

Blunt chest trauma can cause not only damage to the thoracic cage, but can also injure intracardiac structures including the papillary muscles, chordae tendineae, and valve leaflets. Aortic valve (AV) injury secondary to blunt chest trauma is a rare occurrence. Clinically, AV injury may be missed during the initial post-trauma assessment due to the lack of suspicion of cardiac involvement. Thus, the diagnosis of AV injury is often delayed or missed for a time interval of days to months. As a consequence, the traumatic AV regurgitation can rapidly or progressively lead to congestive heart failure unless surgically corrected. Therefore, emergency physicians should be aware of the possibility of intracardiac structure injury, such as valvular injuries, after blunt chest trauma. Guidelines for the appropriate use of bedside cardiac ultrasound (BCU) recommend BCU should be performed in all patients with new murmurs for clinically significant valvular lesions that could potentially change management. We described the case of a 73-year-old female patient with AV injury after blunt trauma. She experienced cardiac arrest (CA) secondary to a moderate-to-severe traumatic AR, which was successfully treated with emergency AV replacement. We discuss how to diagnose and manage a CA patient, aided by BCU, with ventricular failure associated with persistent AV regurgitation. To the best of our knowledge, this is the first case report on CA associated with isolated rupture of bicuspid AV rupture and AV regurgitation secondary to blunt chest trauma because of the lack of early suspicion of AV injury.
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PMID:Cardiac arrest associated with aortic valve regurgitation. 2917 27


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