Mechanical heart valve cavitation in patients with bileaflet valves.

Today, the quality of mechanical heart valves is quite high, and implantation has become a routine clinical procedure with a low operative mortality (< 5%). However, patients still face the risks of blood cell damage, thromboembolic events, and material failure of the prosthetic device. One mechanism found to be a possible contributor to these adverse effects is cavitation.

Revascularization compared to medical treatment in patients with silent vs. symptomatic residual ischemia after thrombolyzed myocardial infarction--the DANAMI study.

Aims: The aim was to compare the effect of revascularization to conservative treatment in patients with residual silent and with residual symptomatic ischemia following acute myocardial infarction (AMI). The study was a subanalysis of the DANAMI (DANish AMI) randomized study of invasive vs. conservative treatment in patients with inducible ischemia after thrombolysis in AMI.

Intraoperative and postoperative evaluation of cavitation in mechanical heart valve patients.

Background: Cavitation has been claimed partly responsible for the increased risk of thromboembolic complications, hemolysis, and fatal valve failure seen in mechanical heart valve patients. In vivo studies have investigated cavitation using high-pass filtering of the high-frequency pressure fluctuations with the root mean square values as an assessment of intensities. In vitro studies have shown that this well-known method may not be ideal owing to loss of data as a consequence of filtering, and because it requires a priori knowledge of the valve resonance pattern.

Suppressed phospholamban levels differentiate irreversibly dysfunctional from hibernating myocardium in humans.

Objectives: We studied whether dysfunction of human hibernating (HIB) and irreversibly dysfunctional myocardium (IRDM) are associated with altered levels of the sarcoplasmatic reticulum calcium handling proteins Ca2+-ATPase (SERCA2a) and its inhibitor phospholamban (PLB).

Design: In 12 patients myocardial biopsies were taken during bypass surgery and analysed for contents of these proteins. We classified regions as control, HIB, or IRDM based on echocardiographic studies before and 6 months after surgery.

Imbalanced chordal force distribution causes acute ischemic mitral regurgitation: mechanistic insights from chordae tendineae force measurements in pigs.

Background: Ischemic mitral regurgitation is caused by an imbalance of the entire mitral-ventricular complex. This interaction is mediated through the chordae tendineae force distribution, which may perturb several elements of the mitral valve apparatus. Our objective was to investigate the association between the mitral valvular 3-dimensional geometric perturbations and chordae tendineae force redistribution in a porcine model of acute ischemic mitral regurgitation.

Three-year outcome after coronary stenting versus bypass surgery for the treatment of multivessel disease.

Background: The primary results of Arterial Revascularization Therapy Study reported a greater need for repeated revascularization after percutaneous coronary intervention with stenting (PCI). However, PCI was less expensive than coronary artery bypass grafting (CABG) and offered the same degree of protection against death, stroke, and myocardial infarction.

Methods And Results: Patients with multivessel disease (n=1205) were randomly assigned to either CABG or PCI and followed up for up to 3 years.

Indication of cavitation in mechanical heart valve patients.

Background And Aim Of The Study: Cavitation may cause erosion of prosthetic heart valve material. The phenomenon has been extensively studied in vitro, and an association between the presence of cavitation bubbles and high-frequency pressure fluctuations (HFPF) has been established. In-vivo studies examining this phenomenon are scarce; hence, the study aim was to compare HFPF in patients with native, bioprosthetic or mechanical aortic valves, using both invasive and non-invasive measuring techniques.

Cavitation caused by mechanical heart valve prostheses--a review.

Heart valve dysfunction often necessitates surgical implantation of a mechanical heart valve (MHV). Although implantation of a MHV is a life-saving procedure, the patient still faces potentially complications such as thromboembolic events and material failure. These complications may be caused by cavitation, which can occur during valve closure.

Revascularization in multivessel disease: comparison between two-year outcomes of coronary bypass surgery and stenting.

Objective: The recent appreciation that stenting has improved the short- and long-term outcomes of patients treated with coronary angioplasty has made it imperative to reconsider the comparison between surgery and percutaneous interventions in patients with multivessel disease.

Methods: One thousand two hundred five patients were randomly assigned to undergo bypass surgery or angioplasty with stent implantation when there was consensus between the cardiac surgeon and interventional cardiologist as to equivalent treatability. The primary clinical end point was freedom from major adverse cardiac and cerebrovascular events at 1 year.

Intraventricular dispersion and temporal delay of early left ventricular filling after acute myocardial infarction. Assessment by magnetic resonance velocity mapping.

This article aims to describe early left ventricular diastolic inflow using magnetic resonance velocity mapping in patients with recent acute myocardial infarction and in normal volunteers. Magnetic resonance velocity mapping was performed in a long axis plane through the hearts of 46 patients with recent, first time acute myocardial infarction and 43 age-matched normal volunteers. The peak velocities at six levels of the early diastolic inflow stream were recorded.