Introduction Late complications such as hemolysis and thrombus formation in patients with an implanted prosthetic heart valve have been related to fluid dynamic characteristics [ 11. Specific blood flow patterns such as flow reversal and vortex flow have been considered to contribute to thrombus formation [2]. In order to detect alterations of flow fields around prostheses in humans MR velocity...

We report the case of a 34-year-old man with aortic valve infective endocarditis caused by methicillin-resistant Staphylococcus aureus, complicated by an aortic annular abscess. A 23-mm St. Jude HP aortic mechanical prosthesis was implanted. The pre-discharge echocardiogram revealed a mycotic aneurysm of the basal posteroinferior wall, confirmed by cardiac magnetic resonance imaging, and it was...

OBJECTIVE To attempt to reconcile reports containing contradictory findings with the St. Jude Medical Silzone heart valve. METHODS Major leak and thromboembolism data were extracted from available Silzone valve studies. Linearized rates were used to summarize and compare the events rates among the studies. RESULTS The Artificial Valve Endocarditis Reduction Trial (AVERT) study reported sign...

A 78-year-old man at high risk for aortic valve replacement (Euroscore, 44%; left ventricular ejection fraction, 30%; previous bypass graft surgery) had undergone a transapical aortic valve implantation (26-mm Edwards Sapien) with a good immediate clinical and echocardiographic outcome: peak transvalvular gradient, 15 mm Hg; aortic valve area, 1.6 cm; and trivial aortic regurgitation (Figure 1)...

1. Permanent therapy with oral anticoagulants offers the most consistent protection in patients with mechanical heart valves. 2. Antiplatelet agents alone do not consistently protect patients with mechanical prosthetic heart valves, including patients in sinus rhythm with St. Jude Medical valves in the aortic position. 3. Levels of oral anticoagulants that prolong the INR to 2.0 to 3.0 appear s...

From the *Division of Cardiology, New Tokyo Hospital, Chiba, Japan; and the yDivision of Cardiology, Harrington Heart & Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve School of Medicine, Cleveland, Ohio. Dr. Attizzani has received consultant honoraria from St. Jude Medical. Dr. Bezerra has received honoraria fees from St. Jude Medical. Dr. Costa is on the spe...

We describe percutaneous closure of an unusual paravalvular leak, with a communication from the noncoronary cusp of the aortic valve to the left atrium adjacent to a St. Jude mitral valve prosthesis, in the absence of an infection. The patient presented with worsening dyspnea and edema. The anatomic location of the valve annulus adjacent to the noncoronary cusp underlies the etiology of this co...