Prevalence of Late Functional Tricuspid Regurgitation in Degenerative Mitral Regurgitation Surgery.

Background: Although significant late tricuspid regurgitation (TR) may develop after surgery for degenerative mitral regurgitation (MR), the use of routine tricuspid annuloplasty is debatable. The study aim was to determine the prevalence and predictors of significant late TR after surgery for degenerative MR.

Methods: A total of 112 patients who had undergone surgery for degenerative MR without concomitant tricuspid valve repair (average follow up 7.

Clinical and Echocardiographic Features of Mitral Annular Calcium in Patients Aged ≤50 Years.

Data regarding characteristics of young patients with mitral annular calcification (MAC) and its associations with other cardiovascular risk factors are scarce. Hence, we sought to characterize patients aged <50 years with MAC and to examine whether in these patients, MAC is also associated with cardiovascular risk factors. Consecutive patients who underwent an echocardiographic study were prospectively entered into a database.

Association Between Mitral Annular Calcium and Flail Mitral Leaflet in Degenerative Mitral Valve Disease.

The aim of this study was to assess the association between mitral annular calcium (MAC) and flail mitral leaflets in a cohort of patients with degenerative mitral valve disease. A retrospective study was conducted of consecutive patients with degenerative mitral valve disease who underwent echocardiography at Rabin Medical Center from 2003 to 2012. Special focus was attended to the presence and grade of MAC and characterization of valve pathology (myxomatous vs nonmyxomatous, prolapse vs flail).

Transoesophageal echocardiography of aortic atherosclerosis: the additive value of three-dimensional over two-dimensional imaging.

Aims: Complex aortic atherosclerotic plaques (AAPs) carry a significant risk of embolism. Currently, two-dimensional (2D) transoesophageal echocardiography (TOE) is the principal diagnostic tool of AAPs. However, we hypothesized that the data obtained from three-dimensional (3D) imaging may improve AAPs' spatial assessment.

Mid-term echocardiographic progression of patients with moderate aortic regurgitation: implications for aortic valve surgery.

Background And Aim Of The Study: Replacement of the aortic valve for moderate aortic regurgitation (AR) as an adjunct to another cardiac surgery, primarily for coronary artery bypass grafting (CABG) or mitral valve replacement or repair, remains the subject of much debate. The study aim was to monitor the progression rate of moderate AR by means of echocardiography, and to reveal the need for future surgical intervention.

Methods: A total of 262 consecutive patients (162 males, 100 females; mean age 65 +/- 15 years; range: 21-93 years) with moderate AR and no more than mild aortic stenosis, were followed for a mean of 42 +/- 31 months.

Does gender affect the rates of abnormal exercise stress echocardiography in patients with asymptomatic severe aortic stenosis?

Background And Aim Of The Study: Patient gender can affect not only the clinical manifestations of coronary artery disease (CAD) but also the clinician's interpretation of the symptoms and results of exercise stress tests for management decisions. This may be true also for aortic stenosis (AS), given its many shared features with CAD and similar symptom-based management. The study aim was to evaluate the effect of gender on the assessment of severe asymptomatic AS by exercise stress echocardiography (ESE).

The value of intraoperative transesophageal echocardiography in patients undergoing aortic valve replacement.

Background And Aim Of The Study: While the role of intraoperative transesophageal echocardiography (IOTEE) in valve repair surgery is well documented, its value in patients undergoing valve replacement is debatable. The study aim was to assess the impact of IOTEE on the management of a large cohort of patients referred for aortic valve replacement (AVR).

Methods: The departmental echocardiography database for patients undergoing AVR with IOTEE between April 1999 and September 2006 at the authors' institution was reviewed.

The association of left atrial volume with exercise capacity in patients with chronic severe mitral regurgitation.

Background: Left atrial volume and exercise capacity are strong predictors of cardiovascular risk. Decreased exercise capacity is expected when LAV is increased due to its association with abnormal left ventricular filling pressure. However, LAV enlargement is expected in chronic mitral regurgitation as well.

Right ventricular pacing increases tricuspid regurgitation grade regardless of the mechanical interference to the valve by the electrode.

Aims: The effect of right ventricular (RV) pacing on tricuspid regurgitation (TR) is debatable and is presumed to be related to an interference with valve closure by the electrode. The aim of the study was to determine the impact of pacing per se on TR grade.

Methods And Results: The study group included 23 clinically stable patients (13 males; mean age 78 +/- 12 years) with a permanent pacemaker at the RV apex (83% DDD mode) and normal left ventricular function.

Does exercise echocardiography have an added value over exercise testing alone in asymptomatic patients with severe aortic stenosis?

Background And Aim Of The Study: The study aim was to assess the clinical utility and added value of exercise stress echocardiography (ESE) over exercise testing alone in asymptomatic patients with severe aortic stenosis (AS).

Methods: The results of treadmill ESE in 101 consecutive patients (59 males, 42 females; mean age 69 +/- 10 years; range: 35-85 years) with asymptomatic severe AS (aortic valve area (AVA) <1 cm2 and/or mean transvalvular pressure gradient > or =50 mmHg) and normal left ventricular function, were analyzed. The test was considered abnormal if stopped prematurely because of limiting symptoms, a fall or small rise in systolic blood pressure, or complex ventricular arrhythmia.

The impact of intraoperative transesophageal echocardiography in infective endocarditis.

Background: [corrected] The use of intraoperative transesophageal echocardiogram in patients with infective endocarditis is usually reserved for cases of inadequate preoperative testing or suspected extension to perivalvular tissue.

Objectives: To explore the impact of routine intraoperative TEE in patients with infective endocarditis.

Methods: The impact of intraoperative TEE on the operative plan, anatomic-physiologic results, and hemodynamic assessment or de-airing was analyzed in 59 patients (38 males, 21 females, mean age 57.

Intraoperative transesophageal echocardiography during valve replacement surgery. A review.

Intraoperative transesophageal echocardiography (IOTEE) has become an important diagnostic and monitoring tool in the operating theatre during cardiac and noncardiac operations. However, its routine application during valve replacement operations has not received universal recognition. The cumulative experience, brought up in this review, shows that IOTEE is invaluable during valve replacement operations.

Relation of tricuspid inflow E-wave peak velocity to severity of tricuspid regurgitation.

E-wave velocity in mitral flow has previously been shown to discriminate between severe and nonsevere mitral regurgitation. In this study, we sought to explore this association in the tricuspid position. The peak velocity of the tricuspid inflow E wave was measured in 118 patients (mean age 62 +/- 16.

Comparison of diameter of ascending aorta in patients with severe aortic stenosis secondary to congenital versus degenerative versus rheumatic etiologies.

Aortic root dilation has been previously reported to be associated with aortic stenosis (AS), but data to support this statement are scarce. The dimensions of the aortic root were measured at 4 levels (annulus, sinuses, sinotubular junction, and ascending aorta) in 88 patients (mean age 71.2+/-9.

Initial clinical experience with a hand-held device (Thrombocheck) for the detection of bileaflet prosthetic valve malfunction.

Background And Aim Of The Study: Early recognition of subclinical prosthetic valve malfunction may promote early treatment and avoidance of serious complications. Echocardiography cannot be applied on a daily basis; thus, a hand-held device (Thrombocheck) which is capable of detecting subtle changes in the acoustic sounds of prosthetic valve has been developed for the routine home monitoring of heart valve function. Herein is reported the authors' initial clinical experience with this device.

Atherosclerosis of the aorta is common in patients with severe aortic stenosis: an intraoperative transesophageal echocardiographic study.

Objective: Several studies have recently reported an association between aortic valve calcification and atherosclerosis of the cardiovascular system, suggesting that aortic valve calcification might represent an atherosclerosis-like process. Hence the aim of the present study was to determine whether there is a similar association between aortic stenosis and aortic atheromas.

Methods: We evaluated the records and echocardiographic videotapes of 91 consecutive patients with severe aortic stenosis who underwent intraoperative transesophageal echocardiography before aortic valve replacement to measure the presence and characteristics of aortic atheromas.

Impact of intraoperative transesophageal echocardiography in patients undergoing valve replacement.

Background: The role of intraoperative transesophageal echocardiography (IOTEE) in valve replacement surgery is not well established. The aim of this study was to explore the impact of immediate postpump IOTEE in valve replacement surgery at a single tertiary medical center.

Methods: The departmental database was screened for valve replacement operations (mechanical or bioprosthetic valves) performed during a 55-month period that were succeeded by immediate postpump IOTEE.

Association between mitral annulus calcification and aortic atheroma: a prospective transesophageal echocardiographic study.

Background And Purpose: Although mitral annulus calcification (MAC) has been reported to be a significant independent predictor of stroke, no causative relationship was proven. It is also known that aortic atheroma (AA), especially those >/=5 mm thick and/or protruding and/or mobile are associated with stroke. This study was designed to determine whether an association exists between MAC and AA.

Nonobstructive aortic valve calcium as a window to atherosclerosis of the aorta.

Aortic valve calcium without stenosis and mitral annulus calcium (MAC) are known to correlate with atherosclerotic risk factors. Recently, it has been reported that MAC is associated with atherosclerosis of the cardiovascular system, suggesting MAC as an atherosclerotic process by itself. Hence, the aim of the present study was to determine whether a similar association between aortic valve calcium and aortic atheroma exists.

Significance of prominent atrial-wave and diastasis deflection in radionuclide diastolic volume curve during exercise in detection of coronary artery disease.

Background: Exercise testing with multigated acquisition technetium radionuclide cineangiography (MUGA) is a useful modality that can discriminate systolic and diastolic performance in patients with ischemic heart disease. However, some patients may have abnormal left ventricular filling dynamics with normal regional and global systolic function.

Hypothesis: The purpose of the study was to assess exercise-induced diastolic dysfunction as expressed by a prominent atrial (A) wave or diastasis deflection at the left ventricular volume curve, in patients with different degrees of ischemic heart disease.

Sudden death among the Israeli civilian population during the Gulf War--incidence and mechanisms.

The Gulf War in January 1991 provided a unique opportunity to evaluate the influence of acute stress on the incidence of sudden cardiac death (SCD) in the Israeli civilian population. Pursuing this intriguing issue seemed warranted as we documented and reported a pronounced increase in the incidence of acute myocardial infarctions during that period. The purpose of the present study therefore was to document the incidence of SCD in different regions of Israel during a 10 day period preceding the Gulf War and a similar period following its onset, and to try to identify a possible correlation between the intensity of threat and the incidence of SCD.