BACKGROUND Long-term outcome of patients treated with a St. Jude prosthetic heart valve was reported by investigators in Lausanne, Switzerland. This article quantifies the mortality and morbidity implications of single or multiple heart valve replacement. RESULTS After hospital discharge, mortality ratios were highest for duration 5-10 years, roughly comparable in patients who received a sing...

Patients with metallic prosthetic heart valves have to use anticoagulants throughout their life because of avoiding prosthetic valve thrombosis. We report the case of a patient with a prosthetic aortic valve without any event to date despite not using warfarin for 31 years. A 53-year-old man who underwent aortic valve replacement (AVR) with a mechanical valve (Medtronic,Inc., Minneapolis, Mines...

Prescribing anticoagulants to pregnant women can be difficult and stressful. Fortunately, low-molecular-weight heparins (LMWHs) and unfractionated heparin are quite safe and efficacious when properly selected, dosed, and monitored. Maternal and fetal concerns must be considered at all times, with a careful assessment of the risks and benefits of anticoagulant therapy in each patient. Further re...

a common complication of prosthetic heart valves is thrombosis. although the incidence of prosthetic valve thrombosis (pvt) in the tricuspid position is high, there are not enough data on the management of it, in contrast to left-sided pvt. here, we describe three cases of tricuspid pvt with three different management approaches: thrombolytic therapy; close observation with oral anticoagulants;...

Patients with mechanical valve prostheses require a lifelong anticoagulant treatment. The combined use of Warfarin and low-dose aspirin appears to reduce the risk of valve thrombosis and systemic embolism at a low risk of bleeding. The management of women with prosthetic heart valves during pregnancy poses a particular challenge, as there are no available controlled clinical trials to provide g...

Surgery for heart diseases during pregnancy, especially necessitating cardiopulmonary bypass, is believed to trigger maternal and fetal risks and should be performed only when medical therapy has been unsuccessful to alleviate the cardiac decompensation. A 33-year-old pregnant woman in her 33rd week of gestation was admitted to our hospital. She had rheumatic mitral valvular stenosis and had un...

OBJECTIVE Definite data in heart surgery with extracorporeal circulation during pregnancy is limited. This report analyzes our experience in this area. METHODS Fifteen women underwent open heart surgery under cardiopulmonary bypass during pregnancy at our institution between 1972 and 1998. Surgical procedures included valve replacement in 13 patients (12 mitral, 1 aortic), declotting of a til...

As the rate of obesity increases in childbearing-aged women, so too will the complications of obesity in pregnancy. An uncommon and likely underreported complication occurs in obese women who have received prepregnancy cardiac valve replacement with a prosthesis that is inadequately sized for body habitus, a condition referred to as patient-prosthesis mismatch (PPM). The physiologic changes of ...

INTRODUCTION Patients with congenital heart disease who underwent pulmonary valvotomy or surgery to open the pulmonary valve ring are prone to develop residual pulmonary insufficiency or stenosis that may lead to right heart failure with clinical deterioration. These children require multiple interventions throughout their lives, which impose a high rate of morbidity and mortality. OBJECTIVE ...