.. Objectives: To study the early outcomes of mitral valve replacement with a mechanical prosthesis is patients with rheumatic mitral valvular disease. Study Design: Retrospective Observational study. Setting: Punjab Institute of Cardiology, Lahore and Rawalpindi Institute of Cardiology, Rawalpindi. Period: From August 2014 to August 2017. Material & Methods: Consecutive patients who underwent mitral valve replacement for a rheumatic pathology were included in the study. Patients undergoing a redo surgery, those with concomitant aortic valve intervention, coronary artery bypass grafting and emergency procedures were excluded from the study. Results: Of the 104 patients included in the study, 58 (56.2%) were female patients. The mean age of the patients was 35 ± 12.36 years (median 33 years). Sixty (58.5%) had hypertension and 22 (21.28%) had diabetes. Mitral valve stenosis was the main pathology in 84 (80.7%). Severe pulmonary hypertension was recorded in 16 (15%) patients. The mean preoperative Tricuspid Valve Pressure Gradient (TVPG) was 55.33 ± 18.35 mmHg. The mean cross clamp time was 45.33 ± 12.32 minutes. The postoperative tricuspid valve pressure gradient came down to 31.5 ± 12.21 mmHg. No patients had acute renal injury, pulmonary complications or re-exploration for bleeding. Perioperative mortality was 4 (3.75%). Conclusion: Rheumatic valvular disease is still prevalent in our part of the world. Most of the patients with rheumatic heart disease will end up with replacement of the valve. Replacement with a mechanical prosthesis has favorable early outcomes.
{"title":"Rheumatic Mitral Valve Disease","authors":"L. Shapiro, A. Kenny","doi":"10.1201/9781315138800-3","DOIUrl":"https://doi.org/10.1201/9781315138800-3","url":null,"abstract":".. Objectives: To study the early outcomes of mitral valve replacement with a mechanical prosthesis is patients with rheumatic mitral valvular disease. Study Design: Retrospective Observational study. Setting: Punjab Institute of Cardiology, Lahore and Rawalpindi Institute of Cardiology, Rawalpindi. Period: From August 2014 to August 2017. Material & Methods: Consecutive patients who underwent mitral valve replacement for a rheumatic pathology were included in the study. Patients undergoing a redo surgery, those with concomitant aortic valve intervention, coronary artery bypass grafting and emergency procedures were excluded from the study. Results: Of the 104 patients included in the study, 58 (56.2%) were female patients. The mean age of the patients was 35 ± 12.36 years (median 33 years). Sixty (58.5%) had hypertension and 22 (21.28%) had diabetes. Mitral valve stenosis was the main pathology in 84 (80.7%). Severe pulmonary hypertension was recorded in 16 (15%) patients. The mean preoperative Tricuspid Valve Pressure Gradient (TVPG) was 55.33 ± 18.35 mmHg. The mean cross clamp time was 45.33 ± 12.32 minutes. The postoperative tricuspid valve pressure gradient came down to 31.5 ± 12.21 mmHg. No patients had acute renal injury, pulmonary complications or re-exploration for bleeding. Perioperative mortality was 4 (3.75%). Conclusion: Rheumatic valvular disease is still prevalent in our part of the world. Most of the patients with rheumatic heart disease will end up with replacement of the valve. Replacement with a mechanical prosthesis has favorable early outcomes.","PeriodicalId":357091,"journal":{"name":"Cardiac Ultrasound","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115217168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sub- and Supra-Aortic Stenosis","authors":"L. Shapiro, A. Kenny","doi":"10.1201/9781315138800-8","DOIUrl":"https://doi.org/10.1201/9781315138800-8","url":null,"abstract":"","PeriodicalId":357091,"journal":{"name":"Cardiac Ultrasound","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123689420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-07DOI: 10.1201/9781315138800-16
L. Shapiro, A. Kenny
{"title":"Sinus of Valsalva Aneurysm","authors":"L. Shapiro, A. Kenny","doi":"10.1201/9781315138800-16","DOIUrl":"https://doi.org/10.1201/9781315138800-16","url":null,"abstract":"","PeriodicalId":357091,"journal":{"name":"Cardiac Ultrasound","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129080722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
clinical symptoms is the major indicator for surgical intervention,4 the natural history of chronic aortic regurgitation is more variable and the onset of myocardial deterioration commonly occurs before the onset of symptoms. Identification of early myocardial decompensation in chronic aortic regurgitation remains one of the major unsolved dilemmas in modern cardiology.5'6 In this specialty conference, we will attempt to correlate current knowledge of the natural history and pathophysiology of these disorders with rational approaches to their medical and surgical management, including use of important information gained from the history, physical examination, and noninvasive and invasive diagnostic
{"title":"Aortic Valve Disease","authors":"L. Shapiro, Antoinette Kenny","doi":"10.1201/9781315138800-6","DOIUrl":"https://doi.org/10.1201/9781315138800-6","url":null,"abstract":"clinical symptoms is the major indicator for surgical intervention,4 the natural history of chronic aortic regurgitation is more variable and the onset of myocardial deterioration commonly occurs before the onset of symptoms. Identification of early myocardial decompensation in chronic aortic regurgitation remains one of the major unsolved dilemmas in modern cardiology.5'6 In this specialty conference, we will attempt to correlate current knowledge of the natural history and pathophysiology of these disorders with rational approaches to their medical and surgical management, including use of important information gained from the history, physical examination, and noninvasive and invasive diagnostic","PeriodicalId":357091,"journal":{"name":"Cardiac Ultrasound","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130786644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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