New observations on the etiology of aortic valve disease: A surgical pathologic study of 236 cases from 1990

Dare, Anthony J.; Veinot, John P.; Edwards, William D.; Tazelaar, Henry D.; Schaff, Hartzell V.

doi:10.1016/0046-8177(93)90267-k

Cited by 138 publications

(41 citation statements)

References 16 publications

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“…[2][3][4][5][6] The problem of P-PtM is most commonly encountered in patients undergoing AVR for severe calcific aortic valve stenosis. 7 Because the Western population is aging, with a consequent increased incidence of degenerative aortic valve stenosis, there are concerns about the potential adverse impact of P-PtM on short-and long-term outcomes. 2 Nonetheless, several studies have not shown a relation between prosthesis size relative to…”

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confidence: 99%

Impact of Prosthesis-Patient Mismatch on Long-Term Survival in Patients With Small St Jude Medical Mechanical Prostheses in the Aortic Position

Mohty-Echahidi¹,

Malouf²,

Girard³

et al. 2006

Circulation

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183

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Background-The impact of aortic prosthesis-patient mismatch (P-PtM) on long-term survival is unclear. . P-PtM was severe in 66 patients (17%), moderate in 168 (43%), and not hemodynamically significant in 154 (40%). Patients with severe P-PtM had a significantly larger body surface area (PϽ0.0001), higher mean gradient (PϽ0.0001), lower preoperative (PϽ0.0001) and postoperative (PϽ0.0001) ejection fractions, and lower stroke volume (PϽ0.0001) and more often received a 19-mm prosthesis (Pϭ0.0008) than patients with moderate or no hemodynamically significant mismatch. For patients with severe mismatch, 5-year survival rates (72Ϯ6%) and 8-year survival rates (41Ϯ8%) were significantly less than for patients with moderate mismatch (80Ϯ3% and 65Ϯ5%; Pϭ0.026) or no hemodynamically significant mismatch (85Ϯ3% and 74Ϯ5%; Pϭ0.002). On multivariate analysis after adjustment for other predictors of outcome, severe mismatch was associated with higher mortality (hazard ratio 2.18; 95% confidence interval 1.24 to 3.85; Pϭ0.007) and higher incidence of congestive heart failure (hazard ratio 3.1; 95% confidence interval 1.3 to 7.4; Pϭ0.009) than no hemodynamically significant mismatch. Conclusions-Severe P-PtM is an independent predictor of higher long-term mortality and congestive heart failure in patients with small St Jude Medical aortic valve prostheses. For patients undergoing AVR who are at risk of severe mismatch, every effort should be made to use a larger prosthesis or to consider a prosthesis with a larger EOA. Methods and Results-Between

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confidence: 99%

Impact of Prosthesis-Patient Mismatch on Long-Term Survival in Patients With Small St Jude Medical Mechanical Prostheses in the Aortic Position

Mohty-Echahidi¹,

Malouf²,

Girard³

et al. 2006

Circulation

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183

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“…Each thoracic aorta was incised longitudinally and was examined macroscopically. Three 5mm tissue samples from each aorta were obtained for analysis from three standard anatomic stations (Figure 1), which are considered to be more fragile and favor the development of atherosclerotic plaques, according to literature (6)(7)(8)(9)(10)(11). These stations were the anterior wall of the ascending aorta, the intimal surface of the aortic arch (Figure 2a) and the point of the descending aorta just below the origin of the subclavian artery (Figure 2b).…”

Section: Methodsmentioning

confidence: 99%

A macroscopic analysis of the epidemiology of thoracic aorta atherosclerosis: An autopsy study

Gogakos¹,

Chatzinikolaou²,

Κoletsa³

et al. 2017

J. Biomed

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Background: Atherosclerosis is the most important cardiovascular disease across the globe with a large proportion of associated morbidity and mortality. The aim of this study is to detect the presence of atherosclerosis-like lesions in the three segments of the thoracic aorta (ascending aorta, aortic arch and descending aorta) of 50 unselected adult cadavers of all ages. Methods: An autopsy analysis was performed using 50 unselected adult cadavers (37 male, 13 female -mean age 64.2 years; age range 19-90 years). Macroscopic dissection of the three segments of the thoracic aorta was performed and the presence of atherosclerosis-like lesions was evaluated according to the subjects' demographic and clinical characteristics. Results: Atherosclerotic lesions in at least one of the three aortic segments were identified in 82% of cadavers, 83.78% of male and 76.92% of female. Of 50 subjects, 30% had an atherosclerotic lesion in the ascending aorta, 48% in the aortic arch and 44% in the descending aorta. No aneurysmal changes were detected. Smoking, hypertension, diabetes, hypercholesterolemia, obesity and coronary disease were the risk factors correlated most with the presence of atherosclerosis. Conclusions: Atherosclerosis-like lesions in the thoracic aorta are prevalent in adults of all ages. Obesity is a major risk factor regarding the development of atheromas. This cadaveric study comes to underline the necessity of further similar studies in order to evaluate the presence of atherosclerosis in the thoracic aorta, and also helps to assess the risk of major cardiovascular events in the general population.

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“…Although the prevalence of valvulopathy is high in Brazil, data on its actual prevalence and clinical profile are still scarce 1,2 .…”

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confidence: 99%

Anemia, disfunção renal e desnutrição associadas à insuficiência cardíaca em pacientes valvopatas

Souza¹,

Araújo²,

Silva

et al. 2010

Arq. Bras. Cardiol.

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New observations on the etiology of aortic valve disease: A surgical pathologic study of 236 cases from 1990

Cited by 138 publications

References 16 publications

Impact of Prosthesis-Patient Mismatch on Long-Term Survival in Patients With Small St Jude Medical Mechanical Prostheses in the Aortic Position

Impact of Prosthesis-Patient Mismatch on Long-Term Survival in Patients With Small St Jude Medical Mechanical Prostheses in the Aortic Position

A macroscopic analysis of the epidemiology of thoracic aorta atherosclerosis: An autopsy study

Anemia, disfunção renal e desnutrição associadas à insuficiência cardíaca em pacientes valvopatas

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