Shannon entropy as a reliable score to diagnose human fibroelastic degenerative mitral chords: A micro-ct ex-vivo study.

This paper is aimed at identifying by means of micro-CT the microstructural differences between normal and degenerative mitral marginal chordae tendineae. The control group is composed of 21 normal chords excised from 14 normal mitral valves from heart transplant recipients. The experimental group comprises 22 degenerative fibroelastic chords obtained at surgery from 11 pathological valves after mitral repair or replacement.

Identification of Human Pathological Mitral Chordae Tendineae Using Polarization-sensitive Optical Coherence Tomography.

Defects of the mitral valve complex imply heart malfunction. The chordae tendineae (CTs) are tendinous strands connecting the mitral and tricuspid valve leaflets to the papillary muscles. These CTs are composed of organized, wavy collagen bundles, making them a strongly birefringent material.

Hessian analysis for the delineation of amorphous anomalies in optical coherence tomography images of the aortic wall.

The aortic aneurysm is a disease originated mainly in the media layer of the aortic wall due to the occurrence of degraded areas of altered biological composition. These anomalous regions affect the structure and strength of the aorta artery, being their occurrence and extension proportional to the arterial vessel health. Optical Coherence Tomography (OCT) is applied to obtain cross-sectional images of the artery wall.

Identification of vessel wall degradation in ascending thoracic aortic aneurysms with OCT.

Degradation of the wall of human ascending thoracic aorta has been assessed through Optical Coherence Tomography (OCT). OCT images of the media layer of the aortic wall exhibit micro-structure degradation in case of diseased aortas from aneurysmal vessels. The OCT indicator of degradation depends on the dimension of areas of the media layer where backscattered reflectivity becomes smaller due to a disorder on the morphology of elastin, collagen and smooth muscle cells (SMCs).

Optical coherence tomography assessment of vessel wall degradation in thoracic aortic aneurysms.

Optical coherence tomography images of human thoracic aorta from aneurysms reveal elastin disorders and smooth muscle cell alterations when visualizing the media layer of the aortic wall. These disorders can be employed as indicators for wall degradation and, therefore, become a hallmark for diagnosis of risk of aneurysm under intraoperative conditions. Two approaches are followed to evaluate this risk: the analysis of the reflectivity decay along the penetration depth and the textural analysis of a two-dimensional spatial distribution of the aortic wall backscattering.

Aspergillus endocarditis in lung transplant recipient: successful surgical treatment.

Solid organ transplantation can be followed by Aspergillus infection, implying high mortality rates. The highest infection rates are registered among lung transplant recipients. We present a recent case of an Aspergillus endocarditis in a young lung transplant recipient.

Structural analysis of chordae tendineae in degenerative disease of the mitral valve.

Background: Degenerative disease of the mitral valve (DDMV) is always accompanied by lengthening and/or rupture of chordae tendineae. However, the mechanisms and the mode of chordal rupture remain controversial, and the pathologic anatomy of the apparently healthy chordae has mostly been overlooked. We analyze the structural aspects of both ruptured and intact chordae tendineae in DDMV.

Repair of rheumatic tricuspid valve disease: predictors of very long-term mortality and reoperation.

Background: We examined predictors of reoperation and late mortality in patients undergoing tricuspid valve repair for rheumatic disease.

Methods: Between 1997 and 2007, 299 consecutive patients (mean age 50.8 + or - 13.

Combined mitral and tricuspid valve repair in rheumatic valve disease: fewer reoperations with prosthetic ring annuloplasty.

Background: We examined predictors of early and very long-term outcome after combined mitral and tricuspid valve repair for rheumatic disease.

Methods And Results: Between 1974 and 2002, 153 consecutive patients (mean age, 46.0+/-13.

Repeat mitral valve replacement: 30-years' experience.

Prosthetic heart valve dysfunction is an acquired condition that carries a significant risk of emergency surgery. However, the long-term natural history of the condition is not well understood. Between 1974 and 2006, 1535 isolated mitral valve replacements were performed at our hospital (in-hospital mortality 5%).

Clinical course and predictors of death in prosthetic valve endocarditis over a 20-year period.

Objective: To compare early and late outcome of patients with prosthetic valve endocarditis treated medically versus surgically and to determine predictors of in-hospital death. We retrospectively reviewed patient's clinical records, including laboratory findings, surgery, and pathologic files, in an acute-care, 1200-bed teaching hospital.

Methods: One hundred thirty-three episodes of definite prosthetic valve endocarditis as defined by the Duke University diagnostic criteria occurred in 122 patients from January 1986 to December 2005.

Surgery for rheumatic tricuspid valve disease: a 30-year experience.

Objective: This study was undertaken to assess factors influencing short- and long-term outcomes of surgery for rheumatic disease of the tricuspid valve.

Methods: Between 1974 and 2005, a total of 328 consecutive patients (mean age 51.3 +/- 13.

[Cardiac surgery in Jehovah's Witnesses. Experience in Santander, Spain].

As patients who are Jehovah's Witnesses are against blood transfusion, they are difficult to manage when a cardiac intervention is required. Between 1998 and 2004, all Jehovah's Witness patients with an indication for cardiac surgery (n=10) were operated on by the same multidisciplinary team. The mean fall in hematocrit was 30% during cardiopulmonary bypass, 35% during the postoperative period, and 22% at discharge.

The 'Valve Racket': a new and different concept of atrioventricular valve repair.

Objective: Mitral regurgitation due to prolapse of the mitral leaflets frequently compromises annuloplasty repair procedures. We present a new annuloplasty ring that overcomes this difficulty, preventing displacement of the leaflets into the atrium.

Methods: The 'Valve Racket' is a prosthetic ring transformed into a racket by means of handmade mesh using expanded polytetrafluoroethylene (ePTFE Gore-Tex).

Incidental in vivo detection of an isolated hemangioma of the aortic valve in a man with a history of renal transplantation.

Hemangiomas of the cardiac valves are exceptional. To our knowledge, only ten cases of valve hemangiomas, six in the mitral and four in the tricuspid valve, have been reported in the English literature. We describe an incidentally detected aortic valve hemangioma of a 62-year-old man with chronic, degenerative aortic valve stenosis, who underwent renal transplantation 7 years before.

Risk factors of prosthetic valve endocarditis: a case-control study.

Background: Prosthetic valve endocarditis is an important cause of the morbidity and mortality associated with heart valve replacement surgery. The objective of this study was to assess risk factors of prosthetic valve endocarditis related to patients, perioperative events, and postoperative complications.

Methods: This was a retrospective case-control study conducted in a tertiary care hospital in Santander, Spain, from January 1986 to January 1998.

Surgical site infection during hospitalization and after discharge in patients who have undergone cardiac surgery.

During a 13-month period, 513 patients who were scheduled to undergo cardiac surgery were prospectively observed for surgical site infection during hospitalization after surgery and for 1 month after hospital discharge. Fifty-three patients showed evidence of surgical site infection (during hospitalization for 31 patients and after discharge for 22). Multivariate analysis identified that risk factors for surgical site infection differed between infections that occurred during hospitalization and those that occurred after discharge.

Performance at 10 years of the CarboMedics "Top-Hat" valve. Postclamping time is a predictor of mortality.

Objective: The CarboMedics "Top-Hat" supraannular prosthesis was designed to permit the implantation of a larger prosthesis. We evaluated the outcome at 10 years in patients with this prosthesis.

Methods: Between June 1993 and May 2001, 269 patients (average age, 63.

Reoperations after tricuspid valve repair.

Objective: The objective was to analyze the short- and long-term results of patients with previous tricuspid valve repair who had valve dysfunction and required cardiac reoperations.

Methods: Between 1976 and 2002, 74 patients with a mean age of 53.8 +/- 12.