ABSTRACT
Isolated tricuspid valve regurgitation is a rare finding after nonpenetrating chest trauma. The clinical course is usually benign and the time of surgery can be delayed for many years. Two-dimensional Doppler echocardiography is an essential procedure in the diagnosis of chordae tendineae or papillary muscle traumatic injury. We present two cases of traumatic tricuspid regurgitation with mild symptoms undiagnosed for sixteen and forty-three years, respectively.
Subject(s)
Echocardiography, Doppler , Thoracic Injuries/complications , Tricuspid Valve Insufficiency/etiology , Adult , Chordae Tendineae/injuries , Hemodynamics , Humans , Male , Middle Aged , Papillary Muscles/injuries , Tricuspid Valve Insufficiency/diagnosis , Tricuspid Valve Insufficiency/physiopathologyABSTRACT
A patient underwent mitral valve replacement because of mitral insufficiency secondary to bacterial endocarditis. Early postoperatively, routine examination with "color Doppler" correctly identified the presence of a left ventricular pseudoaneurysm. To our knowledge, this is the first case of left ventricular pseudoaneurysm diagnosed by this new technique.
Subject(s)
Echocardiography , Heart Aneurysm/diagnosis , Echocardiography/methods , Female , Heart Ventricles/pathology , Humans , Middle AgedSubject(s)
Echocardiography , Hemodynamics , Mitral Valve/pathology , Cardiac Catheterization , HumansABSTRACT
Presentamos los resultados obtenidos con 204 prótesis biológicas de Hancock, implantadas en nuestro Centro entre junio de 1974 y diciembre de 1975 y controladas posteriormente, con un seguimiento máximo de 8.5 años y mínimo de 5.8 años. La mortalidad quirúrgica-hospitalaria (QH) fué del 8.7% y la esperanza de sobrevida a los 8 años del 78.9%. Después de la intervención, del total de 171 enfermos intervenidos, 121 se hallaban en clase funcional I, y 123 presentaban cardiomegalia o esta era ligera. Al final del estudio el 95.3% de los enfermos con cambio mitral y el 95.8% con cambio aórtico estaban libres de endocarditis. La esperanza de ausencia de tromboembolismo a los 8 años fué del 92.1% para los enfermos con un cambio mitral y del 97.8% para la aórticos. A lo largo de la evolución se presentaron 49 disfunciones, de las cuales 16 fueron ligeras, no obligaron a valoración hemodinámica ni a cambio valvular. En un caso la disfunción se valoró como moderada y se indicó el estudio hemodinámico pero no la sustitución valvular. En 32 casos la disfunción fué grave y obligó a la reintervención inmediata. De las 36 prótesis explantadas, 22 presentaban signos de degeneración, 10 de endocarditis y 4 de deshiscencia periprotésica. Al final de los 8 años el 77.2% de los enfermos estaban libres de una disfunción severa. La mortalidad Q-H tras el segundo cambio fué del 9.4%
Subject(s)
Adult , Humans , Female , Bioprosthesis , Heart Valve Prosthesis , Actuarial Analysis , Follow-Up StudiesABSTRACT
From june 1974 to december 1975, 204 Hancock prosthetic valves were engrafted. The in-hospital mortality was 8.7%. The eight year survival rate was 78.9%. Of the 171 patients who had surgery, 121 reverted to functional class I, 123 had a mild or absent cardiomegaly. After 8 years of follow up 92% of the cases had not thromboembolic episodes. Ninety five percent of the patients with mitral valve replacement and 95% with aortic valve replacement were free of bacterial endocarditis. During the follow-up period; there were 49 valvular malfunctions, 16 of them mild that required no treatment. In 32 cases the alteration was severe and required surgical intervention. Thirty six prosthetic valves had to be removed; 22 of them had degenerative changes, 10 had bacterial endocarditis and in 4 the suture line broke down. After 8 years 77% of the valves were functioning well. The in-hospital mortality after the second valve replacement was 9.4%.
