A pulsatile pressure-flow model was developed for in vitro quantitative color Doppler flow mapping studies of valvular regurgitation. The flow through the system was generated by a piston which was driven by stepper motors controlled by a computer. The piston was connected to acrylic chambers designed to simulate "ventricular" and "atrial" heart chambers. Inside the "ventricular" chamber, a pro...

Since the first report of the application of Doppler echocardiography in the evaluation of prosthetic heart valves 10 years ago, dozens of studies have reaffirmed the usefulness of this technique in the noninvasive assessment of transvalvular hemodynamics. Most of these studies have established "normal values" for Doppler-determined pressure gradients and valve areas of prosthetic mitral and ao...

OBJECTIVE Current clinical practice guidelines advocate shared decision-making (SDM) in prosthetic valve selection. This study assesses among adult patients accepted for aortic valve replacement (AVR): (1) experience with current clinical decision-making regarding prosthetic valve selection, (2) preferences for SDM and risk presentation and (3) prosthetic valve knowledge and numeracy. METHODS...

We reviewed M-mode and two-dimensional echocardiographic findings in 11 patients with abacteremic endocarditis to study the application of echocardiography in this setting. All patients had negative blood cultures but underwent surgery that confirmed the presence of active infective endocarditis. The infection involved native valves in five patients and prosthetic valves in six patients. Valvul...

Valvular stenosis is an uncommon finding in bacterial endocarditis involving native cardiac valves. Prosthetic valve endocarditis, however, is more commonly associated with obstruction. Bioprosthetic cardiac valves may be particularly prone to this complication. A case of bioprosthetic tricuspid valve endocarditis with stenosis diagnosed by Doppler echocardiography and confirmed by operative fi...

Infective endocarditis (IE) is an endovascular microbial infection of cardiovascular structures (e.g., native valves, ventricular or atrial endocardium) including endarteritis of the large intrathoracic vessels (e.g., in a patent ductus arteriosus, arteriovenous shunts, coarctation of the aorta) or of intracardiac foreign bodies (e.g., prosthetic valves, pacemaker or ICD leads, surgically creat...

Although porcine aortic valves or pericardial tissue mounted on a stent have made implantation techniques easier, these valves sacrifice orifice area and increase stress at the attachment of the stent, which causes primary tissue failure. Optimizing hemodynamics to prevent patient-prosthetic mismatch and improve durability, stentless bioprostheses use was revived in the early 1990s. The purpose...

In a prospective, randomized, parallel study, two regimens of platelet-suppressant therapy (PST) dipyridamole-aspirin and pentoxifylline-aspirin were compared with standard oral anticoagulation with warfarin in the prevention of prosthetic heart valve thromboembolism. In the entire group of 254 patients followed for 395.6 patient-years, the thromboembolic rate was significantly less in the warf...

A 62-year-old woman presented with a sudden transient ischemic attack (TIA). Symptoms resolved within 2 hours of onset. Neurological evaluation and workout for etiology of the TIA was unremarkable. Her medical history included having a St. Jude mitral valve replacement for mitral regurgitation 10 years before presentation. The patient had been maintained on warfarin with INR levels generally in...

Activity of total lactate dehydrogenase (LDH) and that of the heat-stable isozyme (LDH-1) was measured by the method of Strandjord and Clayson in the serum of 62 cardiac patients with congenital and valvular heart disease before and after cardiac catheterization and at follow-up examination after cardiac surgery. A universal elevation of both total and heat-stable LDH was found in patients with...