Late incidence and predictors of persistent or recurrent heart failure in patients with aortic prosthetic valves.

Background: We examined factors associated with persistent or recurrent congestive heart failure after aortic valve replacement.

Methods: Patients who underwent aortic valve replacement with contemporary prostheses (n = 1563) were followed up with annual clinical assessment and echocardiography. The effect of demographic, comorbid, and valve-related variables on the composite outcome of New York Heart Association class III or IV symptoms or congestive heart failure death after surgery was evaluated with stratified log-rank tests, Cox proportional hazard models, and logistic regression.

Acute aortic intimal tear without a mobile flap mimicking an intramural hematoma.

Several variants of aortic pathology must be considered in the differential diagnosis of the patient presenting with an acute aortic syndrome. In addition to aortic dissection, such entities include intramural hematoma, penetrating aortic ulcer, and localized intimal tear without dissection. These lesions, which lack a mobile intimal flap, may be difficult to correctly identify by transesophageal echocardiography or other imaging modalities.

Direct drainage of the right pulmonary veins into the coronary sinus with intact interatrial septum: a case report.

Partial anomalous pulmonary venous connection to the coronary sinus is rare. This anomaly is even more rare in the absence of interatrial communication. Usually, the anomalous right pulmonary veins drain to the right atrium or venae cavae, while the anomalous left veins connect to the coronary sinus or left innominate vein.

Persistent hypoxemia occurring as a complication of tricuspid valve endocarditis.

A 33-year-old woman had intravenous drug-associated tricuspid valve infective endocarditis. Despite resolution of septic pulmonary emboli, hypoxemia persisted. We report a case of right-to-left shunting across a previously insignificant patent foramen ovale documented by contrast transesophageal echocardiography.