To the Editor: We would like to bring to your attention our recent dilemma of when to re-anticoagulate a patient with a hypertensive cerebral hemorrhage who concurrently has a prosthetic heart valve. The patient, a 63-year-old woman, had had her aortic heart valve replaced in 1978 with a modified Bjork-Shiley prosthetic valve and had been taking warfarin without bleeding complications. She was ...

The surgical replacement of diseased heart valves is based on the premise that the prosthesis chosen to replace a stenotic or insufficient valve will have a beneficial impact on the patient’s heart function, taking into account the risks of surgery and the recognized complications of prosthetic heart valves. It is well established that mitral valve replacement (MVR) is associated with higher sh...

A 65-year-old man was referred with refractory heart failure. A 27-mm Carbomedics bileaflet valve for mitral valve stenosis had been implanted 20 years earlier. The electrocardiogram showed atrial fibrillation with severe bradycardia (30-50/min). Transthoracic echocardiography demonstrated both prosthetic leaflets opening in late diastole (Picture A, arrows), and the anterolateral leaflet inter...

Prosthetic valves are being widely used in the treatment of heart valve disease. Prosthetic valve endocarditis (PVE) is one of the most catastrophic complications seen in these patients. In particular, prosthetic valve dehiscence can lead to acute decompensation, pulmonary edema, and cardiogenic shock. Here, we discuss the medical management of late PVE in a patient with a prior history of late...

there is a paucity of literature regarding iatrogenic aortic valve perforation after cardiac operation is performed in the vicinity of the aortic valve. this report describes the clinical, echocardiographic, and angiocardiographic recognition of iatrogenic aortic valve perforation in a patient who had previously under gone membranous ventricular septal defect and pulmonary stenosis. five days a...

Background Many high-risk patients with severe aortic stenosis cannot undergo valve replacement surgery due to calcification of the ascending aorta. Aortic valve bypass (AVB) surgery uses a conduit and prosthetic valve placed transapically into the left ventricle to divert flow from the apex of the heart through the conduit and prosthetic valve to the descending thoracic aorta to improve cardia...

The classic case of aortic stenosis is a healthy middle-aged patient with/without symptoms, but in practical life, patients with severe calcific aortic valve come with several and severe comorbidities such as advanced age, coronary artery disease, atherosclerotic aorta, significant left ventricular dysfunction. Aortic valve replacement (AVR) is the only options in these patients, and it require...

ment? J Am Soc Echocardiograph 2009;8:895–8. 12. Ionescu AA, Moreno de la Santa P, Dunstan FD, Butchart EG, Fraser AG. Mobile echoes on prosthetic valves are not reproducible. Eur Heart J 1999;20: 140–7. 13. Kiavar M, Sadeghpour A, Bakhshandeh H, Bassiri HA, Tayyebi P, Esmaeilzadeh M et al. Are prosthetic valve fibrin strands negligible? The associations and significance. J Am Soc Echocardiogr ...