IN THE PAST THREE DECADES a striking change has occurred in the microbiological spectra, clinical features and natural history of infective endocarditis. Undoubtedly, the development of a host of potent antimicrobial agents and their widespread availability and, at times, indiscriminate use, have played a key role. Other important factors include the use of prosthetic heart valves, the increasi...

Almost 30 years have passed since the first successful use of an artificial heart valve for the treatment of severe valvular heart disease. Replacement of dysfunctional native heart valves with either mechanical or bioprosthetic materials has become the standard therapy for hemodynamically significant lesions with over 110,000 such procedures performed worldwide in 1988. Despite the general suc...

Background. Thrombolytic therapy is a promising alternative to valve replacement in the management of prosthetic valve thrombosis. We sought to determine the shortand long-term results of treating thrombosed St. Jude heart valves with thrombolytic therapy as the primary treatment modality. Methods and Results. Between March 1978 and December 1991, 988 patients underwent implantation of St. Jude...

Platelet survival time and platelet adhesiveness and aggregation were examined in 16 patients with prosthetic mitral valves. Subsequently, nine patients were treated with sulfinpyrazone in doses of 400 mg and 800 mg/day, and the studies were repeated after a treatment period of 5 to 8 weeks. 51Chromium survival time was shortened in 15 of 16 patients, and the mean value for the entire group was...

Echocardiography and fluoroscopy are the main techniques for prosthetic heart valve (PHV) evaluation, but because of specific limitations they may not identify the morphological substrate or the extent of PHV pathology. Cardiac computed tomography (CT) and magnetic resonance imaging (MRI) have emerged as new potential imaging modalities for valve prostheses. We present an overview of the possib...

The clinical and investigatory findings in five instances of major detachment of an aortic valve prosthesis in four patients are described. This situation was associated with auscultatory and peripheral signs of aortic regurgitation and, in addition, a mid-diastolic murmur in the mitral area. From the haemodynamic and operative findings it was postulated that, in addition to severe aortic regur...

Ochrobactrum anthropi is a gram-negative rod of low virulence. Infections due to this organism are uncommon; however in immunocompromised hosts it can cause severe infections. Among the many infections it can cause, infective endocarditis is very rare. Even rarer is infective endocarditis of the native valves, as Ochrobactrum antropi affects damaged or prosthetic valves almost exclusively. This...

Audible cardiac murmurs are uncommon and may indicate severe native valve dysfunction. In six patients with bioprosthetic mitral valves audible honking systolic murmurs suddenly developed. Doppler echocardiography showed characteristic striated regurgitant signals. At operation each prosthesis had torn cusps. New audible murmurs and striated Doppler signals originating from mitral bioprosthetic...

A large number of prosthetic heart valves (PHV) are being implanted in patients with both congenital and acquired valvular disease. Many of the recipients of such valves are women of childbearing age who desire to have children. The main issues involved with pregnancy in a patient with PHV include the selection of PHV in women during their childbearing age, risks to both the mother and the fetu...

Starr-Edwards mitral and aortic prosthetic valves served as nidi for endocarditis due to M chelonei. Cultural, physiologic, lipid chromatographic, and serologic studies identified the organism as M chelonei (abscessus).