The detection is made possible because of the acoustic impedance between microemboli and blood, which increases the ultrasound intensity. Microemboli are transient (<100ms), high intensity (> 3dB) and unidirectional signal which are accompanied by a characteristic click or chirp sound (Ringelstein, Droste et al. 1998). The origin of microemboli are usually from an atheromatous plaque in the car...

OBJECTIVES The objective of this study was to compare the effectiveness and safety of adding dipyridamole or aspirin to warfarin among patients with prosthetic heart valves using meta-analytic techniques. BACKGROUND Patients with prosthetic heart valves are at increased risk for valve thrombosis and arterial thromboembolism. Oral anticoagulation alone, or the addition of antiplatelet drugs, h...

INTRODUCTION Pregnant women with mechanical prosthetic heart valves are at increased risk for valve thrombosis. Management decisions for this life-threatening complication are complex. Open-heart surgery has a very high risk of maternal mortality and fetal loss. Bleeding and embolic risks associated with thrombolytic agents, the limited efficacy of thrombolysis in certain subgroups, and a lack ...

INTRODUCTION People with various medical conditions and devices are suggested candidates for receiving antibiotic prophylaxis before undergoing dental procedures. This practice is controversial, however, owing to the lack of proof of efficacy. The authors conducted a qualitative, systematic review to determine the level of evidence for this practice and whether antibiotic prophylaxis prevents d...

BACKGROUND We performed the first quadruple valve replacement with mechanical valves, combined with the correction of complex congenital heart disease on November 17, 1999. We report here the 11-year follow-up study. METHODS A 47-year-old man with subacute rheumatic endocarditis, a ventricular septal defect, and an obstruction of the right ventricular outflow tract required replacement of the...

To test the validity of a relation between the pressure half time and the diastolic time interval, previously shown in a pulse duplication system, eight patients with prosthetic mitral valves and permanent pacemaker systems were studied. Recordings were made from the apex by continuous wave or pulsed Doppler echocardiography at heart rates between 75 and 150 beats/min. The pressure half time wa...

• The group of patients where this issue is of prime importance is when considering those groups of patients with underlying Atrial Fibrillation (AF) and prosthetic heart valves. The risk of embolisation is increased with mitral valve prostheses, caged ball devices and multiple prosthetic valves. • It is equally of paramount importance to calculate the thromboembolic risk by applying the CHADS2...

from may 1994 to december 1996 thirty patients received viable fresh aortic homografts. mean age was 55 years (13 to 70), male to female ratio was 2/1, 24 operations were elective whereas 6 were semiurgent. predominant lesions were aortic stenosis or regurgitation in lb patients, aortic valve endocarditis in 10, prosthetic valve dysfunction in 3, and aortic root pathology in one patient. from t...

Heavily calcified annuli increase the incidence of complications after prosthetic valve replacement-heart block, separation of the aorta or the atrium from the ventricle, late aneurysm formation, paravalvular leak, and haemolysis. An ultrasonic calculus-disintegrator has been developed to remove calcific deposits. The instrument is portable, robust, easily sterilized, inexpensive, and provides ...

Approximately 85,000 valve substitutes are implanted in the United States and 275,000 worldwide each year, of which approximately half are mechanical valves and half are bioprosthetic valves. Despite the marked improvements in prosthetic valve design and surgical procedures over the past decades, valve replacement is not a panacea for the patient. Instead, native valve disease is traded for pro...