Morphological aspects of valvular heart disease: Part II

Waller, Bruce F.

doi:10.1016/0146-2806(84)90013-6

Cited by 17 publications

(8 citation statements)

References 214 publications

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“…[1][2][3] Surgeons' willingness to perform tricuspid valve replacement has been diminished by early results showing that mechanical valves do not perform well in a low-flow setting 4 and that bioprosthetic valves have a limited lifespan, which is particularly problematic in younger patients.…”

Section: Discussionmentioning

confidence: 99%

Transvenous Transcatheter Valve-in-Valve Implantation after Bioprosthetic Tricuspid Valve Failure

Mortazavi¹,

Reul²,

Cannizzaro³

et al. 2014

Texas Heart Institute Journal

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T ranscatheter valve-in-valve implantation has gained substantial momentum as a viable alternative to surgical valve replacement in patients who are thought to be at high risk for adverse perioperative outcomes. Valve-in-valve implantation of the Edwards Sapien ® valve (Edwards Lifesciences Corporation; Irvine, Calif ) in the tricuspid position is a relatively new procedure, and few cases have been reported. We describe the percutaneous delivery of the Edwards Sapien valve across an existing bioprosthetic tricuspid valve in a patient with metastatic testicular cancer who had undergone multiple previous thoracic operations. We discuss the technical aspects of the case and briefly review the usefulness of transcatheter valve-in-valve techniques in the tricuspid position. Case ReportIn June 2013, a 38-year-old man with severe tricuspid stenosis and regurgitation presented with New York Heart Association functional class III right-sided heart failure. His medical history included malignant neoplasm of the testes, for which he had undergone radical left orchiectomy in 1995 at the age of 19 years. That same year, he underwent exploratory laparotomy, left nephrectomy, bilateral pulmonary resections through a median sternotomy, and removal of multiple metastatic lesions. In 1996, he underwent right thoracotomy to remove additional metastases. During this operation, his tricuspid valve was replaced with a 27-mm Carpentier-Edwards ® Perimount ® bioprosthesis (Edwards Lifesciences) because of valvular involvement of the malignancy. He did well until 2009, when he presented with atrial flutter and underwent successful radiofrequency ablation. He emergently presented in 2012 with atrial flutter that was medically managed with success; the treatment included therapeutic oral anticoagulation.The patient had remained free of cancer for more than 15 years. However, in the 2 years before his current presentation, he had become more fatigued, with worsening shortness of breath and peripheral edema. Physical examination and transthoracic echocardiograms revealed severe tricuspid bioprosthesis stenosis with central regurgitation. The mean transvalvular gradient was 13 mmHg and the peak gradient was 22 mmHg (Fig. 1A), with a peak velocity of 2.34 m/s. No evidence of thrombus, vegetation, or abscess was seen. The right atrial cavity was severely dilated, and the Case Reports

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Section: Discussionmentioning

confidence: 99%

Transvenous Transcatheter Valve-in-Valve Implantation after Bioprosthetic Tricuspid Valve Failure

Mortazavi¹,

Reul²,

Cannizzaro³

et al. 2014

Texas Heart Institute Journal

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“…The acommissural stenotic pulmonic valve usually is a dome-shaped structure with central aperture. Ridges are usually visible that mark sites of apparently malformed commissures [12]. The second major type of isolated congenital pulmonary stenosis is a tricuspid pulmonary valve in which all the three cusps are greatly thickened and rubbery.…”

Section: Congenitalmentioning

confidence: 99%

Isolated Rheumatic Pulmonary Valve Disease—Case Reports

Muthiah¹

2016

CRCM

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Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults worldwide and particularly developing countries continuing to experience a high incidence of this disease. The unexpected increase in the incidence of the disease in certain areas may explain the clinical and epidemiological characteristics of this disease. The key manifestation of RHD is the cardiac valvular abnormalities characterized principally by deforming the layered and avascular leaflet architecture due to inflammation and subsequent diffuse fibrosis. Mitral valve is mostly involved and pulmonary valve is rarely affected. Background of these case reports highlighted the increased incidence of rheumatic pulmonary valve disease in Thoothukudi region of India in Tamil Nadu state.

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“…Isolated tricuspid stenosis is rare and raises the possibility of carcinoid heart disease, atrial myxoma, atrial thrombus or methysergide use, or congenital causes such as tricuspid atresia and Ebstein's anomaly. [5][6][7] Pathologically, there is fusion and shortening of the chordae tendineae and leaflet thickening. Fusion and calcification of the leaflets is a late sign.…”

Section: Tricuspid Diseasementioning

confidence: 99%