WorldWideScience

Sample records for plastic tricuspid heart

  1. The tricuspid valve in adult congenital heart disease.

    Science.gov (United States)

    Ginns, Jonathan; Ammash, Naser; Bernier, Pierre-Luc

    2014-01-01

    The tricuspid valve is frequently affected in adults with congenital heart disease but is also frequently overlooked. Disease of this valve can occur primarily or develop secondary to changes in the right ventricle caused by other disease states. The embryology and anatomy of the tricuspid valve are important to understanding pathogenesis of valve dysfunction in congenital heart disease. Clinical findings can be subtle. Multimodality imaging may be necessary to fully assess the cause and impact of tricuspid valve lesions. More research is needed in pathophysiology, imaging, and treatment in this area. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Pulmonary and tricuspid valvuloplasty in carcinoid heart disease.

    Science.gov (United States)

    Karimi, Ashkan; Pourafshar, Negiin; Fudge, James C

    2016-12-28

    A 26-year-old female with carcinoid heart disease consisting of severe pulmonary and tricuspid valve stenosis was admitted with line associated sepsis. She recovered from sepsis with antibiotics and aggressive fluid resuscitation but became grossly volume overloaded with evidence of tense ascites and lower extremity edema. She developed worsening renal and hepatic function due to congestive nephropathy and hepatopathy, which did not respond to intravenous diuretics, and she was deemed too sick for surgical pulmonary and tricuspid valve replacement. Pulmonary and tricuspid valvuloplasty was performed as a rescue measure to alleviate her congestive symptoms and improve her candidacy for valve replacement. © 2016 Wiley Periodicals, Inc.

  3. Postoperative tricuspid regurgitation after adult congenital heart surgery is associated with adverse clinical outcomes.

    Science.gov (United States)

    Lewis, Matthew J; Ginns, Jonathan N; Ye, Siqin; Chai, Paul; Quaegebeur, Jan M; Bacha, Emile; Rosenbaum, Marlon S

    2016-02-01

    Many patients with adult congenital heart disease will require cardiac surgery during their lifetime, and some will have concomitant tricuspid regurgitation. However, the optimal management of significant tricuspid regurgitation at the time of cardiac surgery remains unclear. We assessed the determinants of adverse outcomes in patients with adult congenital heart disease and moderate or greater tricuspid regurgitation undergoing cardiac surgery for non-tricuspid regurgitation-related indications. All adult patients with congenital heart disease and greater than moderate tricuspid regurgitation who underwent cardiac surgery for non-tricuspid regurgitation-related indications were included in a retrospective study at the Schneeweiss Adult Congenital Heart Center. Cohorts were defined by the type of tricuspid valve intervention at the time of surgery. The primary end point of interest was a composite of death, heart transplantation, and reoperation on the tricuspid valve. A total of 107 patients met inclusion criteria, and 17 patients (17%) reached the primary end point. A total of 68 patients (64%) underwent tricuspid valve repair, 8 patients (7%) underwent tricuspid valve replacement, and 31 patients (29%) did not have a tricuspid valve intervention. By multivariate analysis, moderate or greater postoperative tricuspid regurgitation was associated with a hazard ratio of 6.12 (1.84-20.3) for the primary end point (P = .003). In addition, failure to perform a tricuspid valve intervention at the time of surgery was associated with an odds ratio of 4.17 (1.26-14.3) for moderate or greater postoperative tricuspid regurgitation (P = .02). Moderate or greater postoperative tricuspid regurgitation was associated with an increased risk of death, transplant, or reoperation in adult patients with congenital heart disease undergoing cardiac surgery for non-tricuspid regurgitation-related indications. Concomitant tricuspid valve intervention at the time of cardiac surgery should

  4. Role of concomitant tricuspid surgery in moderate functional tricuspid regurgitation in patients undergoing left heart valve surgery.

    Science.gov (United States)

    Mahesh, Balakrishnan; Wells, Francis; Nashef, Samer; Nair, Sukumaran

    2013-01-01

    Functional tricuspid regurgitation (FTR) is frequently present in patients undergoing aortic, and particularly mitral valve, surgery. Untreated FTR may lead to right heart failure. Reoperative cardiac surgery for late FTR is associated with high morbidity and mortality. Therefore, severe FTR has emerged as a Class I indication for concomitant tricuspid valve surgery in patients undergoing left valve surgery. Concomitant tricuspid valve surgery during left heart valve surgery to address moderate and mild FTR is controversial. This review addresses this issue and proposes an algorithm for the treatment of FTR in patients undergoing left heart valve surgery.

  5. Tricuspid Valve Regurgitation after Orthotopic Heart Transplantation: Prevalence and Etiology

    Directory of Open Access Journals (Sweden)

    Yaniv Berger

    2012-01-01

    Full Text Available Background. Tricuspid valve regurgitation (TR after orthotopic heart transplantation (OHT is common. The aims of this study were to determine the prevalence of TR after OHT, to examine the correlation between its development and various variables, and to determine its outcomes. Methods. All 163 OHT patients who were followed up between 1988 and 2009 for a minimal period of 12 months were divided into those with no TR/mild TR and those with at least mild-moderate TR, as assessed by doppler echocardiography. These groups were compared regarding preoperative hemodynamic variables, surgical technique employed, number of endomyocardial biopsies, number of acute cellular rejections, incidence of graft vasculopathy, and clinical outcomes. Results. At the end of the followup (average 8.2 years significant TR was evident in 14.1% of the patients. The development of late TR was found by univariate, but not multivariate, analysis to be significantly correlated with the biatrial surgical technique ( and the presence of graft vasculopathy (. TR development was found to be correlated with the need for tricuspid valve surgery but not with an increased mortality. Conclusions. The development of TR after OHT may be related to the biatrial anastomosis technique and to graft vasculopathy.

  6. Tricuspid regurgitation

    Science.gov (United States)

    ... and dentist if you have a history of heart valve disease or congenital heart disease before treatment. Some people ... Regurgitation Tricuspid Regurgitation Ebstein's anomaly References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  7. Long-term tricuspid valve prosthesis-related complications in patients with congenital heart disease

    NARCIS (Netherlands)

    van Slooten, Ymkje J.; Freling, Hendrik G.; van Melle, Joost P.; Mulder, Barbara J. M.; Jongbloed, Monique R. M.; Ebels, Tjark; Voors, Adriaan A.; Pieper, Petronella G.

    2014-01-01

    OBJECTIVES: In patients with acquired valvar disease, morbidity and mortality rates after tricuspid valve replacement (TVR) are high. However, in adult patients with congenital heart disease, though data concerning outcome after TVR are scarce, even poorer results are suggested in patients with Ebst

  8. Utilization of edge-to-edge valve plastic technique to correct severe tricuspid regurgitation in patients with congenital heart disease%"缘对缘"瓣膜成形术在先天性心脏病合并重度三尖瓣关闭不全中的应用

    Institute of Scientific and Technical Information of China (English)

    柳克晔; 来永强; 罗志强; 罗毅; 韩喆; 刘福林; 梁宜武

    2010-01-01

    Objective Tricuspid regurgitation is often associated in patients with congenital heart disease. Significant morbidity and mortality are related to tricuspid valve replacement. Tricuspid valve plasty is still a preferred choice. This report deals with our surgical experience in using edge-to-edge valve plasty technique to correct severe tricuspid regurgitation in patients with congenital heart disease. Methods From April 2001 to Mar. 2010, severe tricuspid regurgitation was corrected with a flexible band anuloplasty and edge-to-edge valve plasty technique in 14 patients with congenital heart disease. The age ranged from 7 years to 62 years [average (31.2 ± 16.1 ) years]. Congenital cardiac anomalies include: atrioventricular canal in 5 cases, secundum atrial septal defect in 6 cases, secundum atrial septal defect with mitral valve regurgitation in 2 cases and cor triatriatum in 1 case. Results No hospital death or postoperative morbidity occurred. No or trivial tricuspid regurgitation was present in 11 cases and mild tricuspid regurgitation in 3 cases at discharge. The follow-up ranged from 3 month to 97 months [average (51.6 ± 26.8 ) months]. No tricuspid stenosis was found. No or trivial tricuspid regurgitation was present in 5 cases. Mild tricuspid regurgitation was present in 8 cases, and moderate tricuspid regurgitation in 1 case at the latest followup. Conclusion Edge-to-edge valve plasty is an easy, effective and important procedure to correct severe tricuspid regurgitation in patients with congenital heart disease.%目的 总结运用"缘对缘"成形技术治疗先天性心脏病病人的重度三尖瓣关闭不全的效果.方法 2001年4月至2010年3月,对14例先大性心脏病合并重度三尖瓣关闭不全病人采用常规三尖瓣瓣环成形和"缘对缘"技术行三尖瓣成形.年龄7~62岁,平均(31.2±16.1)岁.先大性心脏畸形包括继发孔房间隔缺损6例,房室管畸形5例,继发孔房间隔缺损合并二尖瓣关闭不全2

  9. Large animal model of functional tricuspid regurgitation in pacing induced end-stage heart failure.

    Science.gov (United States)

    Malinowski, Marcin; Proudfoot, Alistair G; Langholz, David; Eberhart, Lenora; Brown, Michael; Schubert, Hans; Wodarek, Jeremy; Timek, Tomasz A

    2017-06-01

    Functional tricuspid regurgitation (FTR) is common in patients with advanced heart failure and frequently complicates left ventricular assist device implantation yet remains poorly understood. We set out to establish large animal model of FTR that could serve as a research platform to investigate the pathogenesis of FTR associated with end-stage heart failure. : Through right thoracotomy, ten adult sheep underwent implantation of pacemaker with epicardial LV lead, five sonomicrometry crystals on the right ventricle, and left and right ventricular telemetry pressure sensors during a beating heart off-pump procedure. After 5 ± 1 days of recovery, baseline haemodynamic, echocardiographic and sonomicrometry data were collected. Animals were paced thereafter at a rate of 220-240 beats/min until the development of heart failure and concomitant tricuspid regurgitation. : Three animals died during early recovery period and one during the pacing phase. Six surviving animals were paced for a mean of 14 ± 5 days. Cardiac function was significantly depressed compared to baseline, with LV ejection fraction falling from 69 ± 2% to 22 ± 4% ( P  < 0.001) and RV fractional area change from 52 ± 11% to 25 ± 9% ( P  = 0.005). All animals developed significant enlargement of tricuspid annulus (from 29.5 ± 1.6 to 36.5 ± 4.5 mm; P  = 0.01) and right ventricle (from 21.9 ± 0.2 to 30.3 ± 0.6 mm; P  = 0.03). Sonomicrometry derived contractility of RV free wall was depressed and at least moderate tricuspid insufficiency developed in all animals. : Biventricular dysfunction, tricuspid annular dilatation and significant FTR were observed in our model of ovine tachycardia induced cardiomyopathy. This animal model reflects the clinical situation of end-stage heart failure patients presenting for mechanical support.

  10. Video-based measuring of quality parameters for tricuspid xenograft heart valve implants.

    Science.gov (United States)

    Condurache, Alexandru Paul; Hahn, Tobias; Scharfschwerdt, Michael; Mertins, Alfred; Aach, Til

    2009-12-01

    Defective heart valves are often replaced by implants in open-heart surgery. Both mechanical and biological implants are available. Among biological implants, xenograft ones-i.e., valves grafted from animals such as pigs, are widely used. Good implants should exhibit certain typical anatomical and functional characteristics to successfully replace the native tissue. Here, we describe a video-based system for measuring quality parameters of xenograft heart valve implants, including the area of the orifice and the fluttering of the valves' leaflets, i.e., their flaps (or cusps). Our system employs automatic methods that provide a precise and reproducible way to infer the quality of an implant. The automatic analysis of both a valve's orifice and the fluttering of its leaflets offers a more comprehensive quality assessment than current, mostly manual methods. We focus on valves with three leaflets, i.e., aortic, pulmonary, and tricuspid valves.

  11. Predictors of right ventricular function as measured by tricuspid annular plane systolic excursion in heart failure

    DEFF Research Database (Denmark)

    Kjaergaard, Jesper; Iversen, Kasper K; Akkan, Dilek

    2009-01-01

    INTRODUCTION: Tricuspid Annular Plane Systolic Excursion (TAPSE) has independent prognostic value in heart failure patients but may be influenced by left ventricular (LV) ejection fraction. The present study assessed the association of TAPSE and clinical factors, global and regional LV function...... in 634 patients admitted for symptomatic heart failure. METHODS & RESULTS: TAPSE were correlated with global and regional measures of longitudinal LV function, segmental wall motion scores and measures of diastolic LV function as measured from transthoracic echocardiography.LV ejection fraction, wall...... failure (beta = 1.3, p = 0.002) were independent predictors of TAPSE, R(2) = 0.28, p failure etiology or any of the other clinical factors analyzed, P(interaction) = NS. CONCLUSION: TAPSE is reduced with left ventricular dysfunction...

  12. Improved Right Ventricular Performance with Increased Tricuspid Annular Excursion in Athlete’s Heart

    Directory of Open Access Journals (Sweden)

    Himanshu eGupta

    2015-04-01

    Full Text Available Background: Marathon runners (MTH and patients with mitral regurgitation (MR exhibit left ventricular (LV overload, and LV geometric changes in these groups have been reported. In this study, right ventricular (RV adaptation to chronic volume overload was evaluated in MTH and MR and normal controls together with interventricular septal remodeling and tricuspid annulus (TA motion. Methods: A total of 60 age-matched subjects (including 19 MTH, 17 isolated chronic compensated MR patients and 24 normal subjects underwent conventional cine and tagged cardiac magnetic resonance imaging. Myocardial strain and curvature were computed on the interventricular septum and RV free wall. A dual-propagation technique was applied to construct RV volume-time curves for a single cardiac cycle. Similarly, the tricuspid annulus was tracked throughout the cardiac cycle to create displacement over time curve.Results: Septal curvature was significantly lower in MTH and MR compared to controls. No significant differences in RV free wall strain or RV ejection fraction were noted amongst the 3 groups. However, longitudinal TA excursion was significantly higher in MTH compared to controls (p=0.0061. The peak late diastolic TA velocity in MR was significantly faster than MTH (p=0.0031 and controls (p=0.020. Conclusions: Increased TA kinetics allows for improved RV performance in MTH. Septal remodeling was observed in both MR and MTH, therefore a direct relationship of septal remodeling to TA kinetics in athlete’s heart could not be elucidated in this study.

  13. Predictors of right ventricular function as measured by tricuspid annular plane systolic excursion in heart failure

    Directory of Open Access Journals (Sweden)

    Køber Lars V

    2009-11-01

    Full Text Available Abstract Introduction Tricuspid Annular Plane Systolic Excursion (TAPSE has independent prognostic value in heart failure patients but may be influenced by left ventricular (LV ejection fraction. The present study assessed the association of TAPSE and clinical factors, global and regional LV function in 634 patients admitted for symptomatic heart failure. Methods & Results TAPSE were correlated with global and regional measures of longitudinal LV function, segmental wall motion scores and measures of diastolic LV function as measured from transthoracic echocardiography. LV ejection fraction, wall motion index scores, atrio-ventricular annular plane systolic excursion of the mitral annulus were significantly related to TAPSE. Septal and posterior mitral annular plane systolic excursion (β = 0.56, p 2 = 0.28, p interaction = NS. Conclusion TAPSE is reduced with left ventricular dysfunction in heart failure patients, in particular with reduced septal longitudinal motion. TAPSE is decreased in patients with heart failure of ischemic etiology. However, the absolute reduction in TAPSE is small and seems to be of minor importance in the clinical utilization of TAPSE whether applied as a measure of right ventricular systolic function or as a prognostic factor.

  14. Durability of bioprostheses for the tricuspid valve in patients with congenital heart disease.

    Science.gov (United States)

    Burri, Melchior; Vogt, Manfred O; Hörer, Jürgen; Cleuziou, Julie; Kasnar-Samprec, Jelena; Kühn, Andreas; Lange, Rüdiger; Schreiber, Christian

    2016-11-01

    Only little data exist on the durability of bioprostheses in the tricuspid position in patients with congenital heart disease (CHD). The aim of the study was to determine the reoperation rate and the valve function after primary implantation. Between 1990 and 2013, 51 patients with CHD underwent tricuspid valve (TV) replacement with a bioprosthesis. The median age at operation was 32 years (range: 8-69). The underlying morphology was Ebstein's anomaly in 62% of the patients. Implanted valves included 38 pericardial and 13 porcine valves. All available echocardiographic examinations (n = 714) and clinical data were retrospectively reviewed. Dysfunction was defined as an at least moderate regurgitation or a mean diastolic gradient ≥9 mmHg. Freedom from death, reoperation and prosthetic valve dysfunction was estimated using the Kaplan-Meier method. The 30-day mortality rate was 9%. The estimated survival rate was 86% at one and 80% at ten years. The freedom from reoperation at 1, 5 and 10 years was 100, 86 and 81%, and that from prosthesis dysfunction detected by echocardiography at 1, 5 and 10 years was 89, 66 and 58%, respectively. The main reason for dysfunction was insufficiency (89%). Valve implantation at an age below 16 years was associated with earlier reoperation and dysfunction (the 5-year freedom rate from reoperation/dysfunction was 70%/30% compared with 89%/78% in the rest of the patients, P = 0.016/0.0009). Serial echocardiography shows a high rate of dysfunction of TV bioprosthesis in patients with CHD, which already occurred a few years after implantation. In patients below 16 years of age, most prostheses are dysfunctional within 5 years. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. Application of Percutaneous Balloon Mitral Valvuloplasty in Patients of Rheumatic Heart Disease Mitral Stenosis Combined with Tricuspid Regurgitation

    Directory of Open Access Journals (Sweden)

    Zhang-Qiang Chen

    2015-01-01

    Full Text Available Background: Tricuspid regurgitation (TR is frequently associated with severe mitral stenosis (MS, the importance of significant TR was often neglected. However, TR influences the outcome of patients. The aim of this study was to investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV procedure in rheumatic heart disease patients with mitral valve (MV stenosis and tricuspid valve regurgitation. Methods: Two hundred and twenty patients were enrolled in this study due to rheumatic heart disease with MS combined with TR. Mitral balloon catheter made in China was used to expand MV. The following parameters were measured before and after PBMV: MV area (MVA, TR area (TRA, atrial pressure and diameter, and pulmonary artery pressure (PAP. The patients were followed for 6 months to 9 years. Results: After PBMV, the MVAs increased significantly (1.7 ± 0.3 cm 2 vs. 0.9 ± 0.3 cm 2 , P 0.05. The PAP and left ventricular ejection fraction appeared no statistical difference compared with the postoperative (P > 0.05, the remaining patients without serious complications. Conclusions: PBMV is a safe and effective procedure for MS combined with TR in patients of rheumatic heart disease. It can alleviate the symptoms and reduce the size of TR. It can also improve the quality-of-life and prognosis. Its recent and mid-term efficacy is certain. While its long-term efficacy remains to be observed.

  16. Tricuspid annular motion velocity as a differentiation index of hypertrophic cardiomyopathy from hypertensive heart disease.

    Science.gov (United States)

    Hayashi, Shuji; Yamada, Hirotsugu; Nishio, Susumu; Hotchi, Junko; Bando, Mika; Takagawa, Yuriko; Saijo, Yoshihito; Hirata, Yukina; Sata, Masataka

    2015-06-01

    Hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) are the most frequently encountered entities presenting left ventricular hypertrophy in routine echocardiographic examination, and their differentiation is sometimes difficult. Abnormalities in right ventricular (RV) myocardium have been reported frequently in patients with HCM more than in those with HHD. We therefore hypothesized that tricuspid annular motion (TAM) velocity determined by pulsed tissue Doppler echocardiography can be used to detect RV dysfunction in HCM and discriminate these etiologies. TAM velocities were compared among clinically stable patients with 60 HCM and 60 HHD patients as well as 60 age-matched healthy controls. Peak systolic, early diastolic (TAM-e'), and atrial systolic velocities were measured. RV myocardial performance index was measured by tissue Doppler method. To more accurately differentiate HCM from HHD, electrocardiographic findings and brain natriuretic peptide levels, which can both be examined simply and noninvasively, were investigated in addition to echocardiography. RV wall thickness of the HCM group was greater than the HHD group (p=0.092), while there was no significant difference in RV myocardial performance index between the HCM and HHD groups (p=0.606). TAM-e' was significantly lower in the HCM group than in HHD and control groups (p=0.001). To differentiate HCM from HHD, TAM-e' was a powerful predictor as per multivariate logistic regression analysis (hazard ratio, 0.665; p<0.001) of parameters other than those of left ventricular parameters, and the area under the receiver operating characteristic curve (AUC) was 0.686 and the best cut-off value was ≤8.0cm/s (62% sensitivity, 65% specificity). Multivariate logistic analysis revealed that electrocardiographic ST-T changes were the next most effective marker for differentiating HCM after TAM-e'. When TAM-e' and ST-T changes were combined, the AUC increased to 0.748. TAM-e' is a potentially

  17. Age- and gender-specific changes of tricuspid annular motion velocities in normal hearts.

    Science.gov (United States)

    Hayashi, Shuji; Yamada, Hirotsugu; Nishio, Susumu; Hotchi, Junko; Bando, Mika; Takagawa, Yuriko; Saijo, Yoshihito; Hirata, Yukina; Sata, Masataka

    2015-05-01

    Mitral annular motion (MAM) and tricuspid annular motion (TAM) velocities obtained by pulsed tissue Doppler echocardiography have been used to evaluate left ventricular (LV) and right ventricular (RV) functions. Although TAM velocity has been clinically applied for evaluating various cardiac diseases, the effects of age and gender remain unclear. Therefore, we aimed to determine the effects of age and gender on TAM velocity in normal hearts. We randomly selected 265 subjects (mean age, 59 years; range, 20-89 years) without abnormal clinical, electrocardiographic, and echocardiographic findings from a pool of subjects who had undergone transthoracic echocardiography. They were classified into four age groups: 20-39, 40-59, 60-79, and >80 years. Pulsed wave Doppler was applied to obtain MAM velocity of the lateral side and TAM velocity of the RV free wall side. The peak systolic (s'), early diastolic (e'), and atrial systolic (a') velocities of MAM and TAM were measured in all subjects. While MAM-s' (r=-0.267, p<0.001) correlated with age, TAM-s' did not (p=0.755). TAM-s' in any age groups had no significant gender differences. TAM-e' (r=-0.447, p<0.001) and MAM-e' (r=-0.724, p<0.001) correlated with age, respectively. In those aged 40-59 years, both TAM-e' (p=0.002) and MAM-e' (p=0.048) in females were significantly higher than those in males. The gender differences diminished in the ≥60 years age groups. There was no age-associated decline in TAM-s', while TAM-e' varied with age and gender as did MAM-e'. Although the same criteria for the TAM-s' can be used for identifying abnormal RV systolic function regardless of age and gender, age and gender differences must be considered when one utilizes the TAM-e' for the diagnosis or management of cardiovascular disease. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  18. Tricuspid surgery for tricuspid regurgitation: review.

    Science.gov (United States)

    Isomura, Tadashi; Fukada, Yasuhisa; Miyazaki, Takuya; Endo, Masahiro

    2016-10-01

    The tricuspid regurgitation (TR) is so-called 'functional' rather than organic. And therefore, it was originally thought that in most patients with secondary TR, surgical treatment of the left side heart valve would correct the problems of the TR. However, in recent study, the residual or recurrent TR showed poor prognosis after the surgery and the tricuspid valve is called 'forgotten' valve. The anatomy and pathophysiology of the tricuspid valve are shown as three-dimensional structure which is different from the "saddle-shaped" mitral annulus, and the finding suggests that an annuloplasty for TR is different from that for mitral regurgitation. The indication of tricuspid annuloplasty (TAP) for TR is not only the degree of TR but also annular dilatation without TR at the time of surgery. Tricuspid annuloplasty shows better long-term results after surgery than replacement and additional procedure may be required to prevent recurrence of TR after TAP. In this review, indication, the therapeutic procedures and prognosis depend on surgical procedure with or without ring or additional procedures are reviewed.

  19. Presence of ´isolated´ tricuspid regurgitation should prompt the suspicion of heart failure with preserved ejection fraction

    Science.gov (United States)

    Mascherbauer, Julia; Kammerlander, Andreas A.; Zotter-Tufaro, Caroline; Aschauer, Stefan; Duca, Franz; Dalos, Daniel; Winkler, Susanne; Schneider, Matthias; Bergler-Klein, Jutta; Bonderman, Diana

    2017-01-01

    Background Diastolic dysfunction of the left ventricle is common but frequently under-diagnosed. Particularly in advanced stages affected patients may present with significant functional tricuspid regurgitation (TR) as the most prominent sign on echocardiography. The underlying left ventricular pathology may eventually be missed and symptoms of heart failure are attributed to TR, with respective therapeutic consequences. The aim of the present study was to determine prevalence and mechanisms underlying TR evolution in heart failure with preserved ejection fraction (HFpEF). Methods and results Consecutive HFpEF patients were enrolled in this prospective, observational study. Confirmatory diagnostic tests including echocardiography and invasive hemodynamic assessments were performed. Of the 175 patients registered between 2010 and 2014, 51% had significant (moderate or severe) TR without structural abnormalities of the tricuspid valve. Significant hemodynamic differences between patients with and without relevant TR were encountered. These included elevated pulmonary vascular resistance (p = 0.038), reduced pulmonary arterial compliance (PAC, p = 0.005), and elevated left ventricular filling pressures (p = 0.039) in the TR group. Multivariable binary logistic regression analysis revealed diastolic pulmonary artery pressure (p = 0.029) and PAC (p = 0.048) as independent determinants of TR. Patients were followed for 18.1±14.1 months, during which 32% had a cardiac event. While TR was associated with outcome in the univariable analysis, it failed to predict event-free survival in the multivariable model. Conclusions The presence of ´isolated´ functional TR should prompt the suspicion of HFpEF. Our data show that significant TR is a marker of advanced HFpEF but neither an isolated entity nor independently associated with event-free survival. PMID:28199339

  20. Posttraumatic tricuspid valve injury and severe tricuspid valve regurgitation.

    Science.gov (United States)

    Gucuk Ipek, Esra

    2013-09-01

    A 66-year-old male was brought to our hospital following a car accident. He had subarachnoid hemorrhage, multiple rib fractures, and left hemopneumothorax. He was referred to the Cardiology Department for elevated troponin levels (42 ng/ml, reference 0-1 ng/ml). The electrocardiogram was free of ischemia, whereas the transthoracic echocardiography revealed dilated right heart chambers, enlarged tricuspid annulus and coaptation failure of the tricuspid valvular leaflets. There was rupture on the subvalvular apparatus of the anterior leaflet of the tricuspid valve with accompanying prolapse, causing severe tricuspid valvular regurgitation. The patient did not present right ventricular failure signs and symptoms; he was referred to surgery after the resolution of associated thoracic and cranial injuries.

  1. Transient severe tricuspid regurgitation after transplantation of an extremely oversized donor heart in a child-Does size matter? A case report.

    Science.gov (United States)

    Birnbaum, J; Ulrich, S M; Schramm, R; Hagl, C; Lehner, A; Fischer, M; Haas, N A; Heineking, B

    2017-02-01

    In pediatric heart transplantation, the size of the donor organ is an important criterion for organ allocation. Oversized donor hearts are often accepted with good results, but some complications in relation to a high donor-recipient ratio have been described. Our patient was transplanted for progressive heart failure in dilated cardiomyopathy. The donor-to-recipient weight ratio was 3 (donor weight 65 kg, recipient weight 22 kg). The intra-operative echocardiography before chest closure showed excellent cardiac function, no tricuspid valve regurgitation, and a normal central venous pressure. After chest closure, central venous pressure increased substantially and echocardiography revealed a severe tricuspid insufficiency. As other reasons for right ventricular dysfunction, that is, myocardial ischemia, pulmonary hypertension, and rejection, were excluded, we assumed that the insufficiency was caused by an alteration of the right ventricular geometry. After 1 week, the valve insufficiency regressed to a minimal degree. In pediatric heart transplant patients with a high donor-to-recipient weight ratio, the outlined complication may occur. If other reasons for right ventricular heart failure can be ruled out, this entity is most likely caused by an acute and transient alteration of the right ventricular geometry that may disappear over time. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Porcine Tricuspid Valve Anatomy and Human Compatibility

    DEFF Research Database (Denmark)

    Waziri, Farhad; Lyager Nielsen, Sten; Hasenkam, J. Michael

    2016-01-01

    before clinical use. The study aim was to evaluate and compare the tricuspid valve anatomy of porcine and human hearts. METHODS: The anatomy of the tricuspid valve and the surrounding structures that affect the valve during a cardiac cycle were examined in detail in 100 fresh and 19 formalin...

  3. Application of Percutaneous Balloon Mitral Valvuloplasty in Patients of Rheumatic Heart Disease Mitral Stenosis Combined with Tricuspid Regurgitation

    Institute of Scientific and Technical Information of China (English)

    Zhang-Qiang Chen; Lang Hong; Hong Wang; Lin-Xiang Lu; Qiu-Lin Yin; Heng-Li Lai; Hua-Tai Li

    2015-01-01

    Background:Tricuspid regurgitation (TR) is frequently associated with severe mitral stenosis (MS),the importance of significant TR was often neglected.However,TR influences the outcome of patients.The aim of this study was to investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV) procedure in rheumatic heart disease patients with mitral valve (MV) stenosis and tricuspid valve regurgitation.Methods:Two hundred and twenty patients were enrolled in this study due to rheumatic heart disease with MS combined with TR.Mitral balloon catheter made in China was used to expand MV.The following parameters were measured before and after PBMV:MV area (MVA),TR area (TRA),atrial pressure and diameter,and pulmonary artery pressure (PAP).The patients were followed for 6 months to 9 years.Results:After PBMV,the MVAs increased significantly (1.7 ± 0.3 cm2 vs.0.9 ± 0.3 cm2,P < 0.01);TRA significantly decreased (6.3 ± 1.7 cm2 vs.14.2 ± 6.5 cm2,P < 0.01),right atrial area (RAA) decreased significantly (21.5 ± 4.5 cm2 vs.25.4 ± 4.3 cm2,P < 0.05),TRA/RAA (%) decreased significantly (29.3 ± 3.2% vs.44.2 ± 3.6%,P < 0.01).TR velocity (TRV) and TR continue time (TRT) as well as TRV × TRT decreased significantly (183.4 ± 9.4 cm/s vs.254.5 ± 10.7 cm/s,P < 0.01;185.7 ± 13.6 ms vs.238.6 ± 11.3 ms,P < 0.01;34.2 ± 5.6 cm vs.60.7 ± 8.5 cm,P < 0.01,respectively).The postoperative left atrial diameter (LAD) significantly reduced (41.3 ± 6.2 mm vs.49.8 ± 6.8 mm,P < 0.01) and the postoperative right atrial diameter (RAD) significantly reduced (28.7 ± 5.6 mm vs.46.5 ± 6.3 mm,P < 0.01);the postoperative left atrium pressure significantly reduced (15.6 ± 6.1 mmHg vs.26.5 ± 6.6 mmHg,P < 0.01),the postoperative right atrial pressure decreased significantly (13.2 ± 2.4 mmHg vs.18.5 ± 4.3 mmHg,P < 0.01).The pulmonary arterial pressure decreased significantly after PBMV (48.2 ± 10.3 mmHg vs.60.6 ± 15.5 mmHg,P < 0.01).The

  4. Complex Tricuspid Valve Repair in Patients With Pacer Defibrillator-Related Tricuspid Regurgitation.

    Science.gov (United States)

    Raman, Jaishankar; Sugeng, Lissa; Lai, David T M; Jeevanandam, Valluvan

    2016-04-01

    Tricuspid valve regurgitation in patients with heart failure or in those undergoing complex cardiac operations is associated with increased morbidity and mortality. We report our results with a technique of repairing the tricuspid valves while retaining the pacer defibrillator lead. Patients had tricuspid valve repairs that included repositioning of the pacer defibrillator lead, approximation of septal and inferior/posterior leaflets in a modified cleft repair, and implantation of a tricuspid annuloplasty ring. This procedure was performed in more than 42 patients with good success.

  5. Tricuspid Atresia

    Science.gov (United States)

    ... congenital heart defect, including: A mother who had German measles (rubella) or another viral illness during early ... a family member or friend along, if possible. Learning that your baby has a serious heart condition ...

  6. All you need to know about the tricuspid valve: Tricuspid valve imaging and tricuspid regurgitation analysis.

    Science.gov (United States)

    Huttin, Olivier; Voilliot, Damien; Mandry, Damien; Venner, Clément; Juillière, Yves; Selton-Suty, Christine

    2016-01-01

    The acknowledgment of tricuspid regurgitation (TR) as a stand-alone and progressive entity, worsening the prognosis of patients whatever its aetiology, has led to renewed interest in the tricuspid-right ventricular complex. The tricuspid valve (TV) is a complex, dynamic and changing structure. As the TV is not easy to analyse, three-dimensional imaging, cardiac magnetic resonance imaging and computed tomography scans may add to two-dimensional transthoracic and transoesophageal echocardiographic data in the analysis of TR. Not only the severity of TR, but also its mechanisms, the mode of leaflet coaptation, the degree of tricuspid annulus enlargement and tenting, and the haemodynamic consequences for right atrial and right ventricular morphology and function have to be taken into account. TR is functional and is a satellite of left-sided heart disease and/or elevated pulmonary artery pressure most of the time; a particular form is characterized by TR worsening after left-sided valve surgery, which has been shown to impair patient prognosis. A better description of TV anatomy and function by multimodality imaging should help with the appropriate selection of patients who will benefit from either surgical TV repair/replacement or a percutaneous procedure for TR, especially among patients who are to undergo or have undergone primary left-sided valvular surgery.

  7. 三尖瓣成形术与置换术治疗合并右心衰竭的中重度三尖瓣关闭不全的效果分析%Efficacies of tricuspid valve replacement versus repair for moderate-to-severe tricuspid regurgitation with right heart failure

    Institute of Scientific and Technical Information of China (English)

    付金涛; 陈庆良; 徐栋; 赵丰; 刘子厚; 姜楠

    2015-01-01

    Objective To compare the efficacies of tricuspid valve replacement versus plasty for moderate-to-severe tricuspid regurgitation with right heart failure.Methods From January 2003 to June 2008,a total of 228 patients with right heart failure undergoing tricuspid valve operations were selected.And the procedures included tricuspid valve plasty (n =127) and tricuspid valve replacement (n =101).During a follow-up period of 65 months,their perioperative data were collected to evaluate the surgical outcomes.Results The abnormal liver function rate and average pulmonary artery systolic pressure in tricuspid valve plasty group were lower than those in tricuspid valve replacement group (P =0.023,0.033).In replacement group,average aortic cross-clamping time,cardiopulmonary bypass time,ventilation time and stay length of intensive care unit (ICU),the usage of inotropic drug was significantly higher than repair group (P<0.01).The early complication rate (15.8%) and case fatality rate (6.3%) of repair group were much lower than those of replacement group (27.3%,16.8%) (P =0.042,0.011).Long-term follow-ups revealed that the tricuspid valve thrombosis rate in replacement group was higher than that in repair group (P =0.036).And the recurrence rate of moderate-to-severe tricuspid regurgitation in repair group was higher than that in replacement group (28.7% vs 8.8%) (P =0.011).The survival rate of patients in repair group was much higher than that of replacement group at 3 months,1,3,5 years postoperation.However,the differences were not statistically significant (P =0.231,0.089,0.133,0.078).Conclusion For moderate-to-severe tricuspid regurgitation leading to right heart failure,the early efficacy of tricuspid valve plasty is much better than that of tricuspid valve replacement.The mid-term recurrence rate after tricuspid valve repair is higher than that of replacement.%目的 比较三尖瓣成形术与置换术治疗合并右心衰竭的中重度三尖

  8. Results of tricuspid valve surgery for functional tricuspid regurgitation: acute and long-term outcomes and predictors of failure.

    Science.gov (United States)

    Pozzoli, Alberto; Buzzatti, Nicola; Vicentini, Luca; De Bonis, Michele; Alfieri, Ottavio

    2017-02-15

    The assessment and management of tricuspid valve disease evolved significantly in the last decade. Tricuspid regurgitation is a frequent heart valve disease and it is most often secondary, due to annular dilatation and leaflet tethering from right ventricular remodelling. The indications for tricuspid valve surgery are several and mainly related to the underlying disease, to the severity of the regurgitation and to the right ventricular function. Moreover, surgical tricuspid repair has been avoided for years, because of the erroneous concept that tricuspid regurgitation should disappear once the primary pathology on the left heart has been resolved. Instead, during the last few years, many investigators have reported evidence in favour of a more aggressive surgical approach to functional tricuspid regurgitation, recognising the risk of progressive tricuspid insufficiency in patients with annular dilatation and only moderate regurgitation (or less) at the time of surgery. This concept, along with the acute and long-term outcomes of tricuspid surgical repair techniques and tricuspid replacement are discussed in this review.

  9. Flexible band versus rigid ring annuloplasty for functional tricuspid regurgitation

    Directory of Open Access Journals (Sweden)

    Kanji Kawachi

    2010-09-01

    Full Text Available We review and compare our experience with tricuspid ring annuloplasty between usage of the Cosgrove-Edwards flexible band and the MC3 rigid ring for repair of functional tricuspid regurgitation to determine the efficacy and mid-term durability of tricuspid annuloplasty. 117 patients with functional tricuspid regurgitation undergoing open heart surgery and tricuspid valve repair from May 2005 to December 2007 were reviewed. The flexible bands were used in thirty five patients before October 2006. Since then, the rigid rings were used in the next consecutive eighty two cases. Echocardiographic evaluation of tricuspid regurgitation was performed preoperatively and postoperatively in follow-up schedule. The degree of tricuspid regurgitation was reduced from 2.80±0.67 to 0.71±1.0 (regurgitation severity grade: 0 to 4 in the patients with flexible bands at discharge. It was from 2.68±0.70 to 0.22±0.60 in the patients with rigid rings. At thirty six months postoperative period, tricuspid regurgitation grades in patients with flexible bands and rigid rings were 0.80±0.95 and 0.36±0.77, respectively. Freedom from recurrent tricuspid regurgitation (grade 2 or 3 in patients with flexible bands and rigid rings were 68.6% and 87.8%, respectively. Recurrent tricuspid regurgitation was significantly lower in the patients with rigid rings. Although both flexible band and rigid ring annuloplasty provide low rate of recurrent tricuspid regurgitation, rigid ring annuloplasty might be more effective than flexible band annuloplasty for decreasing functional tricuspid regurgitation in immediate and mid-term postoperative periods.

  10. Preliminary Effect of Tricuspid Annuloplasty for Patients with Dilated Tricuspid Annulus and Left-sided Heart Valve Surgery by Employing Combined Bicuspidization and Modified Kay Annuloplasty%联合二瓣化和改良Kay成形术处理左心瓣膜手术患者三尖瓣瓣环扩张的初步疗效观察

    Institute of Scientific and Technical Information of China (English)

    肖锡俊; 蒋露; 李永波; 唐红; 周文霞; 朱蔚

    2012-01-01

    Objective To evaluate the preliminary effect of tricuspid annuloplasty for patients with dilated tricuspid annulus and left-sided heart valve surgery by employing combined bicuspidization and modified Kay annuloplasty. Methods Combined bicuspidization and modified Kay annuloplasty were performed in 158 patients with dilated tricuspid annulus (tricuspid annulus diameter/body surface area ≥21 mm/m2) and left-sided heart valve surgery in West China Hospital between January 2010 and May 2011. There were 27 male and 131 female patients whose age ranged from 17 to 74 (45. 9± 10. 4) years. A total of 92 patients had atrial fibrillation and 66 patients were in sinus rhythm. The severity of tricuspid regurgitation (TR) was graded 0 through 5 as determined by echocardiography. Results All the patients recovered from surgery and were discharged from hospital. The average cardiopulmonary bypass time was 100.8±30.5( range, 54 to 273) min, and the average aortic cross clamping time was 64. 5 ± 22. 0 (range, 25 to 162)min. The average lowest esophageal temperature during aortic cross clamping was 28. 5 ± 1. 1 (range, 26. 3 to 34. 1)℃ . The average postoperative follow-up was 11. 0 ± 5. 0 ( range, 3 to 19 ) months. The postoperative TR severity was significantly lower than preoperative TR severity (2. 2±1. 3 versus 0. 4±0. 8, P 0.05). Conclusion It is reasonable to perform tricuspid annuloplasty for patients with dilated tricuspid annulus and left-sided heart valve surgery according to their index of tricuspid annulus diameter/body surface area (≥ 21 mm/m2). To prevent postoperative residue or progression of TR in patients with dilated tricuspid annulus, it is effective to employ combined bicuspidization and modified Kay annuloplasty.%目的 观察用联合二瓣化和改良Kay成形术处理左心瓣膜手术患者三尖瓣瓣环扩张的临床结果. 方法 回顾性分析2010年1月至2011年5月华西医院158例伴有三尖瓣瓣环扩张(三

  11. Successful Tricuspid Valve Replacement in a Patient with Severe Pulmonary Arterial Hypertension and Preserved Right Ventricular Systolic Function

    Directory of Open Access Journals (Sweden)

    Jamil A. Aboulhosn

    2009-01-01

    Full Text Available A 56-year-old patient with severe pulmonary hypertension developed severe tricuspid regurgitation, right-sided heart failure, and congestive hepatopathy. She was transferred for possible lung transplant and/or tricuspid valve surgery. Clinical and echocardiographic assessment provided confidence that acute tricuspid valve failure was responsible for the decompensation and that tricuspid valve replacement despite pulmonary hypertension could be performed.

  12. ORGANIC TRICUSPID VALVE REPAIR WITH AUTOLOGOUS GLUTARALDEHYDE FIXED PERICARDIAL PATCH : A SINGLE CENTER RESULTS

    Directory of Open Access Journals (Sweden)

    Murtaza A

    2015-10-01

    Full Text Available AIM AND OBJECTIVE: The aim of this study was to determine the effectiveness and results of repair of Organic Tricuspid Valve disease. INTRODUCTION : since tricuspid valve disease most often found in association with other valve disease. Isolated tricuspid valve disease is ra re. Pattern of involvement of tricuspid valve disease shows functional (75% and primary (organic in (25%. Surgical repair of organic tricuspid valve disease often fails because of abnormal valve. This usually leads to limited options. This study examine s our experience of tricuspid valve repair with autologous pericardium for organic tricuspid valve disease. MATERIAL AND METHODS : From Jan 2014 to May 2015, 22 patients underwent repairs for organic tricuspid valve disease. The patient aged 15 to 65 years and all were in New York Heart Association (NYHA class of III or IV. All patients presented with severe tricuspid disease coexisting with other cardiac pathology, usually left - sided heart valve disease. Repair techniques included Commisurotomy, division o f secondary chordae, Glutaraldehyde treated autologous pericardial patch augmentation of tricuspid valve leaflets, anterior papillary muscle advancement etc with or without ring/suture annuloplasty. Follow - up duration was 3 to 18 months. RESULTS : No deaths or late reoperations occurred. All patients demonstrated clinical improvements on follow up. Echocardiographic studies before hospital discharge showed less than mild tricuspid regurgitation in all patients except one. CONCLUSIONS : Large majorit y of organic tricuspid valve regurgitation is repairable with acceptable early results. Tricuspid stenosis and mixed tricuspid valve disease are more challenging. In the latter group, it is a judgment call whether to accept a suboptimal result or replace t he valve

  13. Diagnosis and treatment of tricuspid valve disease: current and future perspectives.

    Science.gov (United States)

    Rodés-Cabau, Josep; Taramasso, Maurizio; O'Gara, Patrick T

    2016-11-12

    The assessment and management of tricuspid valve disease have evolved substantially during the past several years. Whereas tricuspid stenosis is uncommon, tricuspid regurgitation is frequently encountered and is most often secondary in nature and caused by annular dilatation and leaflet tethering from adverse right ventricular remodelling in response to any of several disease processes. Non-invasive assessment of tricuspid regurgitation must define its cause and severity; advanced three-dimensional echocardiography, MRI, and CT are gaining in clinical application. The indications for tricuspid valve surgery to treat tricuspid regurgitation are related to the cause of the disorder, the context in which it is encountered, its severity, and its effects on right ventricular function. Most operations for tricuspid regurgitation are done at the time of left-sided heart valve surgery. The threshold for restrictive ring annuloplasty repair of secondary tricuspid regurgitation at the time of left-sided valve surgery has decreased over time with recognition of the risk of progressive tricuspid regurgitation and right heart failure in patients with moderate or lesser degrees of tricuspid regurgitation and tricuspid annular dilatation, as well as with appreciation of the high risks of reoperative surgery for severe tricuspid regurgitation late after left-sided valve surgery. However, many patients with unoperated severe tricuspid regurgitation are also deemed at very high or prohibitive surgical risk. Novel transcatheter therapies have begun to emerge for the treatment of tricuspid regurgitation in such patients. Experience with such therapies is preliminary and further studies are needed to determine their role in the management of this disorder.

  14. A rare case of tricuspid valve thrombus with acute pulmonary embolism

    Institute of Scientific and Technical Information of China (English)

    GUO Chun-yan; TENG Ying-xing; YANG Chuan-rui; SHEN Lu-hua; GU Fu-sheng; LI Hong-wei

    2011-01-01

    The development of thrombus on the tricuspid valve is very rare.This report describes a case of acute pulmonary embolism (PE) with a mass on the tricuspid valve in a normal heart,detected by bedside transthoracic echocardiography (TTE).After successful surgical management,the histopathological examination revealed the mass from the tricuspid valve to be mixed thrombus.The early use of bedside TrE can facilitate the prompt diagnosis and aggressive therapy when PE is suspected.

  15. Traumatic Tricuspid Insufficiency Requiring Valve Repair in an Acute Setting.

    Science.gov (United States)

    Enomoto, Yoshinori; Sudo, Yoshio; Sueta, Tomonori

    2015-01-01

    Tricuspid insufficiency due to penetrating cardiac trauma is rare. Patients with tricuspid insufficiency due to trauma can tolerate this abnormality for months or even years. We report a case of a 66-year-old female with penetrating cardiac trauma on the right side of her heart that required tricuspid valve repair in an acute setting. She sustained cut and stab wounds on her bilateral forearms and in the neck and epigastric region. She had cardiac tamponade and developed pulseless electrical activity, which required emergency surgery. The right ventricle and superior vena cava were dissected approximately 5 cm and 2 cm, respectively. After these wounds had been repaired, the patient's inability to wean from cardiopulmonary bypass suggested rightsided heart failure; transesophageal echocardiography revealed tricuspid insufficiency. Right atriotomy was performed, and a detailed examination revealed that the tricuspid valve septal leaflet was split in two. There was also an atrial septal injury that created a connection with the left atrium; these injuries were not detected from the right ventricular wound. After repair, weaning from cardiopulmonary bypass with mild tricuspid insufficiency was achieved, and she recovered uneventfully. This case emphasized the importance of thoroughly investigating intracardiac injury and transesophageal echocardiography.

  16. A new animal model of right heart remodeling caused by tricuspid regurgitation%一种新的三尖瓣关闭不全致右心重构动物模型的建立

    Institute of Scientific and Technical Information of China (English)

    廖胜杰; 黄焕雷; 肖学钧; 费洪文; 吴岳恒; 魏大闯

    2015-01-01

    Objective To establish a new animal model of right heart remodeling caused by tricuspid regurgitation.Methods The beagle dogs were taken as experimental objects (n =14).Firstly,the superior and inferior vena cava were blocked briefly,secondly the right atrium was open,at last the tricuspid valves of beagle dogs were cut off under direct vision on the beating heart.The dogs were divided into operation group and sham operation group at random.Through the echocardiography data of pre-operation,post-operation 3,6,12 months respectively and autopsy results after sacrifice of two animals whom had been raised for 18 months to estimate right ventricular remodeling happens or not.Results 8 beagle dogs were cut off the anterior tricuspid valve,and 3 dogs were cut off the anterior and posterior tricuspid valves with 100% successful rate and 100% survival rate.According to the ratio of TR area and right atrial area (TR/RA),the beagle dogs were divided into severe TR group (40% ≤TR/RA <70%) with 8 dogs and very severe TR group (TR/RA ≥70%) with 3 dogs and sham operation group with 3 dogs.The longest one has raised above 540 days,and no natural death occurred so far.The weight of operation group increased,and the echocardiography showed right atrium and ventricle enlargement and right heart dysfunction.The autopsy of one of operation group dogs found liver cirrhosis and ascites.All of the results indicated the occurrence of right heart remodeling and right heart failure.There is no significant difference in sham operation group before or after operation.Conclusion By cutting off the tricuspid valves through lateral thoracotomy can established a new animal model of right heart remodeling caused by tricuspid regurgitation successfully,which is controllable,repeatable and high successful and survival rate.It is an ideal animal model for the study of right heart remodeling.%目的 建立一种新的三尖瓣关闭不全(TR)致右心重构的动物模型.方法 以

  17. Tricuspid regurgitation after successful mitral valve surgery.

    Science.gov (United States)

    Katsi, Vasiliki; Raftopoulos, Leonidas; Aggeli, Constantina; Vlasseros, Ioannis; Felekos, Ioannis; Tousoulis, Dimitrios; Stefanadis, Christodoulos; Kallikazaros, Ioannis

    2012-07-01

    The tricuspid valve (TV) is inseparably connected with the mitral valve (MV) in terms of function. Any pathophysiological condition concerning the MV is potentially a threat for the normal function of the TV as well. One of the most challenging cases is functional tricuspid regurgitation (TR) after surgical MV correction. In the past, TR was considered to progressively revert with time after left-sided valve restoration. Nevertheless, more recent studies showed that TR could develop and evolve postoperatively over time, as well as being closely associated with a poorer prognosis in terms of morbidity and mortality. Pressure and volume overload are usually the underlying pathophysiological mechanisms; structural alterations, like tricuspid annulus dilatation, increased leaflet tethering and right ventricular remodelling are almost always present when regurgitation develops. The most important risk factors associated with a higher probability of late TR development involve the elderly, female gender, larger left atrial size, atrial fibrillation, right chamber dilatation, higher pulmonary artery systolic pressures, longer times from the onset of MV disease to surgery, history of rheumatic heart disease, ischaemic heart disease and prosthetic valve malfunction. The time of TR manifestation can be up to 10 years or more after an MV surgery. Echocardiography, including the novel 3D Echo techniques, is crucial in the early diagnosis and prognosis of future TV disease development. Appropriate surgical technique and timing still need to be clarified.

  18. Long-Term Follow-Up Study of Temporary Tricuspid Valve Detachment as Approach to VSD Repair without Consequent Tricuspid Dysfunction.

    Science.gov (United States)

    Lucchese, Gianluca; Rossetti, Lucia; Faggian, Giuseppe; Luciani, Giovanni B

    2016-10-01

    Temporary tricuspid valve detachment improves the operative view of certain congenital ventricular septal defects (VSDs), but its long-term effects on tricuspid valve function are still debated. From 2002 through 2012, we performed a prospective study of 68 children (mean age, 1.28 ± 1.01 yr) who underwent transatrial closure of VSDs following temporary tricuspid valve detachment. Sixty patients had conoventricular and 8 had mid-muscular VSDs. All were in sinus rhythm. Seventeen patients had systemic pulmonary artery pressures. Preoperative echocardiograms showed trivial-to-mild tricuspid regurgitation in 62 patients and tricuspid dysplasia with severe regurgitation in 6 patients. Patients were clinically and echocardiographically monitored at 30 postoperative days, 3 months, 6 months, every 6 months thereafter for the first 2 years, and then once a year. No in-hospital or late death was observed at the median follow-up evaluation of 5.9 years. Mean intensive care unit and hospital stays were 1.6 ± 1.1 and 7.3 ± 2.7 days, respectively. Residual small VSDs occurred in 3 patients, and temporary atrioventricular block in one. After VSD repair, 62 patients (91%) had trivial or mild tricuspid regurgitation, and 6 moderate. Five of these last had severe tricuspid regurgitation preoperatively and had undergone additional tricuspid valve repair during the procedure. The grade of residual tricuspid regurgitation remained stable postoperatively, and no tricuspid stenosis was documented. All patients were in New York Heart Association class I at follow-up. Temporary tricuspid valve detachment is a simple and useful method for a complete visualization of certain VSDs without incurring substantial tricuspid dysfunction.

  19. Re-operation of tricuspid regurgitation after mitral valve replacement with rheumatic heart disease%风湿性心脏病二尖瓣置换术后三尖瓣返流的再手术治疗

    Institute of Scientific and Technical Information of China (English)

    罗又桥; 方海宁; 谭伟; 李树松; 曹辉庆; 赖纪昌

    2014-01-01

    Objective To analyze clinical manifestation and investigate therapy effect of re-operation of tricuspid regurgitation (TR) after mitral valve replacement with rheumatic heart disease.Methods Seventeen cases with rheumatic heart disease recurred TR after mitral valve replacement surgery,underwent tricuspid valve surgery again in the Third People's Hospital of Nanchang from January 2000 to December 2011.Of 17 cases,10cases underwent tricuspid valve annuloplasty including 1 case for pure De Vega plasty,9 cases for the valve leaflets forming + artificial valve ring forming.Another 7 cases underwent tricuspid valve replacement surgery including 4 cases for biological valve replacement and 3 cases for mechanical valve.Retrospective analyzed the clinical manifestations,treatment process and condition of prognosis.Results One case was with early postoperative deaths (5.88%,1717),and died of postoperative left ventricular failure.Three cases were postoperative low cardiac output syndrome,2 cases were renal insufficiency,and 2 cases were respiratory insufficiency,all those cases were successfully cured.Sixteen cases were followed up from 3 months to 9 years and 2 cases were lost.Of 14,2 cases were NYHA class Ⅰ,8 cases for grade Ⅱ,4 cases for grade Ⅲ.Conclusion After mitral valve replacement in patients with rheumatic heart disease,TR in patients with reoperation is a suitable choice.Reasonable surgical indications,timing of surgery and good perioperative management are the keys to improve the success rate of surgery.%目的 分析风湿性心脏病二尖瓣置换术后再发三尖瓣返流(TR)患者的临床特点、外科手术方法和疗效,总结围手术期处理经验.方法 2000年1月至2011年12月,17例风湿性心脏病二尖瓣置换术后再发三尖瓣返流的患者在我院接受单纯再次三尖瓣手术,行三尖瓣成形术10例,包括单纯DeVega成形术1例、瓣叶成形+人工瓣环成形9例;行三尖瓣置换术7例,其中置换生物瓣4

  20. Should Tricuspid Annuloplasty be Performed With Pulmonary Valve Replacement for Pulmonary Regurgitation in Repaired Tetralogy of Fallot?

    Science.gov (United States)

    Kurkluoglu, Mustafa; John, Anitha S; Cross, Russell; Chung, David; Yerebakan, Can; Zurakowski, David; Jonas, Richard A; Sinha, Pranava

    2015-01-01

    Indications for prophylactic tricuspid annuloplasty in patients with pulmonary regurgitation (PR) after tetralogy of Fallot (TOF) repair are unclear and often extrapolated from acquired functional tricuspid regurgitation (TR) data in adults, where despite correction of primary left heart pathology, progressive tricuspid annular dilation is noted beyond a threshold diameter >4 cm (21 mm/m(2)). We hypothesized that unlike in adult functional TR, in pure volume-overload conditions such as patients with PR after TOF, the tricuspid valve size is likely to regress after pulmonary valve replacement (PVR). A total of 43 consecutive patients who underwent PVR from 2005 until 2012 at a single institution were retrospectively reviewed. Absolute and indexed tricuspid annulus diameters (TADs), tricuspid annulus Z-scores, grade of TR along with right ventricular size, and function indices were recorded before and after PVR. Preoperative and postoperative echocardiographic data were available in all patients. A higher tricuspid valve Z-score correlated with greater TR both preoperatively (P = 0.005) and postoperatively (P = 0.02). Overall reductions in the absolute and indexed TAD and tricuspid valve Z-scores were seen postoperatively, with greater absolute as well as percentage reduction seen with larger preoperative TAD index (P = 0.007) and higher tricuspid annulus Z-scores (P = 0.06). In pure volume-overload conditions such as patients with PR after TOF, reduction in the tricuspid valve size is seen after PVR. Concomitant tricuspid annuloplasty should not be considered based on tricuspid annular dilation alone.

  1. Prosthetic Tricuspid Valve Thrombosis: Three Case Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Ahmad Yaminisharif

    2015-10-01

    Full Text Available A common complication of prosthetic heart valves is thrombosis. Although the incidence of prosthetic valve thrombosis (PVT in the tricuspid position is high, there are not enough data on the management of it, in contrast to left-sided PVT. Here, we describe three cases of tricuspid PVT with three different management approaches: thrombolytic therapy; close observation with oral anticoagulants; and surgery. The first case was a woman who suffered from recurrent PVT, for which we successfully used Tenecteplase for second and third episodes. We employed Tenecteplase in this case for the first time in the therapy of tricuspid PVT. The second case had fixed leaflets in open position while being symptomless. At six months' follow-up, with the patient having taken oral anticoagulants, the motion of the leaflets was restricted and she was symptom- free. The last case was a woman who had a large thrombus in the right atrium immediately after mitral and tricuspid valvular replacement. The patient underwent re-replacement surgery and a new biological valve was implanted in the tricuspid position. Also, we review the literature on the pathology, signs and symptoms, diagnosis, and management of tricuspid PVT.

  2. A modified tricuspid valve annuloplasty technique for functional tricuspid regurgitation

    Institute of Scientific and Technical Information of China (English)

    WANG Jun; LI Zhi; ZHU Quan; WU Yan-hu; SHAO Yong-feng; QIN Jian-wei; CHEN Yi-jiang

    2013-01-01

    Background Functional tricuspid regurgitation often occurs in patients with concomitant left sided,valve disease.Several types of tricuspid valve annuloplasty have been described,but there is no consensus on the management of functional tricuspid regurgitation.We report a modified annuloplasty technique and compare its efficacy with the conventional Kay technique.Methods A retrospective review was made of 60 patients who received tricuspid valve annuloplasty (group A,modified method; group B,Kay technique) and the early and midterm outcomes of modified method and Kay technique were compared.Results Three patients underwent ring annuloplasty using a semirigid Carpentier-Edwards ring due to failing suture annuloplasty.All patients were completely cured when they left the hospital.The follow-up time was (32±7) months in group A and (30±7) months in group B.After three years,tricuspid regurgitation decreased by more than two grades in 13 patients in group A and 11 in group B.The mean postoperative regurgitation grade in group A was lower than group B at 12,24 and 36 months but not significantly.Three of 28 patients developed recurrent tricuspid regurgitation in group A and five of 26 patients in group B during the follow-up period (three deaths and three ring annuloplasties excluded).Freedom from recurrent tricuspid regurgitation in group A was higher than that group B at all follow-up points.Postoperative right atrium diameter,right ventricle endodiastolic dimension and tricuspid regurgitation area decreased obviously in both groups.The right ventricle endodiastolic dimension and tricuspid regurgitation area improved more significantly in group A than group B over three years of follow-up,Conclusions The modified annuloplasty technique achieved the same outcomes as the conventional Kay annuloplasty over the first three years postoperation.As this modified technique is simple and less expensive,it is another option for correction of functional tricuspid regurgitation.

  3. Heart valve surgery

    Science.gov (United States)

    ... Tricuspid valve stenosis Risks The risks of having cardiac surgery include: Death Heart attack Heart failure Bleeding requiring ... and the A.D.A.M. Editorial team. Heart Surgery Read more Heart Valve Diseases Read more Latest ...

  4. Outcome of surgical treatment of post-traumatic tricuspid insufficiency

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To investigate the optimal time and procedure of surgical treatment of traumatic tricuspid insufficiency.Methods: From May 1984 to September 2004, eight patients underwent operation for traumatic tricuspid valve insufficiency. All patients, male, aged from 7 to 67 years [median: 38 years, mean: (38.5±18.1) years]. The intervals between trauma and operation ranged from 1 month to 20 years [ median: 19 months, mean: ( 52.5±80.3 ) months) ]. In seven patients, tricuspid insufficiency was attributed to blunt chest trauma including vehicle accident in three patients and the other patient is a stab wound. Diagnosis was confirmed by echocardiography. Pre-operative cardiac functions in patients were classified as New York Heart Association (NYHA) classes Ⅱ-Ⅳ.During operation, the anterior leaflet of the tricuspid valve was completely or partially flailed as a result of chordal rupture in all patients. Chordal rupture of septal leaflet was found in one patient. Anterior leaflet was perforated in two patients. Septal leaflet was retracted and adherent to ventricular septum in two patients. Valve repair was intended for all patients. Finally, valve repair was performed successfully in 3 patients and tricuspid replacement was performed in 5 patients.Results: No early or late death occurred. With a follow-up through clinical manifestation and echocardiography for 7-129 months [ median: 39 months, mean: (53.4 ± 42.8) months ], all patients were classified as NYHA class I, without any changes.Conclusions: The satisfactory treatment of traumatic tricuspid insufficiency can be obtained by surgical treatment. Earlier surgery may increase the feasibility of tricuspid valve repair and prevent the deterioration of right ventricular function.

  5. Diagnosis of the downward displacement of the posterior leaflet of tricuspid valve from apical right heart two chamber view by echocardiography%心尖右心两腔观诊断小儿三尖瓣后瓣下移的方法探讨

    Institute of Scientific and Technical Information of China (English)

    蒋国平; 叶菁菁; 何瑾; 彭学慧; 赵镭; 何或; 杨秀珍

    2009-01-01

    Objective To evaluate the value of echocardiography method for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve with apical right heart two chamber view (AP-RH-2CV). Methods Rotating the probe clockwise from apical four chamber view(AP-4CV) to AP-RH-2CV at the septial and posterior leaflet of tricuspid valve, the shape, moving and position of the posterior leaflet of the tricuspid valve were observed by displaying the degree of downward displacement of the septial and posterior leaflet of tricuspid valve. The location of the orifice of tricuspid regurgitation was examined by color Doppler flow imaging(CDFI). Results In 15 patients with Ebstein's anomaly from the AP-RH-2CV, the downward displacement of posterior leaflet of tricuspid valve was clearly observed at the AP-RH-2CV. These results of echocardiography were confirmed by surgery except one ease missing out mild downward displacement of the anterior leaflet of tricuspid valve. Moreover, all 15 patients showed the obvious downward displacement of the location of the orifice of tricuspid regurgitation from AP-RH-2CV by CDFI. Conclusions The AP-RH-2CV is an ideal view in diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by echocardiography. The downward displacement of the location of the orifice of tricuspid regurgitation is a critical character for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by CDFI.%目的 探讨超声心尖右心两腔观诊断小儿三尖瓣后瓣下移的方法.方法 超声在心尖四腔观以隔瓣为中心,探头顺时针方向旋转至心尖右心两腔观,在旋转中动态显示三尖瓣隔瓣和后瓣的下移程度,观察三尖瓣后瓣的形态、活动和位置.彩色多普勒超声显示三尖瓣反流口位置.结果 15例三尖瓣后瓣和隔瓣下移患儿,超声在心尖右心两腔观均可清晰显示三尖瓣后瓣下移的特征.除1例超声诊断三尖瓣隔瓣和

  6. Contemporary management of tricuspid regurgitation: an updated clinical review.

    Science.gov (United States)

    Taylor, Joshua T; Chidsey, Geoffrey; Disalvo, Thomas G; Byrne, John G; Maltais, Simon

    2013-01-01

    Tricuspid regurgitation (TR) is a complex and insidious valvular pathology that represents a complex decision and management algorithm for patients. TR is present in a significant proportion of the population and is especially prevalent in patients with advanced heart failure. Patients with TR have been demonstrated to have a decreased survival even with normal left heart function. TR can be a result of pathology that directly affects the valvular structure (i.e., Ebstein anomaly) or as a result of increased forward pressures (ie, pulmonary hypertension, left heart failure). Conservative management of patients with TR is primarily symptomatic relief. Definitive therapy involves surgical repair of the tricuspid valve. Furthermore, as more patients develop advanced heart failure, the management of TR in patients with left ventricular assist devices has become necessary because of the evidence of increased in-hospital morbidity and a trend toward decreased survival.

  7. Aortic valve calcification and mild tricuspid regurgitation but no clinical heart disease after 8 years of dopamine agonist therapy for prolactinoma

    NARCIS (Netherlands)

    M. Kars; V. Delgado (Victoria); E.R. Holman (Eduard); R.A. Feelders (Richard); J.W.A. Smit (Jan); J.A. Romijn (Johannes); J.J. Bax (Jeroen); A.M. Pereira (Alberto)

    2008-01-01

    textabstractObjective: Treatment with ergot-derived dopamine agonists, pergolide, and cabergoline has been associated with an increased frequency of valvular heart disease in Parkinson's disease. The aim of the present study was to assess the prevalence of valvular heart disease in patients treated

  8. Tricuspid valve endocarditis following central venous cannulation: The increasing problem of catheter related infection

    Directory of Open Access Journals (Sweden)

    Suresh Babu Kale

    2013-01-01

    Full Text Available A central venous catheter (CVC is inserted for measurement of haemodynamic variables, delivery of nutritional supplements and drugs and access for haemodialysis and haemofiltration. Catheterization and maintenance are common practices and there is more to the technique than routine placement as evident when a procedure-related complication occurs. More than 15% of the patients who receive CVC placement have some complications and infectious endocarditis involving the tricuspid valve is a rare and serious complication with high morbidity and mortality. Overenthusiastic and deep insertion of the guide wire and forceful injection through the CVC may lead to injury of the tricuspid valve and predispose to bacterial deposition and endocarditis. We report a case of tricuspid valve endocarditis, probably secondary to injury of the anterior tricuspid leaflet by the guide wire or the CVC that required open heart surgery with vegetectomy and repair of the tricuspid valve.

  9. Tricuspid Valve Replacement in an HIV-Infected Patient with Severe Tricuspid Regurgitation Secondary to Remote Endocarditis.

    Science.gov (United States)

    Myerson, Merle; Armstrong, Ehrin J; Poltavskiy, Eduard; Fefer, Jose; Bang, Heejung

    2016-12-01

    Surgical intervention for severe tricuspid regurgitation secondary to remote infective endocarditis has been infrequent, especially in patients also infected with the human immunodeficiency virus (HIV). We describe the case of a 62-year-old HIV-positive man, with a 24-year history of endocarditis caused by intravenous heroin use, who presented with severe tricuspid regurgitation. The patient was initially asymptomatic, was taking antiretroviral medications, and had a satisfactory CD4 count and an undetectable viral load, so we decided to manage the regurgitation conservatively. Two years later, he presented with biventricular heart failure and dyspnea. After surgical tricuspid valve replacement, his condition improved substantially. This case illustrates that HIV-infected patients with complex medical conditions can successfully undergo cardiac surgery.

  10. Traumatic avulsion of the tricuspid valve after gas bottle explosion

    Directory of Open Access Journals (Sweden)

    Francesca Tedoldi

    2016-06-01

    Full Text Available We present a very rare example of chronic right heart failure caused by torrent tricuspid regurgitation. Massive right heart dilatation and severe tricuspid regurgitation due to avulsion of the tricuspid valve apparatus occurred as a result of a blunt chest trauma following the explosion of a gas bottle 20 years before admission, when the patient was a young man in Vietnam. After this incident, the patient went through a phase of severe illness, which can retrospectively be identified as an acute right heart decompensation with malaise, ankle edema, and dyspnea. Blunt chest trauma caused by explosives leading to valvular dysfunction has not been reported in the literature so far. It is remarkable that the patient not only survived this trauma, but had been managing his chronic heart failure well without medication for over 20 years. Learning points: • Thorough clinical and physical examination remains the key to identifying patients with relevant valvulopathies. • With good acoustic windows, TTE is superior to TEE in visualizing the right heart. • Traumatic avulsion of valve apparatus is a rare but potentially life-threatening complication of blunt chest trauma and must be actively sought for. Transthoracic echocardiography remains the method of choice in these patients.

  11. Traumatic avulsion of the tricuspid valve after gas bottle explosion

    Science.gov (United States)

    Krisper, Maximilian; Köhncke, Clemens; Pieske, Burkert

    2016-01-01

    Summary We present a very rare example of chronic right heart failure caused by torrent tricuspid regurgitation. Massive right heart dilatation and severe tricuspid regurgitation due to avulsion of the tricuspid valve apparatus occurred as a result of a blunt chest trauma following the explosion of a gas bottle 20 years before admission, when the patient was a young man in Vietnam. After this incident, the patient went through a phase of severe illness, which can retrospectively be identified as an acute right heart decompensation with malaise, ankle edema, and dyspnea. Blunt chest trauma caused by explosives leading to valvular dysfunction has not been reported in the literature so far. It is remarkable that the patient not only survived this trauma, but had been managing his chronic heart failure well without medication for over 20 years. Learning points Thorough clinical and physical examination remains the key to identifying patients with relevant valvulopathies.With good acoustic windows, TTE is superior to TEE in visualizing the right heart.Traumatic avulsion of valve apparatus is a rare but potentially life-threatening complication of blunt chest trauma and must be actively sought for. Transthoracic echocardiography remains the method of choice in these patients. PMID:27249554

  12. Tricuspid Valve Repair for Torrential Tricuspid Regurgitation after Permanent Pacemaker Lead Extraction

    OpenAIRE

    Mehrotra, Deepak; Kejriwal, Nand K.

    2011-01-01

    Tricuspid regurgitation secondary to percutaneous lead extraction is uncommon, and it rarely requires surgical intervention. Most tricuspid regurgitation occurs during the implantation of tined leads, which can be entrapped in the tricuspid valve apparatus and may require immediate withdrawal. Severe tricuspid regurgitation as a sequela of extracting chronically implanted leads has rarely been reported. Herein, we report a case of torrential tricuspid regurgitation in a 67-year-old woman afte...

  13. Tricuspid regurgitation following left-sided valve surgery: echocardiographic evaluation and optimal timing of surgical treatment.

    Science.gov (United States)

    Izumi, Chisato

    2015-03-01

    Severe tricuspid regurgitation may often appear and progress late after left-sided valve surgery without left-sided valve dysfunction, significant left heart failure, and pulmonary hypertension. The clinical features, echocardiographic evaluation, treatment, and prognosis of this disease entity have been discussed, but data is limited compared with left-sided valve diseases. Tricuspid annular dilatation associated with atrial fibrillation and right ventricular dysfunction strongly relate to development of isolated tricuspid regurgitation late after left-sided valve surgery. Three-dimensional evaluation may be useful in evaluating tricuspid valve anatomy in more detail. Better prognosis in patients undergoing surgical treatment for severe isolated tricuspid regurgitation than those who were treated medically has been reported; however, the timing of isolated tricuspid valve surgery is often too late. Right ventricular function is a key word for determining the timing of isolated tricuspid valve surgery; however, it is difficult to evaluate by conventional echocardiography. One of the serious issues in the future will be how to accurately evaluate right ventricular function.

  14. Tricuspid Valve Regurgitation as a Presenting Symptom of Metastasized Carcinoid Tumor

    Directory of Open Access Journals (Sweden)

    Anton F. Engelsman

    2012-09-01

    Full Text Available A 66-year-old woman was diagnosed with hepatic metastasized carcinoid tumor of the ileocecal junction resulting in elevated plasma chromogranin A levels and urinary 5-hydroxyindoleacetic acid (5-HIAA levels. Further examination showed right-sided heart failure with severe tricuspid valve regurgitation. Carcinoid tumors produce serotonin which leads to flushing, secretory diarrhea, bronchospasm and hypotension, known as carcinoid syndrome. Serotonin is metabolized to 5-HIAA, which is inactive, in the liver and the lungs. However, hepatic metastases may result in direct exposure of the heart to serotonin, which induces plaque-like deformities on the tricuspid valve, and in turn induces valve regurgitation. This condition is known as carcinoid heart disease. Tricuspid valve regurgitation may induce risk of massive blood loss in case of liver surgery through high-volume backflow in the hepatic veins. This report shows the clinical relevance of carcinoid heart disease in the perioperative setting.

  15. 继发于左心瓣膜病的功能性三尖瓣返流评估及外科治疗现状%Secondary to left heart valvular disease of the functional evaluation and surgical treatment of tricuspid regurgitation

    Institute of Scientific and Technical Information of China (English)

    蒋振威(综述); 向道康(审校)

    2015-01-01

    Functional tricuspid regurgitation (FTR) is mainly refers to secondary to left heart valve disease. At present, the same processing FTR has become a consensus, however, FTR evaluation criteria and surgical indications is unified.%功能性三尖瓣返流(FTR)主要是指继发于左心瓣膜病。目前,同期处理FTR已成共识,然而,FTR的评估标准及手术指征尚统一标准。

  16. Dynamic neural networking as a basis for plasticity in the control of heart rate.

    Science.gov (United States)

    Kember, G; Armour, J A; Zamir, M

    2013-01-21

    A model is proposed in which the relationship between individual neurons within a neural network is dynamically changing to the effect of providing a measure of "plasticity" in the control of heart rate. The neural network on which the model is based consists of three populations of neurons residing in the central nervous system, the intrathoracic extracardiac nervous system, and the intrinsic cardiac nervous system. This hierarchy of neural centers is used to challenge the classical view that the control of heart rate, a key clinical index, resides entirely in central neuronal command (spinal cord, medulla oblongata, and higher centers). Our results indicate that dynamic networking allows for the possibility of an interplay among the three populations of neurons to the effect of altering the order of control of heart rate among them. This interplay among the three levels of control allows for different neural pathways for the control of heart rate to emerge under different blood flow demands or disease conditions and, as such, it has significant clinical implications because current understanding and treatment of heart rate anomalies are based largely on a single level of control and on neurons acting in unison as a single entity rather than individually within a (plastically) interconnected network. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Isolated calcification of tricuspid valve with severe low pressure tricuspid regurgitation in an infant

    OpenAIRE

    Mittal, S.R.

    2013-01-01

    A three-month-old asymptomatic male infant was evaluated for a systolic murmur. Echocardiography revealed calcification of tricuspid leaflets with severe low pressure tricuspid regurgitation. Pulmonary artery flow was normal. There was no other congenital anomaly.

  18. Isolated calcification of tricuspid valve with severe low pressure tricuspid regurgitation in an infant.

    Science.gov (United States)

    Mittal, S R

    2013-12-01

    A three-month-old asymptomatic male infant was evaluated for a systolic murmur. Echocardiography revealed calcification of tricuspid leaflets with severe low pressure tricuspid regurgitation. Pulmonary artery flow was normal. There was no other congenital anomaly.

  19. Cardiac carcinoid: tricuspid delayed hyperenhancement on cardiac 64-slice multidetector CT and magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Martos, R

    2012-02-01

    INTRODUCTION: Carcinoid heart disease is a rare condition in adults. Its diagnosis can be easily missed in a patient presenting to a primary care setting. We revised the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing this condition. MATERIALS AND METHODS: We studied a 65-year-old patient with carcinoid heart disease and right heart failure using transthoracic Doppler-echocardiogram, cardiac MDCT and MRI. Cardiac echocardiogram revealed marked thickening and retraction of the tricuspid leaflets with dilated right atrium and ventricle. Cardiac MDCT and MRI demonstrated fixation and retraction of the tricuspid leaflets with delayed contrast hyperenhancement of the tricuspid annulus. CONCLUSION: This case demonstrates fascinating imaging findings of cardiac carcinoid disease and highlights the increasing utility of contrast-enhanced MRI and cardiac MDCT in the diagnosis of this interesting condition.

  20. Plastik på trikuspidalklappen (Tricuspid valve annuloplasty. The neglected valve)

    DEFF Research Database (Denmark)

    Pedersen, Thais A L; Wierup, Per; Pedersen, Lia Mendes;

    2010-01-01

    INTRODUCTION: Tricuspid valve regurgitation (TVR) is often secondary to left-sided or congenital heart disease (CHD). Surgical correction of TVR is indicated when the primary abnormalities require operation. MATERIAL AND METHODS: Retrospective analysis of all 50 patients (mean age: 65 years (range......: 24-83), 27 males, 23 females) operated with tricuspid valve annuloplasty (TVA) in our hospital from 2000 to 2007. TVA took place concomitantly with operation for left heart disease (n = 39, 78%) or CHD (n = 11, 22%). RESULTS: Preoperatively, TVR was severe in 40, moderate in six and mild in four....... There were five (10%) early and two (4%) late deaths. Temporary arrhythmias requiring medical treatment occurred in 35 cases, but eight required permanent pacemaker. No tricuspid valve reoperations were performed. CONCLUSIONS: The combination of correction of primary heart abnormalities and TVA is associated...

  1. 三尖瓣成形环在风湿性瓣膜病三尖瓣关闭不全中的应用现状%Current Applications of Tricuspid Forming Ring in Rheumatic Valve Disease-Tricuspid Regurgitation

    Institute of Scientific and Technical Information of China (English)

    国欣涛

    2011-01-01

    Tricuspid valve disease is a common heart valve disease, among which tricuspid regurgitation is more common than tricuspid stenosis, especially the functional tricuspid regurgitation.Surgical treatment of tricuspid insufficiency experienced suture annuloplasty to the hard artificial valve ring plasty and the soft artificial valve ring then to the current three-dimensional Edwards MC3 valve ring plasty procedure with constant improvement.Here is mainly to introduce the application of tricuspid forning ring in rheumatic tricuspid valve disease-tricuspid insufficiency.%三尖瓣疾病是一种常见的心脏瓣膜疾病,其中三尖瓣关闭不全较三尖瓣狭窄更为常见,尤其是功能性的三尖瓣关闭不全.三尖瓣关闭不全的外科治疗经历了从缝线成形术到人造硬质瓣环成形术和人造软质瓣环成形术最后改进至目前的三维Edwards MC3瓣环成形术的过程.现主要介绍三尖瓣成形环在风湿性瓣膜病三尖瓣关闭不全中的应用.

  2. Uterine leiomyosarcoma manifesting as a tricuspid valve mass.

    Science.gov (United States)

    Marak, Creticus P; Ponea, Ana M; Alappan, Narendrakumar; Shaheen, Shagufta; Guddati, Achuta K

    2013-01-01

    Uterine leiomyosarcoma is a rare malignancy and carries a poorer prognosis when compared to endometrial carcinoma. It has been observed to metastasize to all the major organs. It presents with symptoms of abdominal distension, vaginal bleeding and may pass unnoticed until an advanced stage in patients with leiomyomas. Surgery is a viable option in patients with disease limited to the uterus, but metastasis to the heart may require surgery to prevent acute and catastrophic complications. The case described here involves metastasis to the tricuspid valve, which caused severe tricuspid regurgitation in the setting of acute pulmonary embolism. Surgical resection restored cardiac function and stabilized the patient. This case illustrates a rare site of metastasis of leiomyosarcoma which required immediate intervention and resulted in a favorable outcome.

  3. Uterine Leiomyosarcoma Manifesting as a Tricuspid Valve Mass

    Directory of Open Access Journals (Sweden)

    Creticus P. Marak

    2013-02-01

    Full Text Available Uterine leiomyosarcoma is a rare malignancy and carries a poorer prognosis when compared to endometrial carcinoma. It has been observed to metastasize to all the major organs. It presents with symptoms of abdominal distension, vaginal bleeding and may pass unnoticed until an advanced stage in patients with leiomyomas. Surgery is a viable option in patients with disease limited to the uterus, but metastasis to the heart may require surgery to prevent acute and catastrophic complications. The case described here involves metastasis to the tricuspid valve, which caused severe tricuspid regurgitation in the setting of acute pulmonary embolism. Surgical resection restored cardiac function and stabilized the patient. This case illustrates a rare site of metastasis of leiomyosarcoma which required immediate intervention and resulted in a favorable outcome.

  4. Percutaneous establishment of tricuspid regurgitation: an experimental model for transcatheter tricuspid valve replacement

    Institute of Scientific and Technical Information of China (English)

    BAI Yuan; CHEN Hai-yan; ZONG Gang-jun; JIANG Hai-bing; LI Wei-ping; WU Hong; ZHAO Xian-xian; QIN Yong-wen

    2010-01-01

    Background Valve replacement or repair Is recommended in patients with tricuspid regurgitation when deterioration of their clinical status occurs as a consequence of right ventricular dysfunction. Percutaneous valve replacement was developed in recent years. To investigate the feasibility, effectiveness and long-term results of percutaneous tricuspid valve replacement, an experimental model with tricuspid regurgitation is needed. We developed a simple and reproducible percutaneous approach for the creation of tricuspid regurgitation in sheep.Methods A specially designed grasping forceps were used to grasp chordae tendineae or the tricuspid valve leaflets through a catheter. Transcatheter creation of tricuspid regurgitation was performed on 7 healthy sheep. These sheep were followed up shortly after the procedure and at 6th month post-procedure with echocardiography. Additionally, all the sheep were sacrificed for anatomic evaluation at 6th month after the procedure.Results Creation of tricuspid regurgitation was successfully accomplished in all sheep. Necropsy confirmed that damage was done to the tricuspid valve apparatus in all animals (tearing of the anterior leaflet of the tricuspid valve in five animals and posterior leaflet of the tricuspid valve in two animals). At the six-month follow-up, there was no significant increase in the right ventricle dimension and ejection fraction measured by echocardiography. Autopsy examinations demonstrated the tearing of tricuspid valve leaflets.Conclusions The creation of an animal model of tricuspid regurgitation via a percutaneous approach using forceps to sever one or more tricuspid leaflets is feasible and will allow investigation of devices designed replace the tricuspid valve via a percutaneous approach. Despite significant tricuspid regurgitation, the hemodynamics did not change during the follow-up period in this model.

  5. Dynamic tricuspid valve stenosis induced with a pacemaker lead: a case report.

    Science.gov (United States)

    Skoric, Bosko; Baricevic, Zeljko; Brida, Margarita; Samardzic, Jure; Jurin, Hrvoje; Milicic, Davor

    2014-01-01

    Isolated severe tricuspid valve stenosis due to an endocardial pacemaker lead is extremely rare, and is usually caused by either fibrosis of a perforated or lacerated leaflet, or fibrotic adherence between the lead and the valvular apparatus. Reported cases typically include clinical manifestations of both systemic venous stasis and low cardiac output. The case is presented of a 20-year-old female with a surgically repaired congenital heart disease who developed severe tricuspid stenosis at six years after the implantation of a DDD pacemaker. Unexpectedly, the patient had no signs of venous stasis and suffered only from exercise intolerance. Right heart catheterization under fluoroscopic guidance revealed an atrial lead forming a loop at the level of the tricuspid valve. A paradoxical inspiratory decrease in the transvalvular diastolic gradient, caused by the caudal heart motion and straightening of the loop during inspiration, was noted. Such a dynamic nature with a temporary inspiratory relief of the obstruction may explain the partial clinical presentation of tricuspid stenosis in this case. The lead was removed and the tricuspid valve repaired surgically, after which the patient's recovery was uneventful with normalization of exercise tolerance.

  6. Case report: Pacemaker lead perforation of a papillary muscle inducing severe tricuspid regurgitation.

    Science.gov (United States)

    Andreas, Martin; Gremmel, Franz; Habertheuer, Andreas; Rath, Claus; Oeser, Claudia; Khazen, Cesar; Kocher, Alfred

    2015-03-25

    We report a rare but severe pacemaker complication of a pacemaker lead perforating the papillary muscle. This induced severe tricuspid regurgitation and right heart failure. Patients suffering from right heart failure have an increased operative risk of open-heart surgery and therefore represent a clinical challenge due to the lack of clear guidelines. A 70-year-old male patient presented with severe tricuspid regurgitation and a history of decompensated right heart failure. One pacemaker lead was described as 'whipping'. Four years earlier he had received a VVIR pacemaker with a passive lead. This lead failed after three years and a new ventricular lead had been placed. We performed on-pump beating heart surgery after a multidisciplinary decision process. One lead was perforating the posterior papillary muscle, severely impairing valve movement. The tricuspid valve was replaced with a stented bioprosthesis. Epicardial pacemaker wires were placed on the right and left ventricle to enable cardiac resynchronization therapy in the case of postoperative heart failure. However, the patient recovered quickly without left ventricular pacing and could be discharged home 12 days after surgery. This particular case emphasizes the importance of meticulous surgical technique during pacemaker lead implantation and a tight postoperative follow-up including echocardiography in complicated cases. The management of patients with an indication for lead removal having developed secondary severe tricuspid valve dysfunction inducing ventricular impairment represents a clinical challenge and should be approached by a multidisciplinary team.

  7. Percutaneous Valvuloplasty for Bioprosthetic Tricuspid Valve Stenosis

    Science.gov (United States)

    Malhotra, Rohit; Sharma, Anjali; Kakouros, Nikolaos

    2017-01-01

    Percutaneous transcatheter tricuspid balloon valvuloplasty (PTTBV) is an accepted treatment option for symptomatic severe native tricuspid valve stenosis, although surgical tricuspid valve replacement remains the treatment of choice. There have been few reports of successful PTTBV for bioprosthetic tricuspid valve stenosis. We present case reports of 3 patients from our hospital experience. Two of the 3 cases were successful, with lasting clinical improvement, whereas the 3rd patient failed to show a reduction in valve gradient. We describe the standard technique used for PTTBV. We present results from a literature review that identified 16 previously reported cases of PTTBV for bioprosthetic severe tricuspid stenosis, with overall favorable results. We conclude that PTTBV should perhaps be considered for a select patient population in which symptomatic improvement and hemodynamic stability are desired immediately, and particularly for patients who are inoperable or at high surgical risk.

  8. Endocarditis tricuspid sub-aigue of post abortion: report of a case.

    Science.gov (United States)

    Codjo, Léopold Houétondji; Savi de Tove, Kofi-Mensa; Hounkponou, Fanny Ahouingnan; Dohou, Serge Hugues Mahougnon; Houenassi, Martin Dàdonougbo

    2015-03-23

    Tricuspid infective endocarditis is rare and represents five to 10% of all cases of infective endocarditis. It occurs predominantly in intravenous drug users, and patients with central venous catheters or intracardiac probes. We report on the case of subacute tricuspid infective endocarditis in a girl of 17 years. She had no particular cardiovascular history. She was admitted for a persistent fever with cachexy, cough and thoracic pains, and right heart failure that appeared one month after a clandestine abortion. Transthoracic echocardiography found several vegetations on the tricuspid valve with massive tricuspid regurgitation. The chest X-ray showed bilateral excavated lung abscesses and condensation areas. Blood culture was not done and broad-spectrum antibiotic therapy was given. She was apyretic after 10 days. However, the massive tricuspid regurgitation with right heart failure persisted. She was discharged from hospital after 40 days of treatment. Although rare, infective endocarditis is one of the more serious complications of gynaecological procedures, particularly clandestine abortion. Therefore any young girl with persistent fever must be suspected of clandestine abortion.

  9. Tricuspid valve repair for torrential tricuspid regurgitation after permanent pacemaker lead extraction.

    Science.gov (United States)

    Mehrotra, Deepak; Kejriwal, Nand K

    2011-01-01

    Tricuspid regurgitation secondary to percutaneous lead extraction is uncommon, and it rarely requires surgical intervention. Most tricuspid regurgitation occurs during the implantation of tined leads, which can be entrapped in the tricuspid valve apparatus and may require immediate withdrawal. Severe tricuspid regurgitation as a sequela of extracting chronically implanted leads has rarely been reported. Herein, we report a case of torrential tricuspid regurgitation in a 67-year-old woman after the extraction of a permanent pacemaker lead. The regurgitation was confirmed on transesophageal echocardiography during lead extraction, and the tricuspid valve was successfully repaired with suture bicuspidization of the valve and the support of ring annuloplasty. A short review of the relevant literature follows the case report.

  10. Severe tricuspid regurgitation 14 years after diagnosis of "transient neonatal tricuspid regurgitation"

    OpenAIRE

    Boshoff, D.; Mertens, L.; Gewillig, M

    2001-01-01

    A 14 year old girl presented with severe tricuspid regurgitation after she was diagnosed with "transient tricuspid regurgitation of the newborn". In the neonatal period she had presented with severe tricuspid regurgitation without an obvious underlying anatomical cause. This spontaneously regressed during the first months of life. She was dismissed from follow up at the age of 5 years after complete normalisation of the clinical and echocardiographic examination. The subsequent evolution and ...

  11. Repair of very severe tricuspid regurgitation following detachment of the tricuspid valve

    OpenAIRE

    Mahgoub, Ahmed; Kamel, Hassan; Simry, Walid; Hosny, Hatem

    2015-01-01

    We report on the case of 5-year-old girl with severe tricuspid regurgitation following previous repair of double outlet right ventricle with subaortic ventricular septal defect, performed through trans-atrial approach using detachment of tricuspid valve leaflet. The severe tricuspid regurgitation was found to be due to dehiscence at the site of the previous detachment and was repaired using a pericardial patch. In this report, we discuss the relative merits and risks of using this technique.

  12. [Tricuspid atresia: A therapeutic problem].

    Science.gov (United States)

    Mata, L A; Espino Vela, J; Castro, A; Cárcamo Tercero, J; Martínez Ríos, M A; Pliego, J; Attié, F

    1975-01-01

    1. The authors present 80 cases of tricuspid atresia of the Children's Cardiology Service of the Instituto Nacional de Cardiología de México. They propose their own classification based on the position of the visceral suits and of the great arteries and the possible existance of a persistent truncus arteriosus. 2. The requirements that should be fulfiled to establish an anatomic and hemodynamic diagnosis are determined; and the need to know in detail the anatomy of the right ventricle; of its exit chamber, of the pulmonary valve and of the pulmonary truncus is emphasized; as well as the measures in the auricles and the left ventricle. 3. They insist upon the need, when the pulmonar arterial pressure cannot be measured directly, to introduce a catheter in a pulmonar vein, because the pressures obtained are quite similar to the pressure in the pulmonar arterial territory. 4. The fundamental data of the anatomic and hemodynamic study are discussed and illustrated. They confirm the close relation that exists between the diameter of the exit chamber of the right ventricle and of the valvular ring, the pulmonary truncus and its branches. 5. In all cases of tricuspid atresia with AQRS deviated to the right and downwards in the frontal plane; transposition of the great arteries should be thought of when it deviates to the left and upwards, in patients with crossed great arteries. 6. In the cases operated with sistemic-pulmonary fistula, there was an intrahospital mortality range of 25%, similar to that obtained by most authors. 7. The paliative surgical procedures are analyzed, and those that at present could be considered as "corrective" such as Fontan and Kreutzer's operations. The need, to gather several diagnostic parameters. To establish the surgical indication in the sistemicpulmonary and venus shunts, is emphasized.

  13. Aorto-right atrial fistula: Late complication of tricuspid valve infective endocarditis

    Institute of Scientific and Technical Information of China (English)

    Pedro; A; Villablanca; Shashvat; Sukhal; Oscar; Maitas; Afiachuukwu; Onuegbu; Juan; M; Muoz-Pea; Ajay; Joseph; Carlos; Requena; Divyanshu; Mohananey

    2014-01-01

    Abnormal connections between the ascending aortaand the cardiac chambers are rare, especially in thecontext of right-sided infective endocarditis(IE). Trans-thoracic echocardiography(TTE) with color-flow Dop-pler, transesophageal echocardiography(TEE), or bothmay be required for diagnosis. We present the case ofa woman admitted with right-sided heart failure(HF)symptoms. She had a previous history of tricuspid valveIE 30 years ago. TTE and TEE revealed an aorto-rightatrium fistula located just under the non-coronary cuspinto the right atrium at the level of the previously af-fected tricuspid valve. The Patient refused surgery andwas discharged home on HF medications. She has beenstable for the last 3 years. The peculiarity of this caseis the late symptomatic presentation of the aorto-atrialfistula and the unusual association to tricuspid valve IE.

  14. Warm fish with cold hearts: thermal plasticity of excitation-contraction coupling in bluefin tuna.

    Science.gov (United States)

    Shiels, H A; Di Maio, A; Thompson, S; Block, B A

    2011-01-07

    Bluefin tuna have a unique physiology. Elevated metabolic rates coupled with heat exchangers enable bluefin tunas to conserve heat in their locomotory muscle, viscera, eyes and brain, yet their hearts operate at ambient water temperature. This arrangement of a warm fish with a cold heart is unique among vertebrates and can result in a reduction in cardiac function in the cold despite the elevated metabolic demands of endothermic tissues. In this study, we used laser scanning confocal microscopy and electron microscopy to investigate how acute and chronic temperature change affects tuna cardiac function. We examined the temporal and spatial properties of the intracellular Ca2+ transient (Δ[Ca2+]i) in Pacific bluefin tuna (Thunnus orientalis) ventricular myocytes at the acclimation temperatures of 14°C and 24°C and at a common test temperature of 19°C. Acute (less than 5 min) warming and cooling accelerated and slowed the kinetics of Δ[Ca2+]i, indicating that temperature change limits cardiac myocyte performance. Importantly, we show that thermal acclimation offered partial compensation for these direct effects of temperature. Prolonged cold exposure (more than four weeks) increased the amplitude and kinetics of Δ[Ca2+]i by increasing intracellular Ca2+ cycling through the sarcoplasmic reticulum (SR). These functional findings are supported by electron microscopy, which revealed a greater volume fraction of ventricular SR in cold-acclimated tuna myocytes. The results indicate that SR function is crucial to the performance of the bluefin tuna heart in the cold. We suggest that SR Ca2+ cycling is the malleable unit of cellular Ca2+ flux, offering a mechanism for thermal plasticity in fish hearts. These findings have implications beyond endothermic fish and may help to delineate the key steps required to protect vertebrate cardiac function in the cold.

  15. Surgical outcomes of isolated tricuspid valve procedures: repair versus replacement.

    Science.gov (United States)

    Ejiofor, Julius I; Neely, Robert C; Yammine, Maroun; McGurk, Siobhan; Kaneko, Tsuyoshi; Leacche, Marzia; Cohn, Lawrence H; Shekar, Prem S

    2017-05-01

    Isolated tricuspid valve (ITV) operations are infrequent and the decision to operate is controversial. We report a series of ITV operations to outline the current disease status requiring this uncommon procedure with an emphasis on the results of tricuspid valve repair (TVr) versus replacement (TVR). Using our prospective cardiac surgery database, 57 patients who underwent ITV operations between 01/02-03/14 were identified. Median follow up time was 3.5 years [interquartile range (IQR), 0.8-6.7 years]. Fifty-seven patients underwent ITV surgery with a mean age of 54.4±14.9 yrs and 61% were women. Baseline characteristics were similar between patients who underwent TVr (n=18) or TVR (n=39). The etiologies of TV dysfunction were: ITV endocarditis 14/57 (25%), persistent TV regurgitation after left-sided valve surgery in 12/57 (21%), traumatic biopsies and iatrogenic injury from pacing leads in 11/57 (19%), orthotopic heart transplant 9/57 (16%), carcinoid syndrome 3/57 (5%), congenital 2/57 (5%) and idiopathic 5/57 (9%). Overall, 32/57 (56%) patients had prior heart surgery; of which 10/32 (31%) were TV procedures. Bioprosthetic prostheses were used in 34/39 (87%) patients. Of those who had repair, 11/18 (61%) had ring annuloplasty, 3/18 (17%) bicuspidization, and 3/18 (17%) De Vega annuloplasty and one had vegetectomy. Operative mortality was 5.1% (n=2) and 16.7% (n=3) for TVR and TVr groups, respectively (P=0.32), with an overall mortality rate of 8.6%. Postoperative complications included new onset renal failure in 6/39 (15%) of TVr and 2/18 (11%) of TVR (P=0.71) and there were no strokes. Overall survival rates and degree of residual RV dysfunction were similar for the two groups (both P=0.3). Five-year survival was 77% and 84% for TVr and TVR respectively (P=0.52). There was no difference in rates of recurrent tricuspid regurgitation for TVr and TVR (35.7% vs. 23.5%, respectively, P=0.4). ITV surgery is associated with improved but still relatively high

  16. Management of moderate functional tricuspid valve regurgitation at the time of pulmonary valve replacement: is concomitant tricuspid valve repair necessary?

    Science.gov (United States)

    Kogon, Brian; Patel, Manisha; Leong, Traci; McConnell, Michael; Book, Wendy

    2010-08-01

    Congenital heart defects with a component of pulmonary stenosis are often palliated in childhood by disrupting the pulmonary valve. Patients often undergo subsequent pulmonary valve replacement (PVR) to protect the heart from the consequences of pulmonary regurgitation. In the presence of associated moderate functional tricuspid valve (TV) regurgitation, it is unclear what factors contribute to persistent TV regurgitation following PVR. In particular, it is unknown whether PVR alone will reduce the right ventricular (RV) size and restore TV function or whether concomitant TV annuloplasty is required as well. Thirty-five patients were analyzed. Each patient underwent initial palliation of congenital pulmonary stenosis or tetralogy of Fallot, underwent subsequent PVR between 2002 and 2008, and had at least moderate TV regurgitation at the time of valve replacement. Serial echocardiograms were analyzed. Pulmonary and TV regurgitation, along with RV dilation and dysfunction, were scored (0, none; 1, mild; 2, moderate; 3, severe). RV volume and area were also calculated. Potential risk factors for persistent postoperative TV regurgitation were evaluated. One month following PVR, there was a significant reduction in pulmonary valve regurgitation (mean, 3 vs. 0.39; P regurgitation (mean, 2.33 vs. 1.3; P regurgitation postoperatively between those patients who underwent PVR alone and those who underwent concomitant tricuspid annuloplasty (mean, 1.29 vs. 1.31; P = 0.81). We conclude that following PVR, improvement in TV regurgitation and RV size occurs primarily in the first postoperative month. TV function improved to a similar degree with or without annuloplasty.

  17. Electrophysiologic studies in tricuspid atresia.

    Science.gov (United States)

    Serratto, M; Pahlajani, D B

    1978-12-01

    Five patients with tricuspid atresia underwent His bundle studies with the recording catheter placed close to the mitral valve ring. Right atrial pacing and measurement of the refractory periods were performed in three. The prolonged intraatrial conduction time found in all patients is thought to be caused by a hypertrophied and dilated right atrium with increased internodal distance due to stretching of internodal pathways. The A-H interval was normal in all; the H-V interval was short in three and normal in two. The pattern of left axis deviation in the group with a short H-V interval is thought to be due to early origin of the posterior branches of the left bundle branch from the bundle of His and early activation of the posteroinferior parts of the left ventricle. The pattern of left axis deviation in the group with a normal H-V interval may be related to the previously reported anomalous course of the left bundle. Atrial pacing produced a normal response. The refractory periods were within normal range, suggesting functional integrity of conduction through the atrioventricular node and bundle branches.

  18. Surgical treatment of tricuspid regurgitation after mitral valve surgery: a retrospective study in China

    Directory of Open Access Journals (Sweden)

    Li Zong-Xiao

    2012-04-01

    Full Text Available Abstract Background Functional tricuspid regurgitation (TR occurs in patients with rheumatic mitral valve disease even after mitral valve surgery. The aim of this study was to analyze surgical results of TR after previous successful mitral valve surgery. Methods From September 1996 to September 2008, 45 patients with TR after previous mitral valve replacement underwent second operation for TR. In those, 43 patients (95.6% had right heart failure symptoms (edema of lower extremities, ascites, hepatic congestion, etc. and 40 patients (88.9% had atrial fibrillation. Twenty-six patients (57.8% were in New York Heart Association (NYHA functional class III, and 19 (42.2% in class IV. Previous operations included: 41 for mechanical mitral valve replacement (91.1%, 4 for bioprosthetic mitral valve replacement (8.9%, and 7 for tricuspid annuloplasty (15.6%. Results The tricuspid valves were repaired with Kay's (7 cases, 15.6% or De Vega technique (4 cases, 8.9%. Tricuspid valve replacement was performed in 34 cases (75.6%. One patient (2.2% died. Postoperative low cardiac output (LCO occurred in 5 patients and treated successfully. Postoperative echocardiography showed obvious reduction of right atrium and ventricle. The anterioposterior diameter of the right ventricle decreased to 25.5 ± 7.1 mm from 33.7 ± 6.2 mm preoperatively (P Conclusion TR after mitral valve replacement in rheumatic heart disease is a serious clinical problem. If it occurs or progresses late after mitral valve surgery, tricuspid valve annuloplasty or replacement may be performed with satisfactory results. Due to the serious consequence of untreated TR, aggressive treatment of existing TR during mitral valve surgery is recommended.

  19. Percutaneous tricuspid valve-In-ring replacement for the treatment of recurrent severe tricuspid regurgitation.

    Science.gov (United States)

    Condado, Jose; Leonardi, Robert; Babaliaros, Vasilis

    2015-12-01

    Percutaneous tricuspid valve-in-ring replacement can be an alternative to surgery for high-risk patients with symptomatic severe tricuspid regurgitation that recurs after surgical ring repair. Practitioners must pay attention to the specific technical details associated with this procedure that include: using the ring as a fluoroscopic landmark, sizing the valve area with multi-modality imaging, choosing the appropriate device based on the patients anatomy, and dealing with the inevitable paravalvular leak (created by the ring deformation in the absence of valve-specific devices). Our case demonstrates that percutaneous tricuspid valve-in-ring replacement is a feasible treatment that can result in both hemodynamic and symptomatic improvement.

  20. Tricuspid valve dysplasia in a domestic feline: case report

    Directory of Open Access Journals (Sweden)

    Matheus Matioli Mantovani

    2017-05-01

    Full Text Available Tricuspid valve dysplasia (TVD is a congenital heart defect described in dogs and cats; however, in Brazil there are no reports of this condition in cats. Therefore, our goal was to report a case of TVD in a domestic cat. A four-year-old, female, domestic short hair cat that was seen at the Cardiology Service of the Veterinary Teaching Hospital, University of São Paulo, for apathy, appetite loss and dyspnea for five days. During physical examination, dyspnea with a restrictive respiratory pattern due to pleural effusion was observed. Thoracocentesis was performed and 450 mL of serosanguineous fluid was drained. Two-dimensional echocardiography in the right parasternal short-axis plane at the level of the papillary muscles showed right ventricular dilatation and paradoxical septal motion. On the left parasternal apical four-chamber view, significant dilatation of the right chambers, loss of mobility of the septal leaflet of the tricuspid valve and a thickened mural leaflet chordae with anomalous insertion were observed. Based on clinical and echocardiographic aspects, a diagnosis of TVD was given. Treatment was initiated with enalapril 0.5 mg/kg, furosemide 0.5 mg/kg and pimobendan 0.3 mg/kg every 12 hours, all per os. The patient experienced remission of clinical manifestations and survived for 50 days after diagnosis.

  1. Percutaneous tricuspid valve replacement in childhood

    Directory of Open Access Journals (Sweden)

    Mathias Emmel

    2015-01-01

    Full Text Available Percutaneous replacement of the tricuspid valve with a bovine jugular venous valve (melody valve was successfully undertaken in a 9-year-old boy. The patient had a previous history of bacterial endocarditis of the native tricuspid valve in infancy. Initially, a pericardial patch valve was created, followed by surgical replacement of the valve using a biological tissue valve at 4 years of age. Progressive stenosis and regurgitation of the biological valve, with severe venous congestion and resulting hepatic dysfunction prompted percutaneous valve replacement.

  2. Modified Cone Reconstruction of the Tricuspid Valve for Ebstein Anomaly as Performed in Siberia

    Science.gov (United States)

    Krivoshchekov, Evgeny V.; Ackerman, Jaeger P.; Yanulevich, Olga S.; Sokolov, Alexander A.; Ershova, Nadezhda V.; Dearani, Joseph A.

    2017-01-01

    The cone reconstruction technique, first described by da Silva and modified by Dearani and by others, has become the repair method of choice in patients with Ebstein anomaly of the tricuspid valve. This report details the outcome of the modified cone reconstruction technique in 6 children who underwent surgical correction of Ebstein anomaly at the Tomsk Institute of Cardiology in Siberia. From 2012 through 2015, 4 boys and 2 girls (age range, 11 mo–12 yr) underwent surgery to correct Ebstein anomaly. All had presented with cyanosis, exertional dyspnea, fatigue, or new-onset atrial arrhythmia, and none had undergone previous cardiac surgery. All survived the operation. One patient needed tricuspid valve replacement with a bioprosthesis after early breakdown of the cone reconstruction. As of December 2016, all the patients had no symptoms, tricuspid stenosis, or arrhythmia. This series indicates that cone reconstruction—the most anatomic repair technique for the dysmorphic Ebstein tricuspid valve—can be successfully performed in pediatric heart centers with a large experience.

  3. Prevalence, Predictors and Clinical Outcome of Residual Pulmonary Hypertension Following Tricuspid Annuloplasty.

    Science.gov (United States)

    Chen, Yan; Liu, Ju-Hua; Chan, Daniel; Sit, Ko-Yung; Wong, Chun-Ka; Ho, Kar-Lai; Ho, Lai-Ming; Zhen, Zhe; Lam, Yui-Ming; Lau, Chu-Pak; Au, Wing-Kok; Tse, Hung-Fat; Yiu, Kai-Hang

    2016-07-22

    Tricuspid annuloplasty is increasingly performed during left heart valve surgery, but the long-term clinical outcome postoperatively is not satisfactory. The aim of this study was to determine whether residual pulmonary hypertension (PHT) contributes to the adverse outcome. One-hundred thirty-seven patients (age 61±11 years; men, 30%) who underwent tricuspid annuloplasty during left-side valve surgery were enrolled. The mean pulmonary artery systolic pressure before surgery was 49±13 mm Hg and 32±15 mm Hg following surgery. Patients were divided into 3 groups according to postoperative pulmonary artery systolic pressure: no residual PHT (n=78, 57%), mild residual PHT (n=43, 31%), or significant residual PHT (n=16, 12%). A preoperative larger right ventricular (RV) geometry and tricuspid valve tethering area were associated with mild or significant residual PHT. A total of 24 adverse events (20 heart failures and 4 cardiovascular deaths) occurred during a median follow-up of 25 months. Kaplan-Meier survival curve demonstrated that patients with significant residual PHT had the highest percentage of adverse events followed by those with mild residual PHT. Patients with no residual PHT had a very low risk of adverse events. Multivariable Cox regression analysis revealed that both mild (hazard ratio=4.94; 95% CI =1.34-18.16; P=0.02) and significant residual PHT (hazard ratio=8.67; 95% CI =2.43-30.98; P<0.01) were independent factors associated with adverse events. The present study demonstrated that 43% of patients who underwent tricuspid annuloplasty had residual PHT. The presence of mild or significant residual PHT was associated with adverse events in these patients. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  4. Concomitant Tricuspid Valve Surgery Affects Outcomes Following Mitral Operations: A multi-institutional, statewide analysis

    Science.gov (United States)

    LaPar, Damien J.; Mulloy, Daniel P.; Stone, Matthew L.; Crosby, Ivan K.; Lau, Christine L; Kron, Irving L.; Ailawadi, Gorav

    2012-01-01

    Background Mitral valve disease is often accompanied by concomitant tricuspid valve disease. The purpose of this study was to determine the influence of performing tricuspid procedures in the setting of mitral valve surgery within a multi-institutional patient population. Methods From 2001–2008, 5,495 mitral valve operations were performed at 17 different statewide centers. Patients underwent either mitral valve alone (MV alone, n=5,062, age=63.4±13.0 years) or mitral + tricuspid valve operations (MV+TV, n=433, age=64.0±14.2 years). Univariate and multivariate analyses were used to assess the influence of concomitant tricuspid procedures on operative mortality and the composite incidence of major complications. Results Patients undergoing MV+TV were more commonly female (62.7% vs. 45.5%, p<0.001), had higher rates of heart failure (73.7% vs. 50.9%, p<0.001), and more frequently underwent reoperations (17.1% vs. 7.4%, p<0.001) compared to MV alone patients. Other patient characteristics, including preoperative endocarditis (8.5% vs. 8.2%, p=0.78), were similar between groups. Mitral replacement (63.5%) was more common than repair (36.5%, p<0.001) in MV+TV operations, and MV+TV operations incurred longer median cardiopulmonary bypass (181 min. vs. 149 min, p<0.001) times. Unadjusted operative mortality (6.0% vs. 10.4%, p=0.001) and postoperative complications were higher following MV+TV compared to MV alone. Importantly, after risk adjustment, performance of concomitant tricuspid valve procedures proved an independent predictor of operative mortality (OR=1.50, p=0.03) and major complications (OR=1.39, p=0.004). Conclusions Concomitant tricuspid surgery is a proxy for more advanced valve disease. Compared to mitral operations alone, simultaneous mitral-tricuspid valve operations are associated with elevated morbidity and mortality even after risk adjustment. This elevated risk should be considered during preoperative patient risk stratification. PMID:22607786

  5. The results of surgical treatment of 14 patients underwent repeated tricuspid valve operations%三尖瓣再次手术14例

    Institute of Scientific and Technical Information of China (English)

    周明阳; 张健群; 孟旭; 李温斌; 孔晴宇

    2008-01-01

    目的 总结三尖瓣再次手术的治疗效果及经验.方法 2002年至2006年,收治14例三尖瓣再次手术病人,其中三尖瓣成形术后再次出现关闭不全12例,三尖瓣置换术后人工瓣膜功能障碍2例.结果 再次实施三尖瓣成形术5例,三尖瓣置换术9例.死亡2例,余者治愈出院.10例随访2~40个月,1例心功能Ⅲ级,余者均为Ⅰ~Ⅱ级.结论 再次三尖瓣手术治疗效果确切,手术死亡与手术方式的选择以及围术期心、肾功能衰竭有关.%Objective To evaluate the results and surgical treatment of the repeated tricuspid valve operations. Methods The hospital records was reviewed for 14 patients who underwent repeated tricuspid valve operations between 2003 and 2006, including 12 patients with tricuspid regurgitation received first tricuspid valve repair and 2 patients, with prosthetic valve dysfunction. Results Reoperations of tricuspid valve included 5 tricuspid valve repair and 9 tricuspid valve replacement. There were two postoperative deaths. Post-operative heart function (NYHA) was improved significantly, 1 case in Ⅲ and 9 in Ⅰ-Ⅱ. Ten survivors were followed up for 2 - 40 months. Conclusion Tricuspid valve reoperations may be performed with acceptable operative mortality. Perioperative death was associated with surgical methods and heart or renal function failure.

  6. Reference values of tricuspid annular peak systolic velocity in healthy pediatric patients, calculation of z score, and comparison to tricuspid annular plane systolic excursion.

    Science.gov (United States)

    Koestenberger, Martin; Nagel, Bert; Ravekes, William; Avian, Alexander; Heinzl, Bernd; Cvirn, Gerhard; Fritsch, Peter; Fandl, Andrea; Rehak, Thomas; Gamillscheg, Andreas

    2012-01-01

    The tricuspid annular peak systolic velocity (TAPSV) is an echocardiographic measurement assessing right ventricular systolic function in children and adults. We determined the growth-related changes of the TAPSV to establish the references values for the entire pediatric age group. A prospective study was conducted of a group of 860 healthy pediatric patients (age 1 day to 18 years; body surface area [BSA] 0.14 to 2.30 m(2)). We determined the effects of age, gender, and BSA on the TAPSV values. Stepwise linear multiple regression analysis was used to estimate the TAPSV from the age, BSA, and gender. A correlation of normal TAPSV with normal tricuspid annular plane systolic excursion values was performed. The TAPSV ranged from a mean of 7.2 cm/s (z score ± 2: 4.8 to 9.5 cm/s) in the newborn to 14.3 cm/s (z score ± 2: 10.6 to 18.6 cm/s) in the 18-year-old adolescent. The TAPSV values showed a positive correlation with age and BSA, with a nonlinear course. No significant difference was found in the TAPSV values according to gender. A significant correlation was found between the TAPSV and tricuspid annular plane systolic excursion values in our pediatric population. In conclusion, the z scores of the TAPSV values were calculated, and percentile charts were established to serve as reference data for patients with congenital heart disease.

  7. THE RESULTS OF SURGICAL TREATMENT OF TRICUSPID VALVE INFECTIVE ENDOCARDITIS USING VALVE REPAIR AND VALVE REPLACEMENT OPERATIONS

    Directory of Open Access Journals (Sweden)

    S. A. Kovalev

    2015-01-01

    Full Text Available Aim. To evaluate in-hospital and long-term results of surgical treatment of patients with infective endocarditis of the tricuspid valve, to compare the effectiveness of valve repair and valve replacement techniques, and to identify risk factors of mortality and reoperations. Materials and methods. 31 surgical patients with tricuspid valve infective endocarditis were evaluated. Patients were divided into 2 groups. In Group 1 (n = 14 repairs of the tricuspid valve were performed, in Group 2 (n = 17 patients had undergone tricuspid valve replacements. Epidemiological, clinical, microbiological and echocardiographic data were studied. Methods of comparative analysis, the Kaplan–Meier method, and Cox risk models were applied. Results. The most common complication of in-hospital stay was atrioventricular block (17.7% of cases in Group 2. In Group 1, this type of complication was not found. Hospital mortality was 7.14% in Group 1, and 0% in Group 2. Long-term results have shown the significant reduction of heart failure in general cohort and in both groups. In Group 1 the severity of heart failure in the long term was less than in Group 2. No significant differences in the severity of tricuspid regurgitation were found between the groups. In 7-year follow up no cases of death were registered in Group 1. Cumulative survival rate in Group 2 within 60 months was 67.3 ± 16.2%. No reoperations were performed in patients from Group 1. In Group 2, the freedom from reoperation within 60 months was 70.9 ± 15.3%. Combined intervention was found as predictor of postoperative mortality. Prosthetic valve endocarditis was identified as risk factor for reoperation. Conclusion. Valve repair and valve replacement techniques of surgical treatment of tricuspid valve endocarditis can provide satisfactory hospital and long-term results. Tricuspid valve repair techniques allowed reducing the incidence of postoperative atrioventricular block. In the long-term, patients

  8. Tricuspid valve endocarditis due to Neisseria cinerea.

    Science.gov (United States)

    Benes, J; Dzupova, O; Krizova, P; Rozsypal, H

    2003-02-01

    Reported here is a case of infective endocarditis caused by the saprophytic species Neisseria cinerea. To the best of our knowledge, this etiology has not been documented in the medical literature previously. The patient was an intravenous drug addict who developed tricuspid endocarditis with lung embolism. The disease was cured after treatment with ampicillin/clavulanate that was changed to ceftriaxone after an embolic event.

  9. Severe Tricuspid Regurgitation Diagnosed 13 Years after a Car Accident: A Case Report

    Directory of Open Access Journals (Sweden)

    Burak Acar

    2015-10-01

    Full Text Available Blunt chest traumas mostly occur due to car accidents and can cause many cardiac complications such as septal rupture, free-wall rupture, coronary artery dissection or thrombosis, heart failure, arrhythmias, and chordae and papillary muscle rupture. One of the most serious complication is tricuspid regurgitation (TR, which can be simply diagnosed by physical examination and confirmed by echocardiography. We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident. TR was diagnosed with transthoracic echocardiography and three dimensional transthoracic echocardiography had defined the exact pathology of the tricuspid valve. The patient underwent successful surgery with bioprosthetic valve implantation and was discharged at 6th postoperative day without any complication. The patient had no problem according to the follow-up one month and six months after operation

  10. Papillary muscle approximation to septum for functional tricuspid regurgitation.

    Science.gov (United States)

    Lohchab, Shamsher Singh; Chahal, Ashok Kumar; Agrawal, Nilesh

    2015-07-01

    Current techniques for repair of functional tricuspid regurgitation are associated with a significant degree of residual or recurrent regurgitation. We describe a technique of anterior papillary muscle attachment to the septum to correct residual tricuspid regurgitation persisting after annuloplasty. In our early experience in 15 patients (6 men and 9 women) with a mean age of 32 ± 11 years, who underwent annuloplasty for severe functional tricuspid regurgitation secondary to rheumatic mitral valve disease, this technique effectively eliminated residual tricuspid regurgitation.

  11. 'Hearts and bones': the ups and downs of 'plasticity' in stem cell biology.

    Science.gov (United States)

    Bonfanti, Paola; Barrandon, Yann; Cossu, Giulio

    2012-05-01

    More than a decade ago, 'plasticity' suddenly became a 'fashionable' topic with overemphasized implications for regenerative medicine. The concept of 'plasticity' is supported by old transplantation work, at least for embryonic cells, and metaplasia is a classic example of plasticity observed in patients. Nevertheless, the publication of a series of papers showing rare conversion of a given cell type into another unrelated cell raised the possibility of using any unaffected tissue to create at will new cells to replace a different failing tissue or organ. This resulted in disingenuous interpretations and a reason not to fund anymore research on embryonic stem cells (ESc). Moreover, many papers on plasticity were difficult to reproduce and thus questioned; raising issues about plasticity as a technical artefact or a consequence of rare spontaneous cells fusion. More recently, reprogramming adult differentiated cells to a pluripotent state (iPS) became possible, and later, one type of differentiated cell could be directly reprogrammed into another (e.g. fibroblasts into neurons) without reverting to pluripotency. Although the latter results from different and more robust experimental protocols, these phenomena also exemplify 'plasticity'. In this review, we want to place 'plasticity' in a historical perspective still taking into account ethical and political implications. Copyright © 2012 EMBO Molecular Medicine.

  12. Repair or Replacement for Isolated Tricuspid Valve Pathology? Insights from a Surgical Analysis on Long-Term Survival

    Science.gov (United States)

    Farag, Mina; Arif, Rawa; Sabashnikov, Anton; Zeriouh, Mohamed; Popov, Aron-Frederik; Ruhparwar, Arjang; Schmack, Bastian; Dohmen, Pascal M.; Szabó, Gábor; Karck, Matthias; Weymann, Alexander

    2017-01-01

    Background Long-term follow-up data concerning isolated tricuspid valve pathology after replacement or reconstruction is limited. Current American Heart Association guidelines equally recommend repair and replacement when surgical intervention is indicated. Our aim was to investigate and compare operative mortality and long-term survival in patients undergoing isolated tricuspid valve repair surgery versus replacement. Material/Methods Between 1995 and 2011, 109 consecutive patients underwent surgical correction of tricuspid valve pathology at our institution for varying structural pathologies. A total of 41 (37.6%) patients underwent tricuspid annuloplasty/repair (TAP) with or without ring implantation, while 68 (62.3%) patients received tricuspid valve replacement (TVR) of whom 36 (53%) were mechanical and 32 (47%) were biological prostheses. Results Early survival at 30 days after surgery was 97.6% in the TAP group and 91.1% in the TVR group. After 6 months, 89.1% in the TAP group and 87.8% in the TVR group were alive. In terms of long-term survival, there was no further mortality observed after one year post surgery in both groups (Log Rank p=0.919, Breslow p=0.834, Tarone-Ware p=0.880) in the Kaplan-Meier Survival analysis. The 1-, 5-, and 8-year survival rates were 85.8% for TAP and 87.8% for TVR group. Conclusions Surgical repair of the tricuspid valve does not show survival benefit when compared to replacement. Hence valve replacement should be considered generously in patients with reasonable suspicion that regurgitation after repair will reoccur. PMID:28236633

  13. Three-dimensional echocardiography of a tricuspid valve papillary fibroelastoma

    Directory of Open Access Journals (Sweden)

    Atooshe Rohani

    2017-01-01

    Full Text Available Papillary fibroelastomas (PFE on tricuspid valve (TV are rare, accounting for fewer than 11% of all PFE. Most often they are asymptomatic, and detect on mitral valve. We report a case of a typical chest pain found to be due to papillary fibroelastoma of the tricuspid valve.

  14. RNA expression profile of calcified bicuspid, tricuspid, and normal human aortic valves by RNA sequencing.

    Science.gov (United States)

    Guauque-Olarte, Sandra; Droit, Arnaud; Tremblay-Marchand, Joël; Gaudreault, Nathalie; Kalavrouziotis, Dimitri; Dagenais, Francois; Seidman, Jonathan G; Body, Simon C; Pibarot, Philippe; Mathieu, Patrick; Bossé, Yohan

    2016-10-01

    The molecular mechanisms leading to premature development of aortic valve stenosis (AS) in individuals with a bicuspid aortic valve are unknown. The objective of this study was to identify genes differentially expressed between calcified bicuspid aortic valves (BAVc) and tricuspid valves with (TAVc) and without (TAVn) AS using RNA sequencing (RNA-Seq). We collected 10 human BAVc and nine TAVc from men who underwent primary aortic valve replacement. Eight TAVn were obtained from men who underwent heart transplantation. mRNA levels were measured by RNA-Seq and compared between valve groups. Two genes were upregulated, and none were downregulated in BAVc compared with TAVc, suggesting a similar gene expression response to AS in individuals with bicuspid and tricuspid valves. There were 462 genes upregulated and 282 downregulated in BAVc compared with TAVn. In TAVc compared with TAVn, 329 genes were up- and 170 were downregulated. A total of 273 upregulated and 147 downregulated genes were concordantly altered between BAVc vs. TAVn and TAVc vs. TAVn, which represent 56 and 84% of significant genes in the first and second comparisons, respectively. This indicates that extra genes and pathways were altered in BAVc. Shared pathways between calcified (BAVc and TAVc) and normal (TAVn) aortic valves were also more extensively altered in BAVc. The top pathway enriched for genes differentially expressed in calcified compared with normal valves was fibrosis, which support the remodeling process as a therapeutic target. These findings are relevant to understand the molecular basis of AS in patients with bicuspid and tricuspid valves.

  15. Two- and Three-dimensional Transthoracic Echocardiographic Assessment of Tricuspid Valve Prolapse with Mid-to-Late Systolic Tricuspid Regurgitation.

    Science.gov (United States)

    Elsayed, Mahmoud; Thind, Munveer; Nanda, Navin C

    2015-06-01

    We present the two-dimensional echocardiographic findings of tricuspid valve prolapse with mid-to-late systolic tricuspid regurgitation and describe the incremental value provided by live/real time three-dimensional transthoracic echocardiography. We also discuss a potential pitfall when assessing the severity of regurgitation in this setting.

  16. Measuring isovolumic contraction peak velocity at the tricuspid annulus by Doppler tissue imaging to ;assess right heart function in patients with pulmonary hypertension%组织多普勒成像测量三尖瓣环等容收缩期峰值速度在评价肺高压患者右心功能中的应用

    Institute of Scientific and Technical Information of China (English)

    魏丽群; 李越; 王广义; 朱航; 王娟; 翟亚楠

    2014-01-01

    imaging. Methods In 41 patients with suspected diagnosis of PH, IVCv at the tricuspid annulus were measured by echocardiography and Doppler tissue imaging. The right heart systolic function parameters such as tricuspid annular plane systolic excursion (TAPSE), peak systolic velocity (PSv) and right ventricular fractional area change (RVFCA) were also measured. The pulmonary artery pressure was detected by right-heart catheterization (RHC). According to different levels of pulmonary arterial systolic pressure, patients were classiifed into four groups to compare and analyze if any signiifcance could be found, including without PH group, mild PH group, moderate PH group and severe PH group. The sensitivity and speciifcity for diagnosing right heart impairment were assessed by ROC curves. Last, correlation analysis was performed. Results IVCv was signiifcantly and positively correlated with the right heart systolic function parameters, such as TAPSE (r=0.557, P0.05). Using the lower limit of right ventricular systolic function parameter obtained by common echocardiographic assessment as standard (TAPSE<16 mm, PSv<10 cm/s and RVFAC<35%), the sensitivities of IVCv<6.5 cm/s for diagnosing right ventricular systolic function reduction were 91%, 96%and 87%and the speciifcities were 70%, 53%and 77%, respectively. Conclusions IVCv obtained by Doppler tissue imaging is a new objective parameter for diagnosing right ventricular systolic function reduction. It is worth further study and application in clinic.

  17. A novel approach to an anatomical adapted stent design for the percutaneous therapy of tricuspid valve diseases: preliminary experiences from an engineering point of view.

    Science.gov (United States)

    Pott, Desiree; Malasa, Margarita; Urban, Ute; Kütting, Maximilian; Safi, Yara; Roggenkamp, Jan; Steinseifer, Ulrich; Hatam, Nima; Autschbach, Rüdiger; Spillner, Jan; Amerini, Andrea

    2012-01-01

    Tricuspid valve regurgitation mostly occurs as result of dilation of the right ventricle, secondary to left heart valve diseases. Until recently, little attention has been given to the development of percutaneous therapeutic tools exclusively designed for tricuspid valve disease. A new approach to the interventional therapy of tricuspid regurgitation, in particular, the design of a conceptual new valve-bearing, self-expansible stent, is presented here. A three-dimensional computer model of a right porcine heart was developed to gain a realistic anatomical geometry. The new design consists of two tubular stent elements, one inside the superior vena cava and the other inside the tricuspid valve annulus after being eventually equipped with a biological valve prosthesis, which are connected by struts. Anchoring to the heart structure is provided primarily by the vena cava stent, strengthened by the struts. The stents are designed to be cut from a 10 mm tube and later expanded to their designated diameter. Simulation software analyzing the expansion process with respect to the intended geometrical design is used in an iterative process. A validation of the anatomical geometry and function of the stent design inside a silicone model within in vitro tests and a random porcine heart shows an accurate anatomical fitting.

  18. Tricuspid annulus: A spatial and temporal analysis

    Directory of Open Access Journals (Sweden)

    Ziyad O Knio

    2016-01-01

    Full Text Available Background: Traditional two-dimensional (2D echocardiographic evaluation of tricuspid annulus (TA dilation is based on single-frame measurements of the septolateral (S-L dimension. This may not represent either the axis or the extent of dynamism through the entire cardiac cycle. In this study, we used real-time 3D transesophageal echocardiography (TEE to analyze geometric changes in multiple axes of the TA throughout the cardiac cycle in patients without right ventricular abnormalities. Materials and Methods: R-wave-gated 3D TEE images of the TA were acquired in 39 patients undergoing cardiovascular surgery. The patients with abnormal right ventricular/tricuspid structure or function were excluded from the study. For each patient, eight points along the TA were traced in the 3D dataset and used to reconstruct the TA at four stages of the cardiac cycle (end- and mid-systole, end- and mid-diastole. Statistical analyses were applied to determine whether TA area, perimeter, axes, and planarity changed significantly over each stage of the cardiac cycle. Results: TA area (P = 0.012 and perimeter (P = 0.024 both changed significantly over the cardiac cycle. Of all the axes, only the posterolateral-anteroseptal demonstrated significant dynamism (P < 0.001. There was also a significant displacement in the vertical axis between the points and the regression plane in end-systole (P < 0.001, mid-diastole (P = 0.014, and mid-systole (P < 0.001. Conclusions: The TA demonstrates selective dynamism over the cardiac cycle, and its axis of maximal dynamism is different from the axis (S-L that is routinely measured with 2D TEE.

  19. [Asymptomatic myxoma of the tricuspid valve septal leaflet].

    Science.gov (United States)

    Jedliński, Ireneusz; Jamrozek-Jedlińska, Maria; Bugajski, Paweł; Kalawski, Ryszard; Poprawski, Kajetan; Słomczyński, Marek

    2012-01-01

    We presented a case of asymptomatic myxoma of the tricuspid valve septal leaflet. The tumour was diagnosed accidentally during rutine transthoracic echocardiography and confirmed by transesophageal echocardiography. It was resected and the septal leaflet repaired during surgery.

  20. First percutaneous Micra leadless pacemaker implantation and tricuspid valve repair with MitraClip NT for lead-associated severe tricuspid regurgitation.

    Science.gov (United States)

    Tang, Gilbert H L; Kaple, Ryan; Cohen, Martin; Dutta, Tanya; Undemir, Cenap; Ahmad, Hasan; Poniros, Angelica; Bennett, Joanne; Feng, Cheng; Lansman, Steven

    2017-02-03

    Pacemaker lead-associated severe tricuspid regurgitation (TR) can lead to right heart failure and poor prognosis. Surgery in these patients carries significant morbidities. We describe a successful treatment of symptomatic severe TR by leadless pacemaker implantation followed by tricuspid valve (TV) repair with the MitraClip NT. A 71-year-old frail female with poor functional status, chronic atrial fibrillation and permanent pacemaker implantation in 2012 presented with symptomatic moderate-severe mitral regurgitation (MR) and severe TR with the pacemaker lead as the culprit. She was deemed extreme risk for double valve surgery and, because of her pacemaker dependency, the decision was to stage her interventions first with transcatheter mitral repair, then laser lead extraction and leadless pacemaker implantation to free the TV from tethering, then TV repair. An obstructive LAD lesion was identified and treated during mitral repair with the MitraClip NT. The Micra leadless pacemaker implantation and subsequent TV repair with the MitraClip NT were successful and the patient's MR improved to mild and TR to moderate, respectively. We report here a first successful transcatheter strategy to treat lead-associated severe TR by leadless pacemaker and MitraClip. Removing the pacemaker lead relieved leaflet tethering and improved the reparability of the TV.

  1. Correlation between tricuspid annular plane systolic excursion and glomerular filtration rate in patients with acute decompensated heart failure%急性失代偿型心力衰竭患者三尖瓣收缩期位移与肾小球滤过率的关系

    Institute of Scientific and Technical Information of China (English)

    李邵琳; 张菲斐

    2016-01-01

    目的:探讨急性失代偿型心力衰竭患者三尖瓣收缩期位移(TAPSE)变化及其与肾小球滤过率的关系。方法选取慢性收缩性心力衰竭急性失代偿入院患者102例,经胸超声心动图检测TASPE、左室射血分数(LVEF)及肺动脉收缩压(PASP),静脉采血测定B型氨基端利钠肽原(NT- proBNP)、电解质、血尿素氮(BUN)及血肌酐,采用改良的MDRD方程计算肾小球滤过率(eGFR),将eGFR0.05)。在肾功能不全组中肾小球滤过率分别与TASPE、NT- proBNP、PASP、LVEF进行相关性分析,显示只有TASPE与肾小球滤过率呈显著相关(=0.62,%Objective To explore the change of tricuspid annular plane systolic excursion (TAPSE) and its corre-lation with glomerular filtration rate (GFR) in patients with acute decompensated heart failure (ADHF). Methods One hundred and two consecutive patients with acute decompensated heart failure and left ventricular ejection fraction (LVEF) below 50% on echocardiogram were enrolled. The value of TASPE, LVEF and pulmonary arterial systolic pressure (PASP) were measured by the transthoracic echocardiography. Blood test was conducted to determine NT-proBNP, electrolytes, BUN and creatinine. The estimated GFR (eGFR) was calculated on the basis of simplified Modification of Diet in Renal Disease (MDRD). According to the eGFR, the patients were divided into preserved re-nal function (PRF) group [eGFR≥60 ml/(min·1.73m2), =54] and renal dysfunction (RDSF) group [eGFR﹤60 ml/(min·1.73m2), = 48]. The echocardiographic parameters and serum indexes were compared between the two groups. The correlations between TASPE and echocardiographic parameters, serum indexes in the RDSF group were analyzed. Results TASPE in the PRF group [(16.4 ± 4.0) mm] was significantly lower than that in the RDSF group [(18.9 ± 3.8) mm, ﹤ 0.001], but no significant difference in NT-proBNP, PASP or LVEF was observed between the two groups ( ﹥ 0

  2. The Effects of Tricuspid De Vega Annuloplasty on Ventricular Functions in Patients with Mitral Valve Replacement and Concomitant Tricuspid Regurgitation

    Directory of Open Access Journals (Sweden)

    Sevinç Bayer Erdoğan

    2012-12-01

    Full Text Available Introduction: The aim of this study is to evaluate the long term results of de Vega annuloplasty on ventricular functions in patients undergoing mitral valve replacement due to mitral valve pathology and functional tricuspid regurgiatiton.Patients and Methods: Eighty six patients who underwent mitral valve replacement in our clinic, during January 2008-June 2008 were involved in the study. The patients were grouped into two according to the presence of tricuspid pathology and annuloplasty. The demographic data and 6th and 24th month echocardiographic follow up were recorded.Results: First group consisted of 49 patients with pure mitral valve replacement patients and second group consisted of 37 patients that had tricuspid annuloplasty with mitral valve replacement. The demographic data and follow up echocardiographic results were compared. The statistical analysis showed that the patients with tricuspid regurgitation and recieved an annuloplasty had similiar ventricular functions with those who had pure mitral replacement. More significantly, in patients who recieved an annuloplasty with preoperative high pulmonary artery pressure and central venous pressure and bigger right atrial diameter, the ventricular findings in follow up were similiar with the pure mitral valve pathology.Conclusion: Tricuspid de vega annuloplasty is effective in functional tricuspid valve regurgitation. Long term follow up showed that ventricular findings were similiar with those who had only pure mitral pathology and mimimal regurgitation. Preoperative ejection fraction and grade of regurgiatiton is important in the decision making to perform annuloplasty.

  3. Evaluation of near and mid term effect of tricuspid annuloplasty ring on tricuspid regurgitation%三尖瓣成形环治疗功能性三尖瓣反流的近中期效果评价

    Institute of Scientific and Technical Information of China (English)

    王其逊; 刘锦屏; 孙炜琪; 薛昊

    2015-01-01

    目的:探讨三尖瓣成形环在治疗功能性三尖瓣关闭不全手术中使用的指征和近中期效果。方法选择连云港市第一人民医院2010年3月至2012年3月收治的120例患者,根据术前心脏彩超检查提示左心系统瓣膜病合并三尖瓣轻、中度反流分两组,每组60例。第一组在施行左心瓣膜置换同时行 KAYS 成形、Devega 成形术;第二组在行左心瓣膜置换同时使用三尖瓣成形环进行三尖瓣成形。结果术后所有患者完成随访3年,进行心脏彩超复诊观察三尖瓣反流情况。第一组其中有12例患者三尖瓣反流程度呈中度及以上反流;第二组:使用三尖瓣软环进行三尖瓣成形,结果有3例三尖瓣反流情况达到中度及甚至以上反流,两者相比反流比率差异有统计学意义( P <0.05)。结论手术治疗功能性三尖瓣反流对于中度以上反流的患者应更积极采用成形环,尤其是三尖瓣瓣环扩大者。%Objective To evaluate the short and mid term effect of tricuspid annuloplasty ring on tricuspid regurgitation. Methods A total of 120 patients from March 2010 to March 2012 in the First People’s Hospital of Lianyungang were divided in-to two groups which based on the results of cardiac color ultrasoud,each group included 60 patients. Group 1 underwent Kays or Devega procedure operation method,at the same time when coped with the left heart valve disease;group 2 used the Tricuspid annuloplasty ring when done the left heart valve diseases. Results The 3 years’followed-up results showed that 12 patients had medium tricuspid regurgitation 3 years after operation in group 1;3 patients had medium tricuspid regurgitation in group 2. The difference was significant. Conclusion In the treatment of functional tricuspid regurgitation,tricuspid annuloplasty ring should be used more positively in moderate or severe tricuspid reguargitation,especially in the patients with large tricuspid annular.

  4. Redoing a bioprosthetic tricuspid valve replacement with pacemaker wire through the ruined bioprosthetic valve orifice

    Institute of Scientific and Technical Information of China (English)

    GUO Hong-wei; PAN Shi-wei; SONG Yun-hu; HU Sheng-shou

    2011-01-01

    Severe tricuspid regurgitation with permanent pacemaker wire passing through the orifice of bioprosthetic tricuspid valve is extremely rare. We present a case of such kind of patient and redid bioprosthetic tricuspid valve replacement. A hawk mouth forceps for bone surgery was used to cut off the mental ring of ruined bioprosthetic tricuspid valve and the ruined valve was removed. A new bioprosthetic tricuspid valve was implanted and the wire of permanent pacemaker was left outside the ring of bioprosthetic tricuspid valve. This method may be helpful for such kind of patient.

  5. Tricuspid regurgitation in screening for trisomies 21, 18 and 13 and Turner syndrome at 11+0 to 13+6 weeks of gestation.

    Science.gov (United States)

    Kagan, K O; Valencia, C; Livanos, P; Wright, D; Nicolaides, K H

    2009-01-01

    To investigate the performance of first-trimester screening for aneuploidies by including assessment of tricuspid blood flow in the combined test of maternal age, fetal nuchal translucency (NT) thickness, fetal heart rate (FHR) and serum free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein A (PAPP-A). Screening by the combined test was performed in singleton pregnancies, including 19 614 with chromosomally normal fetuses or the delivery of a phenotypically normal baby (euploid group), 122 with trisomy 21, 36 with trisomy 18, 20 with trisomy 13 and eight with Turner syndrome. In all cases tricuspid flow was assessed to determine if there was tricuspid regurgitation. We examined the performance of two screening strategies: firstly, assessment of tricuspid flow in all patients and secondly, first-stage screening using the combined test in all patients followed by second-stage assessment of tricuspid flow only in those with an intermediate risk of 1 in 51 to 1 in 1000 after the first stage. Tricuspid regurgitation was observed in 0.9% of the euploid fetuses and 55.7%, 33.3% and 30% of the fetuses with trisomies 21, 18 and 13, respectively, and in 37.5% of those with Turner syndrome. In a screening policy based on maternal age, fetal NT, FHR, serum free beta-hCG and PAPP-A, for a fixed false positive rate of 3% the standardized detection rates were 91% for trisomy 21 and 100% for trisomy 18, trisomy 13 and Turner syndrome. Assessment of tricuspid flow in all pregnancies would increase the detection rate of trisomy 21 to 96%, and the detection rates of trisomy 18, trisomy 13 and Turner syndrome would be 92%, 100% and 100%, respectively. The same detection rates were achieved with the two-stage strategy-in which it was necessary to assess tricuspid flow in only 15% of the total population-at a false positive rate of 2.4%. Assessment of tricuspid flow improves the performance of first-trimester screening for trisomy 21. Copyright (c

  6. Progress In Surgieal Treatment of Secondary Tricuspid Insuffieieney%继发性三尖瓣关闭不全的外科治疗进展

    Institute of Scientific and Technical Information of China (English)

    潘世伟

    2012-01-01

    继发于左心系统瓣膜病变的三尖瓣关闭不全,多为三尖瓣瓣环扩大导致的功能性三尖瓣关闭不全,也有少数患者同时合并三尖瓣风湿性等器质性改变.对三尖瓣反流的处理,目前主张如果能通过瓣膜成形方法恢复三尖瓣瓣膜功能,应尽量行三尖瓣成形手术.三尖瓣成形方法主要包括线性成形和人工瓣环成形技术,但目前各种手术成形方法的适应证选择和临床应用尚无统一的标准,多年来一直是困扰心脏外科医师的难题和研究热点,是否需要同期行三尖瓣成形术,采用什么成形方法才能达到最佳的三尖瓣成形效果.因此,对继发性三尖瓣关闭不全患者三尖瓣病变程度的判定、矫治标准及手术方法等进行综述.%Tricuspid insufficiency founded in the setting of left-sided heart disease is usually secondary bicuspid insufficiency caused by tricuspid valve annular dilation. Some patients had rheumatic tricuspid valve diseases. Tricuspid valve repair rather than valve replacement is recommend for functional tricuspid regurgitation. Linear annuloplasty and ring annuloplasty are two main tricuspid valve repair methods. However, the indications for treatment of secondary tricuspid regurgitatioa remain controversial. The optimal surgical repair technique to eliminate secondary tricuspid regurgilation remains challenging. In this article, we review the assessment of tncuspid valve lesions, criteria for correction, and surgical management of secondary tricuspid insufficiency.

  7. Tricuspid Valve Replacement, Mechnical vs. Biological Valve, Which Is Better?

    Directory of Open Access Journals (Sweden)

    Haitham Akram Altaani

    2013-06-01

    Full Text Available Background: The initial trial in tricuspid surgery is repair; however, replacement is done whenever the valve is badly diseased. Tricuspid valve replacement comprises 1.7% of all tricuspid valve surgeries. Materials and Methods: The present retrospective study was performed using the medical records of 21 cases who underwent tricuspid valve replacement from January 2002 until the end of December 2010. The mean age of the participants was 52.3±8.8 years and 66.7% were females. In addition, tricuspid valve replacement was associated with mitral valve surgery, aortic valve surgery, and both in 14.3%, 4.8%, and 33.3% of the cases, respectively. Yet, isolated tricuspid valve replacement and redo surgery were performed in 10 cases (47.6% and 8 cases (38.1%, respectively. Besides, trial of repair was done in 14 cases (66.7%. Moreover, biological and mechanical valves were used in 76.2% and 23.8% of the patients, respectively. Results: According to the results, early mortality was 23.8% and one year survival was 66.7%. Moreover, early mortality was caused by right ventricular failure, multiorgan failure, medistinitis, and intracerbral bleeding in 42%, 28.6%, 14.3%, and 14.3% of the cases, respectively. In addition, 57.1% of the deaths had occurred in the cases where the biological valve was used, while 42.9% of the deaths had taken place where the mechanical one was utilized. Conclusions: The patients who require tricuspid valve replacement are usually high risk surgical candidates with early and long term mortality. The findings of the current study showed no significant hemodynamic difference between mechanical and biological valves.

  8. Plasticity of heart rate signalling and complexity with exercise training in obese individuals with and without type 2 diabetes.

    Science.gov (United States)

    Kanaley, J A; Goulopoulou, S; Franklin, R M; Baynard, T; Holmstrup, M E; Carhart, R; Weinstock, R S; Fernhall, B

    2009-10-01

    To examine the responsiveness of cardiac autonomic function and baroreflex sensitivity (BRS) to exercise training in obese individuals without (OB) and with type 2 diabetes (ObT2D). Subjects were tested in the supine position and in response to a sympathetic challenge before and after a 16-week aerobic training program. All testing was conducted in the morning following a 12-h fast. A total of 34 OB and 22 ObT2D men and women (40-60 years of age) were studied. Heart rate variability (HRV) was measured at rest via continuous ECG (spectral analysis with the autoregressive approach) and in response to upright tilt. The dynamics of heart rate complexity were analyzed with sample entropy and Lempel-Ziv entropy, and BRS was determined via the sequence technique. Subjects were aerobically trained 4 times per week for 30-45 min for 16 weeks. Resting HR decreased and total power (lnTP, ms(2)) of HRV increased in response to exercise training (Pchanges occurred in ln low frequency/HF power with training. Upright tilt decreased lnTP and lnHF and increased LF/HF (Pchanges nor were they altered with training in either group. Tilt also decreased complexity (sample entropy and Lempel-Ziv entropy; Pchange with training. Compared to OB subjects the ObT2D had less tilt-induced changes in BRS. Exercise training improved HRV and parasympathetic modulation (lnHF) in OB subjects but not in ObT2D, indicating plasticity in the autonomic nervous system in response to this weight-neutral exercise program only in the absence of diabetes. HR complexity and BRS were not altered by 16 weeks of training in either OB or ObT2D individuals.

  9. Pulmonary Atresia with Intact Ventricular Septum and Absence of Tricuspid Valve. A Report of Four Cases

    Directory of Open Access Journals (Sweden)

    Adel E. González Morejón

    2013-12-01

    Full Text Available Pulmonary atresia with intact ventricular septum suggests a simple congenital heart malformation. However, nothing could be further from the truth. Among the morphological peculiarities of this condition, the presence of congenitally unguarded tricuspid valve orifice is rarely observed. The present paper aims at describing a series of four patients with both malformations detected in the William Soler Children’s Heart Center from 1986 through 2012. Echocardiographic diagnosis could be accurately performed in the last two patients; identification of the initial cases was established by the findings at necropsy. All patients underwent Blalock – Taussig shunt as initial palliative treatment, which was associated with balloon atrioseptostomy in two cases. Only one of the last children mentioned survived. Vital prognosis of patients suffering from this association of malformations lies in early echocardiographic detection.

  10. Surgical indication for functional tricuspid regurgitation at initial operation: judging from long term outcomes.

    Science.gov (United States)

    Pozzoli, Alberto; Elisabetta, Lapenna; Vicentini, Luca; Alfieri, Ottavio; De Bonis, Michele

    2016-09-01

    The assessment and management of tricuspid valve disease have evolved substantially during the past several years. Whereas tricuspid stenosis is uncommon, tricuspid regurgitation is frequently encountered and it is most often secondary due to annular dilatation and leaflet tethering from right ventricular remodelling. The indications for tricuspid valve surgery to treat tricuspid regurgitation are several and mainly related to the underlying disease, to the severity of insufficiency and to the right ventricular function. Surgical tricuspid repair has been avoided for years, because of the misleading concept that tricuspid regurgitation should disappear once the primary left-sided problem has been eliminated. Instead, during the last decade, many investigators have reported evidence in favor of a more aggressive surgical approach to functional tricuspid regurgitation, recognising the risk of progressive tricuspid insufficiency in patients with moderate or lesser degrees of tricuspid regurgitation and tricuspid annular dilatation. This concept, along with the long-term outcomes of principal surgical repair techniques are reported and discussed. Last, novel transcatheter therapies have begun to emerge for the treatment of severe tricuspid regurgitation in high-risk patients. Hence, very preliminary pre-clinical and clinical experiences are illustrated. The scope of this review is to explore the anatomic basis, the pathophysiology, the outcomes and the new insights in the management of functional tricuspid regurgitation.

  11. Transvenous right ventricular pacing in a patient with tricuspid mechanical prosthesis

    Directory of Open Access Journals (Sweden)

    Rubio José

    2008-07-01

    Full Text Available Abstract We report a patient in whom permanent endocardial pacing was accomplished by passage of the electrode through a mechanical tricuspid valve. Echocardiography study showed a minimal tricuspid regurgitation.

  12. Functional tricuspid regurgitation in mitral valve disease: epidemiology and prognostic implications.

    Science.gov (United States)

    Anyanwu, Ani C; Adams, David H

    2010-01-01

    In this review we summarize the data on epidemiology and natural history of functional tricuspid valve regurgitation as it applies to surgery for mitral valve disease. Tricuspid regurgitation in the context of mitral valve disease is frequent and is associated with substantial reduction in survival and quality of life. In many patients, the correction of left-sided cardiac lesions does not lead to resolution of tricuspid regurgitation. Significant tricuspid regurgitation after mitral valve surgery portends a poor prognosis, a course that is often not altered by subsequent surgical therapy. Although a liberal approach to tricuspid annuloplasty is widely practiced, the evidence that this approach alters the natural history of functional tricuspid regurgitation is not yet available, so it is not certain how much of the negative impact of tricuspid regurgitation is causative, rather than confounding, and to what degree we will improve long-term outcomes of mitral valve surgery by liberal tricuspid annuloplasty.

  13. Post-Traumatic Chordae Rupture of Tricuspid Valve

    Directory of Open Access Journals (Sweden)

    Kyomars Abbasi

    2015-10-01

    Full Text Available Blunt injury to the chest can affect any one or all components of the chest wall and thoracic cavity. The clinical presentation of patients with blunt chest trauma varies widely and ranges from minor reports of pain to florid shock. Traumatic tricuspid valve regurgitation is a rare cardiovascular complication of blunt chest trauma. Tricuspid valve regurgitation is usually begotten by disorders that cause the right ventricle to enlarge. Diagnosis is made by physical examination findings and is confirmed by echocardiography. We report two cases of severe tricuspid regurgitation secondary to the rupture of the chordae tendineae of the anterior leaflet following non-penetrating chest trauma. Both patients had uneventful postoperative courses.

  14. The changing 'face' of endocarditis in Kentucky: an increase in tricuspid cases.

    Science.gov (United States)

    Seratnahaei, Arash; Leung, Steve W; Charnigo, Richard J; Cummings, Matthew S; Sorrell, Vincent L; Smith, Mikel D

    2014-08-01

    Advancements in medical technology and increased life expectancy have been described as contributing to the evolution of endocarditis. We sought to determine whether there has been a change in the incidence, demographics, microbiology, complications, and outcomes of infective endocarditis over a 10-year time span. We screened 28,420 transthoracic and transesophageal echocardiogram reports performed at the Gill Heart Institute for the following indications: fever, masses, emboli (including stroke), sepsis, bacteremia, and endocarditis in 2 time periods: 1999 to 2000 and 2009 to 2010. Data were collected from diagnosed endocarditis cases. Overall, 143 cases of infective endocarditis were analyzed (48 in 1999-2000 and 95 in 2009-2010). The endocarditis incidence per number of admissions remained nearly constant at 0.113% for 1999-2000 and 0.148% for 2009-2010 (P = .153). However, tricuspid valve involvement increased markedly from 6% to 36% (P endocarditis at the University of Kentucky Medical Center has not changed and mortality remains high, but the "face of endocarditis" in Kentucky has evolved with an increased incidence of tricuspid valve involvement, valvular complications, and embolic events. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Evaluation of Tricuspid Valvuloplasty with Mitral Valve Replacement in severely ill patients

    Directory of Open Access Journals (Sweden)

    H. MOBARHAN

    1975-06-01

    Full Text Available A group or twenty ca ses or class IV or New York Hearl Assiciation Classification is reported. T hey were selected among 55 ca ses of mitral valve'10 :; JJj'[ ' ~ J i l l ; J "J( ff1 Ii rll l'li %J1 %:J '/J ; ~1 ?idJ bru: b:;ib -: Jr I'Ji lJ;q :J':.nrlT . JrI'JrrJ'J'Jlil q ':,f[ /Jw[ ' ~ I ;': J ; l q o I I J'l [ I i'1 biq% lJ :Ji•IT x l'; r1 Jo'lo lJ;r!J rlJ i 1/ ;-lm o f[;'-'JTIO' rbid'll "II (, I 10 be car ried out in seven cases. In lWO cases. reported in detail. two commissurcs and ring had to be repaired. The nature of pathology was organic and fu nctional while in the rcmaininu-live cases it was onl.v functional. None or the cases required tricuspid valve replacement. Wc believe that tricuspid va lvuloplasty has a n importa nt position in heart surgery and should not be underestimated . Also. we conclude that no patient should be denied 0PCI1"tion on the basis or the severity or his d isease unless ad vanced co ronal' di sease or primary myocardiac d isease arc also in volved.

  16. Tricuspid regurgitation: noninvasive techniques for determining causes and severity.

    Science.gov (United States)

    DePace, N L; Ross, J; Iskandrian, A S; Nestico, P F; Kotler, M N; Mintz, G S; Segal, B L; Hakki, A H; Morganroth, J

    1984-06-01

    Tricuspid regurgitation is often not apparent on physical examination and several methods are now available to aid in this difficult assessment. Cardiac catheterization using right ventriculography, previously considered the diagnostic standard, has several limitations. Currently available noninvasive tools such as M-mode and two-dimensional echocardiography (with or without contrast), Doppler techniques and even radionuclide cardiologic imaging have added significantly to the precise assessment of the presence and severity of tricuspid regurgitation. This review examines the comparative use and limitations of these various techniques.

  17. Nonsurgical management of a tricuspid valvular pedunculated papillary fibroelastoma

    Directory of Open Access Journals (Sweden)

    Yang Tae-Hyun

    2009-09-01

    Full Text Available Abstract A 25-year-old woman with a history of kidney transplantation for lupus nephritis was referred for the evaluation and management of a mass incidentally found on echocardiography. An oval and pedunculated mass attached to the tricuspid valve was managed with nonsurgical treatment. No symptoms and complications attributable to the mass developed. Three years later, the size of the mass decreased. Here we report the case of a probable cardiac papillary fibroelastoma (PFE, a mobile mass, with a stalk on the septal leaflet of the tricuspid valve that was managed for three years without surgical treatment.

  18. Morphology of tricuspid valve in pulmonary atresia with intact ventricular septum.

    Science.gov (United States)

    Choi, Y H; Seo, J W; Choi, J Y; Yun, Y S; Kim, S H; Lee, H J

    1998-01-01

    Pulmonary atresia with intact ventricular septum (PAIVS) is a rare congenital cardiac anomaly that has been classified into two types: one is a more frequent type having dysplasia of tricuspid valve (TV) with a small annulus, underdeveloped right ventricle (RV) with a hypoplastic cavity and a hypertrophic wall; the other type has severe dysplasia of TV and dilatation of RV, right atrium (RA), and right atrioventricular junction with thinning of the RV wall. We performed a morphologic study on 11 autopsied hearts with PAIVS, giving particular emphasis to the variation of morphology of the TV. We could classify these hearts into 3 groups according to the degree of right ventricular development. In the first group of 7 cases (type I), the RVs were underdeveloped. Thick leaflets, restricted valve apparatus with short chordae, and small annuli were characteristics of the TV. In the second group of 3 cases (type II), the RVs showed marked enlargement of the cavity and thinning of the wall. The TV showed redundant, dysplastic, sail-like anterior leaflets, and the downward displacement of septal leaflet and/or posterior leaflet, which are the findings frequently observed in Ebstein's malformation. The RVs were dilated and with partially unguarded tricuspid orifice. The septal leaflet of the TV was dysplastic and, in two cases, the septal leaflet showed chordal structure at the upper surface facing the RA, which is a peculiar finding that has not been described in the literature. The remaining case was a heart with a moderately developed RV (type III). The TV showed mildly dysplastic appearance and we classify this as a separate type, because we could expect the best surgical results in this type. This type had optimal size of RV and the mildest degree of dysplasia of TV. In PAIVS, the morphology of TV correlates well with the type of the right ventricular development.

  19. Imaging diagnosis of right ventricular infarction and tricuspid regurgitation by radionuclide first pass method

    Energy Technology Data Exchange (ETDEWEB)

    Koito, Hitoshi; Iwasaka, Toshiji; Yoshioka, Hiroshi (Kansai Medical School, Moriguchi, Osaka (Japan))

    1983-07-01

    Radionuclide first pass findings of right ventricular infarction and tricuspid regurgitation are reported. Findings of right ventricular infarction are reduced wall motion and regional ejection fraction in the right ventricular inferior wall. Tricuspid regurgitation is suggested when the dilatation of right atrium and right ventricle are seen with regurgitant RI images through tricuspid valve. We can get regurgitant fraction from time-activity curve. Dynamic images are also useful for assessing quality of right ventricular infarction and tricuspid regurgitation. We conclude that radionuclide first pass method is useful to diagnose right ventricular infarction and to quantify tricuspid regurgitation.

  20. Ruptured chordae tendineae of the posterior leaflet of the tricuspid valve as a cause of tricuspid regurgitation following blunt chest trauma.

    Science.gov (United States)

    dos Santos, J; de Marchi, C H; Bestetti, R B; Corbucci, H A; Pavarino, P R

    2001-01-01

    A 12-year-old boy suffered a blunt chest trauma. Some hours later, a pulsatile bilateral jugular venous distension, a holosystolic murmur heard at the low parasternal border and hepatomegaly were observed. On echocardiography, ruptured chordae tendineae of the posterior leaflet of the tricuspid valve, as well as tricuspid regurgitation were detected. He remained asymptomatic during hospital stay and was discharged home in good condition. Thus, isolated ruptured chordae tendineae of the posterior leaflet of the tricuspid valve is another cause of tricuspid regurgitation following blunt chest trauma.

  1. Transesophageal echocardiography evaluation of tricuspid and pulmonic valves

    Directory of Open Access Journals (Sweden)

    Aneeta Bhatia

    2016-01-01

    Full Text Available The tricuspid is the lost valve and the pulmonary being the most anterior, is not visualized well on TEE; The Pulmonary valve is a semilunar valve that separates the right ventricle from the pulmonary artery. It is situated anterior and superior to the aortic valve, almost at right angle to the aortic valve and parallel to the beam of the ultrasound.

  2. 'Crescent Sign': Phase abnormality in radionuclide multigated study in tricuspid regurge: Description and clinical evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Ziada, G.; Abdel-Dayem, H.M.; Shafy, M.Z.; Constantinides, C.; Yousif, A.M.; Nair, N.

    1987-08-01

    A phase abnormality in radionuclide multigated studies (MUGA) in patients with tricuspid regurge (TR) is being described. In this condition of TR, as the right ventricle contracts, if causes the blood to regurge through the tricuspid valve to the right atrium and through the inferior Vena cava and hepatic veins to the adjacent liver tissue. As a result the right atrium and the liver will be in the same delayed phase forming a Crescent to the right side of the heart representing the right atrium and extending below the heart into the region of the liver. This Crescent has been graded according to how far it is extending in the liver and below the heart. In 15 patients with cardiac cath finding of TR (done within 2-3 days of the MUGA study), the phase displays of the radionuclide MUGA studies were analysed in order to find out the sensitivity of the Crescent Sign in the detection of TR and whether there is a relationship between the grade of the Crescent and the severity of the regurgitation. The Crescent was found in 13 of the 15 patients (sensitivity = 87%). We have not found a correlation between the severity of TR and the grade of the Crescent. We conclude that the presence of the Crescent Sign in phase display of the MUGA study should direct the attention of the clinician towards the recognition of TR, a condition which is sometimes difficult to diagnose non-invasively.

  3. Tricuspid valve mycetoma in an infant successfully treated by excision and complex tricuspid valve repair followed by fluconazole therapy.

    Science.gov (United States)

    Anil Kumar, V; Francis, Edwin; Sreehari, Sreekala; Raj, Benedict

    2014-04-01

    Fungal valve endocarditis in children is an uncommon and lethal disease. The risk increases with use of central venous catheters (CVC), total parenteral nutrition (TPN), and use of broad-spectrum antibiotics during the neonatal period. Due to high mortality, a combination of surgery and antifungal therapy is usually recommended for treatment. Case report and review of the literature. We present a case of an asymptomatic infant with multiple Candida tricuspid valve mycetomas. Complete cure was achieved by combined tricuspid valve repair and fluconazole therapy. We also review 26 cases of tricuspid valve Candida endocarditis in children published in the literature. From being uniformly fatal five decades ago to a current survival rate of 64% to 100%, the prognosis of Candida endocarditis has changed dramatically with the use of antifungal therapy alone or in combination with surgery. Our case re-emphasizes the role of valve-sparing debridement with repair of the native valve using autologous pericardium in combination with long-term antifungal therapy as a feasible option in managing tricuspid valve Candida endocarditis.

  4. De Vega annuloplasty for functional tricupsid regurgitation: concept of tricuspid valve orifice index to optimize tricuspid valve annular reduction.

    Science.gov (United States)

    Hwang, Ho Young; Chang, Hyoung Woo; Jeong, Dong Seop; Ahn, Hyuk

    2013-12-01

    We evaluated long-term results of De Vega annuloplasty measured by cylindrical sizers for functional tricuspid regurgitation (FTR) and analyzed the impact of measured annular size on the late recurrence of tricuspid valve regurgitation. Between 2001 and 2011, 177 patients (57.9±10.5 yr) underwent De Vega annuloplasty for FTR. Three cylindrical sizers (actual diameters of 29.5, 31.5, and 33.5 mm) were used to reproducibly reduce the tricuspid annulus. Long-term outcomes were evaluated and risk factor analyses for the recurrence of FTR ≥3+ were performed. Measured annular diameter indexed by patient's body surface area was included in the analyses as a possible risk factor. Operative mortality occurred in 8 patients (4.5%). Ten-year overall and cardiac death-free survivals were 80.5% and 90.8%, respectively. Five and 10-yr freedom rates from recurrent FTR were 96.5% and 93.1%, respectively. Cox proportional hazard model revealed that higher indexed annular size was the only risk factor for the recurrence of FTR (P=0.006). A minimal P value approach demonstrated that indexed annular diameter of 22.5 mm/m(2) was a cut-off value predicting the recurrence of FTR. De Vega annuloplasty for FTR results in low rates of recurrent FTR in the long-term. Tricuspid annulus should be reduced appropriately considering patients' body size to prevent recurrent FTR.

  5. Ascending aortic wall cohesion: comparison of bicuspid and tricuspid valves.

    Science.gov (United States)

    Benedik, Jaroslav; Pilarczyk, Kevin; Wendt, Daniel; Indruch, Jiri; Flek, Radek; Tsagakis, Konstantinos; Alaeddine, Savvas; Jakob, Heinz

    2012-01-01

    Objectives. Bicuspid aortic valve (AV) represents the most common form of congenital AV malformation, which is frequently associated with pathologies of the ascending aorta. We compared the mechanical properties of the aortic wall between patients with bicuspid and tricuspid AV using a new custom-made device mimicking transversal aortic wall shear stress. Methods. Between 03/2010 and 07/2011, 190 consecutive patients undergoing open aortic valve replacement at our institution were prospectively enrolled, presenting either with a bicuspid (group 1, n = 44) or a tricuspid (group 2, n = 146) AV. Aortic wall specimen were examined with the "dissectometer" resulting in nine specific aortic-wall parameters derived from tensile strength curves (TSC). Results. Patients with a bicuspid AV showed significantly more calcified valves (43.2% versus 15.8%, P group (P = 0.003, P = 0.02, P = 0.01). We found no difference in the aortic wall cohesion between both groups as revealed by shear stress testing (P = 0.72, P = 0.40, P = 0.41). Conclusion. We observed no differences of TSC in patients presenting with tricuspid or bicuspid AVs. These results may allow us to assume that the morphology of the AV and the pathology of the ascending aorta are independent.

  6. Evaluation of Tricuspid Valvuloplasty with Mitral Valve Replacement in severely ill patients

    Directory of Open Access Journals (Sweden)

    H. MOBARHAN

    1975-01-01

    Full Text Available A group or twenty ca ses or class IV or New York Hearl Assiciation Classification is reported. T hey were selected among 55 ca ses of mitral valve'10 :; JJj'[ ' ~ J i l l ; J "J( ff1 Ii rll l'li %J1 %:J '/J ; ~1 ?idJ bru: b:;ib -: Jr I'Ji lJ;q :J':.nrlT . JrI'JrrJ'J'Jlil q ':,f[ /Jw[ ' ~ I ;': J ; l q o I I J'l [ I i'1 biq% lJ :Ji•IT x l'; r1 Jo'lo lJ;r!J rlJ i 1/ ;-lm o f[;'-'JTIO' rbid'll "II (, I 10 be car ried out in seven cases. In lWO cases. reported in detail. two commissurcs and ring had to be repaired. The nature of pathology was organic and fu nctional while in the rcmaininu-live cases it was onl.v functional. None or the cases required tricuspid valve replacement. Wc believe that tricuspid va lvuloplasty has a n importa nt position in heart surgery and should not be underestimated . Also. we conclude that no patient should be denied 0PCI1 ion on the basis or the severity or his d isease unless ad vanced co ronal' di sease or primary myocardiac d isease arc also in volved.

  7. M型超声心动图测量中晚孕正常胎儿三尖瓣环位移评价胎儿右心室功能%Tricuspid annular plane systolic excursion in evaluation of right heart systolic function of fetuses in second and late trimester with conventional M-mode and free angle M-mode echocardiography

    Institute of Scientific and Technical Information of China (English)

    郭显峰; 赵博文; 邱俊芬; 王蓓; 彭晓慧; 潘美

    2015-01-01

    Objective To evaluate the usefulness of free angle M-mode echocardiography (FAM) in obtaining tricuspid annular plane systolic excursion (TAPSE) for assessing the fetal right ventricular function,and to compare the results of measurements of TAPSE by conventional M-mode(CM) and FAM.Methods Two hundred and forty-three normal fetuses in second and late trimester were divided into 5 groups by gestational age(GA):20-24 weeks,24+1-28 weeks,28+1-32 weeks,32+1-36 weeks,36+1-40 weeks.The TAPSE were measured by CM and FAM echocardiography,meanwhile multiple parameters for evaluating right ventricular function were obtained by using myocardial tissue Doppler imaging (TDI),and the correlation between TAPSE and other parameters were analyzed by linear correlation.ANOVA was used to compare CM-TAPSE,FAM-TAPSE,Em,Sm and right ventricular fractional shortening(RVFS)with different GA.Regression equation estimate was used to compare the relationship of FAM-TAPSE with GA.Independent sample t test was used to compare CM TAPSE with FAM TAPSE.Results There were significant differences in CM-TAPSE,FAM-TAPSE,Em,and Sm among 5 groups (P =0.000),the measured value of FAM-TAPSE was higher than that of CM TAPSE (P =0.000).Both FAM-TPASE and CM-TAPSE showed significant positive correlations with GA,Em and Sm,but FAM TAPSE demonstrated better correlation than CM-TAPSE.Conclusions By adjusting sample line of FAM,measuring the maximum displacement of tricuspid annular plane is feasible,and FAM may evaluate fetal right ventricular function more accurately and effectively.%目的 应用解剖M型超声心动图(free angle M-mode,FAM)测量不同孕周胎儿三尖瓣环运动位移(tricuspid annular plane systolic excursion,TAPSE),探讨其评估右室功能的有效性并建立测值参考范围.方法 选取243例胎儿,根据不同孕周分成5组:20~24周,24+1~28周,28+1~32周,32+1~36周,36+1~40周,分别应用普通M型超声心动图(conventional M-mode,CM)及FAM测量胎儿TAPSE,

  8. Permanent pacemaker lead induced severe tricuspid regurgitation in patient undergoing multiple valve surgery.

    Science.gov (United States)

    Lee, Jung Hee; Kim, Tae Ho; Kim, Wook Sung

    2015-04-01

    Severe and permanent tricuspid regurgitation induced by pacemaker leads is rarely reported in the literature. The mechanism of pacemaker-induced tricuspid regurgitation has been identified, but its management has not been well established. Furthermore, debate still exists regarding the proper surgical approach. We present the case of a patient with severe tricuspid regurgitation induced by a pacemaker lead, accompanied by triple valve disease. The patient underwent double valve replacement and tricuspid valve repair without removal of the pre-existing pacemaker lead. The operation was successful and the surgical procedure is discussed in detail.

  9. Multimodal imaging of the tricuspid valve: normal appearance and pathological entities

    Directory of Open Access Journals (Sweden)

    Soham Shah

    2016-06-01

    Full Text Available Abstract The tricuspid valve, which is the atrioventricular valve attached to the morphological right ventricle, is affected by a wide range of pathological processes. Tricuspid valve diseases are now increasingly recognized as a significant cause of morbidity and mortality. Echocardiography is the most widely available and, hence, the first-line imaging modality used in the evaluation of tricuspid valve disorders; however, CT and MRI are also increasingly used for further evaluation and characterization of these entities. In this article, we first review the normal anatomy and embryology of the tricuspid valve, followed by a discussion of the role of multiple imaging modalities in the evaluation of tricuspid valve abnormalities. We then review and illustrate the imaging appearance of several congenital and acquired tricuspid valve abnormalities. Main Messages • Tricuspid valve diseases have a significant impact on morbidity and mortality. • CT and MRI are increasingly used in the evaluation of tricuspid disorders. • CT and MRI help in diagnosis, functional evaluation, pre-surgical planning and post-surgical follow-up. • The most common cause of tricuspid regurgitation is functional.

  10. [Easy and reproducible technique to address tricuspid valve regurgitation with patch augmentation.

    Science.gov (United States)

    Solinas, Marco; Bianchi, Giacomo; Glauber, Mattia

    2013-11-01

    We describe a patch augmentation of the anterior leaflet of the tricuspid valve to address tricuspid valve regurgitation due to leaflet retraction. The area of the anterior leaflet is measured using a tricuspid valve annuloplasty sizer; a glutaraldehyde-fixed autologous pericardial patch is trimmed with slight 5 mm oversize. The anterior leaflet is detached and the patch is sutured with three 5/0 running interlocked sutures, then an annuloplasty is performed with an undersized ring. This technique offers an easy and reproducible tool to address tricuspid regurgitation due to lack of leaflet coaptation.

  11. Ratio of early diastolic tricuspid inflow to tricuspid lateral annulus velocity reflects pulmonary regurgitation severity but not right ventricular diastolic function in children with repaired Tetralogy of Fallot.

    Science.gov (United States)

    Hayabuchi, Yasunobu; Sakata, Miho; Ohnishi, Tatsuya; Inoue, Miki; Kagami, Shoji

    2013-06-01

    The current study assessed relationships between the ratio of early diastolic tricuspid inflow to tricuspid lateral annular velocity (tricuspid E/e') and right ventricular (RV) function in children after tetralogy of Fallot (TOF) repair. The RV function of 25 asymptomatic children with surgically repaired TOF (age 3.3 ± 2.0 years) was assessed by echocardiography and cardiac catheterization. Right ventricular end-diastolic pressure and volume (RVEDP and RVEDV), systolic pressure, and ejection fraction, as well as mean pulmonary arterial pressure, mean right atrial pressure (RAP), and the severity of both pulmonary regurgitation (PR) and tricuspid regurgitation (TR) were assessed in terms of the contribution to tricuspid E/e'. Univariate analysis discovered a relationship between tricuspid E/e' and RVEDV (R(2) = 0172), pressure half-time of PR (PR-PHT) (R(2) = 0.173), and TR grade (R(2) = 0.145) (p PR-PHT was significantly associated with tricuspid E/e' (β = 0.210; p function but reflects the severity of PR in asymptomatic children after TOF repair.

  12. [Severe tricuspid insufficiency and primary carcinoid tumor of the ovary. Long term success after valve replacement. Apropos of a case].

    Science.gov (United States)

    Herreman, F; Vernant, P; Cachera, J P; Monier, P

    1978-01-01

    The case is reported of carcinoid heart disease in a lady of 70 with intractable congestive cardiac failure 5 years after the removal of a primary carcinoid tumour of the ovary. The special features of primary carcinoid tumours of the ovary are recalled, with emphasis on their rarity and of the absence of liver metastases. The various features of carcinoid syndrome are recalled in the light of current knowledge of the pathogenesis. A review of the literature on cardiac involvement in primary carcinoid tumours of the ovary, amounting to 10 cases, is included. The possibility of surgical cure of the heart lesions in carcinoid tumour by a prosthetic tricuspid valve are discussed, in the light of the 6 reported cases and the present one. Our report is the first one of replacement of the valve after removal of a primary ovarien carcinoid tumour, and the excellent result has been maintained after three years.

  13. A modified tricuspid annuloplasty for functional severe tricuspid regurgitation%改良三尖瓣环成形技术治疗功能性重度三尖瓣反流

    Institute of Scientific and Technical Information of China (English)

    姜胜利; 高长青; 任崇雷; 张林; 龚志云; 陈婷婷; 张涛; 王瑶

    2011-01-01

    Objective To retrospectively analyze clinical data of patients who has left-side valvular disease combined with severe tricuspid regurgitation and evaluate the effect of our modified tricuspid annuloplasty with enforcement of artificial felt strip.Methods 76 patients who had left-side valvular disease combined with severe tricuspid regurgitation received operations between Jan.2008 and Jun.2010.The average age of the patients was 53.5 years old (32 male and 44 female).Besides the severe tricuspid regurgitation, other combined cardiac impairments included mitral valvar disease (52 cases), aortic valvar disease(5 cases), double valvar disease(19 cases) and left atrial thrombosis(22 cases).6 patients had grade II cardiac function according to the NYHA criteria, while 47 and 23 were in grade III and IV, respectively.Other signs included cyanosis(5cases), jaundice(11 cases), neck vein engorgement(48 cases) , ascites(22 cases), hepatomegaly(41 cases) and pitting edema in the lower limbs(68 cases).The concomitant operative procedures included mitral valve replacement in 52 patients,aortic valve replacement in 5 patients, double valve replacement in 19 patients, removal of left atrial thrombus in 22 patients,left atrium folding in 21 patients and left atrium appendage suture in 68 patients.Left-sided valve disease were corrected first,TAP was performed on the beating heart after the heart had been defibrillated.The anteroseptal commissure was plicated first.A double-armed 3-0 pledgeted suture was taken through the base of the septal leaflet, 5-6 mm from the commissure, extending along the annulus, and out from the point in the anterior annulus 10-12 mm from the anteroseptal commissure.Both ends of the suture was tied until the two Teflon pledgets approximated each other near the commissure.Then a semicircular De Vega type of plicating with a 3-0 prolene was taken, starting just from the anterior annulus near the anteroposterior commissure, and extending clockwise to a

  14. Simultaneous aortic and tricuspid valve rupture after fall injury

    Science.gov (United States)

    Sabzi, Feridoun; Niazi, Mojtaba; Ahmadi, Alireza

    2013-01-01

    Abstract: This case study concerns a patient with disruption of both tricuspid and aortic valves: a previously healthy, adult man, who sustained a 5-meter fall from a building under construction. The mechanism of the injury was acceleration and deceleration, acting in two different phases of the cardiac cycle, i.e. systole and diastole. Simultaneous occurrence of these injuries is exceedingly rare and in a careful literature review, we did not find any such combination of injury. The possible mechanisms of this injury, as well as surgical techniques are discussed. PMID:23511124

  15. Tricuspid regurgitation in patients with mitral valve disease%二尖瓣疾病相关的三尖瓣反流

    Institute of Scientific and Technical Information of China (English)

    吴美华; 余茂生

    2012-01-01

    Tricuspid regurgitation (TR) in patients with mitral valve (MV) disease is associated with poor outcome. It is common if left untreated after MV replacement. It might appear many years after surgery and not resolve after correcting the MV lesion. Detailed Tricuspid valve (TV) assessment, including measurement of the tricuspid annulus diameter, is mandatory in patients with MV disease. A TV annuloplasty with a ring is the best procedure to correct or prevent TR in most cases. It improves survival, prevents late TR and heart failure, and should therefore be performed at the time of the initial MV surgery.%二尖瓣疾病患者常常有三尖瓣反流(TR),后者与不良预后有关.风湿性二尖瓣置换术后如果没有同期处理三尖瓣病变,则TR很常见.纠正二尖瓣病变后TR可能不会消失,可在二尖瓣手术后很多年出现.对三尖瓣疾病患者应详细评估三尖瓣,包括测量三尖瓣环直径.在二尖瓣手术同期用成形环进行三尖瓣环成形是纠正或预防TR的最好方法,可改善生存,预防晚期TR和心力衰竭.

  16. 两种三尖瓣环成形术的近期临床效果评价%Evaluation of clinic effects after different tricuspid valvuloplasty in patients with secondary tricuspid valve insufficiency

    Institute of Scientific and Technical Information of China (English)

    褚银平; 高奇英; 张羽; 崔少鹏; 张栋

    2013-01-01

    Objectives Tricuspid valve(TV) insufficiency secondary to valvular heart disease or congenital heart disease is the most common aetiology of tricuspid regurgitation(TR). Appropriate treatment can improve long-term outcome. However, valve annuloplasty is the primary treatment for TV insufficiency. Our objective was to assess the short-term effectiveness of patients underwent tricuspid valve procedures for moderate or severe tricuspid regurgitation. These included De Vega suture tricuspid valve annuloplasty and ring annuloplasty. Methods A retrospective analysis of 65 consecutive patients with moderate to severe TR who underwent TV surgery between January 2010 and December 2012 with either a ring annuloplasty(Group Ring: n=35) or a De Vega suture annuloplasty (Group De Vega: n=30) at our hospital. The etiology for tricuspid regurgitation was rheumatic mitral and/or aortic valve diseases in 52 cases, adult atrial septal defect(ASD) in 13 cases. At different follow-up time point, the tricuspid regurgitation of all the patients was tested using ultrasound cardiography. The follow-up results were compared in 2 groups of patients. Results All patients survived from the operation. The follow up time was 0.5 to 2.6 years. The heart function improved to be NYHA class Ⅱ to Ⅲ in all patients. By 6 months after operation, right atrial diameter, right ventricle diameter and pulmonary artery systolic pressure in 2 groups was lower than the preoperative(P<0.05). However, by 2 years, pulmonary artery systolic pressure in ring group was still a downward trend(P<0.05). Echocardiography showed that trivial to mild TR was in all patients with ring annuloplasty after 6 months, and no moderate to severe TR war observed in one or two years later. By 0.5year, 1year and 2years follow up, echocardiography showed that trivial to mild TR was 83.3%, 94.5% and 88.9% respectively, and moderate TR was 16.7%, 4.5% and 11.1% respectively, but no severe TR cases in De Vega group. Conclusions In

  17. [Indications for surgery for valvular heart disease].

    Science.gov (United States)

    Halbach, Marcel; Wahlers, Thorsten; Baldus, Stephan; Rudolph, Volker

    2015-11-01

    Due to the demographic change, chronic valvular heart disease becomes increasingly important - especially age-related primary diseases of the aortic and mitral valve as well as secondary diseases of the mitral and tricuspid valve caused by other age-related cardiac disorders. Medical treatment is limited to symptom relief by use of diuretics. Specific drugs or drugs with a prognostic benefit are not available. Thus, valve repair or replacement are the key options for treatment of relevant valvular heart disease. While open heart surgery was the only approach for a long time, interventional, catheter-based therapies have evolved in the last decade. This article describes up-to-date recommendations on indications for surgery for the most prevalent valvular heart diseases in adults - aortic stenosis, and aortic, mitral and tricuspid regurgitation).

  18. Percutaneous pulmonary and tricuspid valve implantations: An update

    Institute of Scientific and Technical Information of China (English)

    Robert; Wagner; Ingo; Daehnert; Philipp; Lurz

    2015-01-01

    The field of percutaneous valvular interventions is one of the most exciting and rapidly developing within interventional cardiology.Percutaneous procedures focusing on aortic and mitral valve replacement or interventional treatment as well as techniques of percutaneous pulmonary valve implantation have already reached worldwide clinical acceptance and routine interventional procedure status.Although techniquesof percutaneous pulmonary valve implantation have been described just a decade ago,two stent-mounted complementary devices were successfully introduced and more than 3000 of these procedures have been performed worldwide.In contrast,percutaneous treatment of tricuspid valve dysfunction is still evolving on a much earlier level and has so far not reached routine interventional procedure status.Taking into account that an "interdisciplinary challenging",heterogeneous population of patients previously treated by corrective,semi-corrective or palliative surgical procedures is growing inexorably,there is a rapidly increasing need of treatment options besides redo-surgery.Therefore,the review intends to reflect on clinical expansion of percutaneous pulmonary and tricuspid valve procedures,to update on current devices,to discuss indications and patient selection criteria,to report on clinical results and finally to consider future directions.

  19. Value of proximal regurgitant jet size in tricuspid regurgitation.

    Science.gov (United States)

    Rivera, J M; Vandervoort, P; Mele, D; Weyman, A; Thomas, J D

    1996-04-01

    Recent studies have shown good agreement between proximal regurgitant jet size obtained with transthoracic color flow mapping and regurgitant fraction in patients with mitral regurgitation. To evaluate this in patients with tricuspid regurgitation, we analyzed 40 patients in sinus rhythm, 16 with free jets and 24 with impinging jets, comparing proximal jet size (millimeters) with parameters derived from the Doppler two-dimensional echocardiographic method (regurgitant fraction) and the flow-convergence method (peak flow rate, effective regurgitant orifice area, and momentum). Good agreement was noted between peak flow rate (r = 0.80, p fair between effective regurgitant orifice (r = 0.65, p < 0.001), peak flow rate (0.65, p < 0.001), and momentum (r = 0.62, p < 0.001) with mean jet proximal size. Jet proximal size obtained with transthoracic color flow mapping is a good semiquantitative tool for measuring tricuspid regurgitation in free jets that correlates well with established measures of the severity and with new parameters available from analysis of the proximal acceleration field. In patients with eccentrically directed wall jets, the correlation weakens but still appears clinically significant.

  20. Comparison of tricuspid and bicuspid aortic valve hemodynamics under steady flow conditions

    Science.gov (United States)

    Seaman, Clara; Ward, James; Sucosky, Philippe

    2011-11-01

    The bicuspid aortic valve (BAV), a congenital valvular defect consisting of two leaflets instead of three, is associated with a high prevalence of calcific aortic valve disease (CAVD). CAVD also develops in the normal tricuspid aortic valve (TAV) but its progression in the BAV is more severe and rapid. Although hemodynamic abnormalities are increasingly considered potential pathogenic contributor, the native BAV hemodynamics remain largely unknown. Therefore, this study aims at comparing experimentally the hemodynamic environments in TAV and BAV anatomies. Particle-image velocimetry was used to characterize the flow downstream of a native TAV and a model BAV mounted in a left-heart simulator and subjected to three steady flow rates characterizing different phases of the cardiac cycle. While the TAV developed a jet aligned along the valve axis, the BAV was shown to develop a skewed systolic jet with skewness decreasing with increasing flow rate. Measurement of the transvalvular pressure revealed a valvular resistance up to 50% larger in the BAV than in the TAV. The increase in velocity between the TAV and BAV leads to an increase in shear stress downstream of the valve. This study reveals strong hemodynamic abnormalities in the BAV, which may contribute to CAVD pathogenesis.

  1. Late coronary artery and tricuspid valve injury post pectus excavatum surgery.

    Science.gov (United States)

    Bibiloni Lage, Ignacio; Khan, Khalid; Kaabneh, Ahmed; Kendall, Simon

    2013-10-01

    We report the surgical case of a 25-year old man admitted because of progressive dyspnoea and stabbing chest pain, who had undergone a pectus excavatum correction using a retrosternal strut 8 years previously. The computerized tomography scan showed that the right tip of the pectus bar had migrated across his right ventricle and tricuspid valve into the right atrium. Intraoperatively, it was confirmed that in its path, the right coronary artery and the posterior leaflet of the tricuspid valve had been damaged. After removing the bar and repairing the tricuspid valve, the patient made a full recovery.

  2. Trans-esophageal echocardiography for tricuspid and pulmonary valves

    Directory of Open Access Journals (Sweden)

    Prabhu Mahesh

    2009-01-01

    Full Text Available Transesophageal echocardiography has been shown to provide unique information about cardiac anatomy, function, hemodynamics and blood flow and is relatively easy to perform with a low risk of complications. Echocardiographic evaluation of the tricuspid and pulmonary valves can be achieved with two-dimensional and Doppler imaging. Transesophageal echocardiography of these valves is more challenging because of their complex structure and their relative distance from the esophagus. Two-dimensional echocardiography allows an accurate visualization of the cardiac chambers and valves and their motion during the cardiac cycle. Doppler echocardiography is the most commonly used diagnostic technique for detecting and evaluating valvular regurgitation. The lack of good quality evidence makes it difficult to recommend a validated quantitative approach but expert consensus recommends a clinically useful qualitative approach. This review ennumerates probe placement, recommended cross-sectional views, flow patterns, quantitative equations including the clinical approach to the noninvasive quantification of both stenotic and regurgitant lesions.

  3. Finite element modelling of the tricuspid valve: A preliminary study.

    Science.gov (United States)

    Stevanella, Marco; Votta, Emiliano; Lemma, Massimo; Antona, Carlo; Redaelli, Alberto

    2010-12-01

    The incomplete efficacy of current surgical repair procedures of the tricuspid valve (TV) demands a deeper comprehension of the physiological TV biomechanics. To this purpose, computational models can provide quantitative insight into TV biomechanical response and allow analysing the role of each TV substructure. We present here a three-dimensional finite element model of the tricuspid valve that takes into account most of its peculiar features. Experimental measurements were performed on human and porcine valves to obtain a more detailed TV anatomical framework. To overcome the complete lack of information on leaflets mechanical properties, we performed a sensitivity analysis on the parameters of the adopted non-linear hyperelastic constitutive model, hypothesizing three different parameter sets for three significant collagen fibre distributions. Results showed that leaflets' motion and maximum principal stress distribution were almost insensitive to the different material parameters considered. Highest stresses (about 100kPa) were located near the annulus of the anterior and septal leaflets, while the posterior leaflet experienced lower stresses (about 55kPa); stresses at the commissures were nearly zero. Conversely, changes in constitutive parameters deeply affected leaflets' strains magnitude, but not their overall pattern. Strains computed assuming that TV leaflets tissue are reinforced by a sparse and loosely arranged network of collagen fibres fitted best experimental data, thus suggesting that this may be the actual microstructure of TV leaflets. In a long-term perspective, this preliminary study aims at providing a starting point for the development of a predictive tool to quantitatively evaluate TV diseases and surgical repair procedures.

  4. Percutaneous Therapy for Tricuspid Regurgitation: A New Frontier for Interventional Cardiology.

    Science.gov (United States)

    Kapadia, Samir R; Krishnaswamy, Amar; Tuzcu, E Murat

    2017-03-23

    Functional tricuspid regurgitation (FTR) is common, whether in association with mitral or aortic valve disease or presenting as an isolated valvular disease. Several studies have shown that TR is associated with poor patient outcomes, though a cause-and-effect relationship of TR to mortality has not been proven. Similarly the impact of surgical treatment of TR on outcomes needs well-controlled randomized trials that are under planning. The current professional society guidelines for treatment of TR are based on expert opinions with a level of evidence C for all indications. Transcatheter therapies for valvular heart disease are often based on established surgical techniques. When surgical therapy has well studied benefits including a reduction in mortality (e.g. aortic valve replacement for aortic stenosis), percutaneous therapies can be compared to surgery with survival as an endpoint. Similarly, the safety of surgical therapies (e.g. surgical aortic valve replacement) can serve as a benchmark for the safety of percutaneous treatment. In establishing percutaneous treatments for TR, on the other hand, there are several challenges: 1) the severity of TR and RV dysfunction are often difficult to determine; 2) the impact of TR on mortality or heart failure outcomes is not as clearly defined; and 3) surgical treatments are multiple without robust data for indications and outcomes. Importantly, the US Food and Drug Administration (FDA) is interested in providing expedited access for devices that fill an unmet clinical need by demonstrating appropriate intermediate and surrogate endpoints. Therefore, the aforementioned challenges also present opportunities to better define how trials for percutaneous treatments of TR can be conducted as we move forward (Table).

  5. Surgical treatment of Ebstein's anomaly by tricuspid valvuloplasty applying autologous pericardium%利用自体心包片修复三尖瓣治疗Ebstein畸形

    Institute of Scientific and Technical Information of China (English)

    刘琛; 邵孟平

    2013-01-01

    目的 介绍一种利用自体心包片修复三尖瓣治疗Ebstein畸形的新方法和临床经验.方法 2008年1月至2012年6月手术治疗8例Ebstein畸形患者,根据Carpentier病理分型,B型1例,C型6例,D型1例.术中在Carpentier术式的基础上,应用戊二醛处理过的自体心包片重建前瓣、后瓣,增加瓣叶对合面积.结果 围术期无死亡.三尖瓣成形术后超声心动图示三尖瓣反流明显减轻.随访3~48个月,超声心动图表现明显改善,所有患者心功能均恢复至Ⅰ~Ⅱ级.结论 利用自体心包片修复三尖瓣治疗Ebstein畸形拓宽了瓣膜成形的适应证,能够更好地恢复三尖瓣的解剖形态及功能.%Objective To introduce a new method for surgical treatment of Ebstein's anomaly by tricuspid valvuloplasty applying autologous pericardium and summarize the clinical experience. Methods Eight patients of Ebstein's anomaly were treated from Jan. ,2008 to June,2012,and divided into one of type B,6 of type C and one of type D based on the Carpentier' s criteria for pathological classification. During the operations, autologous pericardia treated with glutaraldehyde were used to rebuild anterior and posterior valves, and increase the closing area of valves on the basis of the Carpentier method. Results There was no death during the perioperative period. Tricuspid regurgitation was mitigated significantly as indicated by ultrasonic cardiograms after tricuspid valvuloplasty. In the follow-up period of 3 to 48 months, the ultrasonic cardiogram performance was significantly improved and the heart function was restored to NYHA Class I or Ⅱ in all the patients. Conclusions The application of tricuspid valvuloplasty to the treatment of Ebstein s anomaly by autologous pericardium broadens indications for valvoplasty,and is more effective in restoring the anatomical form and functionality of the tricuspid.

  6. Reflections on the 24 years durability of an isolate tricuspid bovine pericardium IMC/Braile bioprosthesis.

    Science.gov (United States)

    Bassetto, Solange; Menardi, Antonio Carlos; Alves Junior, Lafaiete; Rodrigues, Alfredo José; Évora, Paulo Roberto Barbosa

    2011-01-01

    We were challenged by the experience of one patient reoperation for a bioprosthetic bovine pericardium degenerative stenosis, 24 years after implantation. This bioprosthesis was implanted due to tricuspid valve bacterial staphylococcal endocarditis after septic abortion.

  7. Regression of severe tricuspid regurgitation after mitral balloon valvotomy for severe mitral stenosis

    Directory of Open Access Journals (Sweden)

    Mohamed Eid Fawzy

    2014-03-01

    Conclusions: Regression of significant TR after successful MBV in patients with severe mitral stenosis was observed in patients who had severe pulmonary hypertension. This improvement in TR occurred even in the presence of organic tricuspid valve disease.

  8. Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence

    Directory of Open Access Journals (Sweden)

    Yiyun Lin

    2014-12-01

    Conclusions: Rigid ring annuloplasty efficaciously improved post-operative tricuspid valve function in patients with FTR. Atrial fibrillation, a large left atrium, low EF and postoperative permanent pacemaker installation were independent risk factors for severe recurrent TR.

  9. [Loculated pericardial effusion leading to functional tricuspid stenosis in a case of rheumatoid arthritis].

    Science.gov (United States)

    Galli, C A; Alimento, M; Pepi, M

    1995-09-01

    We describe a case of loculated pericardial effusion, occurring in a women affected by rheumatoid arthritis. Because of its peculiar location, close to the atrioventricular plane, the effusion caused a haemodynamic pattern resembling tricuspid valve stenosis.

  10. 改良三尖瓣成形环技术治疗继发性三尖瓣关闭不全的中期效果%Evaluation of mid-term outcomes after modified tricuspid ring annuloplasty

    Institute of Scientific and Technical Information of China (English)

    袁昕; 潘世伟; 胡盛寿; 郑哲; 孙寒松

    2012-01-01

    Objective To improve short-and mid-term surgical outcomes ofter the tricuspid ring annuloplasty,and to provide theoretic basis for strategy making among patients with tricuspid regurgitation secondary to left-sided heart diseases.Methods Tricuspid regurgitation secondary to left-sided heart diseases ( including mitral valve diseases and aortic valve diseases) were treated by using tricuspid ring annuloplasty techniques.Patients'age averaged (47.3 ± 12.0) years old,there were a total of 84 female patients(53.2% ).The average systolic pulmonary pressure was (53.4 ± 19.8) mm Hg.From August 2002 to December 2007,a total of 158 consecutive patients underwent tricuspid ring annuloplasty in Fuwai Cardiovascular disease Hospital.Among this group of patients,there were 66 mild tricuspid regurgitation(41.8% ),54 moderate(34.2% ),and 38 severe tricuspid regurgitation(24.0% ).The average age was (47.3 ± 12.0) years old and female accounted for 53.2% of the whole cohort.The indications for the tricuspid ring annuloplasty included:moderate to severe tricuspid regurgitation or moderate to severe pulmonary hypertension ( systolic pulmonary hypertension >40 mm Hg).In the current study,the ring annuloplasty techniques were modified in the following aspects:selection of undersized ring and partial fixation of tricuspid septal segment.In all the patients,we chose Cosgrove-Edwards ring for tricuspid annuloplasty.The surgical outcomes were evaluated through multivariate regression and Cox analysis.Results Compared with moderate and severe tricuspid regurgitation groups,mild regurgitation group had the smallest ring diameter,mild group ( 38.2 ± 4.9 ) mm,moderate group(47.0 ± 11.6 ) mm,severe group(44.5 ± 8.9) mm,P <0.001.No significant differences were noted in terms of ejection fraction among three groups (0.59 ± 0.08,0.59 ± 0.06 and 0.58 ± 0.09,P =0.73 ).Compared with mild and moderate tricuspid regurgitation groups,severe regurgitation group had the highest

  11. Follow-up value of ultrasound in fetal tricuspid regurgitation%胎儿功能性三尖瓣反流的超声随访观察

    Institute of Scientific and Technical Information of China (English)

    战鸿雁; 刘传玺; 尹虹

    2014-01-01

    Objective To explore the follow‐up value of ultrasound in fetal tricuspid regurgitation . Methods 44 fetuses who presented with moderate tricuspid regurgitation with differential pressure over 20 mmHg ,dilation of right atria and ventricles were chosen as the observation group .Examinations ,in terms of the degree ,velocity and differential pressure of reflux ,size of heart chamber and the presence pericardial or pleural effusion were carried out once every four weeks from 24 weeks of pregnancy to 9 weeks after birth . Results 40 9.% (18/44) of cases had been getting better before birth .The degree of regurgitation of 56 8.%(25/44) cases significantly decreased or even disappeared from 1 to 62 days after birth .Especially ,3 cases whose regurgitation velocity reached to 4 2. m/s with the differential pressure over 70 mmHg as well as onset of heart failure symptoms had been recovered gradually after born in advance 1. case (2 3.% ) with the persistence of both tricuspid regurgitation and heart failure symptoms after birth died in right heart failure , even though using different active treatments ,such as oxygen ,strong heart and diuresis .Conclusions High‐speed tricuspid regurgitation in fetuses without pathological changes can be almost reversed ,and the prognosis is good .Once the fetal tricuspid regurgitation pressure is over 70 mmHg or a fetus appears the onset of heart failure symptoms ,pre‐term delivery should be advised in a bid to prevent accidents in uterine cavity .%目的:探讨胎儿功能性三尖瓣反流的超声随访价值。方法选择中度及以上三尖瓣反流、压差大于20 mmHg(1 mmHg=01.33 kPa)、右房右室增大的44例胎儿进行观察。自孕24周至胎儿出生后9周,每4周观测一次三尖瓣反流速度、反流压差、心腔大小、有无心包腔或胸腔积液等。结果44例中有18例(409.%)在出生前好转;25例(568.%)于出生1~62 d后三尖瓣反流消

  12. Plastic Surgery

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  13. Outcomes of Mild to Moderate Functional Tricuspid Regurgitation in Patients Undergoing Mitral Valve Operations: A Meta-Analysis of 2,488 Patients.

    Science.gov (United States)

    Kara, Ibrahim; Koksal, Cengiz; Erkin, Alper; Sacli, Hakan; Demirtas, Mucahit; Percin, Bilal; Diler, Mevriye Serpil; Kirali, Kaan

    2015-12-01

    This meta-analysis examined the prognosis of patients who were found to have mild to moderate functional tricuspid regurgitation during mitral valve operations. Overall, this meta-analysis included 2,488 patients in 10 studies. Compared with the group without tricuspid valve annuloplasty, the probability of not progressing to moderate to severe functional tricuspid regurgitation was significantly higher in the tricuspid valve annuloplasty group. A more aggressive surgical approach involving concomitant tricuspid repair with mitral valve operations may be considered to avoid the development of moderate to severe functional tricuspid regurgitation in the follow-up.

  14. Deformation Differences between Tricuspid and Bicuspid Aortic Valves in Vitro

    Science.gov (United States)

    Szeto, Kai; Rodriguez-Rodriguez, Javier; Pastuszko, Peter; Nigam, Vishal; Lasheras, Juan C.

    2011-11-01

    It has been shown in clinical studies that patients with congenital bicuspid aortic valves (CBAVs) develop degenerative calcification of the leaflets at young ages compared to patients with the normal tricuspid aortic valves (TAVs). It has been hypothesized that the asymmetrical geometry of the leaflets in CBAVs, flow shear stresses (SS), disturbed flow, and excessive strain rate levels are possible causes for the early calcification and stenosis. Central to the validation of this hypothesis is the need to quantify the differences in strain rate levels between the BAVs and TAVs. We simulate the CBAVs by surgically stitching two of the leaflets of a porcine aortic valve together. To quantify strain differences, we performed in-vitro experiments in both trileaflet and bileaflet valves by tracking the motion of small ink dots marked on each leaflet surface. We then used phase-locked stereo photogrammetry to reconstruct at each instant of time the 3D surface of the leaflets and measure the strain rates in both radial and circumferential directions during the whole cardiac cycle. Our results indicate that the total strain rate of the simulated BAVs is about 15 to 20% higher than the normal leaflets of TAVs at systole. In the BAVs' case, the fused leaflet stretches radially up to 25% higher than the reference length. The excessive stretching in both directions in the fused leaflet results in large changes in the flow patterns and associated wall SS.

  15. Cardiac Resynchronization for Corrected Transposition of the Great Arteries with Systemic Right Ventricle Failure after Tricuspid Valve Replacement and Ventricle Septal Defect Closure

    Directory of Open Access Journals (Sweden)

    Kosuke Fujii, MD

    2010-01-01

    Full Text Available A 32-year-old man developed systemic right ventricular (RV heart failure after ventricular septal defect (VSD closure and tricuspid valve replacement for corrected transposition of the great arteries with VSD and Ebstein anomaly. He subsequently experienced RV failure with wide QRS and atrial fibrillation (AF. Because corrective surgery for this condition seemed over risky, we decided to perform cardiac resynchronization therapy with implantation of an implantable cardioverter defibrillator (CRT-D. After CRT-D device implantation, the patient showed improved performance status in terms of New York Heart Association functional class, B-type brain natriuretic peptide levels, RV ejection fraction and cardiac electrical rhythm. CRT-D implantation is a useful approach for systemic RV failure with wide QRS duration showing right bundle branch block and AF.

  16. Influence of Tricuspid Bioprosthetic Mitral Valve Orientation Regarding the Flow Field Inside the Left Ventricle: In Vitro Hydrodynamic Characterization Based on 2D PIV Measurements.

    Science.gov (United States)

    Bazan, Ovandir; Ortiz, Jayme P; Fukumasu, Newton K; Pacifico, Antonio L; Yanagihara, Jurandir I

    2016-02-01

    The flow patterns of a prosthetic heart valve in the aortic or mitral position can change according to its type and orientation. This work describes the use of 2D particle image velocimetry (PIV) applied to the in vitro flow fields characterization inside the upper part of a left ventricular model at various heart rates and as a function of two orientations of stented tricuspid mitral bioprostheses. In the ventricular model, each mitral bioprosthesis (27 and 31 mm diameter) was installed in two orientations, rotated by 180°, while the aortic bileaflet mechanical valve (27 mm diameter) remained in a fixed orientation. The results (N = 50) showed changes in the intraventricular flow fields according to the mitral bioprostheses positioning. Also, changes in the aortic upstream velocity profiles were noticed as a function of mitral orientations.

  17. Patient-specific pediatric silicone heart valve models based on 3D ultrasound

    Science.gov (United States)

    Ilina, Anna; Lasso, Andras; Jolley, Matthew A.; Wohler, Brittany; Nguyen, Alex; Scanlan, Adam; Baum, Zachary; McGowan, Frank; Fichtinger, Gabor

    2017-03-01

    PURPOSE: Patient-specific heart and valve models have shown promise as training and planning tools for heart surgery, but physically realistic valve models remain elusive. Available proprietary, simulation-focused heart valve models are generic adult mitral valves and do not allow for patient-specific modeling as may be needed for rare diseases such as congenitally abnormal valves. We propose creating silicone valve models from a 3D-printed plastic mold as a solution that can be adapted to any individual patient and heart valve at a fraction of the cost of direct 3D-printing using soft materials. METHODS: Leaflets of a pediatric mitral valve, a tricuspid valve in a patient with hypoplastic left heart syndrome, and a complete atrioventricular canal valve were segmented from ultrasound images. A custom software was developed to automatically generate molds for each valve based on the segmentation. These molds were 3D-printed and used to make silicone valve models. The models were designed with cylindrical rims of different sizes surrounding the leaflets, to show the outline of the valve and add rigidity. Pediatric cardiac surgeons practiced suturing on the models and evaluated them for use as surgical planning and training tools. RESULTS: Five out of six surgeons reported that the valve models would be very useful as training tools for cardiac surgery. In this first iteration of valve models, leaflets were felt to be unrealistically thick or stiff compared to real pediatric leaflets. A thin tube rim was preferred for valve flexibility. CONCLUSION: The valve models were well received and considered to be valuable and accessible tools for heart valve surgery training. Further improvements will be made based on surgeons' feedback.

  18. Clinical Application of Annuloplasty Ring in Tricuspid Valvuloplasty for the Treatment of Tricuspid Regurgitation%成形环在三尖瓣成形术治疗三尖瓣关闭不全中的临床应用

    Institute of Scientific and Technical Information of China (English)

    刘勇; 刘健; 黄击修; 李世樱; 林小彬; 付建

    2013-01-01

    目的 观察利用人工瓣环行三尖瓣成形术治疗风湿性心脏病继发性三尖瓣关闭不全患者的近、中期效果. 方法 2009年12月至201 1年9月四川省简阳市人民医院共有41例风湿性心脏病患者接受左心瓣膜置换术并同期置人人工瓣环行三尖瓣成形术,其中男12例、女29例,平均年龄49(21~67)岁.术前合并心房颤动38例,合并左心房血栓13例;三尖瓣微量反流2例,轻度反流5例,中度反流11例,重度反流23例;行二尖瓣置换术28例,二尖瓣+主动脉瓣置换术13例.所有患者术后均经门诊随访(术后每3个月门诊复查1次),术后6个月复查心脏彩色超声心动图观察三尖瓣反流情况. 结果 术后心功能较术前改善2~3级,心功能Ⅰ级和Ⅱ级共39例,差异有统计学意义(P<0.05);全组患者随访6~27个月,随访期内无死亡.术后6个月心脏彩色超声心动图检查提示:三尖瓣反流程度较术前明显减轻,微量反流和轻度反流共39例,差异有统计学意义(P<0.05);术后右心测值较术前明显缩小,右心室横径由术前20 mm降至术后17mm,差异有统计学意义(P<0.05). 结论 利用人工瓣环行三尖瓣成形术治疗继发性三尖瓣关闭不全,其近、中期疗效明确,远期疗效需要继续随访观察.%Objective To observe early and intermediate-term clinical outcomes of tricuspid valvuloplasty with annuloplasty ring for the treatment of secondary tricuspid regurgitation (TR) of patients with rheumatic heart disease. Methods From December 2009 to September 2011,41 patients with rheumatic heart disease underwent left-side heart valve replacement and concomitant tricuspid valvuloplasty with annuloplasty ring in Sichuan Jianyang People's Hospital. There were 12 males and 29 females with their mean age of 49 (21-67) years. Preoperatively, there were 38 patients with atrial fibrillation, 13 patients with left atrial thrombus; 2 patients with trivial TR, 5 patients with

  19. Perivalvular Abscess of Tricuspid Valve: A Rare Complication of Infective Endocarditis

    Directory of Open Access Journals (Sweden)

    Khallil Zarrabie

    2010-05-01

    Full Text Available Infective endocarditis is a serious complication of intravenous (IV drug abuse, with a reported mortality of 5 to 10%. A 21-year-old man, who was an intravenous drug abuser, presented with fever and dyspnea. Transthoracic echocardiography showed a highly mobile, large vegetation on the anterior leaflet of the tricuspid valve. Despite antibiotic therapy for ten days, the patient remained febrile. Transesophageal echocardiography revealed severe aortic regurgitation and an echo-lucent space between the tricuspid and aortic valves. Color Doppler demonstrated a flow within the echo-lucent space and a connection between that and the left ventricle, suggesting a perivalvular abscess of the tricuspid valve opening in the left ventricle. The patient was transferred to the operating room, where he unfortunately expired.

  20. Successful retrieval of a knotted pulmonary artery catheter trapped in the tricuspid valve apparatus.

    Science.gov (United States)

    Ishaq, Muhammad; Alexander, Nicki; Scott, David H T

    2013-04-01

    We report the case of a 64-year-old patient in whom a pulmonary artery catheter formed a knot fixed within the right ventricle in the region of the tricuspid valve apparatus. Knot formation is a recognized complication associated with pulmonary artery catheters (PAC) insertion. This problem is usually dealt with by simply withdrawing the PAC until the knot impacts onto the introducer and after enlarging the puncture site by a small skin incision removing the introducer-PAC as one unit. However, we recently encountered a situation where the PAC was knotted around the tricuspid valve apparatus and could not be withdrawn. An interventional radiologist was able to unknot the catheter and release it from the tricuspid valve. We reviewed the literature related to this topic. We believe our experience could be of use to others.

  1. Successful retrieval of a knotted pulmonary artery catheter trapped in the tricuspid valve apparatus

    Directory of Open Access Journals (Sweden)

    Muhammad Ishaq

    2013-01-01

    Full Text Available We report the case of a 64-year-old patient in whom a pulmonary artery catheter formed a knot fixed within the right ventricle in the region of the tricuspid valve apparatus. Knot formation is a recognized complication associated with pulmonary artery catheters (PAC insertion. This problem is usually dealt with by simply withdrawing the PAC until the knot impacts onto the introducer and after enlarging the puncture site by a small skin incision removing the introducer-PAC as one unit. However, we recently encountered a situation where the PAC was knotted around the tricuspid valve apparatus and could not be withdrawn. An interventional radiologist was able to unknot the catheter and release it from the tricuspid valve. We reviewed the literature related to this topic. We believe our experience could be of use to others.

  2. Medtronic Duran AnCore versus Edwards MC3 rings for tricuspid annuloplasty.

    Science.gov (United States)

    Lee, Seok In; Kim, Ho Jin; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won

    2017-06-01

    Ring annuloplasty is now regarded as the standard surgical technique for the correction of tricuspid regurgitation (TR). However, comparative research on the durability of commercially available annuloplasty rings is limited. We reviewed early and late surgical results of tricuspid annuloplasty using the Duran AnCore and Edwards MC3 rings. From our institutional prospective cardiac surgical database, we identified 581 adult patients (55.9 ± 12.9 years) undergoing tricuspid ring annuloplasty using either a Duran AnCore ( n  = 370; Duran group) or an Edwards MC3 ring ( n  = 211; MC3 group) from January 2001 through December 2012. Survival rates, valve-related outcomes and late tricuspid functions were compared between the 2 groups. Propensity score analysis was conducted to adjust for selection bias. The degree of TR assigned preoperatively was mild in 128 (22.0%), moderate in 205 (35.3%), and severe in 248 patients (42.7%), with a higher prevalence of severe TR in the Duran group than in the MC3 group (46.5% vs 36.0%; P  = 0.014). Over an observation period of 47.0 months, 46 patients developed significant TR (≥ moderate). After propensity score matching, there were no significant differences in the risks of early mortality ( P  = 0.36), early complications ( P  > 0.99) and recurrence of significant TR ( P  = 0.33). Both the Duran and the MC3 rings showed comparable safety and tricuspid valve durability for tricuspid valve annuloplasty.

  3. Edwards MC3成形环三尖瓣成形的临床应用%Clinical Application of Tricuspid Valvuloplasty Using Edwards MC3 Forming Ring

    Institute of Scientific and Technical Information of China (English)

    周素明

    2015-01-01

    目的 探讨Edwards MC3成形环三尖瓣成形术后的近、中期效果,评价其优势作用.方法 将我科2010年2月至2014年2月收治心脏病(包括风湿性心瓣膜病、房间隔缺损等)伴发中、重度三尖瓣关闭不全患者106例,根据三尖瓣手术不同处理方式分为两组:DeVega组和MC3组,术后定期评估心功能及超声心动图检查,比较两组患者不同时间段三尖瓣的返流情况.结果 术后两组患者均无死亡.随访106例,随访时间0.5至2.0年.术后心功能分级均较术前明显改善2-3级;两组患者3个月、1年和2年MC3组三尖瓣返流明显少于DeVega组(P<0.05); MC3组患者三尖瓣返流的复发率明显降低(P<0.05).结论 应用Edwards MC3成形环行三尖瓣成形术,其近、中期效果明显优于De-Vega成形术.%Objective: To study the effects of near and medium-term of the tricuspid valve in patients with moderate and severe insufficiency of using Edwards MC3 forming ring,then evaluate of the advantages.Methods:106 cases of patients (in-cluding rheumatic valvular heart disease, pathogenesy, etc.)with moderate and severe tricuspid regurgitation were enrolled in our department from February 2010 to Febru ary 2014.There are divided into two groups including DeVega and Edwards MC3 group according to different operation methods. Postoperative evaluation of cardiac functionand and echocardiography were on a reg-ular basis . we compared to the conditions of tricuspid regurgitation of two groups in different periods of postoperative.Results:There were not died in two groups of patients. 106 cases were followed up for from 0.5 to 2.0 years.Postoperative cardiac func-tion class than preoperative obviously improved from 2 to 3. After 3 months, 1 year and 2 years ,the echocardiography hinted of tricuspid regurgitation of Edwards MC3 group was obviously less than DeVega group (P<0.05). Compared two groups, Edwards MC3group tricuspid regurgitation in patients with recurrence rate

  4. Features and prognosis of fetal tricuspid valve regurgitation by Prenatal Ultrasound Cardiogram Examination%产前超声检测胎儿三尖瓣反流及其预后初探

    Institute of Scientific and Technical Information of China (English)

    刘清求; 余燕明; 肖迎军; 高小午; 陈宏颖

    2011-01-01

    Objective: To investigate the relations between the causes and reflux extent of fetal tricuspid valve regurgitation and fetal prognosis. Methods: Segmental analysis was used in examining the heart and other structures outside the heart of 52 cases with fetal tricuspid regurgitation which were found by routine ultrasound cardiogram examination from January 2009 to September 2010 in our hospital. All cases were classified into three groups that is congenital heart disease group, non - congenital heart disease group, simple regurgitation group in the light of without other abnormalities or not. Features and prognosis of fetal tricuspid valve regurgitation in three groups were observed and analysed. Results: There are 10 patients in congenital heart disease group including 3 cases with mild regurgitation and 7 cases with moderate regurgitation, resulting in 8 cases induced abortion and 2 cases survived; There are 23 cases in non- congenital heart disease group including 19 cases with mild regurgitation and 4 cases with moderate regurgitation, resulting in 4 cases induced abortion and 19 cases survived; There are 19 cases in simple regurgitation group including 17 cases with mild regurgitation and 2 cases with moderate regurgitation, resulting in 19 cases survived. Conclusion: The cause and reflux degree of fetal tricuspid valve regurgitation are related to fetal prognosis. Mild to moderate tricuspid regurgitation accompanied with a good general condition, which the fetal prognosis is good; tricuspid regurgitation combined severe structural abnormalities inside and outside the structure of fetal heart, which the fetal prognosis is poor.%目的 探讨胎儿三尖瓣反流原因、程度与胎儿预后的关系.方法 对2009年1月至2010年9月行常规超声检查所发现的52例胎儿三尖瓣反流病例,采用节段分析法,对胎儿进行系统超声心动图检查和心外其他结构全面细致地检查.根据检查情况分先心组、非先心组、单纯

  5. Cabergoline-induced tricuspid regurgitation: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Mohammad Hayat Bhat

    2011-01-01

    Full Text Available The increased risk of cardiac valve disease in patients treated for Parkinson′s disease with cabergoline has raised concerns about the safety of treatment with ergot-derived dopamine agonists in patients with endocrine diseases, especially prolactinoma. Concern is raised because the use of cabergoline was associated in one study with an increased prevalence of moderate tricuspid regurgitation, and in two other studies with mild tricuspid regurgitation. Furthermore, the use of cabergoline was associated with increased frequencies of valvular thickening, calcifications, and increased mitral tenting area.

  6. Heart failure due to severe myocardial calcification; A rare complication after irradiation on the chest wall

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Shouichi; Maida, Kiyoshi; Yokoyama, Hitoshi; Tanaka, Shigeo (Aomori Prefectural Central Hospital (Japan))

    1993-11-01

    A 28-year-old female who had had irradiation on the chest wall at the age of 5 as a remedy for keloid granulation after burn, recently developed congestive heart failure. Severe tricuspid regurgitation was demonstrated by echocardiography with a certain calcification in the cardiac shadow on chest radiogram. Calcified right ventricle and ventricular septum were noticed operatively, which disturbed ventricular motion and also caused tricuspid valve deformity. These calcified myocardium apparently corresponded with the irradiation field. After tricuspid valve replacement, she regained physical activity satisfactorily without congestive heart failure. Because she had no other known causes of cardiac calcification such as hypercalcemia, myocarditis, myocardial infarction or renal diseases, irradiation on the chest wall could be responsible for the severe myocardial calcification. (author).

  7. Pregnancy-induced remodeling of heart valves.

    Science.gov (United States)

    Pierlot, Caitlin M; Moeller, Andrew D; Lee, J Michael; Wells, Sarah M

    2015-11-01

    Recent studies have demonstrated remodeling of aortic and mitral valves leaflets under the volume loading and cardiac expansion of pregnancy. Those valves' leaflets enlarge with altered collagen fiber architecture, content, and cross-linking and biphasic changes (decreases, then increases) in extensibility during gestation. This study extends our analyses to right-sided valves, with additional compositional measurements for all valves. Valve leaflets were harvested from nonpregnant heifers and pregnant cows. Leaflet structure was characterized by leaflet dimensions, and ECM composition was determined using standard biochemical assays. Histological studies assessed changes in cellular and ECM components. Leaflet mechanical properties were assessed using equibiaxial mechanical testing. Collagen thermal stability and cross-linking were assessed using denaturation and hydrothermal isometric tension tests. Pulmonary and tricuspid leaflet areas increased during pregnancy by 35 and 55%, respectively. Leaflet thickness increased by 20% only in the pulmonary valve and largely in the fibrosa (30% thickening). Collagen crimp length was reduced in both the tricuspid (61%) and pulmonary (42%) valves, with loss of crimped area in the pulmonary valve. Thermomechanics showed decreased collagen thermal stability with surprisingly maintained cross-link maturity. The pulmonary leaflet exhibited the biphasic change in extensibility seen in left side valves, whereas the tricuspid leaflet mechanics remained largely unchanged throughout pregnancy. The tricuspid valve exhibits a remodeling response during pregnancy that is significantly diminished from the other three valves. All valves of the heart remodel in pregnancy in a manner distinct from cardiac pathology, with much similarity valve to valve, but with interesting valve-specific responses in the aortic and tricuspid valves.

  8. 彩色多普勒检测胎儿三尖瓣反流产前筛查的临床意义%Clinical significance of color doppler detection in prenatal screening of fetal tricuspid regurgitation

    Institute of Scientific and Technical Information of China (English)

    王京平; 王萍平; 郑来坤

    2014-01-01

    目的:探讨彩色多普勒在中晚孕胎儿三尖瓣反流产前筛查中的临床意义及鉴别诊断。方法选择2009年3月~2012年6月就诊的11265例中晚期孕妇。观察其胎儿三尖瓣口彩色多普勒反流情况及脉冲多普勒评估流速、压差,追踪随访。结果1306例胎儿监测到三尖瓣反流,发生率11.6%。其中反流速度大于2.8m/s者46例,小于2.8m/s者1261例。结论彩色多普勒能够敏感地检出胎儿三尖瓣反流,对胎儿某些心脏疾病的诊断提供重要临床价值。%Objective To investigate the clinical significance and differential diagnosis of color doppler in the prenatal screening of middle and late pregnancy fetal tricuspid regurgitation. Methods 11265 middle and late pregnancy gravidae treated from March 2009 to June 2012 were selected. The color doppler tricuspid regurgitation situation of their fetuses was observed and the pulse doppler was used to evaluate the flow rate and pressure difference;the fetuses received follow-up visits. Results 1306 fetuses showed tricuspid regurgitation, with the incidence of 11.6%.Among them, 46 fetuses had a backflow rate over 2.8m/s and 1261 fetuses less than 2.8m/s. Conclusion Color doppler can detect fetal tricuspid regurgitation sensitively and is therefore of important clinical value for some fetal heart diseases.

  9. Right Ventricular Remodeling Determines Tricuspid Valve Geometry and the Severity of Functional Tricuspid Regurgitation: A Real-Time 3-Dimensional Echocardiography Study

    Science.gov (United States)

    Jang, Min-Kyoung; Kim, Yun-Jeong; Kim, Dae-Hee; Kang, Duk-Hyun; Song, Jae-Kwan

    2010-01-01

    Background and Objectives Right ventricle (RV) remodeling can determine tricuspid valve (TV) geometry and the severity of functional tricuspid regurgitation (TR). Subjects and Methods In 53 patients with various degrees of functional TR and in sinus rhythm, RV and TV geometries were analyzed using real-time 3-dimensional echocardiography, including tenting angles of 3 leaflets, septal-lateral and antero-posterior tricuspid annulus diameters and inlet RV dimensions, mid-RV septal-lateral dimension, and the distance between annulus and apex. A mid-systole frame when the TV tenting is smallest was selected for the analysis. RV end-diastolic and end-systolic volumes were measured. The severity of functional TR was determined by distal jet area. Results TR distal jet area was mainly determined by septal-lateral annulus diameter (p<0.001) RV inlet dimension (p=0.015), RV end-systolic volume (p=0.010), septal (p=0.019), and anterior leaflet tenting angles (p=0.045) by multiple stepwise linear regression analysis. Leaflet tenting angles were mainly determined by septal-lateral RV inlet dimension. Septal-lateral annulus diameter was determined by septal-lateral RV inlet dimension (p<0.001) and mid RV dimension (p=0.033), whereas antero-posterior annulus diameter was determined by antero-posterior RV inlet dimension (p<0.001). Conclusion Functional TR severity is determined by septal-lateral annulus and RV dilation, and tenting of septal and anterior leaflets. TV leaflet tenting is mainly determined by septal-lateral RV inlet dilation, and tricuspid annulus dilation is closely linked with inlet RV dilation. PMID:20967146

  10. Plasticity theory

    CERN Document Server

    Lubliner, Jacob

    2008-01-01

    The aim of Plasticity Theory is to provide a comprehensive introduction to the contemporary state of knowledge in basic plasticity theory and to its applications. It treats several areas not commonly found between the covers of a single book: the physics of plasticity, constitutive theory, dynamic plasticity, large-deformation plasticity, and numerical methods, in addition to a representative survey of problems treated by classical methods, such as elastic-plastic problems, plane plastic flow, and limit analysis; the problem discussed come from areas of interest to mechanical, structural, and

  11. Tricuspid annular plane systolic excursion and response to cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Kjaergaard, Jesper; Ghio, Stefano; St John Sutton, Martin

    2011-01-01

    The aims of this study were to evaluate tricuspid annular plane systolic excursion (TAPSE) as a predictor of left ventricular (LV) reverse remodeling and clinical benefit of cardiac synchronization therapy (CRT) and to evaluate the effect of CRT on TAPSE in patients with mildly symptomatic systol...

  12. Staphylococcus aureus endocarditis of the tricuspid valve after septic abortion: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Nelson López-Garzón

    2011-06-01

    Full Text Available We report a case of a female patient, 22 years old, with a diagnosis of tricuspid valve endocarditis by S. aureus following septic abortion. The diagnosis was established by the Duke University criteria and it was confirmed by the echocardiographic findings.

  13. Intravenous drug abuse and tricuspid valve endocarditis: Growing trends in the Middle East Gulf region.

    Science.gov (United States)

    Panduranga, Prashanth; Al-Abri, Seif; Al-Lawati, Jawad

    2013-11-26

    Traditionally, tricuspid valve endocarditis is uncommon in the Middle East region. However, recent global data indicate growing trends in the use of illicit drug abuse, specifically injectable heroin, in the Middle East Gulf region. The presence of many transit port services in the Middle East Gulf States has led to smuggling of substance abuse drugs in the region. The Middle East Gulf States, currently a transit market, are also becoming a growing consumer market in view of the increased substance abuse in the youth. However, there is a paucity of data with respect to the prevalence or incidence of tricuspid valve endocarditis in the region, probably due to underdiagnosis or underreporting. A high index of suspicion of tricuspid valve endocarditis is essential in patients with a history of intravenous drug abuse. This article reviews the epidemiology of illicit drug abuse in the Middle East Gulf region, as well as the diagnosis and treatment of tricuspid valve endocarditis, and calls for all physicians in the region to be vigilant while dealing with intravenous drug abuse.

  14. Severe tricuspid regurgitation is predictive for adverse events in tetralogy of Fallot

    NARCIS (Netherlands)

    Bokma, J.P.; Winter, M.M.; Oosterhof, T.; Vliegen, H.W.; Dijk, A.P.J. van; Hazekamp, M.G.; Koolbergen, D.R.; Groenink, M.; Mulder, B.J.; Bouma, B.J.

    2015-01-01

    OBJECTIVE: Patients with surgically repaired tetralogy of Fallot (rTOF) may develop functional tricuspid regurgitation (TR) due to annulus dilation. Guidelines suggest pulmonary valve replacement (PVR) in patients with rTOF with progressive TR, but data on clinical outcomes are lacking. Our objectiv

  15. Huge right atrial myxoma causing fixed tricuspid stenosis with constitutional symptoms.

    Science.gov (United States)

    Kuralay, Erkan; Cingöz, Faruk; Günay, Celalettin; Demirkiliç, Ufuk; Tatar, Harun

    2003-01-01

    Nonspecific constitutional symptoms are reported mostly in patients with left-atrial myxomas, which occur five times as often as its right-atrial counterpart. We present huge right-atrial myxoma, which obstructs tricuspid orifice with nonspecific constitutional symptoms without any pulmonary embolism attack.

  16. Percutaneous Edwards SAPIEN valve implantation in the tricuspid position : case report and review of literature

    NARCIS (Netherlands)

    Hoendermis, Elke S.; Douglas, Yvonne L.; van den Heuvel, Ad F. M.

    2012-01-01

    Aims: Experience with transcatheter valve-in-valve implantation in a failing bioprosthetic tricuspid valve is very limited. Fewer than 30 cases have been reported, and in most of them the Melody valve (Medtronic, Inc., Minneapolis, MN, USA) was used. With this case report and review of literature we

  17. Mujer joven con hipertiroidismo asociado a insuficiencia tricuspídea grave Young woman with hyperthyroidism associated with severe tricuspid regurgitation

    Directory of Open Access Journals (Sweden)

    Ariel K. Saad

    2008-02-01

    fever. The clinical findings were tachycardia with irregular pulse, right heart failure and regurgitant tricuspid murmur that increased with inspiration. The chest radiograph and the echocardiogram showed right ventricular dilatation and severe tricuspid regurgitation without pulmonary hypertension. The treatment with propranolol, corticosteroids and diuretics was successful. The patient was asymptomatic with sinus rhythm. We discuss the effects of thyroidal hormones on the cardiovascular system and postulate pathophysiologic mechanisms of heart failure in hyperthyroidism.

  18. Long-term effects of permanent pacemaker implantation on tricuspid valve regurgitation%起搏器植入术后对三尖瓣反流的远期影响

    Institute of Scientific and Technical Information of China (English)

    任崇雷; 王瑶; 王嵘; 李伯君; 耿仁义; 高长青

    2012-01-01

    Objective To explore the long-term effects of permanent pacemaker implantation (PPI) on tricuspid valve regurgitation (TR) in Chinese patients so as to determine the incidence and related factors,evaluate its effects on heart structure and function and ascertain the exact mechanism of TR after PPI.Methods A total of 430 patients undergoing permanent pacemaker replacement at our hospital between January 2000 and June 2011 were recruited.The patients with isolated atrial lead implantation procedures,significant heart valve disease or chronic obstructive pulmonary disease were excluded. The data of 108 patients who had Doppler echocardiograms performed before the first pacemaker implantation procedure and this pacemaker replacement procedure were obtained and retrospectively analyzed. According to the post-implant grade of TR,the patients were divided into two groups:normal tricuspid ( n =79 ) and abnormal tricuspid(n =29 ). Their clinical characteristics and echocardiographic data between two groups were analyzed and compared.Results The mean follow-up time (from the first pacemaker implantation) was ( 13 ± 6) years( range:4 -34 ).Among 108 patients with initially normal tricuspid post-implant,29 patients (26.9% ) developed significant TR during the follow-up.In comparison to those in normal tricuspid group,the patients in abnormal tricuspid group had a longer time from the first pacemaker implantation ( ( 16 ± 7 )vs (12±5) years,P=0.003),more transtricuspid leads (1.31 ±0.66 vs 1.10 ±0.30,P=0.026),larger right atrial size ( (38 ±7) vs (35 ±4) mm,P =0.028) and higher prevalence of mild TR and mitral valve regurgitation (MR) pre-implantation(TR:21% vs 4%,P =0.015,MR:28% vs 5%,P=0.003).The size of right atrium,right ventricle and left atrium in abnormal tricuspid group were more than those in normal tricuspid group.The prevalence of significant MR post-implantation in abnormal tricuspid group was higher than that in normal tricuspid group.The ejection

  19. Mitral valve repair and redo repair for mitral regurgitation in a heart transplant recipient

    NARCIS (Netherlands)

    Bouma, Wobbe; Brugemann, Johan; Wijdh-den Hamer, Inez J.; Klinkenberg, Theo J.; Koene, Bart M.; Kuijpers, Michiel; Erasmus, Michiel E.; van der Horst, Iwan C. C.; Mariani, Massimo A.

    2012-01-01

    A 37-year-old man with end-stage idiopathic dilated cardiomyopathy underwent an orthotopic heart transplant followed by a reoperation with mitral annuloplasty for severe mitral regurgitation. Shortly thereafter, he developed severe tricuspid regurgitation and severe recurrent mitral regurgitation du

  20. Plastic Jellyfish.

    Science.gov (United States)

    Moseley, Christine

    2000-01-01

    Presents an environmental science activity designed to enhance students' awareness of the hazards of plastic waste for wildlife in aquatic environments. Discusses how students can take steps to reduce the effects of plastic waste. (WRM)

  1. Examination of mitral regurgitation with a goat heart model for the development of intelligent artificial papillary muscle.

    Science.gov (United States)

    Shiraishi, Y; Yambe, T; Yoshizawa, M; Hashimoto, H; Yamada, A; Miura, H; Hashem, M; Kitano, T; Shiga, T; Homma, D

    2012-01-01

    Annuloplasty for functional mitral or tricuspid regurgitation has been made for surgical restoration of valvular diseases. However, these major techniques may sometimes be ineffective because of chamber dilation and valve tethering. We have been developing a sophisticated intelligent artificial papillary muscle (PM) by using an anisotropic shape memory alloy fiber for an alternative surgical reconstruction of the continuity of the mitral structural apparatus and the left ventricular myocardium. This study exhibited the mitral regurgitation with regard to the reduction in the PM tension quantitatively with an originally developed ventricular simulator using isolated goat hearts for the sophisticated artificial PM. Aortic and mitral valves with left ventricular free wall portions of isolated goat hearts (n=9) were secured on the elastic plastic membrane and statically pressurized, which led to valvular leaflet-papillary muscle positional change and central mitral regurgitation. PMs were connected to the load cell, and the relationship between the tension of regurgitation and PM tension were measured. Then we connected the left ventricular specimen model to our hydraulic ventricular simulator and achieved hemodynamic simulation with the controlled tension of PMs.

  2. Assessment of right ventricular function with Doppler echocardiographic indices derived from tricuspid annular motion: comparison with radionuclide angiography

    OpenAIRE

    Ueti, O M; Camargo,E.E.; de A Ueti, A; Lima-Filho,E.C.; Nogueira, E A

    2002-01-01

    Objective: To assess right ventricular systolic function using indices derived from tricuspid annular motion, and to compare the results with right ventricular ejection fraction (RVEF) calculated from radionuclide angiography.

  3. Successful management of multiple permanent pacemaker complications – infection, 13 year old silent lead perforation and exteriorisation following failed percutaneous extraction, superior vena cava obstruction, tricuspid valve endocarditis, pulmonary embolism and prosthetic tricuspid valve thrombosis

    Science.gov (United States)

    Kaul, Pankaj; Adluri, Krishna; Javangula, Kalyana; Baig, Wasir

    2009-01-01

    A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary embolism requiring TPA thrombolysis which was instantly successful. A review of literature of pacemaker endocarditis and tricuspid thrombosis along with the relevant management strategies is presented. We believe this case report is unusual on account of non operative management of right atrial lead perforation following an unsuccessful attempt at percutaneous removal of right sided infected pacemaker leads and the incidental discovery of the perforated lead 13 years later at sternotomy, presentation of pacemaker endocarditis with a massive load of vegetations along the entire pacemaker lead tract in superior vena cava, right atrial endocardium, tricuspid valve and right ventricular endocardium, leading to a functional and structural SVC obstruction, requirement of an unusually large dose of warfarin postoperatively occasioned, in all probability, by antibiotic drug interactions, presentation of tricuspid prosthetic valve thrombosis uniquely as vasovagal syncope and isolated hypoxia and near instantaneous resolution of tricuspid prosthetic valve thrombosis with Alteplase thrombolysis. PMID:19239701

  4. Morphologic and functional abnormalities in patients with Ebstein's anomaly with cardiac magnetic resonance imaging: Correlation with tricuspid regurgitation.

    Science.gov (United States)

    Liu, Xi; Zhang, Qin; Yang, Zhi-Gang; Guo, Ying-Kun; Shi, Ke; Xu, Hua-Yan; Wen, Ling-Yi; Li, Rui; Chen, Jing

    2016-09-01

    The aim of this study was to assess the correlations of functional and dimensional parameters with the severity of tricuspid regurgitation in patients with Ebstein's anomaly (EA) by using cardiac magnetic resonance (CMR) imaging. Thirty-three patients with EA without previous cardiac surgery and 25 normal individuals were recruited and underwent both cardiac MR imaging and preoperative transthoracic echocardiography. The left ventricular (LV) functional parameters and dimensions of the right ventricle (RV) and LV were measured using 3.0-T cardiac MR imaging. Tricuspid regurgitation severity grading was estimated by echocardiography. The functional and dimensional parameters were compared between EA patients and controls using independent sample t-tests. Spearman's rank correlation was used to determine the correlations between the functional and dimensional parameters and tricuspid regurgitation. Receiver operating characteristic (ROC) analysis was used to predict tricuspid regurgitation severity using individual functional and dimensional parameters. Statistical analysis revealed significant differences in the functional and dimensional parameters between EA patients and controls. Within the EA group, tricuspid valve regurgitation negatively correlated well with the left ventricular ejection fraction (LVEF) (r=-0.558, p=0.001). The ratio of the right ventricular (functional right ventricle) end-diastolic dimension to the left ventricle end-diastolic dimension (RVEDD/LVEDD) in EA patients also correlated well with the severity of tricuspid valve regurgitation (r=0.492, p=0.004). Moreover, ROC analysis revealed that high sensitivity and specificity were obtained for predicting the severity of tricuspid valve regurgitation with LVEF (78.3%, 90.0%) and RVEDD/LVEDD (78.3%, 94.3%). In EA patients, the left and right ventricular functional and dimensional parameters from MRI correlated well with tricuspid regurgitation, which helped predict the severity of EA. Copyright

  5. Transplante cardíaco com anastomose bicaval e anuloplastia tricúspide profilática no enxerto Cardiac transplantation with bicaval anastomosis and prophylactic graft tricuspid annuloplasty

    Directory of Open Access Journals (Sweden)

    Alfredo Inácio Fiorelli

    2008-03-01

    Full Text Available OBJETIVO: O presente estudo tem por objetivo avaliar os efeitos da anuloplastia tricúspide profilática no coração doador em transplante cardíaco com anastomose bicaval. MÉTODOS: De 2002 a 2005, foram selecionados de forma não aleatória 20 pacientes submetidos ao transplante cardíaco pela técnica bicaval e com sobrevida superior a seis meses. Eles foram divididos em dois grupos: Grupo I - 10 pacientes que receberam coração doador com anuloplastia tricúspide profilática, pela técnica de De Vega; e Grupo II - 10 pacientes que não receberam a anuloplastia, ambos com características semelhantes. O grau de regurgitação tricúspide foi avaliado pela ecocardiografia transtorácica com Doppler e foi quantificado entre 0 e 3 (0=ausente, 1=discreto, 2=moderado, 3=grave. O desempenho miocárdico foi avaliado pela fração de ejeção ventricular e pelo estudo hemodinâmico invasivo, durante as biópsias endomiocárdicas de rotina. RESULTADOS: O período médio de observação foi de 14,6±4,3 meses (6 e 16 meses. Houve apenas um óbito no grupo II não relacionado à anuloplastia. O grau médio de regurgitação tricúspide no Grupo I foi de 0,4±0,6 e no Grupo II foi de 1,6±0,8 (p OBJECTIVE: This study aims to evaluate the effects of prophylactic heart donor tricuspid annuloplasty in patients after heart transplantation with bicaval anastomosis. METHODS: From 2002 to 2005, 20 patients undergoing heart transplantation with bicaval anastomosis and with a survival rate over 6 months were deliberately selected. Patients were divided into two groups: Group I - 10 patients who underwent prophylactic heart donor tricuspid annuloplasty by the De Vega technique; and Group II - 10 patients did not undergo annuloplasty. In both groups, presurgical clinical characteristics were the same. The tricuspid regurgitation degree was evaluated by transthoracic Doppler echocardiography and it was qualified from 0 to 3 (0=absent, 1=mild, 2=moderated, 3

  6. Surgical management of tricuspid valve endocarditis in the current era: A review.

    Science.gov (United States)

    Yong, Matthew S; Coffey, Sean; Prendergast, Bernard D; Marasco, Silvana F; Zimmet, Adam D; McGiffin, David C; Saxena, Pankaj

    2016-01-01

    The incidence of isolated tricuspid valve infective endocarditis is increasing. Medical management is the mainstay of treatment but surgical intervention is required in a subset of patients. Surgical treatment options include valve excision and replacement or valve reconstruction. We searched PubMed and the Cochrane library to identify articles to be included in this review of surgical outcomes. References of selected articles were crosschecked for other relevant studies. Surgical management of tricuspid valve endocarditis can be achieved with satisfactory outcomes. However, the optimal indication and timing of surgery remain unclear, and the frequent association with intravenous drug use complicates management. Repair techniques are preferable though there is no clear evidence supporting one method over another.

  7. Synchronous intra-myocardial ventricular pacing without crossing the tricuspid valve or entering the coronary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Konecny, Tomas; DeSimone, Christopher V.; Friedman, Paul A.; Bruce, Charles [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Asirvatham, Samuel J., E-mail: asirvatham.samuel@mayo.edu [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Department of Pediatric and Adolescent Medicine, Pediatric Cardiology, Mayo Clinic, Rochester, MN (United States)

    2013-05-15

    Ventricular pacing is most commonly performed at the right ventricular (RV) apex. This is not without risk as placement requires crossing the tricuspid valve (TV) and may cause valvular dysfunction and dyssynchronous activation of the ventricles. The fact that the tricuspid valve lies more apically than the mitral valve allows for the possibility of pacing the ventricles from the right atrium (RA) via the “atrio-ventricular septum” without crossing the TV or entering the coronary sinus (CS). In order to mitigate far field activation inherent to current pacing technology, we constructed a novel lead in which the cathode and anode are both intra-myocardial. We demonstrate safety and efficacy of this novel lead for ventricular pacing at the atrio-ventricular septum in canines, including improved synchronous activation of both ventricles, improved differentiation in ventricular versus atrial sensing, while providing reliable ventricular capture, opening novel and a potentially safer alternative to human cardiac resynchronization therapy.

  8. Tricuspid atresia and pulmonary atresia in a child with Rubinstein-Taybi syndrome

    Directory of Open Access Journals (Sweden)

    Rohit S Loomba

    2015-01-01

    Full Text Available Rubinstein-Taybi syndrome is a well-characterized condition causing distinctive physical characteristics, intellectual disability, and multiple congenital malformations. Cardiac abnormalities are found in a third of individuals with this condition and usually consist of isolated septal defects or patent ductus arteriosus, although more complex congenital lesions have been described. We present the first reported case of tricuspid atresia and pulmonary atresia with hypoplasia of the right ventricle in the setting of Rubenstein-Taybi syndrome.

  9. Bioprosthesis valve replacement in dogs with congenital tricuspid valve dysplasia: technique and outcome.

    Science.gov (United States)

    Arai, Shiori; Griffiths, Leigh G; Mama, Khursheed; Hackett, Timothy B; Monnet, Eric; Boon, June A; Carter, Leslie; Orton, E Christopher

    2011-06-01

    To describe the surgical technique and report outcome of dogs undergoing bioprosthesis valve replacement for severe tricuspid regurgitation (TR) secondary to congenital tricuspid valve dysplasia (TVD). Twelve client-owned dogs (19-43 kg) with TVD underwent tricuspid valve replacement with a bovine pericardial or porcine aortic bioprosthesis with the aid of cardiopulmonary bypass. Anticoagulation with warfarin was maintained for 3 months after surgery and then discontinued. Ten of 12 (83.3%) dogs survived surgery and were discharged from the hospital. Seven dogs were alive with complete resolution of TR for a median period of 48 months (range 1-66 months) after surgery. Two dogs underwent euthanasia because of bioprosthesis failure due to inflammatory pannus at 10 and 13 months after surgery. Two dogs experienced valve thrombosis that was resolved by tissue plasminogen activator. One dog developed suspected endocarditis after surgery that was resolved with antibiotics. Serious cardiac complications included atrial fibrillation and flutter, right-to-left shunt through an uncorrected patent foramen ovale, complete atrioventricular block, and sudden cardiac arrest. Postoperative atrial fibrillation or flutter did not occur in 7 dogs treated prophylactically with oral amiodarone before surgery. Curative intermediate-term outcomes are possible in dogs undergoing open tricuspid valve replacement with a bioprosthesis. Prosthesis-related complications include inflammatory pannus, thrombosis, and endocarditis. Postoperative atrial fibrillation or flutter can be reduced or prevented by prophylactic preoperative treatment with amiodarone. Several identified complications are avoidable or can be reduced with increased awareness and experience with these techniques. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. 人工血管环代成形环治疗三尖瓣关闭不全56例%Ring Annuloplasty Using Prosthetic Vascular Graft for the Treatment of Tricuspid Regurgitation: Experience in 56 Patients

    Institute of Scientific and Technical Information of China (English)

    邹良建; 唐昊; 郎希龙; 徐激斌; 王军; 王尔松; 曲艺; 金海

    2012-01-01

    目的 探讨以人工血管环代替成形环治疗三尖瓣关闭不全的临床效果.方法 回顾性分析第二军医大学长海医院2000年7月至2010年7月收治三尖瓣关闭不全56例患者的临床资料,其中男24例,女32例;年龄14~73 (45.7±21.8)岁;均经心脏彩色多普勒超声心动图明确诊断为三尖瓣中度至大量反流(瞬时反流量>6ml),其中风湿性心脏瓣膜病47例,先天性心脏病三尖瓣下移畸形9例.均采用人工血管环代替成形环治疗三尖瓣关闭不全.结果 全组患者无早期死亡.术后1个月心脏超声心动图提示无三尖瓣关闭不全或轻度关闭不全,发生并发症3例,其中术后呼吸功能衰竭1例,肾功能不全1例,开胸止血1例.远期随访48例,平均随访3.8(1.0~9.5)年,无晚期死亡,发生抗凝并发症(脑梗死)1例;心功能分级(NYHA):Ⅰ级16例,Ⅱ级26例,Ⅲ级6例.随访期间超声心动图检查提示:三尖瓣无关闭不全36例,轻度关闭不全10例,中度关闭不全2例,无严重并发症.结论 人工血管环代替成形环治疗三尖瓣关闭不全可以取得较满意的早期和中期的临床疗效,可作为治疗三尖瓣关闭不全的手术方法之一.%Objective To evaluate the surgical effect of ring annuloplasty using prosthetic vascular graft for the treatment of tricuspid regurgitation. Methods From July 2000 to July 2010, ring annuloplasty using prosthetic vascular graft was performed to a total of 56 patients with tricuspid regurgitation in Changhai Hospital of Second Military Medical University. There were 24 male patients and 32 female patients. Their mean age was (45.7+21. 8) years (ranging from 14 to 73 years). All the patients were diagnosed as moderate to severe tricuspid regurgitation by color Doppler echocardiog-raphy examination, including 47 patients with rheumatic heart valve diseases, and 9 patients with congenital heart disease (Ebstein's anomaly). All the 56 patients underwent ring annuloplasty using

  11. 二尖瓣置换术后远期功能性三尖瓣关闭不全的外科治疗%Surgical treatment of late functional tricuspid regurgitation after mitral valve replacement

    Institute of Scientific and Technical Information of China (English)

    梅举; 张宝仁; 郝家骅; 朱家麟; 徐志云; 邹良健

    2001-01-01

    Objective: To report the results and role of surgical treatment of functional tricuspid regurgitation (TR) late after mitral valve replacement (MVR). Methods: There were thirty-seven patients with moderate to severe functional TR after MVR. Prior MVR was performed with mechanical valve in 24 cases and biological valve in 13. 11 patients received medical therapy, and 26 surgical treatment. The types of surgery included MVR and tricuspid valve replacement in 3 and tricuspid valve annuloplasty in 10. Three different methods of tricuspid valve annuloplasty were used for correction of TR, including modified Kay annuloplasty in 12 cases and modified DeVega annuloplasty in 7 and tricuspid valve ring annuloplasty in 2. Results: Six of 11 patients who received medical therapy died within 7 months to 7.5 years and the mortality rate was 54.5%. Two of 26 patients who received surgical treatment died early after operation and the hospital mortality rate was 7.7%. The 24 survivors were followed up from 8 months to 10.5 years and there was one late death and 2 had moderate functional TR. Conclusions: The irreversible right heart impairment and/or servere pulmonary hypertension are responsible for the development of late functional TR after MVR. The surgical management of the TR, which include tricuspid valve replacement and tricuspid valve annuloplasty may achieve excellent results in the patients with significant clinical symptoms and preserved left ventricular functions.%目的 报告二尖瓣置换(MVR)术后远期三尖瓣关闭不全(TR)外科治疗的结果及作用。方法 37例MVR术后中重度TR病人,其中人工二尖瓣为生物瓣者13例,机械瓣24例。有11例行内科保守治疗,26例行外科手术治疗。手术类型:MVR加三尖瓣置换2例,MVR加三尖瓣成形11例,三尖瓣置换3例,三尖瓣成形10例。三尖瓣成形术包括改良Kay成形术12例,改良DeVega成形术7例,加成形环的三尖瓣成形术2

  12. Delayed recovery of right ventricular systolic function after repair of long-standing tricuspid regurgitation associated with severe right ventricular failure.

    Science.gov (United States)

    Kim, Jong Hun; Kim, Kyung Hwa; Choi, Jong Bum; Kuh, Ja Hong

    2016-03-01

    After tricuspid valve surgery for long-standing tricuspid regurgitation associated with right ventricular failure, reverse remodelling of the enlarged right ventricle, including recovery of right ventricular systolic function, is unpredictable. We present the case of a 31-year old man with early reduction of dilated right ventricular dimensions and delayed recovery of impaired right ventricular systolic function after valve repair for traumatic tricuspid regurgitation lasting 16 years.

  13. 功能性三尖瓣反流影响因素的分析%Analysis on the Influence Factors of Functional Tricuspid Regurgitation

    Institute of Scientific and Technical Information of China (English)

    梁柱

    2012-01-01

    Functional tricuspid regurgitation ( FTR) is a common finding in patients with concomitant left-sided valvular disease. The long-standing moderate-to-severe FTR can result on poor recovery of cardiac function, or even worsening of heart function and death, reducing long-term survival rates after left-sided valve surgery. Previous studies suggested that FTR reduced in different levels after valve replacement; observed in some patients after valve replacement FTR failed to achieve the expected therapeutic effect, and late postoperative FTR or aggravating FTR occurred. Positive tricuspid valve plasty has been adopted for FTR in recent years,which has achieved good clinical results,while there is still recurrence in long term. Currently influencing factors on FTR residual, reverse or aggravation are various, without uniform conclusions.%左心系统瓣膜病变患者常合并功能性三尖瓣反流(FTR),中度及以上FTR长期存在可引起手术后期心功能恢复不良,甚至心功能进行性恶化、死亡,降低长期生存率.既往研究认为,瓣膜置换术后FTR将不同程度减轻;但观察发现瓣膜置换术后部分患者FTR未能达到术前所期望的疗效,术后远期出现FTR或FTR进行性加重.近年对FTR采取积极的三尖瓣成形术手术,取得良好的临床效果,但仍存在一定的中、远期复发情况.目前影响FTR的残留、逆转或加重的因素较多,尚无定论.

  14. The occurrence and suspected mode of inheritance of congenital subaortic stenosis and tricuspid valve dysplasia in Dogue de Bordeaux dogs.

    Science.gov (United States)

    Ohad, D G; Avrahami, A; Waner, T; David, L

    2013-08-01

    The Dogue de Bordeaux (DdB) breed has gone through several genetic 'bottle necks' and has a relatively small effective population size. Importing new stock into Israel has been limited, further narrowing the already restricted local gene-pool and increasing the chances of inherited defects. In 56 DdB dogs examined between 2003 and 2010, the authors sought to study the proportion congenital subaortic stenosis (SAS) and tricuspid valve dysplasia (TVD). The aim was also to identify a probable mode of inheritance (MOI) using segregation and pedigree analyses of genealogical data available from 13/21 DdB dogs diagnosed with these conditions between 2004 and 2007. Among all breeds in the country, TVD was highest in the DdB breed, which also displayed the second highest proportion of SAS. Echocardiographic measurements and selected physical examination findings from 26 normal DdB dogs, 18 DdB dogs with SAS, and 12 DdB dogs with TVD are reported. Based on pedigree and segregation analyses, the most probable MOI appeared to be autosomal recessive. Pedigree analyses helped to identify three ancestors that might have introduced these two congenital heart defects into the local DdB population. Excluding those three dogs and their progeny from future mating could therefore reduce the prevalence of these diseases in the DdB population in Israel. The unusual local breeding circumstances may offer a unique opportunity to identify associated SAS and TVD genes in the DdB, as well as in other dog breeds. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Plastics Technology.

    Science.gov (United States)

    Barker, Tommy G.

    This curriculum guide is designed to assist junior high schools industrial arts teachers in planning new courses and revising existing courses in plastics technology. Addressed in the individual units of the guide are the following topics: introduction to production technology; history and development of plastics; safety; youth leadership,…

  16. Mitral valve repair and redo repair for mitral regurgitation in a heart transplant recipient

    Directory of Open Access Journals (Sweden)

    Bouma Wobbe

    2012-09-01

    Full Text Available Abstract A 37-year-old man with end-stage idiopathic dilated cardiomyopathy underwent an orthotopic heart transplant followed by a reoperation with mitral annuloplasty for severe mitral regurgitation. Shortly thereafter, he developed severe tricuspid regurgitation and severe recurrent mitral regurgitation due to annuloplasty ring dehiscence. The dehisced annuloplasty ring was refixated, followed by tricuspid annuloplasty through a right anterolateral thoracotomy. After four years of follow-up, there are no signs of recurrent mitral or tricupid regurgitation and the patient remains in NYHA class II. Pushing the envelope on conventional surgical procedures in marginal donor hearts (both before and after transplantation may not only improve the patient’s functional status and reduce the need for retransplantation, but it may ultimately alleviate the chronic shortage of donor hearts.

  17. Heart Health - Brave Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  18. Reversal of echocardiographic right-sided heart pathology in a dog with severe pulmonary hypertension: a case report

    Directory of Open Access Journals (Sweden)

    McMahon P

    2015-06-01

    Full Text Available Peggy McMahon,1 Carley Saelinger 2  1Emergency and Critical Care Department, 2Cardiology Department, Animal Specialty and Emergency Center, Los Angeles, CA, USA Abstract: Pathologic right-sided heart changes are a common echocardiographic finding in patients with pulmonary hypertension (PH. Canines with PH may have right heart pathology documented via echocardiographic color Doppler interrogation including tricuspid valve regurgitation, pulmonic valve insufficiency, elevated pulmonary arterial systolic pressure, elevated pulmonary arterial diastolic pressure, and alterations in ejection profiles. Two-dimensional echocardiographic findings may include right ventricular hypertrophy, interventricular septal flattening, paradoxical interventricular septal motion, pulmonary artery dilation, and potentially abnormal left heart dimensions. In veterinary medicine, much confidence is given to the measurement of pulmonary arterial systolic pressure estimated from tricuspid valve regurgitation to grade the severity of PH and monitor its improvement with little emphasis placed on the integration of two-dimensional echocardiographic right and left heart pathology in conjunction with Doppler findings. To the authors’ knowledge, marked improvement and/or resolution of echocardiographic-documented right heart pathology have not been previously reported in the veterinary literature. This case report documents profound echocardiographic improvement of right-sided heart disease in a dog with severe PH. Keywords: canine, pulmonary hypertension, tricuspid valve regurgitation, right heart hypertrophy, sildenafil  

  19. Screening performance for trisomy 21 comparing first trimester combined screening and a first trimester contingent screening protocol including ductus venosus and tricuspid flow

    DEFF Research Database (Denmark)

    Ekelund, Charlotte Kvist; Petersen, Olav Bjørn; Sundberg, Karin Milner

    2012-01-01

    To compare the standard first trimester combined risk assessment for trisomy 21 with a contingent screening protocol including tricuspid flow and ductus venosus flow.......To compare the standard first trimester combined risk assessment for trisomy 21 with a contingent screening protocol including tricuspid flow and ductus venosus flow....

  20. Plastic bronchitis

    National Research Council Canada - National Science Library

    Singhi, Anil Kumar; Vinoth, Bharathi; Kuruvilla, Sarah; Sivakumar, Kothandam

    2015-01-01

    Plastic bronchitis, a rare but serious clinical condition, commonly seen after Fontan surgeries in children, may be a manifestation of suboptimal adaptation to the cavopulmonary circulation with unfavorable hemodynamics...

  1. Surgical treatment of infective endocarditis with aortic and tricuspid valve involvement using cryopreserved aortic and mitral valve allografts.

    Science.gov (United States)

    Ostrovsky, Yury; Spirydonau, Siarhei; Shchatsinka, Mikalai; Shket, Aliaksandr

    2015-05-01

    Surgical treatment of infective and prosthetic endocarditis using allografts gives good results. Aortic allograft implantation is a common technique, while tricuspid valve replacement with a mitral allograft is very rare. Multiple valve disease in case of infective endocarditis is a surgical challenge as such patients are usually in a grave condition and results of surgical treatment are often unsatisfactory. In this article we describe a clinical case of successful surgical treatment in a patient with active infective endocarditis of aortic and tricuspid valve, complicated by an aortic-right ventricular fistula. The aortic valve and ascending aorta were replaced with a cryopreserved aortic allograft; the tricuspid valve was replaced with a cryopreserved mitral allograft. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. 风湿性心脏病手术3个瓣膜同时置换的临床经验%Experience of triple-valve replacement in rheumatic heart valve disease

    Institute of Scientific and Technical Information of China (English)

    张国报; 乔刚; 赵小娟; 权晓强; 赵健; 程兆云

    2012-01-01

    Objective:To explore the triple-valve replacement experience in rheumatic heart valve disease. Methods: We reviewed our experience in A patients who underwent combined mitral and aortic valve replacement with tricuspid valve replacement between 2007 and 2011. Results:We found tricuspid annular dilatation and leaflet thickening resulting in tricuspid regurgitation in four patients, tricuspid commissural fusion leading to tricuspid stenosis in two patients. One patient received bioprosthetic valves replacement procedures in aortic and mitral position with tricuspid position. The other three patients received mechanical valves replacement procedures in aortic and mitral position, and bioprosthetic valve in tricuspid position. One patient died after operation due to low cardiac output syndrome. The mean follow-up was 30 months (range, 12 to 49 months). Post-operative heart function NYHA classifi-cation:two cases in class I, one case in class Ⅱ. Conclusion;We recommend the use of a bioprosthetic valve in tricuspid position if tricuspid valve should be replaced. Even if mechanical valves are implanted in the left side of the heart, a bioprosthetic valve may be a better choice at the tricuspid position.%目的:探讨风湿性心脏病手术中3个瓣膜同时置换的经验.方法:对4例同时置换二尖瓣、主动脉瓣和三尖瓣的病人资料进行分析.结果:术中发现4例病人均有三尖瓣环扩大和瓣叶增厚导致关闭不全,2例病人伴有交界融合导致瓣膜狭窄.1例病人接受了二尖瓣位、主动脉瓣位以及三尖瓣位生物瓣置换.另3例病人接受了二尖瓣位和主动脉瓣位机械瓣置换,以及三尖瓣位生物瓣置换.1例病人死于术后低心排.其他病人平均随访30个月(12~49个月),术后心功能I级2例,Ⅱ级1例.结论:如果三尖瓣需要置换时应使用生物瓣.尽管左侧心脏瓣膜应用机械瓣,三尖瓣位应用生物瓣仍是较好的选择.

  3. Plastic Fishes

    CERN Multimedia

    Trettnak, Wolfgang

    2015-01-01

    In terms of weight, the plastic pollution in the world’s oceans is estimated to be around 300,000 tonnes. This plastic comes from both land-based and ocean-based sources. A lecture at CERN by chemist Wolfgang Trettnak addressed this issue and highlighted the role of art in raising people’s awareness. The slideshow below gives you a taste of the artworks by Wolfgang Trettnak and Margarita Cimadevila.

  4. Plastic Bridge

    Institute of Scientific and Technical Information of China (English)

    履之

    1994-01-01

    Already ubiquitous in homes and cars, plastic is now appearing inbridges. An academic-industrial consortium based at the University ofCalifornia in San Diego is launching a three-year research program aimed atdeveloping the world’s first plastic highway bridge, a 450-foot span madeentirely from glass-,carbon,and polymer-fiber-reinforced composite mate-rials, the stuff of military aircraft. It will cross Interstate 5 to connect thetwo sides of the school’s campus.

  5. Transcatheter closures for fistula tract and paravalvular leak after mitral valve replacement and tricuspid annuloplasty.

    Science.gov (United States)

    Om, Sang Yong; Park, Gyung Min; Kim, Jin Yong; Yoon, Yong Hoon; Lee, Sinwon; Kim, Young-Hak; Song, Jae-Kwan

    2014-01-01

    Paravalvular leaks (PVLs) often occur after surgical valve replacement. Surgical reoperation has been the gold standard of therapy for PVLs, but it carries a higher operative risk and an increased incidence of re-leaks compared to the initial surgery. In high surgical risk patients with appropriate geometries, transcatheter closure of PVLs could be an alternative to redo-surgery. Here, we report a case of successful staged transcatheter closures of a fistula tract between the aorta and right atrium, and mitral PVLs after mitral valve replacement and tricuspid annuloplasty.

  6. Successful retrieval of a knotted pulmonary artery catheter trapped in the tricuspid valve apparatus

    OpenAIRE

    Muhammad Ishaq; Nicki Alexander; David H. T. Scott

    2013-01-01

    We report the case of a 64-year-old patient in whom a pulmonary artery catheter formed a knot fixed within the right ventricle in the region of the tricuspid valve apparatus. Knot formation is a recognized complication associated with pulmonary artery catheters (PAC) insertion. This problem is usually dealt with by simply withdrawing the PAC until the knot impacts onto the introducer and after enlarging the puncture site by a small skin incision removing the introducer-PAC as one unit. Howeve...

  7. The maverick heart sound.

    Science.gov (United States)

    Witt, Chance M; Miranda, William R; Newman, Darrell B

    2016-07-01

    An asymptomatic 29-year-old woman presented for prenatal counselling. She had a history of a heart murmur since childhood and a previous echocardiogram suggesting 'enlargement of the heart'. Physical exam revealed normal jugular venous pressure and contour. Precordial palpation was unremarkable. Auscultation, however, was abnormal; findings on inspiration and expiration are presented in Figure 1, sound clip. Based on the phonocardiogram and online supplementary audio clip, which of the following is correct? An early diastolic filling sound (S3) is heard, indicating increased right ventricular filling pressures.An ejection click without respiratory variation and a systolic ejection murmur are heard, consistent with bicuspid aortic valve stenosis.An ejection click with respiratory variation and a systolic ejection murmur are heard, consistent with pulmonic valve stenosis.A holosystolic murmur with inspiratory augmentation is heard, indicating tricuspid regurgitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. 瓣膜病术后三尖瓣重度关闭不全的外科治疗%Effect of surgical treatment of tricuspid valve regurgitation after valve replacement

    Institute of Scientific and Technical Information of China (English)

    浮志坤; 董自超; 谷小卫; 张志远; 杜虹; 姚伟; 吴信

    2013-01-01

    Objective To evaluate the outcome of surgical treatment of tricuspid valve regurgitation after valve replacement.Methods Twenty one patients with tricuspid valve insufficiency after valve replacement were performed surgical treatment.Tricuspid valve-plasty was performed in 17 patients and tricuspid valve replacement was done in 4 patients.Three patients underwent edge-to-edge tricuspid valveplasty.DeVega procedure was performed in 5 patients.Cosgrove-Edward annuloplasty ring was used in 15 patients.Four patients' valve were replaced by SJM bileallet mechanical prostheses.Results There was 3 patients dead early after operation with a mortality of 14.3%(3/21).The causes of death including multiple organ failure,cardiac arrest and low cardiac output syndrome.The rate of early postoperative complications was 33.3% (7/21),including pulmonary edema,arrhythmia,acute renal failure and low cardiac output syndrome.The patients were followed up 9-60 months.The rate of readmission was 23.8% (5/21).Two patients went to hospital again for pleural effusion,1 patient for left ventricular dysfunction and 2 patients for right ventricular dysfunction.The other patients recovered well.Conclusions Surgical therapy is effective on severe tricuspid valve regurgitation after valve replacement.Preoperative aggressive treatment of heart failure,a reasonable grasp of surgical indications and timing of surgery,strict perioperative management are the keys to guarantee patients a smooth recovery.%目的 评价瓣膜病术后三尖瓣重度关闭不全的外科治疗效果.方法 21例瓣膜病术后人工瓣膜无障碍及毁损、三尖瓣重度关闭不全患者行三尖瓣成形术或三尖瓣置换术;三尖瓣成形术17例,三尖瓣置换术4例.三尖瓣成形术包括缘对缘3例,改良DeVega法成形5例,放置Cosgrove-Edward成形环15例,4例换瓣均为SJM双叶机械瓣.结果 术后早期病死率为14.3%(3/21),死亡原因:多脏器功能衰竭、心脏骤停和低心

  9. Reversal of echocardiographic right-sided heart pathology in a dog with severe pulmonary hypertension: a case report

    OpenAIRE

    McMahon P; Saelinger C

    2015-01-01

    Peggy McMahon,1 Carley Saelinger 2  1Emergency and Critical Care Department, 2Cardiology Department, Animal Specialty and Emergency Center, Los Angeles, CA, USA Abstract: Pathologic right-sided heart changes are a common echocardiographic finding in patients with pulmonary hypertension (PH). Canines with PH may have right heart pathology documented via echocardiographic color Doppler interrogation including tricuspid valve regurgitation, pulmonic valve insufficiency, elevat...

  10. Evaluation of the structure of tricuspid valve with three dimensional echocardiography in hypoplastic right ventricle%三维超声心动图评估发育不良型三尖辦结构的价值

    Institute of Scientific and Technical Information of China (English)

    陈笋; 孙锟; 陈树宝; 张玉奇; 张志芳; 吴兰萍

    2009-01-01

    目的 应用三维超声心动图探讨右心室发育不良时三尖辦装置的结构特点.方法 28例诊断为右心室发育不良的患儿,按照三尖辦反流程度分为反流组(三尖辦反流中度及以上)与非反流组(三尖辦反流轻度及以下).18例年龄匹配的正常儿童作为对照组.应用实时三维超声心动图测定右心室容积、三尖辦辦环面积、三尖辦各辦叶的面积以及辦尖至最近乳头肌顶点的距离.测值应用体表面积(USA)进行标化.结果 右心室发育不良患儿组的右心室容积显著低于正常组,三尖辦辦环面积与右心室容积显著相关(r=0.90,P<0.0001).在三尖辦反流组,三尖辦前辦面积与辦环面积的比值较非反流组以及正常组显著增加,而后辦所占比值显著缩小.右心发育不良组各辦尖至相邻乳头肌顶点的距离显著小于正常组.反流组隔辦辦尖至相邻乳头肌距离显著小于非反流组(P=0.0023).结论 三维超声心动图可以用来评估先天性心脏病三尖辦病变.右心室发育不良患儿后辦发育不良以及隔辦腱索偏短可能是三尖辦反流的原因.%Objective To reveal the character of tricuspid valve in hypoplastic right ventricular heart syndrome (HPRVHS) using 3-dimensional echocardiography(3DE). Methods Twenty eight patients with HPRVHS were included in the study, and they were divided into two groups according the degree of tricuspid regurgitation. Eighteen normal children were included as the control. Volume of right ventricle(VRV), area of tricuspid annulus(TVA),proportion of the leaflets and the distance from tips of leaflets to the nearest papillary muscle were measured with 3DE. These data was standardized by body surface area. Results The volume of right ventricle in HPRVHS was significantly less than that in normal group. The area of tricuspid annulus was significantly correlated with volume of right ventricle(r = 0. 90, P < 0. 0001). In the tricuspid regurgitation

  11. Virtual reality 3D echocardiography in the assessment of tricuspid valve function after surgical closure of ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Kappetein A Pieter

    2007-02-01

    Full Text Available Abstract Background This study was done to investigate the potential additional role of virtual reality, using three-dimensional (3D echocardiographic holograms, in the postoperative assessment of tricuspid valve function after surgical closure of ventricular septal defect (VSD. Methods 12 data sets from intraoperative epicardial echocardiographic studies in 5 operations (patient age at operation 3 weeks to 4 years and bodyweight at operation 3.8 to 17.2 kg after surgical closure of VSD were included in the study. The data sets were analysed as two-dimensional (2D images on the screen of the ultrasound system as well as holograms in an I-space virtual reality (VR system. The 2D images were assessed for tricuspid valve function. In the I-Space, a 6 degrees-of-freedom controller was used to create the necessary projectory positions and cutting planes in the hologram. The holograms were used for additional assessment of tricuspid valve leaflet mobility. Results All data sets could be used for 2D as well as holographic analysis. In all data sets the area of interest could be identified. The 2D analysis showed no tricuspid valve stenosis or regurgitation. Leaflet mobility was considered normal. In the virtual reality of the I-Space, all data sets allowed to assess the tricuspid leaflet level in a single holographic representation. In 3 holograms the septal leaflet showed restricted mobility that was not appreciated in the 2D echocardiogram. In 4 data sets the posterior leaflet and the tricuspid papillary apparatus were not completely included. Conclusion This report shows that dynamic holographic imaging of intraoperative postoperative echocardiographic data regarding tricuspid valve function after VSD closure is feasible. Holographic analysis allows for additional tricuspid valve leaflet mobility analysis. The large size of the probe, in relation to small size of the patient, may preclude a complete data set. At the moment the requirement of an I

  12. GREEN PLASTIC: A NEW PLASTIC FOR PACKAGING

    OpenAIRE

    Mr. Pankaj Kumar*, Sonia

    2016-01-01

    This paper gives a brief idea about a new type of plastic called as bio-plastic or green plastic. Plastic is used as a packaging material for various products, but this plastic is made up of non renewable raw materials. There are various disadvantages of using conventional plastic like littering, CO2 production, non-degradable in nature etc. To overcome these problems a new type of plastic is discovered called bio-plastic or green plastic. Bio-plastic is made from renewable resources and also...

  13. Multiresistant-MRSA tricuspid valve infective endocarditis with ancient osteomyelitis locus

    Directory of Open Access Journals (Sweden)

    Gambarati Gianpaolo

    2006-07-01

    Full Text Available Abstract Background Methicillin-resistant S. aureus (MRSA with low susceptibility to glycopeptides is uncommon. Case presentation The case of a 50-year-old non-drug addict patient presenting with tricuspid valve infective endocarditis (IE by MRSA resistant to vancomycin and linezolid is presented. There was response only to quinupristin/dalfopristin. He had a motorcycling accident four years before undergoing right above-the-knee amputation and orthopaedic fixation of the left limb. There were multiple episodes of left MRSA-osteomyelitis controlled after surgery and vancomycin therapy. MRSA isolated from the blood at the time of IE presented with the same profile than the isolated four years earlier. Sequential treatment with teicoplanin-cotrimoxazole and Linezolid associated to vancomycin – rifampicin – cotrimoxazole had no improvement. Infection was controlled after 28 days of therapy with quinupristin/dalfopristin. Conclusion The literature presents only a few cases of MRSA IE not susceptible to glycopeptides in not drug addicted patients. This case shows the comparison of a highly-resistant MRSA after previous S. aureus osteomyelitis treated with glycopeptides. This is the first description of successful treatment of resistant-MRSA IE of the tricuspid valve complicated by multiple pulmonary septic infarction with quinupristin/dalfopristin

  14. The Changing “Face” of Endocarditis in Kentucky: A Rise in Tricuspid Cases

    Science.gov (United States)

    Seratnahaei, Arash; Leung, Steve W.; Charnigo, Richard J.; Cummings, Matthew S.; Sorrell, Vincent L.; Smith, Mikel D.

    2015-01-01

    Background Advancements in medical technology and increased life expectancy have been described as contributing to the evolution of endocarditis. We sought to determine whether there has been a change in the incidence, demographics, microbiology, complications, and outcomes of infective endocarditis over a ten-year time span. Methods We screened 28,420 transthoracic and transesophageal echocardiogram reports performed at our center for the following indications: fever, masses, emboli (including stroke), sepsis, bacteremia, and endocarditis in two time periods: 1999 through 2000 and 2009 through 2010. Data were collected from diagnosed endocarditis cases. Results Overall, 143 cases of infective endocarditis were analyzed (48 in 1999-2000 and 95 in 2009-2010). The endocarditis incidence per number of admissions remained nearly constant at 0.113% for 1999-2000 and 0.148% for 2009-2010 (p = 0.153). However, tricuspid valve involvement increased markedly from 6% to 36% (p endocarditis at our center has not changed and mortality remains high, but the “face of endocarditis” in Kentucky has evolved with an increased incidence of tricuspid valve involvement, valvular complications, and embolic events. PMID:24769025

  15. Tropheryma whipplei tricuspid endocarditis: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Greub Gilbert

    2010-08-01

    Full Text Available Abstract Introduction The main clinical manifestations of Whipple's disease are weight loss, arthropathy, diarrhea and abdominal pain. Cardiac involvement is frequently described. However, endocarditis is rare and is not usually the initial presentation of the disease. To the best of our knowledge, this is the first reported case of a patient with Tropheryma whipplei tricuspid endocarditis without any other valve involved and not presenting signs of arthralgia and abdominal involvement. Case presentation We report a case of a 50-year-old Caucasian man with tricuspid endocarditis caused by Tropheryma whipplei, showing signs of severe shock and an absence of other more classic clinical signs of Whipple's disease, such as arthralgia, abdominal pain and diarrhea. Tropheryma whipplei was documented by polymerase chain reaction of the blood and pleural fluid. The infection was treated with a combined treatment of doxycycline, hydroxychloroquine and sulfamethoxazole-trimethoprim for one year. Conclusion Tropheryma whipplei infectious endocarditis should always be considered when facing a blood-culture negative endocarditis particularly in right-sided valves. Although not standardized yet, treatment of Tropheryma whipplei endocarditis should probably include a bactericidal antibiotic (such as doxycycline and should be given over a prolonged period of time (a minimum of one year.

  16. Idiopathic mitral valve prolapse with tricuspid, aortic and pulmonary valve involvement: An autopsy case report

    Directory of Open Access Journals (Sweden)

    Heena M Desai

    2015-01-01

    Full Text Available Mitral valve prolapse (MVP is usually asymptomatic, but can be associated with complications such as infective endocarditis, mitral regurgitation, thromboembolism and sudden cardiac death. It has been very rarely reported to occur in association with other valvular involvement. A 55-year-old male patient was brought dead and at autopsy the mitral valve orifice was stenotic and the leaflets were enlarged, myxoid and bulging suggestive of MVP and chordae tendinae were thickened, stretched and elongated. Similar changes were seen in the tricuspid valve. The pulmonary and aortic valves also showed myxomatous degeneration of their cusps. Myxomatous degeneration is the most common cause of MVP and it can be associated with involvement of the other valves. Concomitant involvement of the aortic valve has been reported, however it is very rare and simultaneous involvement of the pulmonary valve has not been reported in the literature so far. We report a case of MVP associated with myxomatous degeneration of the tricuspid, pulmonary and aortic valves.

  17. Plastic condoms.

    Science.gov (United States)

    1968-01-01

    Only simple equipment, simple technology and low initial capital investment are needed in their manufacture. The condoms can be made by people who were previously unskilled or only semi-skilled workers. Plastic condoms differ from those made of latex rubber in that the nature of the plastic film allows unlimited shelf-life. Also, the plastic has a higher degree of lubricity than latex rubber; if there is a demand for extra lubrication in a particular market, this can be provided. Because the plastic is inert, these condoms need not be packaged in hermetically sealed containers. All these attributes make it possible to put these condoms on the distributors' shelves in developing countries competitively with rubber condoms. The shape of the plastic condom is based on that of the lamb caecum, which has long been used as luxury-type condom. The plastic condom is made from plastic film (ethylene ethyl acrilate) of 0.001 inch (0.0254 mm.) thickness. In addition, a rubber ring is provided and sealed into the base of the condom for retention during coitus. The advantage of the plastic condom design and the equipment on which it is made is that production can be carried out either in labour-intensive economy or with varying degrees of mechanization and automation. The uniform, finished condom if made using previously untrained workers. Training of workers can be done in a matter of hours on the two machines which are needed to produce and test the condoms. The plastic film is provided on a double wound roll, and condom blanks are prepared by means of a heat-sealing die on the stamping machine. The rubber rings are united to the condom blanks on an assembly machine, which consists of a mandrel and heat-sealing equipment to seal the rubber ring to the base of the condom. Built into the assembly machine is a simple air-testing apparatus that can detect the smallest pinhole flaw in a condom. The manufacturing process is completed by unravelling the condom from the assembly

  18. Physiopathological approach to infective endocarditis in chronic hemodialysis patients: left heart versus right heart involvement.

    Science.gov (United States)

    Bentata, Yassamine

    2017-11-01

    Infectious endocarditis (IE), a complication that is both cardiac and infectious, occurs frequently and is associated with a heavy burden of morbidity and mortality in chronic hemodialysis patients (CHD). About 2-6% of chronic hemodialysis patients develop IE and the incidence is 50-60 times higher among CHD patients than in the general population. The left heart is the most frequent location of IE in CHD and the different published series report a prevalence of left valve involvement varying from 80% to 100%. Valvular and perivalvular abnormalities, alteration of the immune system, and bacteremia associated with repeated manipulation of the vascular access, particularly central venous catheters, comprise the main factors explaining the left heart IE in CHD patients. While left-sided IE develops in altered valves in a high-pressure system, right-sided IE on the contrary, generally develops in healthy valves in a low-pressure system. Right-sided IE is rare, with its incidence varying from 0% to 26% depending on the study, and the tricuspid valve is the main location. Might the massive influx of pathogenic and virulent germs via the central venous catheter to the right heart, with the tricuspid being the first contact valve, have a role in the physiopathology of IE in CHD, thus facilitating bacterial adhesion? While the physiopathology of left-sided IE entails multiple and convincing mechanisms, it is not the case for right-sided IE, for which the physiopathological mechanism is only partially understood and remains shrouded in mystery.

  19. Plastic Bronchitis.

    Science.gov (United States)

    Rubin, Bruce K

    2016-09-01

    Plastic bronchitis is an uncommon and probably underrecognized disorder, diagnosed by the expectoration or bronchoscopic removal of firm, cohesive, branching casts. It should not be confused with purulent mucous plugging of the airway as seen in patients with cystic fibrosis or bronchiectasis. Few medications have been shown to be effective and some are now recognized as potentially harmful. Current research directions in plastic bronchitis research include understanding the genetics of lymphatic development and maldevelopment, determining how abnormal lymphatic malformations contribute to cast formation, and developing new treatments. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Mixed plastics recycling technology

    CERN Document Server

    Hegberg, Bruce

    1995-01-01

    Presents an overview of mixed plastics recycling technology. In addition, it characterizes mixed plastics wastes and describes collection methods, costs, and markets for reprocessed plastics products.

  1. European association of echocardiography recommendations for the assessment of valvular regurgitation. Part 2: Mitral and tricuspid regurgitation (native valve disease)

    NARCIS (Netherlands)

    P. Lancellotti (Patrizio); L. Moura (Luis); L. Pié rard (Luc); E. Agricola (Eustachio); B.A. Popescu (Bogdan); C. Tribouilloy (Christophe); A. Hagendorff (Andreas); J.L. Monin; L. Badano (Luigi); J.L. Zamorano (Jose); R. Sicari (Rosa); A. Vahanian (Alec); J.R.T.C. Roelandt (Jos)

    2010-01-01

    textabstractMitral and tricuspid are increasingly prevalent. Doppler echocardiography not only detects the presence of regurgitation but also permits to understand mechanisms of regurgitation, quantification of its severity and repercussions. The present document aims to provide standards for the as

  2. Virtual reality 3D echocardiography in the assessment of tricuspid valve function after surgical closure of ventricular septal defect

    NARCIS (Netherlands)

    G. Bol-Raap (Goris); A.H.J. Koning (Anton); T.V. Scohy (Thierry); A.D.J. ten Harkel (Arend); F.J. Meijboom (Folkert); A.P. Kappetein (Arie Pieter); P.J. van der Spek (Peter); A.J.J.C. Bogers (Ad)

    2007-01-01

    textabstractBackground. This study was done to investigate the potential additional role of virtual reality, using three-dimensional (3D) echocardiographic holograms, in the postoperative assessment of tricuspid valve function after surgical closure of ventricular septal defect (VSD). Methods. 12 da

  3. Situs inversus with levocardia and congenitally corrected transposition of great vessels with rheumatic tricuspid valve stenosis and regurgitation

    Directory of Open Access Journals (Sweden)

    Bharat B Kukreti

    2011-01-01

    Full Text Available Congenitally corrected transposition of great arteries is a rare congenital anomaly. This case report describes a 30-year-old patient of congenitally corrected transposition of the great arteries with rheumatic involvement of systemic (tricuspid atrio-ventricular valve.

  4. European association of echocardiography recommendations for the assessment of valvular regurgitation. Part 2: Mitral and tricuspid regurgitation (native valve disease)

    NARCIS (Netherlands)

    P. Lancellotti (Patrizio); L. Moura (Luis); L. Pié rard (Luc); E. Agricola (Eustachio); B.A. Popescu (Bogdan); C. Tribouilloy (Christophe); A. Hagendorff (Andreas); J.L. Monin; L. Badano (Luigi); J.L. Zamorano (Jose); R. Sicari (Rosa); A. Vahanian (Alec); J.R.T.C. Roelandt (Jos)

    2010-01-01

    textabstractMitral and tricuspid are increasingly prevalent. Doppler echocardiography not only detects the presence of regurgitation but also permits to understand mechanisms of regurgitation, quantification of its severity and repercussions. The present document aims to provide standards for the as

  5. Plastic fish

    CERN Multimedia

    Antonella Del Rosso

    2015-01-01

    In terms of weight, the plastic pollution in the world’s oceans is estimated to be around 300,000 tonnes. This plastic comes from both land-based and ocean-based sources. A lecture at CERN by chemist Wolfgang Trettnak addressed this issue and highlighted the role of art in raising people’s awareness.   Artwork by Wolfgang Trettnak. Packaging materials, consumer goods (shoes, kids’ toys, etc.), leftovers from fishing and aquaculture activities… our oceans and beaches are full of plastic litter. Most of the debris from beaches is plastic bottles. “PET bottles have high durability and stability,” explains Wolfgang Trettnak, a chemist by education and artist from Austria, who gave a lecture on this topic organised by the Staff Association at CERN on 26 May. “PET degrades very slowly and the estimated lifetime of a bottle is 450 years.” In addition to the beach litter accumulated from human use, rivers bring several ki...

  6. Plastic zonnecellen

    NARCIS (Netherlands)

    Roggen, Marjolein

    1998-01-01

    De zonnecel van de toekomst is in de maak. Onderzoekers van uiteenlopend pluimage werken eendrachtig aan een plastic zonnecel. De basis is technisch gelegd met een optimale, door invallend licht veroorzaakte, vorming van ladingdragers binnen een composiet van polymeren en buckyballs. Nu is het zaak

  7. Tricuspid atresia

    Science.gov (United States)

    ... This procedure connects half of the veins carrying blue blood from the upper half of the body directly ... Fontan procedure. The rest of the veins carrying blue blood from the body are connected directly to the ...

  8. Relation of tricuspid annular displacement and tissue Doppler imaging velocities with duration of weaning in mechanically ventilated patients with acute pulmonary edema

    Directory of Open Access Journals (Sweden)

    Dragoumanis Christos K

    2010-05-01

    Full Text Available Abstract Background Liberation from the ventilator is a difficult task, whereas early echocardiographic indices of weaning readiness are still lacking. The aim of this study was to test whether tricuspid annular plane systolic excursion (TAPSE and right ventricular (RV systolic (Sm and diastolic (Em & Am tissue Doppler imaging (TDI velocities are related with duration of weaning in mechanically ventilated patients with acute respiratory failure due to acute pulmonary edema (APE. Methods Detailed quantification of left and right ventricular systolic and diastolic function was performed at admission to the Intensive Care Unit by Doppler echocardiography, in a cohort of 32 mechanically ventilated patients with APE. TAPSE and RV TDI velocities were compared between patients with and without prolonged weaning (≥ or Results Patients with prolonged weaning (n = 12 had decreased TAPSE (14.59 ± 1.56 vs 19.13 ± 2.59 mm, Sm (8.68 ± 0.94 vs 11.62 ± 1.77 cm/sec and Em/Am ratio (0.98 ± 0.80 vs 2.62 ± 0.67, p 2 = 0.53, beta slope = 0.76, p 2 = 0.52, beta = 0.75, p 2 = 0.57, beta = 0.32, p Conclusions We suggest that in mechanically ventilated patients with APE, low TAPSE and RV TDI velocities upon admission are associated with delayed liberation from mechanical ventilation, probably due to more severe LV heart failure.

  9. Application of vena cava intraluminal occlusion technique in minimally invasive isolated tricuspid valve surgery%腔静脉内阻断技术在单纯性三尖瓣微创手术中的应用

    Institute of Scientific and Technical Information of China (English)

    姜兆磊; 朱家全; 梅举; 丁芳宝; 沈赛娥; 黄健兵; 张俊文; 何毅; 蒋连勇

    2013-01-01

    Objective To summarize the experiences of appling vena cava intraluminal occlusion technique in minimally invasive repeated isolated tricuspid valve surgery.Methods Consecutive patients (n=46) with isolated significant late tricuspid regurgitation (TR) after previous cardiac surgery received minimally invasive repeated tricuspid valve surgery in beating heart without cmssclamping ascending aorta from 2002 to 2012.Computed tomography showed that severe adhesions exited in the pericardium and the posterior of the sternum.It was difficult to carry out the conventional median thoracotomy and segregate the vena cava.Cardiopulmonary bypass was initiated by cannulating the right femoral artery for arterial access.A right anterolateral thoracotomy incision was made over the fourth intercostal space.Under transoesophageal echocardiographic guidance,the balloon cannulas were insterted through the surface of the right atrium for the venous drainage both of the superior vena cava (SVC) and the inferior vena cava (IVC) respectively.The balloon of the cannula was inflated to obtain the occlusion of SVC and IVC when the nasopharyngeal temperature was about 32 ℃-33 ℃.After the endovascular occlusion of both the caval veins,the right atrium was opened and the tricuspid valve surgery was performed.Results The tricuspid valve was repaired in 12 patients and replaced in 34 patients.There was not cardiopulmonary bypass accident during the operation.The time of operation was (161±52) min.The time of building cardiopulmonary bypass(CPB) was (55±15) min and the time of CPB was (58±23) min.The postoperative drainage was (275±108) ml,and the postoperative inhospital time was (8±7) days.There was no death in hospital.During the follow-up,2 patients died.One died of pulmonary vascular rupture,and the other died of heart failure.There was no paravalvular leakage occurs in tricuspid valve replacement (TVR).Echocardiography showed that one patient who had tricuspid valve plasty (TVP

  10. [Offer early attention and intervention to patients with valvular heart disease].

    Science.gov (United States)

    Jiang, Shengli; Ren, Chonglei

    2015-02-01

    As a key feature of the updates, early intervention of valvular heart disease is highlighted in the 2014 AHA/ACC guideline for the management of patients with valvular heart disease. This article reviewed the new guideline in regards to the issue of early intervention of diseases such as aortic stenosis, aortic insufficiency, mitral stenosis, mitral insufficiency, tricuspid insufficiency, and infective endocarditis, with discussion on the related topics according to the authors' understanding and practical experience in China. We conclude that valvular heart disease should receive early intervention and attention should also be paid on the progress of disease.

  11. Plastic Surgery Statistics

    Science.gov (United States)

    ... PSN PSEN GRAFT Contact Us News Plastic Surgery Statistics Plastic surgery procedural statistics from the American Society of Plastic Surgeons. Statistics by Year Print 2016 Plastic Surgery Statistics 2015 ...

  12. Comparison of transcatheter laser and direct-current shock ablation of endocardium near tricuspid anulus

    Science.gov (United States)

    Zhang, Yu-Zhen; Wang, Shi-Wen; Li, Junheng

    1993-03-01

    Forty to eighty percent of the patients with accessory pathways (APs) manifest themselves by tachyarrhythmias. Many of these patients needed either life-long medical therapy or surgery. In order to avoid the discomfort and expenses in surgical procedures, closed chest percutaneous catheter ablation of APs became a potentially desirable therapeutic approach. Many investigations indicated that ablation of right APs by transcatheter direct current (dc) shock could cause life-threatening arrhythmias, right coronary arterical (RCA) spasm, etc. With the development of transcatheter laser technique, it has been used in drug-incurable arrhythmias. The results show that laser ablation is much safer than surgery and electric shock therapy. The purpose of this study is to explore the effectiveness, advantages, and complications with transcatheter Nd:YAG laser and dc shock in the ablation of right atrioventricular accessory pathways in the atrium near the tricuspid annulus (TA) in 20 dogs.

  13. Reversible tricuspid valve stenosis due to a metastatic dissemination of a noncardiac sarcoma.

    Science.gov (United States)

    Uribe-Etxebarria, Naia; Voces, Roberto; Rodriguez, Miguel Angel; Llorente, Alberto; Perez, Pedro; Aramendi, Jose I

    2005-07-01

    Malignant disease is present in the pericardium of 1.5% to 20.6% of patients dying of malignant diseases as was examined postmortem. We present a case of a 57-year-old man with a history of Hodgkin's disease and a sarcoma of gluteus who presented with tachypnea, generalized weakness, and anasarca for 7 days. The echocardiogram revealed the presence of a significant pericardial thickening and localized pericardial effusion resulting from a tricuspid stenosis. A right anterior thoracotomy was performed, and a pericardiectomy (4 x 4 cm) was done. The histologic examination of the pericardium revealed the presence of a metastatic dissemination from a sarcoma. The cause for the clinical presentation and the treatment of malignant pericardial disease are discussed.

  14. Aortic and tricuspid endocarditis in hemodialysis patient with systemic and pulmonary embolism.

    Science.gov (United States)

    Rosa, Silvia Aguiar; Germano, Nuno; Santos, Ana; Bento, Luis

    2015-01-01

    This is a case report of a 43-year-old Caucasian male with end-stage renal disease being treated with hemodialysis and infective endocarditis in the aortic and tricuspid valves. The clinical presentation was dominated by neurologic impairment with cerebral embolism and hemorrhagic components. A thoracoabdominal computerized tomography scan revealed septic pulmonary embolus. The patient underwent empirical antibiotherapy with ceftriaxone, gentamicin and vancomycin, and the therapy was changed to flucloxacilin and gentamicin after the isolation of S. aureus in blood cultures. The multidisciplinary team determined that the patient should undergo valve replacement after the stabilization of the intracranial hemorrhage; however, on the 8th day of hospitalization, the patient entered cardiac arrest due to a massive septic pulmonary embolism and died. Despite the risk of aggravation of the hemorrhagic cerebral lesion, early surgical intervention should be considered in high-risk patients.

  15. Flexible band versus rigid ring annuloplasty for tricuspid regurgitation: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Nelson; Phan, Steven; Tian, David H; Yan, Tristan D; Phan, Kevin

    2017-05-01

    Up to 20% of patients have pre-discharge residual moderate to severe tricuspid regurgitation (TR) after tricuspid repair. Reoperations for recurrent TR carry high mortality rates, which emphasizes the importance of identifying the optimal technique for the surgical management of TR. The present study is a systematic review and meta-analysis that aims to compare short and long term survival and freedom from TR of flexible band ring versus rigid ring for annuloplasty of TR. We conducted a systematic review and meta-analysis of comparative studies to evaluate these procedures. A systematic search of the literature was performed from six electronic databases. Pooled meta-analysis was conducted using odds ratio (OR) and weighted mean difference (WMD). The rates of in-hospital mortality were not different between the two groups, with cumulative rates of 6.9% for flexible band and 7.3% for rigid ring (OR: 0.92; 95% CI: 0.49-1.71). Rates of stroke were also similar with 1.7% of flexible band and 1.3% of rigid rings suffering a perioperative stroke (OR: 1.29; 95% CI: 0.74-2.23). Rigid ring had significantly better freedom from grade ≥2 TR at 5 years (OR: 0.44; 95% CI: 0.20-0.99) and overall (P=0.005). There was no significant difference in overall rates of reoperation (P=0.232) and survival (P=0.086) between flexible band and rigid ring. Both rigid ring and flexible band offer acceptable outcomes for the treatment of TR. Compared to flexible band, rates of TR are stable after rigid ring annuloplasty and long term freedom from TR are superior for rigid ring devices. Large prospective randomized trials are required in order to validate these findings and assess for improvements in patient survival.

  16. Heart valve disease associated with treatment with ergot-derived dopamine agonists: a clinical and echocardiographic study of patients with Parkinson's disease

    DEFF Research Database (Denmark)

    Rasmussen, Vibeke Guldbrand; Poulsen, Steen Hvitfeldt; Dupont, E

    2007-01-01

    OBJECTIVE: To elucidate the association between treatment with ergot-derived dopamine agonists (EDDA) and valvular abnormalities amongst patients with idiopathic Parkinson's disease (IPD) and secondly, to analyse the yield of clinical screening for valvular heart disease. DESIGN: A cross....... Interventions. Patients were screened for valvular heart disease by clinical means and by examiner-blinded echocardiography. Main outcome measure was valvular regurgitation revealed by echocardiography. RESULTS: Severe aortic regurgitation (n = 4) or moderate aortic (n = 12), mitral (n = 3) or tricuspidal valve...

  17. Plastic bronchitis

    Directory of Open Access Journals (Sweden)

    Anil Kumar Singhi

    2015-01-01

    Full Text Available Plastic bronchitis, a rare but serious clinical condition, commonly seen after Fontan surgeries in children, may be a manifestation of suboptimal adaptation to the cavopulmonary circulation with unfavorable hemodynamics. They are ominous with poor prognosis. Sometimes, infection or airway reactivity may provoke cast bronchitis as a two-step insult on a vulnerable vascular bed. In such instances, aggressive management leads to longer survival. This report of cast bronchitis discusses its current understanding.

  18. An unusual case of infective endocarditis: extension of a tricuspid valve vegetation into the left atrium through a patent foramen ovale.

    Science.gov (United States)

    Johri, Amer M; Kovacs, Katherine A; Kafka, Henryk

    2009-07-01

    Tricuspid valve endocarditis frequently occurs in the setting of intravenous drug use. A case of tricuspid valve endocarditis in a 37-year-old woman with a history of intravenous cocaine use is described. Transthoracic echocardiography showed extension of the tricuspid valve mass through a patent foramen ovale and into the left atrium. One week after intravenous antibiotic treatment, the mass no longer traversed the patent foramen ovale, and only two smaller tricuspid valve vegetations remained. The present case demonstrates the value of performing a complete and thorough transthoracic echocardiography to visualize and evaluate both the right- and left-sided consequences of infective endocarditis in intravenous drug users. It also serves as a useful reminder to physicians caring for such patients that right sided endocarditis can have important left-sided complications.

  19. 人工软环与改良De Vega术治疗三尖瓣关闭不全的疗效观察与对比%Observation and comparison of the clinical efficacy of the tricuspid annuloplasty ring and the modified De Vega tricuspid annuloplasty for the treatment of functional tricuspid regurgitation

    Institute of Scientific and Technical Information of China (English)

    赵鹏英; 祁亮; 宋兵

    2016-01-01

    。但两种不同术式的短期临床疗效相似。%ObjectiveTo evaluate the clinical efficacy of tricuspid annuloplasty ring and the modified De Vegatricuspid annuloplasty for the treatment of functional tricuspid regurgitation.MethodsA total of 40 patients withfunctional tricuspid from June 2015 to September2015 in our hospitalwere involved in this study. The patients were randomly divided into two groups, modified De Vega tricuspid annuloplasty group(n=20) and tricuspid annuloplasty ring group(n=20, treated with imported Edwards4600 tricuspid annuloplasty ring). All patients were reviewed and followed-up in 1 week, 1 month and 3 months after operation.The clinical efficacy wasevaluatedby the diameter of right atrium,the diameter of ventriculus dexter,the differential pressure of tricuspid valve and the reverse flow of tricuspid valve.ResultsDe Vega group pre-operation indexes: right atrium diameterwas (50.12±10.34)mm,right ventricular internal dimensionwas(28.47±6.35)mm,tricuspid valve differential pressurewas(39.56±7.84)mmHg,tricuspid regurgitation in beam area/right atrium areawas 23.98%±5.42%, postoperation indexes: right atrium diameterwas(32.63±6.53)mm,right ventricular internal dimensionwas(24.64±4.67)mm,tricuspid valve differential pressurewas(30.76±5.96)mmHg,tricuspid regurgitation in beam area/right atrium areawas4.10%±2.35%.Tricuspid annuloplasty ring group pre-operation indexes: right atrium diameterwas(45.30±7.95)mm,right ventricular internal dimensionwas(24.10±4.71)mm, tricuspid valve differential pressurewas(41.15±9.65)mmHg,tricuspid regurgitation inbeam area/right atrium areawas22.75%±6.52%, postoperation indexes: right atrium diameterwas(35.25±6.67)mm,right ventricular internal dimensionwas(21.60±2.99)mm,tricuspid valve differential pressurewas(26.00±6.67)mmHg,tricuspid regurgitation inbeam area/right atrium areawas3.90%±1.89%. There were obvious improvements in all of the postoperative indexescompared withpreoperativeindexesin

  20. Traumatic tricuspid regurgitation and right-to-left intra-atrial shunt--an unusual complication of a horse-kick.

    LENUS (Irish Health Repository)

    Byrne, R A

    2010-02-01

    A 63-year-old male presented with sudden onset chest pain and dyspnoea following a kick to the praecordium while gelding a horse. Transthoracic echocardiography showed evidence of flail tricuspid valve leaflets, severe tricuspid regurgitation and a widely patent foramen ovale with a right-to-left shunt. Due to progressive severe systemic hypoxemia the patient underwent emergent surgical intervention. Operative findings confirmed rupture of the anterior and septal tricuspid valve papillary muscles. Successful papillary muscle reattachment was performed in association with tricuspid annuloplasty and suture closure of his patent foramen ovale. Disruption of the tricuspid valve is well described as consequence of blunt trauma to the chest wall and is often well tolerated, coming to light many years post injury. Valve disruption due to rupture at the papillary muscle level, however, typically results in greater severity of tricuspid regurgitation and the abrupt rise in right intra-atrial pressure may lead to a right-to-left shunt across a patent foramen ovale. Where hemodynamic compromise ensues, prompt surgical intervention is mandated.

  1. Heart Disease

    Science.gov (United States)

    ... type of heart disease you have. Symptoms of heart disease in your blood vessels (atherosclerotic disease) Cardiovascular disease ... can sometimes be found early with regular evaluations. Heart disease symptoms caused by abnormal heartbeats (heart arrhythmias) A ...

  2. Stepwise Progression of Right-to-Left Atrial Shunting through a Combination of Patent Foramen Ovale and Tricuspid Regurgitation.

    Science.gov (United States)

    Kransdorf, Evan P; Kransdorf, Lisa N; Fortuin, F David; Sweeney, John P; Wilansky, Susan

    2016-04-01

    Patent foramen ovale is a common clinical finding that generally becomes a concern in the presence of transient ischemic attack or stroke. Rarely, patent foramen ovale is associated with hypoxemia in the presence of substantial right-to-left atrial shunting. We present the case of an 86-year-old woman with a pacemaker, who was initially asymptomatic notwithstanding a patent foramen ovale. Over 1.5 years, her symptoms progressed in a stepwise fashion, in the setting of progressive pacemaker-associated tricuspid regurgitation. Ultimately, the patient's symptoms and her hypoxemia resolved after percutaneous closure of her patent foramen ovale with use of a 25-mm "Cribriform" occluder device. This case highlights the fact that clinically significant right-to-left shunting requires an anatomic lesion, such as patent foramen ovale, together with elevated right atrial pressure, which in this case was contributed by severe tricuspid regurgitation.

  3. Tc-99m-HMPAO-Labeled leukocyte SPECT/CT in pediatrics: detecting Candida albicans tricuspid endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Calais, Jeremie; Edet-Sanson, Agathe; Gaucher, Stephane; Vera, Pierre; Cloirec, Joseph Le [Henri Becquerel Cancer Center and Rouen Univ. Hospital, Rouen (France)

    2015-12-15

    These results led to performing TEE, which showed tricuspid vegetation. Blood cultures were then positive to Candida albicans. Control blood cultures and TEE performed 6 weeks later after adapted antifungal therapy remained negative. In accordance with the results of Erba and al., this case illustrates the usefulness of late thoracic SPECT-CT acquisition of a WBC scan in a patient with high clinical suspicion of endocarditis and identified risk factors but inconclusive echocardiographic findings.

  4. Surgical treatment of severe chronic venous insufficiency caused by pulsatile varicose veins in a patient with tricuspid regurgitation.

    Science.gov (United States)

    Casian, D; Gutsu, E; Culiuc, V

    2009-04-01

    A case of severe chronic venous insufficiency caused by pulsatile varicose veins in a 46-year-old man with tricuspid regurgitation is presented. Active venous leg ulcer complicated with recurrent venous bleeding and inefficacy of conservative management serve as indications for surgical treatment. This case demonstrates the possibility of radical surgical correction of pathological venous reflux by means of saphenofemoral ligation, foam sclerotherapy and subfascial endoscopic perforator surgery.

  5. Isolated native tricuspid valve endocarditis presenting as PUO in a young adult male without any risk factors

    Directory of Open Access Journals (Sweden)

    Piyush Ranjan

    2015-01-01

    Full Text Available A 28-year-old male presented to our hospital with high-grade fever and weight loss for 4 months. Clinical examination was non-contributory and there was no history of any high-risk behavior or prolonged skin or dental infections. Native tricuspid-valve endocarditis may rarely present in these settings and high index of suspicion is essential for early diagnosis.

  6. Daptomycin Failure for Treatment of Pulmonary Septic Emboli in Native Tricuspid and Mitral Valve Methicillin-Resistant Staphylococcus aureus Endocarditis

    Directory of Open Access Journals (Sweden)

    Hadeel Zainah

    2013-01-01

    Full Text Available Daptomycin has been used with success for the treatment of right-sided methicillin-resistant Staphylococcus aureus (MRSA endocarditis. However, its efficacy has not been completely assessed for the treatment of MRSA endocarditis when it is associated with pulmonary septic emboli. Hereby, we present a case of MRSA mitral and tricuspid native valve endocarditis with pulmonary septic emboli, which was treated with daptomycin as a sole agent, resulting in worsening pulmonary infiltrates and treatment failure.

  7. Plastia tricúspide utilizando anuloplastia baseada na proporção entre os segmentos do anel da valva tricúspide normal Tricuspid valve repair using the proportion between segments of normal tricuspid annulus as a parameter for annuloplasty

    Directory of Open Access Journals (Sweden)

    Fernando Antoniali

    2007-12-01

    Full Text Available OBJETIVO: Determinar a proporção existente entre os segmentos do anel da valva tricúspide (VT normal e aplicála na realização da anuloplastia tricúspidea "in vitro" e "in vivo". MÉTODOS: Imagens digitais do anel tricuspídeo de 30 corações de cadáveres humanos, sem formolização e sem insuficiência tricúspide (IT, foram analisadas e a proporção entre os segmentos ântero-posterior e septal foi determinada. Esta proporção foi utilizada na anuloplastia da VT com anel maleável de pericárdio bovino (PB, em 15 corações de cadáveres com IT e dilatação do anel valvar. A mesma proporção e técnica foi utilizada na realização de anuloplastia tricuspídea, em 11 pacientes com IT funcional, entre os quais, sete possuíam IT importante e quatro, moderada; cinco apresentavam insuficiência cardíaca (IC classe IV (NYHA e seis, classe III. RESULTADOS: Nas valvas continentes de cadáveres, a razão média entre o segmento ântero-posterior e septal foi 2,43±0,212. O tamanho médio dos anéis maleáveis PB utilizados "in vitro" foi 71,5±5,2mm e mediana 70mm. Todas as valvas ficaram continentes após a anuloplastia tricuspídea "in vitro". O tamanho médio do anel maleável PB utilizado "in vivo" foi 73,4±6,5mm e mediana 72mm. Ocorreu um (9,1% óbito. Na avaliação com 6 meses de pós-operatório, sete pacientes não possuíam IT e três possuíam IT leve; seis pacientes apresentavam IC classe I, três, classe II e um, classe III. CONCLUSÃO: O uso da proporção de 2,43:1 entre os segmentos ântero-posterior e septal, como um parâmetro na anuloplastia da VT, utilizando anel maleável de pericárdio bovino, demonstrou resultados iniciais favoráveis.OBJECTIVE: To determine the proportion between the segments of the normal human tricuspid valve (TV annulus and its use as a parameter for ring annuloplasty "in vitro" and "in vivo". METHODS: Digital images of the tricuspid ring of 30 human cadaveric hearts, without fixation and

  8. 功能性三尖瓣关闭不全的治疗策略%The therapy policy about functional tricuspid regurgitate

    Institute of Scientific and Technical Information of China (English)

    祝岩; 王辉山; 金岩

    2015-01-01

    Objective To assess and compare the the results of tricuspid annuloplasty performed with the Edwards MC3 and Kay methode.Methods From January 2010 to May 2014, 759 patients with function tricuspid regurgitation(FTR) secondary to left-sided valve disease received tricuspid annuloplasty.Cardiac ultrasound Heartbeat diagram were made to confirm the degree of tricuspid regurgitation, the diameter of tricuspid annulus, the pressure of pulmonary artery and the heart function both in the left and the right, and so on.Of them, 355 cases of male, female 404 cases, at the mean age of(54.1 ± 8.3) years old, with the heart function classical(NYHA) : Ⅰ 13, Ⅱ 177, Ⅲ 400, Ⅳ 169, the mean left ventricles ejection fraction(LVEF) was 0.53 ±0.04, the mean pulmonary artery pressure was(62.5 ± 17.6) mmHg(1 mmHg =0.133 kPa).The diagnosis include rheumatic heart disease 517 cases, degenerative disease 209 cases and infective endocarditis 33 cases.The operation include mitral annuloplasty 132 case, mitral replacement 295 cases, mitral annuloplasty and aortic replacement 20 cases, mitral and aortic replacement 388 cases, CABG 86 cases and Maze Ⅲ methode 23 cases.The degree of tricuspid regurgitation before the operation were class Ⅰ 88, Ⅱ 189, Ⅲ 352 and V 130.From January 2010 to May 2012, 447 cases received Kay' s methods and 312 cases received MC3 annuloplasty ring during May 2012 to May 2014.In the MC3, We use the rings in 28mm size were 79 cases, 30 mm 155 cases, 32 mm 66 cases and 34 mm 12 cases.Results There were no death, reoperation and adverse events in both groups.There were no diffent in the aorta block time, the circulation bypass time, the time of mechanical ventilation, stay in ICU and in the hospital(P > 0.05).All the patient were followed up regularity.The rat of follow up was 90.4% (686/759), and the mean time of follow up was(39.9 ± 7.7) month.The patients' s EF increased, inner diameter of the right ventricle decreased in both group.There were no

  9. Proporção entre os segmentos do anel da valva tricúspide normal: um parâmetro para realização da anuloplastia valvar Proportion among the segments of the normal tricuspid valve annulus: parameter for valve annuloplasty

    Directory of Open Access Journals (Sweden)

    Fernando Antoniali

    2006-09-01

    Full Text Available OBJETIVO: Determinar a proporção existente entre os segmentos do anel da valva tricúspide normal em humanos. MÉTODO: Foram estudados 30 corações de cadáveres humanos não formolizados, com menos de 6h de período post-mortem, sem lesões congênitas ou adquiridas e com valvas tricúspides continentes. A continência valvar foi confirmada por injeção de água sob pressão no interior do ventrículo direito estando a valva pulmonar fechada. Fotos digitais da valva tricúspide com o anel valvar íntegro, e após secção e retificação, foram avaliadas por programa de computador. Compararam-se as medidas médias e as razões entre elas nas condições de anel íntegro e retificado. RESULTADOS: Com o anel valvar íntegro, os valores médios do perímetro, segmento septal e ântero-posterior foram 105mm (±12,7, 30,6mm (±3,7 e 74mm (±9,4, respectivamente. Com o anel valvar retificado, os valores médios foram 117,5mm (±13,3, 32mm (±3,7, 46,3mm (±8,3 e 39,1mm (±8,5, respectivamente para perímetro, segmento septal, anterior e posterior. As razões médias entre o segmento ântero-posterior e o septal foram 2,43 (±0,212 e 2,67 (±0,304, respectivamente, em anéis íntegros e retificados. Houve diferenças significantes nas medidas do perímetro (pOBJECTIVE: The purpose of this study was to determine the proportions among the segments of the human tricuspid valve annulus. METHODS: A descriptive autopsy study was made of 30 human hearts without fixation, within six hours of death, without congenital or acquired lesions and without tricuspid regurgitation. Tricuspid valve insufficiency was excluded by the infusion of pressurized water in the right ventricle with the pulmonary valve closed. Digital images of the tricuspid ring in its anatomical position and after flattening were analyzed by specific software. The mean measurements and ratios were compared in the two different situations. RESULTS: The mean measurements of the perimeter

  10. 超声心动图评价三尖瓣硬质三维环成形术对继发性三尖瓣关闭不全的疗效%Evaluation of Rigid 3D Ring Annuloplasty for Functional Tricuspid Regurgitation by Echocardiography

    Institute of Scientific and Technical Information of China (English)

    武俊; 夏稻子; 李阳; 张东明; 潘永泉

    2013-01-01

    Objective To evaluate the outcomes of rigid 3D ring annuloplasty for functional tricuspid regurgitation by echocardiography. Methods 35 patients with functional tricuspid regurgitation undergoing rigid 3D ring annuloplasty and left-side valve operation were observed as TVP+ group, and 15 patients with functional tricuspid regurgitation undergoing left-side valve operation but not received tricuspid annuloplasty were observed as TVR- group. The degree of TR,TVAD, RAD, RVD,VE and RVEF were measured by Echocardiography preoperatively and postopera-tively. Results The degree of TR, TV AD, RAD, RVD were decreased significantly after operation in TVR+ group (P0. 05). RAD and RVD were reduced further(P0. 05). However, the degree of TR, TVAD, RAD, RVD were enlarged and RVEF was reduced significantly after one year of operation in TVR- group (P<0. 05 ). Conclusions Tricuspid annuloplasty should be preformed simultaneously with left-side valve operation for patients with functional tricuspid regurgitation. Rigid 3D ring annuloplasty for functional tricuspid regurgitation is helpful to improve the right heart structure and function. The outcome is stable after operation.%目的 通过超声心动图评价继发性三尖瓣关闭不全患者行三尖瓣硬质三维环成形术的意义及疗效.方法 左心瓣膜手术同期行三尖瓣硬质三维环成形术的患者(TVP阳性组)35例与未能同期行三尖瓣成形术者(TVP阴性组)15例,分别于术前、术后2周、术后1年通过超声心动图测量三尖瓣环直径(TVAD),舒张期三尖瓣口E峰值流速(ⅤE),三尖瓣反流束面积(TRA),三尖瓣反流分数(TRF),右房内径(RAD),右室内径(RVD)及右室射血分数(RVEF),重点比较术后与术前、术后1年与术后2周时各参数的变化.结果 TVP阳性组:术后2周及术后1年TVAD、TRA、TRF、RAD及RVD均显著减低(P<0.05);ⅤE及RVEF无显著变化(P>0.05);术后1年与术后2周相比,TVAD、TRA、TRF无明显变化(P>0.05),

  11. Cine-MR imaging of valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Han, Man Chung; Kim, Chu Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Jin; Kim, Woo Sung; Park, Hyun Wuk; Cho, Zang Hee [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    1989-04-15

    Cine-MR imaging was done in 2 normal persons and 9 patients of valvular heart disease with 2.0 T superconducting MR system (Spectro-2000; GoldStar, Korea). The MRI was undertaken using gradient echo technique with small flip angle. Repetition time (TR) was 34 msec, and echo time (TE), 18 msec. In most cases, 20 to 30 frames could be obtained during one cardiac cycle. With normal heart, high signal intensity was identified in the blood filled cardiac chambers. Transient signal void was observed near tricuspid, mitral and aortic valves due to the turbulences induced by valve opening or closure. In 6 cases of mitral valvular disease, mitral valve was identified in all cases. The valvular motion was limited revealing doming toward cardiac apex during diastole. Signal void was evident in pansystolic phase of left ventricle in all cases. Evidence of combined aortic or tricuspid valve disease were also demonstrated, revealing signal void in the corresponding cardiac chambers. Cine-MRI seemed to be not only a good non-invasive diagnostic modality for the valvular heart disease, but also an accurate modality for cardiac functional evaluation.

  12. Remodelling of the aortic root in severe tricuspid aortic stenosis: implications for transcatheter aortic valve implantation

    Energy Technology Data Exchange (ETDEWEB)

    Stolzmann, Paul; Desbiolles, Lotus; Scheffel, Hans; Leschka, Sebastian; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Knight, Joseph; Kurtcuoglu, Vartan; Poulikakos, Dimos [Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich (Switzerland); Maier, Willibald [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Plass, Andre [University Hospital Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland)

    2009-06-15

    Detailed knowledge of aortic root geometry is a prerequisite to anticipate complications of transcatheter aortic valve (TAV) implantation. We determined coronary ostial locations and aortic root dimensions in patients with aortic stenosis (AS) and compared these values with normal subjects using computed tomography (CT). One hundred consecutive patients with severe tricuspid AS and 100 consecutive patients without valvular pathology (referred to as the controls) undergoing cardiac dual-source CT were included. Distances from the aortic annulus (AA) to the left coronary ostium (LCO), right coronary ostium (RCO), the height of the left coronary sinus (HLS), right coronary sinus (HRS), and aortic root dimensions [diameters of AA, sinus of Valsalva (SV), and sino-tubular junction(STJ)] were measured. LCO and RCO were 14.9 {+-} 3.2 mm (8.2-25.9) and 16.8 {+-} 3.6 mm (12.0-25.7) in the controls, 15.5 {+-} 2.9 mm (8.8-24.3) and 17.3 {+-} 3.6 mm (7.3-26.0) in patients with AS. Controls and patients with AS had similar values for LCO (P = 0.18), RCO (P = 0.33) and HLS (P = 0.88), whereas HRS (P < 0.05) was significantly larger in patients with AS. AA (r = 0.55,P < 0.001), SV (r = 0.54,P < 0.001), and STJ (r = 0.52,P < 0.001) significantly correlated with the body surface area in the controls; whereas no correlation was found in patients with AS. Patients with AS had significantly larger AA (P < 0.01) and STJ (P < 0.01) diameters when compared with the controls. In patients with severe tricuspid AS, coronary ostial locations were similar to the controls, but a transverse remodelling of the aortic root was recognized. Owing to the large distribution of ostial locations and the dilatation of the aortic root, CT is recommended before TAV implantation in each patient. (orig.)

  13. Tricuspid Regurgitation Improvement in Relation to the Amount of Pulmonary Artery Pressure Reduction

    Directory of Open Access Journals (Sweden)

    Mahmood Sheikhfathollahi

    2010-08-01

    Full Text Available Background: Given the common concomitance of tricuspid regurgitation (TR with significant mitral stenosis, we aimed at exploring the relation between TR severity and pulmonary artery hypertension (PAH in patients who underwent mitral balloon valvotomy (MBV.Methods: We analyzed the echocardiography data of 133 consecutive patients (82.0% female, mean age 44.68 ± 12.56 years with different degrees of TR severity that underwent MBV between April 2006 and March 2008. The pulmonary artery systolic pressure (PAPs > 35 mmHg was considered as PAH.Results: Before MBV, 36.20% of the patients had moderate to severe TR, 92.5% PAH, and 18.0% right ventricular (RVdilation (RV dimension ≥ 33 mm. After MBV, TR severity improved in 41.4%, worsened in 8.3%, and did not change in 50.4%. Before and after MBV, PAPs was significantly correlated with TR severity, and the mean PAPs change in patients with improved TR was significantly more than that of patients without TR improvement (p value = 0.042. Tricuspid regurgitation severity and mean PAPs (from 52.83 ± 18.82 to 35.89 ± 9.39 mmHg decreased significantly after MBV (both p values <0.001; this reduction was significantly correlated to the amount of PAPs decrease. A cut-off point of ≥ 19 mmHg reductionin PAPs had a specificity of 71.79% and sensitivity of 52.73% to show TR severity improvement (by Receiver-Operative-Characteristics analysis. The mean of RV dimension decreased from 28.94 ± 5.43 to 27.95 ± 4.67 mm (p value < 0.001. In contrast to patients with RV dilation, TR reduced significantly in patients without RV dilation (p value < 0.001.Conclusion: Improvement in TR severity was directly correlated with the amount of PAPs reduction after MBV. Morestudies are needed to better define a cut-off value for PAPs reduction related to TR severity improvement.

  14. Echocardiographic evaluation of simple fetal tricuspid regurgitation%超声心动图检测胎儿单纯性三尖瓣反流

    Institute of Scientific and Technical Information of China (English)

    宋晓霞; 姜志荣; 吴海爽; 马淑娴

    2012-01-01

    Objective To assess the value of echocardiography in detecting simple fetal tricuspid regurgitation (TR). Methods Five hundred fetuses with 18-41 gestation weeks were analyzed by echocardiography. Fetuses with TR were divided into 3 groups: Simple TR group, non-congenital heart disease group, and congenital heart disease group. Results Sixty eight fetuses were revealed with TR (68/500, 13. 60%) , including 29 in simple TR group, 25 in non-congenital heart disease group and 14 in congenital heart disease group. The maximum regurgitation blood flow velocity of the simple TR group ([169. 00 ± 10. 70]cm/s) was lower than the non-congenital heart disease group ([188. 00±15. 70)cm/s) and congenital heart disease group ([200. 00±16. 80)cm/s) (both P<0. 05). There was no TR after born in simple TR group, nor in non-congenital heart disease group. Conclusion The relevance ratio of "physiological TR" raises up with echocardiography. The level of TR should not be considered as a termination of pregnancy index, even it is heavy and fast. The postnatal development of fetus is good when there is no congenital heart disease nor other risk factors.%目的 探讨超声心动图对胎儿单纯性三尖瓣反流的诊断价值.方法 应用超声心动图对500胎胎龄18~41周的胎儿进行检测,将检出三尖瓣反流的胎儿分为单纯反流组、非先心病组及先心病组,并测定反流程度及反流速度.结果 共检出胎儿三尖瓣反流68胎,检出率为13.60%(68/500);其中单纯反流组29胎,非先心病组25胎,先心病组14胎.单纯反流组最大反流速度[(169.00±10.70)cm/s]低于非先心病组[(188.00±15.70) cm/s]和先心病组[(200.00±16.80) cm/s](P均<0.05).单纯反流组及非先心病组胎儿出生后反流均消失.结论 超声心动图对“生理性”胎儿三尖瓣反流的检出率较高;反流程度不能作为终止妊娠的指标,即使程度重、速度快,如不合并严重心脏畸形及其他异常因素,胎儿均可发育良好.

  15. Overcoming maladaptive plasticity through plastic compensation

    Directory of Open Access Journals (Sweden)

    Matthew R.J. MORRIS, Sean M. ROGERS

    2013-08-01

    Full Text Available Most species evolve within fluctuating environments, and have developed adaptations to meet the challenges posed by environmental heterogeneity. One such adaptation is phenotypic plasticity, or the ability of a single genotype to produce multiple environmentally-induced phenotypes. Yet, not all plasticity is adaptive. Despite the renewed interest in adaptive phenotypic plasticity and its consequences for evolution, much less is known about maladaptive plasticity. However, maladaptive plasticity is likely an important driver of phenotypic similarity among populations living in different environments. This paper traces four strategies for overcoming maladaptive plasticity that result in phenotypic similarity, two of which involve genetic changes (standing genetic variation, genetic compensation and two of which do not (standing epigenetic variation, plastic compensation. Plastic compensation is defined as adaptive plasticity overcoming maladaptive plasticity. In particular, plastic compensation may increase the likelihood of genetic compensation by facilitating population persistence. We provide key terms to disentangle these aspects of phenotypic plasticity and introduce examples to reinforce the potential importance of plastic compensation for understanding evolutionary change [Current Zoology 59 (4: 526–536, 2013].

  16. Overcoming maladaptive plasticity through plastic compensation

    Institute of Scientific and Technical Information of China (English)

    Matthew R.J.MORRIS; Sean M.ROGERS

    2013-01-01

    Most species evolve within fluctuating environments,and have developed adaptations to meet the challenges posed by environmental heterogeneity.One such adaptation is phenotypic plasticity,or the ability of a single genotype to produce multiple environmentally-induced phenotypes.Yet,not all plasticity is adaptive.Despite the renewed interest in adaptive phenotypic plasticity and its consequences for evolution,much less is known about maladaptive plasticity.However,maladaptive plasticity is likely an important driver of phenotypic similarity among populations living in different environments.This paper traces four strategies for overcoming maladaptive plasticity that result in phenotypic similarity,two of which involve genetic changes (standing genetic variation,genetic compensation) and two of which do not (standing epigenetic variation,plastic compensation).Plastic compensation is defined as adaptive plasticity overcoming maladaptive plasticity.In particular,plastic compensation may increase the likelihood of genetic compensation by facilitating population persistence.We provide key terms to disentangle these aspects of phenotypic plasticity and introduce examples to reinforce the potential importance of plastic compensation for understanding evolutionary change.

  17. A systematic method for using 3D echocardiography to evaluate tricuspid valve insufficiency in hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Christopher Robin Mart

    2014-01-01

    We have proposed a systematic method for evaluating and displaying the TV using 3DE which can provide significant insight into the mechanisms causing TVI in HLHS. This has the potential to improve both the surgical approach to repairing the valve and, ultimately, patient outcomes.

  18. 涤纶对折条在三尖瓣环成形术中的应用%Application of terylene folded strip in tricuspid valve annuloplasty

    Institute of Scientific and Technical Information of China (English)

    刘日辉; 赵华; 陈家军

    2016-01-01

    Objective To summarize the application effect of terylene folded strip in tricuspid valve annuloplasty (TVA).Methods Clinical data of 74 cases of functional tricuspid regurgitation (FTR)treated from January 2010 to January 2012 in Hospital Affiliated to Hubei University of Arts and Science were retrospectively analyzed.All patients underwent TVA operation over the same period of heart valve replacement or congenital heart disease orthodontic treatment.According to various forming methods patients were assigned into two groups:De Vega forming group (group 1,n =32),of which tricuspid valve with mild regurgitation in 12 cases,moderate regurgi-tation in 18 cases,severe reflux in 2 cases,and terylene folded strip forming group (group 2,n =40),of which tricuspid valve with mild regurgitation in 12 cases,moderate regurgitation in 17 cases,severe reflux in 11 cases.Patients were compared between the two groups before operation and the first year,third years after surgery in clinical and echocardiographic follow -up data.Results There were 2 cases of early postoperative death.One case in group 1 died of malignant arrhythmia,cardiac arrest,and 1 case in group 2 died of severe low cardiac,renal failure.The other patients were cured and discharged.72 patients had 1 -year follow -up,and 68 pa-tients (94.9%)had 3 or more years of follow -up.According to the 1 -year and 3 -year follow -up, tricuspid regurgitation degree between the two groups had obvious statistical difference (P 0.05)while RA,RV,DTv had significant difference (P 0.05),and the levels of Sm/SRA ,DTv in group 2 were lower than those in group 1 (P <0.01)the first year after surgery.At the third year after sur-gery,RA,RV,Sm/SRA ,DTv between the two groups were significantly different (P <0.01).Conclusion The long -term effect of using terylene foleded strip in TVA intraoperatively is better than De Vega plasty.%目的:总结涤纶对折条在三尖瓣环成形术中的应用效果。方法回顾分析2010年1

  19. 中-重度功能性三尖瓣关闭不全瓣膜置换与成形手术近远期效果的比较研究%Immediate and long-term outcomes of tricuspid valve replacement versus repair for functional tricuspid regurgitation

    Institute of Scientific and Technical Information of China (English)

    苏洁; 程蕊; 张金洲; 刘金成; 王红兵; 程亮; 支伟伟

    2012-01-01

    Objective Functional tricuspid regurgitation ( FTR) is very common in patients with rheumatic heart valve diseases. For moderate and( or) severe FTR,although heart valve replacement and repair procedures both can correct this heart valve disorder,it remains unclear which one can bring more benefits to patients with FTR. We aimed to examine the immediate and long term outcomes of FTR patients retrospectively. Methods From November, 1998 to December,2009,68 patients admitted to our hospital and underwent tricuspid valve replacement or repair operation, of which 45 patients underwent anuloplasty procedure and 23 patients underwent tricuspid valve replacement. We compared clinical data of these patients retrospectively. Results The average age of patients in repair group were greater than those in replacement group [ ( 43. 7 ± 22. 3 ) years vs. ( 45. 9 ±21.3) years, P = 0. 035 ]. The grade of tricuspid regurgitation in replacement group was much more severer than that in repair group [ (21. 9 ±35. 4)ml vs. ( 19. 8 ±24. 5)ml,P <0. 001 ]. The average time required for aorta clamping,cardiopulmonary bypass in replacement group were much longer than that in repair group [ ( 152. 0 ± 52. 0) min vs. ( 122. 6 ± 57. 6) min, (86. 6 ±20. 6) min vs. (81.5 ± 33. 5) min,P < 0. 001 ,respectively]. Early after surgery, the usage of inotropic agents in replacement group were much more than that in repair group, consequently, the staying time of ICU in replacement group was much longer than that in repair group [ ( 97. 2 ± 75. 3 ) h vs. ( 83. 7 ± 47. 5 ) h, P < 0. 001 ].Although the postoperative complication morbidity showed no difference between these two groups ( 30.4% vs. 17. 8% ,P =0. 234) , the mortality in replacement group was much higher than that in repair group (30. 4% vs. 11. 1% ,P =0. 048) . The follow up time ranged from 17 months to 10 years. The rates of follow-up were 93. 8% and 97. 5% in replacement and repair group respectively. The total rate of recurrence

  20. Pulsed-wave Doppler ultrasonographic evaluation of hepatic vein in dogs with tricuspid regurgitation

    Science.gov (United States)

    Kim, Jaehwan; Kim, Soyoung

    2017-01-01

    This study was performed to identify the relationships between hepatic vein (HV) measurements, including flow velocity and waveform, using pulsed-wave (PW) Doppler ultrasonography, and the severity of tricuspid regurgitation (TR) in dogs. The study included 22 dogs with TR and 7 healthy dogs. The TR group was subdivided into 3 groups according to TR jet profile obtained by echocardiography. The hepatic venous waveform was obtained and classified into 3 types. A variety of HV measurements, including the maximal velocities of the atrial systolic, systolic (S), end ventricular systolic, and diastolic (D) waves and the ratio of the S- and D- wave velocities (S/D ratio), were acquired. TR severity was significantly correlated with the S- (r = −0.380, p = 0.042) and D- (r = 0.468, p = 0.011) wave velocities and the S/D ratio (r = −0.747, p < 0.001). Receiver operating characteristic curve analysis revealed the highest sensitivity and specificity for the S/D ratio (89% and 75%, respectively) at a threshold of 0.97 with excellent accuracy (AUC = 0.911, p < 0.001). In conclusion, PW Doppler ultrasonography of the HV can be used to identify the presence of significant TR and to classify TR severity in dogs. PMID:27515264

  1. Tricuspid Annular Plane Systolic Excursion pada Bayi Kurang Bulan dan Cukup Bulan

    Directory of Open Access Journals (Sweden)

    Sri Endah Rahayuningsih

    2011-12-01

    Full Text Available A preterm infant is a baby born with gestational age less than 37 weeks. Preterm babies tend to have problems compared to normal ones. Premature gestational age might result in immaturity of all organ systems of the body including cardiovascular organs. The aim of this study was to find out the right ventricle function by tricuspid annular plane systolic excursion (TAPSE and left ventricle by ejection fraction and shortening fraction using echocardiography on preterm babies. The subject of this study were term and preterm babies who fulfilled the inclusion criteria: appropiate gestational age babies 3–30 days old. This was an analytic descriptive study with cross-sectional method held in Department of Child Health Dr. Hasan Sadikin Hospital Bandung during July–October 2010, and statistical analysis using t–test Spearman rank correlation test. The result of the study showed that the right ventricle function examined by TAPSE method was different on preterm compared to term babies (p=0.006. No significant difference was found in the ejection fraction between preterm and term babies (p=0.22 and so did the shortening fraction (p=0.20. It was concluded that there is a difference in the right ventricle function by TAPSE method between preterm (lower and term babies.

  2. Association of edge-to-edge valve repair to artificial ring annuloplasty for severe tricuspid insufficiency%人工瓣环成形术与其联合"缘对缘"瓣膜成形术治疗重度三尖瓣关闭不全

    Institute of Scientific and Technical Information of China (English)

    柳克晔; 来永强; 刘福林; 罗志强; 李进华; 韩喆; 罗毅

    2011-01-01

    Objective To analyze whether association of edge to edge valve repair to artificial ring annuloplasty would result in better results in patients with severe tricuspid regurgitation (TR).Methods From April,2001 to May,2010,41 patients underwent tricuspid valve repair to treat severe TR were studied.Twenty-one patients were done artificial ring annuloplasty alone (group R) and twenty patients were done artificial ring annuloplasty associated with edge to edge valve repair ( group E).All the patients received echocardiography before surgery,before discharge and in mid and long-term follow-up.The ratio between TR jet area (TRA) and right atrial area (RAA) was used to quantitatively evaluate the seriousness of TR.Movement of tricuspid valve leaflets,tricuspid valve orifice area,pulmonary artery pressure ( PAP),left ventricular ejection fraction ( LVEF) were obserbed to evaluate heart function.Results At discharge in group R,no or trivial TR was presented in 7 patients,mild TR in 12 patients and moderate TR in 2 patient.Bad apposition of the free edges of anterior and septal leaflets was observed in paients with mild and moderate TR.While in group E,no or trivial TR was presented in 13 patients and mild TR in 7 patients.The follow-up ranged from 6 months to 100 months[average (54.8 ±26.7) months].In group R,no or trivial TR was present in 5 patients,mild TR in 11 patients,moderate TR in 4 patients and severe in 1 patient.Bad apposition of the free edges of anterior and septal leaflets was observed in paients with mild to severe TR.Redo tricuspid valve repair was done in one patient in group R for recurrent severe TR and the edge-to-edge valve repair was utilized.In group E,no tricuspid stenosis was found.No or trivial TR was presented in 10 patients,mild TR in 9 patients and moderate TR in 1 patient.The ratio of TRA/RAA of group R was significantly higher than that of group E (0.25 ±0.16 vs.0.13±0.10,P < 0.01).Conclusion Association of edge-to-edge valve technique to

  3. Recycling of Plastic

    DEFF Research Database (Denmark)

    Christensen, Thomas Højlund; Fruergaard, Thilde

    2011-01-01

    Plastic is produced from fossil oil. Plastic is used for many different products. Some plastic products like, for example, wrapping foil, bags and disposable containers for food and beverage have very short lifetimes and thus constitute a major fraction of most waste. Other plastic products like......, good strength and long durability. Recycling of plastic waste from production is well-established, while recycling of postconsumer plastic waste still is in its infancy. This chapter describes briefly how plastic is produced and how waste plastic is recycled in the industry. Quality requirements...

  4. A novel technique to predict pulmonary capillary wedge pressure utilizing central venous pressure and tissue Doppler tricuspid/mitral annular velocities.

    Science.gov (United States)

    Uemura, Kazunori; Inagaki, Masashi; Zheng, Can; Li, Meihua; Kawada, Toru; Sugimachi, Masaru

    2015-07-01

    Assessing left ventricular (LV) filling pressure (pulmonary capillary wedge pressure, PCWP) is an important aspect in the care of patients with heart failure (HF). Physicians rely on right ventricular (RV) filling pressures such as central venous pressure (CVP) to predict PCWP, assuming concordance between CVP and PCWP. However, the use of this method is limited because discordance between CVP and PCWP is observed. We hypothesized that PCWP can be reliably predicted by CVP corrected by the relationship between RV and LV function, provided by the ratio of tissue Doppler peak systolic velocity of tricuspid annulus (S(T)) to that of mitral annulus (S(M)) (corrected CVP:CVP·S(T)/S(M)). In 16 anesthetized closed-chest dogs, S T and S M were measured by transthoracic tissue Doppler echocardiography. PCWP was varied over a wide range (1.8-40.0 mmHg) under normal condition and various types of acute and chronic HF. A significantly stronger linear correlation was observed between CVP·S(T)/S(M) and PCWP (R2 = 0.78) than between CVP and PCWP (R2 = 0.22) (P 10.5 mmHg predicted PCWP >18 mmHg with 85% sensitivity and 88% specificity. Area under ROC curve for CVP·S T/S M to predict PCWP >18 mmHg was 0.93, which was significantly larger than that for CVP (0.66) (P < 0.01). Peripheral venous pressure (PVP) corrected by S T/S M (PVP·S(T)/S(M) also predicted PCWP reasonably well, suggesting that PVP·S(T)/S (M) may be a minimally invasive alternative to CVP·S(T)/S(M) In conclusion, our technique is potentially useful for the reliable prediction of PCWP in HF patients.

  5. Heart Disease

    Science.gov (United States)

    ... daily aspirin to prevent heart attack? Does taking birth control pills increase my risk for heart disease? Does using ... tells you to. Return to top Does taking birth control pills increase my risk for heart disease? Taking birth ...

  6. 9. Incidence of tricuspid valve regurgitation following pacemaker/defibrillator lead extraction

    Directory of Open Access Journals (Sweden)

    A. AlFagih

    2016-07-01

    Full Text Available Despite advanced sterile techniques in cardiac device implantations, long-term complications such as wound infections and/or lead-induced endocarditis can develop mandating lead and device extraction. It has been suggested that lead extraction carries a risk of new-onset Tricuspid Regurgitation (TR, or a deterioration of a formerly known regurgitant valve. Yet, there is no enough scientific evidence to our knowledge to back this claim. In this study we aim to explore the risk of TR following lead extraction.We conducted a retrospective chart review in 113 patients whom underwent lead extraction at Prince Sultan Cardiac Center in Saudi Arabia during the period of Jan, 2002 to Jul, 2015. Six patients underwent lead extraction twice, making the total number of extractions to be 119. Of this study cohort, we include 52 cases who had Tricuspid valve function evaluation via Transthoracic Echocardiography (TTE prior to and after device and lead extraction. TR severity was assessed using a grading system as the following; normal, mild, mild-to-moderate, moderate-to-severe, and severe. Worsening or improvement by more than 1 grade was considered clinically significant. TR following lead extraction was examined over a median of 5 months. Of the 52 cases included in this study, 37 (71.2% were males and 15 (28.8% were females, with a mean age of 46 (SD = 18 years. Eleven patients (21.2% experienced worsening of TR (3 had normal functioning valves before extraction, and 8 were known to have TR prior to extraction, 2 (3.8% had improvement, and the majority (75.0% did not experience any significant changes. Compared with those who had no change, average lead duration was higher in the worsening TR group (67.2 vs. 27.9 months. A lead-attached vegetation was detected in 4 out of the 11 patients with TR. Lead type (High-voltage vs. Pacing was not predictive of TR, 5 (45.5% of the patients in the worsening group had high-voltage leads, while the remaining (54

  7. Stenotic Bicuspid and Tricuspid Aortic Valves - Micro-Computed Tomography and Biological Indices of Calcification.

    Science.gov (United States)

    Mazur, Piotr; Wypasek, Ewa; Gawęda, Bogusław; Sobczyk, Dorota; Kapusta, Przemysław; Natorska, Joanna; Malinowski, Krzysztof Piotr; Tarasiuk, Jacek; Bochenek, Maciej; Wroński, Sebastian; Chmielewska, Katarzyna; Kapelak, Bogusław; Undas, Anetta

    2017-06-23

    Valve calcification is well estimated by ex-vivo micro-computed tomography (micro-CT). The objective of this study was to investigate the associations between micro-CT findings and biological indices of calcification in aortic stenosis (AS), as well as differences between bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV).Methods and Results:Aortic valves and plasma were obtained from patients undergoing valve surgery. Valves were dissected and underwent micro-CT, genetic analyses, and calcium content assessment. Plasma levels of calcification markers were measured. Forty-two patients with isolated severe AS, including 22 with BAV, were studied. BAV patients had a lower median CT value (140.0 [130.0-152.0] vs. 157.0 [147.0-176.0], P=0.002) and high-density calcification (HDC) fraction (9.3 [5.7-23.3] % vs. 21.3 [14.3-31.2] %, P=0.01), as compared with TAV. Calcification fraction (CF) correlated with AS severity (measured as maximal transvalvular pressure gradient [r=0.34, P=0.03], maximal flow velocity [r=0.38, P=0.02], and indexed aortic valve area [r=-0.37, P=0.02]). For TAV patients only, mRNA expression of integrin-binding sialoprotein correlated with CF (r=0.45, P=0.048), and the receptor activator of the nuclear factor κ-B ligand transcript correlated with HDC corrugation (r=0.54, P=0.01). TAV patients with AS present more mineralized calcifications in micro-CT than BAV subjects. The relative volume of calcifications increases with the AS severity. In TAV patients, upregulated expression of genes involved in osteoblastogenesis in AS correlates with leaflet mineralization in micro-CT.

  8. Impact of Isolated Coronary Artery Bypass Grafting on Non-Organic Tricuspid Regurgitation Severity

    Directory of Open Access Journals (Sweden)

    Mahmood Sheikhfathollahi

    2009-12-01

    Full Text Available Background: Moderate non-organic tricuspid regurgitation (TR concomitant with coronary artery disease is not uncommon. Whether or not TR improves after pure coronary artery bypass grafting (CABG, however, is unclear. The aim of this study was to evaluate the effect of isolated CABG on moderate non-organic TR.Methods: This study recruited 50 patients (40% female, mean age: 65.38±8.01 years, mean left ventricular ejection fraction (LVEF: 45.74±13.05% with moderate non-organic TR who underwent isolated CABG. TR severity before and after CABG was compared. Pulmonary arterial systolic pressure (PAPs>30mmHg and LVEF<50% were considered elevated PAPs (EPAPs and LV systolic dysfunction, respectively. Presence of Q-wave in leads II, III, and aVF was considered inferior myocardial infarction (inf. MI.Results: Pre-operatively, 81.5% of the patients had EPAPs, 16% right ventricle (RV dilation, and 50% left ventricle (LV and 16% RV systolic dysfunction. TR severity improved in 64% after CABG, whereas it remained unchanged or even worsened in others (P value<0.001. Patients with inf. MI showed no improvement in TR, while patients without inf. MI had significant TR regression after CABG (P value=0.050. Improvement of TR severity after CABG was not related to pre-operative RV size and function, LV systolic function, or PAPs reduction.Conclusion: Although TR severity decreased remarkably after isolated CABG, a considerable number of the patients had no TR regression. In addition, only absence of inf. MI was significantly correlated to TR improvement after CABG. Further prospective studies with long-term follow-up are needed to determine the other factors predicting TR regression after isolated CABG.

  9. Evaluation of Tricuspid Regurgitant Jet Velocity in Thalassemia Patients with Splenectomy

    Directory of Open Access Journals (Sweden)

    Nikparvar

    2015-02-01

    Full Text Available Background β-thalassemia is an inherited disorder of β-globin biosynthesis. Dysfunction in hemoglobin chain production, ineffective erythropoiesis, and hemolysis occur in β-thalassemia. Pulmonary arterial hypertension (PAH is increasingly detected in patients with β-thalassemia, and splenectomy which decreases the need for blood transfusion increases the pulmonary artery pressure (PAP. Objectives This study aimed to assess the PAP in patients with β-thalassemia (male or female and major or intermedia who had undergone splenectomy. Methods A total of 137 patients suffering from β-thalassemia were evaluated during the study. All subjects were referred for cardiac evaluation. Clinical history, presence of cardiac symptoms, and previous splenectomy were noted. Standard M-mode, 2D, and Doppler echocardiographic examinations were performed for all subjects. Patients with a tricuspid regurgitant jet velocity (TRV ≥ 2.5 m/s were considered at risk for PAH. Results Average age of the patients was 21.15 ± 6.68 years. No significant difference was observed in the PAP between the 2 groups of thalassemia major and intermedia and also the 2 sex groups. Indeed, 6.6% of the patients had an increased PAP. The significant finding of the study was that the patients who had had splenectomy were significantly at an increased risk of PAH (P = 0.046. Conclusions The etiology of PAH in thalassemia is multifactorial such as inflammatory mediators. Also, the absence of the spleen plays an important role in developing a high TRV and PAH.

  10. Cohort profile: prevalence of valvular heart disease in community patients with suspected heart failure in UK

    Science.gov (United States)

    Marciniak, Anna; Glover, Keli; Sharma, Rajan

    2017-01-01

    Purpose The aim of this study was to evaluate the proportion of suspected heart failure patients with significant valvular heart disease. Early diagnosis of valve disease is essential as delay can limit treatment and negatively affect prognosis for undiagnosed patients. The prevalence of unsuspected valve disease in the community is uncertain. Participants We prospectively evaluated 79 043 patients, between 2001 and 2011, who were referred to a community open access echocardiography service for suspected heart failure. All patients underwent a standard transthoracic echocardiogram according to British Society of Echocardiography guidelines. Findings to date Of the total number, 29 682 patients (37.5%) were diagnosed with mild valve disease, 8983 patients (11.3%) had moderate valve disease and 2134 (2.7%) had severe valve disease. Of the total number of patients scanned, the prevalence of aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation was 10%, 8.4%, 1%, and 12.5% respectively. 18% had tricuspid regurgitation. 5% had disease involving one or more valves. Conclusions Of patients with suspected heart failure in the primary care setting, a significant proportion have important valvular heart disease. These patients are at high risk of future cardiac events and will require onward referral for further evaluation. We recommend that readily available community echocardiography services should be provided for general practitioners as this will result in early detection of valve disease. PMID:28131996

  11. Two rings too tight: sequential emergency PCI for hemodynamic and arrhythmic complications of mitral and tricuspid valve repair.

    Science.gov (United States)

    Patel, Niket; Cuculi, Florim; Banning, Adrian P

    2014-01-01

    New intra-operative mitral regurgitation is an unusual complication of tricuspid annuloplasty and maybe ischemic in etiology as a consequence of right coronary artery distortion. We report the case of a woman in whom this was treated by mitral valve annuloplasty with ensuing hemodynamic instability and ventricular arrhythmia secondary to a new left circumflex occlusion. Injury/distortion to either of the coronary arteries running in the atrio-ventricular groove is rare, and described only several times. To our knowledge, concurrent right coronary artery and circumflex artery injury/distortion has not been reported previously.

  12. Improving the Recognition of Heart Murmur

    Directory of Open Access Journals (Sweden)

    Magd Ahmed Kotb

    2016-07-01

    Full Text Available Diagnosis of congenital cardiac defects is challenging, with some being diagnosed during pregnancy while others are diagnosed after birth or later on during childhood. Prompt diagnosis allows early intervention and best prognosis. Contemporary diagnosis relies upon the history, clinical examination, pulse oximetery, chest X-ray, electrocardiogram (ECG, echocardiography (ECHO, computed tomography (CT and cardiac catheterization. These diagnostic modalities reliable upon recording electrical activity or sound waves or upon radiation. Yet, congenital heart diseases are still liable to misdiagnosis because of level of operator expertise and other multiple factors. In an attempt to minimize effect of operator expertise this paper built a classification model for heart murmur recognition using Hidden Markov Model (HMM. This paper used Mel Frequency Cepestral coefficient (MFCC as a feature and 13 MFCC coefficients. The machine learning model built by studying 1069 different heart sounds covering normal heart sounds, ventricular septal defect (VSD, mitral regurgitation (MR, aortic stenosis (AS, aortic regurgitation (AR, patent ductus arteriosus (PDA, pulmonary regurgitation (PR, and pulmonary stenosis (PS. MFCC feature used to extract feature matrix for each type of heart sounds after separation according to amplitude threshold. The frequency of normal heart sound (range= 1Hz to 139Hz was specific without overlap with any of the studied defects (ranged= 156-556Hz. The frequency ranges for each of these defects was typical without overlap according to examined heart area (aortic, pulmonary, tricuspid and mitral area. The overall correct classification rate (CCR using this model was 96% and sensitivity 98%. This model has great potential for prompt screening and specific defect detection. Effect of cardiac contractility, cardiomegaly or cardiac electrical activity on this novel detection system needs to be verified in future works.

  13. Pathophysiology of valvular heart disease.

    Science.gov (United States)

    Zeng, Y I; Sun, Rongrong; Li, Xianchi; Liu, Min; Chen, Shuang; Zhang, Peiying

    2016-04-01

    Valvular heart disease (VHD) is caused by either damage or defect in one of the four heart valves, aortic, mitral, tricuspid or pulmonary. Defects in these valves can be congenital or acquired. Age, gender, tobacco use, hypercholesterolemia, hypertension, and type II diabetes contribute to the risk of disease. VHD is an escalating health issue with a prevalence of 2.5% in the United States alone. Considering the likely increase of the aging population worldwide, the incidence of acquired VHD is expected to increase. Technological advances are instrumental in identifying congenital heart defects in infants, thereby adding to the growing VHD population. Almost one-third of elderly individuals have echocardiographic or radiological evidence of calcific aortic valve (CAV) sclerosis, an early and subclinical form of CAV disease (CAVD). Of individuals ages >60, ~2% suffer from disease progression to its most severe form, calcific aortic stenosis. Surgical intervention is therefore required in these patients as no effective pharmacotherapies exist. Valvular calcium load and valve biomineralization are orchestrated by the concerted action of diverse cell-dependent mechanisms. Signaling pathways important in skeletal morphogenesis are also involved in the regulation of cardiac valve morphogenesis, CAVD and the pathobiology of cardiovascular calcification. CAVD usually occurs without any obvious symptoms in early stages over a long period of time and symptoms are identified at advanced stages of the disease, leading to a high rate of mortality. Aortic valve replacement is the only primary treatment of choice. Biomarkers such as asymmetric dimethylarginine, fetuin-A, calcium phosphate product, natriuretic peptides and osteopontin have been useful in improving outcomes among various disease states. This review, highlights the current understanding of the biology of VHD, with particular reference to molecular and cellular aspects of its regulation. Current clinical questions

  14. Heart Transplantation

    Science.gov (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  15. Heart Diseases

    Science.gov (United States)

    ... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the U.S. ... of disability. There are many different forms of heart disease. The most common cause of heart disease is ...

  16. Recycling of Plastic

    DEFF Research Database (Denmark)

    Christensen, Thomas Højlund; Fruergaard, Thilde

    2011-01-01

    Plastic is produced from fossil oil. Plastic is used for many different products. Some plastic products like, for example, wrapping foil, bags and disposable containers for food and beverage have very short lifetimes and thus constitute a major fraction of most waste. Other plastic products like......, for example, gutters, window frames, car parts and transportation boxes have long lifetimes and thus appear as waste only many years after they have been introduced on the market. Plastic is constantly being used for new products because of its attractive material properties: relatively cheap, easy to form......, good strength and long durability. Recycling of plastic waste from production is well-established, while recycling of postconsumer plastic waste still is in its infancy. This chapter describes briefly how plastic is produced and how waste plastic is recycled in the industry. Quality requirements...

  17. Surgical repair of tricuspid valve leaflet tear following percutaneous closure of perimembranous ventricular septal defect using Amplatzer duct occluder I: Report of two cases

    Directory of Open Access Journals (Sweden)

    Saatchi Mahesh Kuwelker

    2017-01-01

    Full Text Available Tricuspid valve (TV injury following transcatheter closure of perimembranous ventricular septal defect (PMVSD with Amplatzer ductal occluder I (ADO I, requiring surgical repair, is rare. We report two cases of TV tear involving the anterior and septal leaflets following PMVSD closure using ADO I. In both the patients, the subvalvular apparatus remained unaffected. The patients presented with severe tricuspid regurgitation (TR 6 weeks and 3 months following the device closure. They underwent surgical repair with patch augmentation of the TV leaflets. Postoperatively, both are asymptomatic with a mild residual TR.

  18. Surgical repair of tricuspid valve leaflet tear following percutaneous closure of perimembranous ventricular septal defect using Amplatzer duct occluder I: Report of two cases

    Science.gov (United States)

    Kuwelker, Saatchi Mahesh; Shetty, Devi Prasad; Dalvi, Bharat

    2017-01-01

    Tricuspid valve (TV) injury following transcatheter closure of perimembranous ventricular septal defect (PMVSD) with Amplatzer ductal occluder I (ADO I), requiring surgical repair, is rare. We report two cases of TV tear involving the anterior and septal leaflets following PMVSD closure using ADO I. In both the patients, the subvalvular apparatus remained unaffected. The patients presented with severe tricuspid regurgitation (TR) 6 weeks and 3 months following the device closure. They underwent surgical repair with patch augmentation of the TV leaflets. Postoperatively, both are asymptomatic with a mild residual TR. PMID:28163430

  19. 两种三尖瓣成形术治疗功能性三尖瓣返流疗效比较%Efficacy comparison of two methods of tricuspid annuloplasty in the treatment of functional tricuspid regurgitation

    Institute of Scientific and Technical Information of China (English)

    柴守栋; 马增山; 马胜军; 董铭锋; 王建堂; 唐培哲

    2011-01-01

    Objective To investigate the operation indications,surgical procedures and peri -operative management of functional tricuspid insufficiency (FTI) secondary to rheumatic valve disease.Methods Tricuspid annuloplasty was performed in 126 patients from Dec 2005 to Jan 2009 with rheumatic valve disease and FTI.They were divided into devegar procedure group ( n =61 ),and ring annuloplasty group ( n =65 ).All patients underwent in addition one - stage valve replacement including mitral valve replacement in 84 cases and combined aortic and mitral valve replacement in 42 cases.Results Early mortality was 4 cases (3.2%).Follow - up was made in 114 patients for 2 years.Four patients died of cardiac failure,and the others were considerably improved in quality of life.Diameter of right atriums and ventricles was significantly shorter than that preoperatively.Mild to moderate tricuspid insufficiency remained in 20 cases.Conclusions According to location of tricuspid annulus dilatation and degree of FTI,Ring annuloplasty was an effective treatment for functional tricuspid regurgitation with better midterm result.Diuretics and vasodilators are helpful to reduce pulmonary artery hypertension and improve long -term effect.%目的 探讨在瓣膜置换术同期行三尖瓣成形术的合理手术指征、方法及围术期的处理.方法 回顾性分析2005年12月至2009年1月间行三尖瓣成形术治疗中度至重度功能性三尖瓣关闭不全126例患者的临床资料,其中行Devega成形61例,人工环成形65例.同时行二尖瓣置换84例,二尖瓣+主动脉瓣置换42例.结果 术后早期死亡4例,死于顽固性心力衰竭,病死率为3.2%,以术后第2年随访结果做为对比分析观测点,获访114例,心功能明显改善.心脏超声示右心房及右心室较术前明显缩小.共有20例仍有中度以上返流.结论 在瓣膜置换术中据三尖瓣环扩大的部位及返流程度使用三尖瓣成形环进行三尖瓣成形具有更良好的

  20. The role of cardiac magnetic resonance in valvular heart disease.

    Science.gov (United States)

    Lopez-Mattei, Juan C; Shah, Dipan J

    2013-01-01

    The prevalence of valvular heart disease is increasing as the population ages. In diagnosing individuals with valve disease, echocardiography is the primary imaging modality used by clinicians both for initial assessment and for longitudinal evaluation. However, in some cases cardiovascular magnetic resonance has become a viable alternative in that it can obtain imaging data in any plane prescribed by the scan operator, which makes it ideal for accurate investigation of all cardiac valves: aortic, mitral, pulmonic, and tricuspid. In addition, CMR for valve assessment is noninvasive, free of ionizing radiation, and in most instances does not require contrast administration. The objectives of a comprehensive CMR study for evaluating valvular heart disease are threefold: (1) to provide insight into the mechanism of the valvular lesion (via anatomic assessment), (2) to quantify the severity of the valvular lesion, and (3) to discern the consequences of the valvular lesion.

  1. Case report: successful repeat tricuspid valve replacement combined with atrial flutter ablation during correction of Ebstein's anomaly

    Directory of Open Access Journals (Sweden)

    Bockeria L.A.

    2013-09-01

    Full Text Available Patients with Ebstein's anomaly often suffer from a variety of arrhythmias, such as paroxysmal supraventricular tachycardia, atrial fibrillation and atrial flutter, which in turn adversely affects the prognosis of these patients. This is why early diagnosis and treatment can reduce the risk of sudden cardiac death. Patient V. 34 years old admitted to the department of surgical treatment of interactive pathology Bakoulev's Сenter for Сardiovascular Surgery RAMS. In 1987 the patient underwent tricuspid valve replacement with bioprosthesis made of aortic valve of a pig. After the operation he felt well. Worsening of the disease was noticed in July 2012. Due to worsening of the symptoms the patient admitted to a hospital. Dysfunction of bioprosthesis with calcification and insufficiency were revealed. Atrial flutter was diagnosed as well. 19.10.2012 redo tricuspid valve replacement with bioprosthesis Bioglis (28 in diameter, cryoablation of right isthmus and the dase of right atrial appendage with Atri Cure system. The patient was discharged on postoperative day 12. He felt well and was sent to supervision of cardiologist for follow-up.

  2. 77 FR 54930 - Carlyle Plastics and Resins, Formerly Known as Fortis Plastics, A Subsidiary of Plastics...

    Science.gov (United States)

    2012-09-06

    ... Employment and Training Administration Carlyle Plastics and Resins, Formerly Known as Fortis Plastics, A... plastic parts. New information shows that Fortis Plastics is now called Carlyle Plastics and Resins. In... of Carlyle Plastics and Resins, formerly known as Fortis Plastics, a subsidiary of...

  3. 3D printing of normal and pathologic tricuspid valves from transthoracic 3D echocardiography data sets.

    Science.gov (United States)

    Muraru, Denisa; Veronesi, Federico; Maddalozzo, Anna; Dequal, Daniele; Frajhof, Leonardo; Rabischoffsky, Arnaldo; Iliceto, Sabino; Badano, Luigi P

    2017-07-01

    To explore the feasibility of using transthoracic 3D echocardiography (3DTTE) data to generate 3D patient-specific models of tricuspid valve (TV). Multi-beat 3D data sets of the TV (32 vol/s) were acquired in five subjects with various TV morphologies from the apical approach and analysed offline with custom-made software. Coordinates representing the annulus and the leaflets were imported into MeshLab (Visual Computing Lab ISTICNR) to develop solid models to be converted to stereolithographic file format and 3D print. Measurements of the TV annulus antero-posterior (AP) and medio-lateral (ML) diameters, perimeter (P), and TV tenting height (H) and volume (V) obtained from the 3D echo data set were compared with those performed on the 3D models using a caliper, a syringe and a millimeter tape. Antero-posterior (4.2 ± 0.2 cm vs. 4.2 ± 0 cm), ML (3.7 ± 0.2 cm vs. 3.6 ± 0.1 cm), P (12.6 ± 0.2 cm vs. 12.7 ± 0.1 cm), H (11.2 ± 2.1 mm vs. 10.8 ± 2.1 mm) and V (3.0 ± 0.6 ml vs. 2.8 ± 1.4 ml) were similar (P = NS for all) when measured on the 3D data set and the printed model. The two sets of measurements were highly correlated (r = 0.991). The mean absolute error (2D - 3D) for AP, ML, P and tenting H was 0.7 ± 0.3 mm, indicating accuracy of the 3D model of printing of the TV from 3DTTE data is feasible with highly conserved fidelity. This technique has the potential for rapid integration into clinical practice to assist with decision-making, surgical planning, and teaching.

  4. The relationship between tricuspid regurgitation and atrial fibrillation after left-sided valve surgery%左心瓣膜术后心房颤动与三尖瓣反流的关系

    Institute of Scientific and Technical Information of China (English)

    魏丹; 孟旭; 李岩; 刘静

    2012-01-01

    Objective:To investigate if atrial fibrillation ( AF) is an independent risk factor for tricus-pid regurgitation(TR) after left-sided heart valve surgery. Methods;374 cases were followed-up from March 2002 to November 2008 with aortic valve replacement or mitral valve replacement without tricuspid repaire or tricuspid valve replacement 151 male,223 female,23-79years old,mean age of (52 ± 11) years. All patients underwent preoperative and postoperative color Doppler echocardiography and electrocardiogram ( ECG). Uni-variate analysis between groups using the χ2 test. Using logistic regression model for risk factors analysis. Results ; Postoperative AF is an independent risk factor for TR. Logistic multivariate analysis results reveal that: Postoperative AF, female gender, left atrial enlargement were independent risk factors for TR; age, size of left ventricular and right ventricular, ejection fraction of left ventricular after surgery were not risk factors for TR. Conclusion; AF after Left-sided heart valve surgery is an independent risk factor for TR. So it is important to notice that, postoperative AF should be treated actively.%目的:研究左心瓣膜术后三尖瓣反流与术后心房颤动(房颤)的关系.方法:随访2002年3月至2008年11月接受主动脉瓣置换术或二尖瓣置换术,且未行三尖瓣成形术或三尖瓣置换术的患者374例,其中男性151例,女性223例,年龄23~79岁,平均(52±11)岁.所有患者均经过术前和术后彩色多普勒超声心动检查及心电图检查.单因素分析组间使用x2检验.危险因素采用Logistic回归模型分析.结果:左心瓣膜术后房颤是术后发生三尖瓣反流的独立危险因素.Logistic多因素分析结果为:术后房颤、女性及术后左心房扩大,是术后三尖瓣反流的独立危险因素;术时年龄、术后左心室大小、术后右心室大小及术后射血分数这4项不是三尖瓣反流的危险因素.结论:左心瓣膜术后房颤是术后

  5. 左心系统瓣膜置换术后三尖瓣关闭不全的外科治疗%Surgical treatment of tricuspid regurgitation after left cardiac valve replacement

    Institute of Scientific and Technical Information of China (English)

    王黎; 李伯君; 姜胜利; 任崇雷; 叶卫华

    2011-01-01

    To summarize our experiences in surgical treatment of bicuspid regurgitation after left valve replacement. Methods Clinical data about 20 patients who developed tricuspid insufficiency after they underwent left valve replacement in our hospital from January 2007 to November 2010 were retrospectively analyzed. Of the 20 patients, 8 underwent mitral valve replacement and 12 aortic and mitral double-valve replacement. The surgery was completed on beating heart under hypothermia by implanting biological tricuspid valve. Results Of the 20 patients after operation, 1 died of multiple organ failure caused by low cardial output syndrome(LCOS)with a mortality of 5%, 6 presented with LCOS, 2 had pleural effusion, 2 had renal inadequacy which was recovered after peritoneal dialysis, 1 had pericardial effusion, 1 presented with frequent ventricular tachycardia and ventricular Fibrillation which were recovered after defibrillation and anti-arrhythmia treatment. All the patients were recovered, except for 1 patient who died. Echocardiography revealed that the size of their right atrium and ventricle was much smaller after operation than before operation. Conclusion The effect of surgical treatment on tricuspid regurgitation after left valve replacement is satisfactory. Mild hypothermia for beating heart can effectively protect myocardium. Biological valve is a better choice. Rational indications for surgery and perioperative treatment are the key to successful surgery.%目的 总结左心系统瓣膜置换术后三尖瓣关闭不全的外科治疗经验.方法 回顾分析2007年1月-2010年11月在我院手术治疗的20例左心系统瓣膜置换术后三尖瓣关闭不全的患者资料.其中二尖瓣置换术后8例,二尖瓣、主动脉瓣置换术后12例.手术均在浅低温跳动下完成,以三尖瓣生物瓣膜置换.结果 全组1例死亡(死于严重低心排引起的多脏器功能衰竭),手术死亡率5%;6例有不同程度的低心排血量综合征;2

  6. Our plastic age

    National Research Council Canada - National Science Library

    Richard C. Thompson; Shanna H. Swan; Charles J. Moore; Frederick S. vom Saal

    2009-01-01

    Within the last few decades, plastics have revolutionized our daily lives. Globally we use in excess of 260 million tonnes of plastic per annum, accounting for approximately 8 per cent of world oil production...

  7. Weinig plastic in vissenmaag

    NARCIS (Netherlands)

    Foekema, E.M.

    2012-01-01

    Waar de magen van sommige zeevogels vol plastic zitten, lijken vissen in de Noordzee nauwelijks last te hebben van kunststofafval. Onderzoekers die plastic resten zochten in vissenmagen vonden ze in elk geval nauwelijks.

  8. Ear Plastic Surgery

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  9. Biodegradability of Plastics

    OpenAIRE

    Yutaka Tokiwa; Calabia, Buenaventurada P.; Charles U. Ugwu; Seiichi Aiba

    2009-01-01

    Plastic is a broad name given to different polymers with high molecular weight, which can be degraded by various processes. However, considering their abundance in the environment and their specificity in attacking plastics, biodegradation of plastics by microorganisms and enzymes seems to be the most effective process. When plastics are used as substrates for microorganisms, evaluation of their biodegradability should not only be based on their chemical structure, but also on their physical ...

  10. Chemical Recycle of Plastics

    Directory of Open Access Journals (Sweden)

    Sara Fatima

    2014-11-01

    Full Text Available Various chemical processes currently prevalent in the chemical industry for plastics recycling have been discussed. Possible future scenarios in chemical recycling have also been discussed. Also analyzed are the effects on the environment, the risks, costs and benefits of PVC recycling. Also listed are the various types of plastics and which plastics are safe to use and which not after rcycle

  11. Plastic value chains

    DEFF Research Database (Denmark)

    Baxter, John; Wahlstrom, Margareta; Zu Castell-Rüdenhausen, Malin

    2014-01-01

    Optimizing plastic value chains is regarded as an important measure in order to increase recycling of plastics in an efficient way. This can also lead to improved awareness of the hazardous substances contained in plastic waste, and how to avoid that these substances are recycled. As an example...

  12. Right Ventricular Myocardial Tissue Velocities, Myocardial Performance Index, and Tricuspid Annular Plane Systolic Excursion in Totally Corrected Tetralogy of Fallot Patients

    Directory of Open Access Journals (Sweden)

    Asadolah Tanasan

    2015-10-01

    Full Text Available Background: Longer survival after the total repair of the Tetralogy of Fallot increases the importance of late complications such as right ventricular dysfunction. This is a prospective study of the right ventricular function in totally corrected Tetralogy of Fallot patients versus healthy children.Methods: Thirty-two healthy children were prospectively compared with 30 totally corrected Tetralogy of Fallot patients. Right ventricular myocardial tissue velocities, right ventricular myocardial performance index, and tricuspid annular plane systolic excursion were investigated as well as the presence and severity of pulmonary regurgitation.Results: The two groups were age-and sex-matched. Mean systolic peak velocity (Sa and tricuspid annular plane systolic excursion were significantly decreased, while myocardial performance index and early to late diastolic velocity (Ea/Aa were significantly increased in the Tetralogy of Fallot patients. Early diastolic velocity (Ea showed no significant difference between the two groups. Sa correlated significantly with tricuspid annular plane systolic excursion in both the normal children and totally corrected Tetralogy of Fallot patients. Myocardial performance index was significantly higher in the patients with moderate to severe pulmonary regurgitation than in those with mild regurgitation. However, there was no significant correlation between this index and right ventricular myocardial tissue velocities.Conclusion: In this study, systolic right ventricular function indices (Sa and tricuspid annular plane systolic excursion were impaired in the totally corrected Tetralogy of Fallot patients. Myocardial performance index was affected by the severity of pulmonary regurgitation.

  13. Heart Failure

    Science.gov (United States)

    ... heart failure due to systolic dysfunction. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ... patient with heart failure or cardiomyopathy. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ...

  14. Heart palpitations

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  15. Heart pacemaker

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  16. Biodegradability of plastics.

    Science.gov (United States)

    Tokiwa, Yutaka; Calabia, Buenaventurada P; Ugwu, Charles U; Aiba, Seiichi

    2009-08-26

    Plastic is a broad name given to different polymers with high molecular weight, which can be degraded by various processes. However, considering their abundance in the environment and their specificity in attacking plastics, biodegradation of plastics by microorganisms and enzymes seems to be the most effective process. When plastics are used as substrates for microorganisms, evaluation of their biodegradability should not only be based on their chemical structure, but also on their physical properties (melting point, glass transition temperature, crystallinity, storage modulus etc.). In this review, microbial and enzymatic biodegradation of plastics and some factors that affect their biodegradability are discussed.

  17. Plastic value chains

    DEFF Research Database (Denmark)

    Baxter, John; Wahlstrom, Margareta; Zu Castell-Rüdenhausen, Malin

    2014-01-01

    Optimizing plastic value chains is regarded as an important measure in order to increase recycling of plastics in an efficient way. This can also lead to improved awareness of the hazardous substances contained in plastic waste, and how to avoid that these substances are recycled. As an example......, plastics from WEEE is chosen as a Nordic case study. The project aims to propose a number of improvements for this value chain together with representatives from Nordic stakeholders. Based on the experiences made, a guide for other plastic value chains shall be developed....

  18. Biodegradability of Plastics

    Directory of Open Access Journals (Sweden)

    Yutaka Tokiwa

    2009-08-01

    Full Text Available Plastic is a broad name given to different polymers with high molecular weight, which can be degraded by various processes. However, considering their abundance in the environment and their specificity in attacking plastics, biodegradation of plastics by microorganisms and enzymes seems to be the most effective process. When plastics are used as substrates for microorganisms, evaluation of their biodegradability should not only be based on their chemical structure, but also on their physical properties (melting point, glass transition temperature, crystallinity, storage modulus etc.. In this review, microbial and enzymatic biodegradation of plastics and some factors that affect their biodegradability are discussed.

  19. Journal of CHINA PLASTICS

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Journal of CHINA PLASTICS was authorized and approved by The State Committee of Science and Technology of China and The Bureau of News Press of China, and published by The China Plastics Processing Industry Association,Beijing Technology and Business University and The Institute of Plastics Processing and Application of Light Industry, distributed worldwide. Since its birth in 1987, CHINA PLASTICS has become a leading magazine in plastics industry in China, a national Chinese core journal and journal of Chinese scientific and technological article statistics. It is covered by CA.

  20. Heart Attack

    Science.gov (United States)

    ... a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get ... It's important to know the symptoms of a heart attack and call 9-1-1 if someone ...

  1. Challenges in plastics recycling

    DEFF Research Database (Denmark)

    Pivnenko, Kostyantyn; Jakobsen, L. G.; Eriksen, Marie Kampmann

    2015-01-01

    Recycling of waste plastics still remains a challenging area in the waste management sector. The current and potential goals proposed on EU or regional levels are difficult to achieve, and even to partially fullfil them the improvements in collection and sorting should be considerable. A study...... was undertaken to investigate the factors affecting quality in plastics recycling. The preliminary results showed factors primarily influencing quality of plastics recycling to be polymer cross contamination, presence of additives, non-polymer impurities, and polymer degradation. Deprivation of plastics quality......, with respect to recycling, has been shown to happen throughout the plastics value chain, but steps where improvements may happen have been preliminary identified. Example of Cr in plastic samples analysed showed potential spreading and accumulation of chemicals ending up in the waste plastics. In order...

  2. Glassy metallic plastics

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    This paper reports a class of bulk metallic glass including Ce-, LaCe-, CaLi-, Yb-, and Sr-based metallic glasses, which are regarded as glassy metallic plastics because they combine some unique properties of both plastics and metallic alloys. These glassy metallic plastics have very low glass transition temperature (Tg~25oC to 150oC) and low Young’s modulus (~20 GPa to 35 GPa). Similar to glassy plastics, these metallic plastics show excellent plastic-like deformability on macro-, micro- and even nano-scale in their supercooled liquid range and can be processed, such as elongated, compressed, bent, and imprinted at low temperatures, in hot water for instance. Under ambient conditions, they display such metallic properties as high thermal and electric conductivities and excellent mechanical properties and other unique properties. The metallic plastics have potential applications and are also a model system for studying issues in glass physics.

  3. Plastic surgery after solid organ transplantations

    Institute of Scientific and Technical Information of China (English)

    QI Fa-zhi; ZHANG Yong; YANG Zhen; FENG Zi-hao; GU Jian-ying

    2009-01-01

    Background More patients receive organ transplantation surgeries due to the advancement in immunosuppressive agents and surgical techniques. Some of those patients may need to undergo plastic or reconstructive surgery.Long-term use of immunosuppressive agents raises some serious problems. Therefore, this study aimed to introduce our experience about the safety and effectiveness of plastic surgeries after solid organ allograft transplantation.Methods A retrospective review of 17 transplant recipients who underwent different reconstructive or cosmetic operations was carried out. The subjects included 1 heart transplant, 1 liver transplant and 15 kidney transplant recipients.Results "All patients tolerated the plastic surgery procedures well. Flaps and skin grafts were the main constructive methods. There were no postoperative infections and wound dehiscence. Transferred flaps survived completely. Skin grafts took well. Three of the cosmetic surgery patients were satisfied with the results.Conclusions Immunosuppressed organ transplant recipients can successfully undergo major reconstructive and cosmetic surgery when given special attention.

  4. [ESC guidelines on the management of valvular heart disease. What has changed and what is new?].

    Science.gov (United States)

    Mangner, N; Schuler, G

    2013-12-01

    In 2012 the new and collaborative "Guidelines on the management of valvular heart disease (version 2012)" were published by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). These guidelines emphasize that decision-making in patients with valvular heart disease should ideally be carried out by a"heart team" with particular expertise in valvular heart disease. In aortic regurgitation pathologies of the aortic root are frequent and in patients with Marfan syndrome, surgery is indicated when the maximal ascending aortic diameter is ≥50 mm, while the threshold for intervention should be lower in patients with risk factors for progression. Regarding aortic stenosis, transcatheter aortic valve implantation (TAVI) should be performed only in hospitals with on-site cardiac surgery and with a"heart team" available to assess patient risks. The TAVI procedure is indicated in patients with severe symptomatic aortic stenosis who are judged by the"heart team" to be unsuitable for surgery but have sufficient life expectancy. It should be considered for high-risk patients with severe symptomatic aortic stenosis based on the individual risk profile assessed by the"heart team". Furthermore, low flow - low gradient aortic stenosis with normal ejection fraction and the difficult topic of asymptomatic severe aortic stenosis and the indications for aortic valve replacement are discussed. With respect to mitral regurgitation, valve repair should be the preferred technique when it is expected to be durable. The topics of asymptomatic mitral regurgitation as well as percutaneous mitral valve repair using the edge to edge technique as an alternative for high risk patients are discussed. Tricuspid disease should not be forgotten and during left-sided valve surgery, tricuspid valve surgery should be considered in the presence of mild to moderate secondary regurgitation if there is significant annular dilatation. Last but not least

  5. Transhepatic implant of a trimmed Melody™ valved stent in tricuspid position in a 1-year-old infant.

    Science.gov (United States)

    Cools, Bjorn; Rega, Filip; Gewillig, Marc

    2017-02-15

    Percutaneous valved stent implantation is precluded in small infants because large delivery sheaths and large devices. We describe a procedure in a 1-year-old boy in whom a 19 mm Epic™ valve in tricuspid position had become dysfunctional. As the internal diameter of the prosthetic valve was about 16 mm, the only available valve was the Melody™ valved stent. Technical modifications were required to address issues like venous access, the bulky delivery system, and the length of the valved stent. The Melody™ valved stent was surgically trimmed and mounted on a 16 mm Tyshak balloon, access was provided transhepatically through a short 18 Fr sheath. After deployment, the intrahepatic route was sealed with two vascular plugs (8 and 10 mm) in tandem. The procedure was uncomplicated with perfect valve function 18 months after implant. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  6. Relationships between melanocytes, mechanical properties and extracellular matrix composition in mouse heart valves.

    Science.gov (United States)

    Carneiro, Flavia; Kruithof, Boudewijn Pt; Balani, Kanthesh; Agarwal, Arvind; Gaussin, Vinciane; Kos, Lidia

    2015-01-01

    Heart valves are complex structures composed of organized layers of extracellular matrix, and interstitial and overlying endothelial cells. In this article, we present the specific localization of a population of melanocytes within the murine heart valves at ages important for their post-natal development. In all stages analyzed in our study, melanocytes were found in high numbers populating the atrial aspect of the tricuspid and mitral leaflets. The pulmonary valve did not present melanocytes. To characterize a putative role for the valve melanocytes, the dynamic nanomechanical properties of tricuspid leaftets containing large numbers or no melanocytes were measured. The stiffness coefficient of hyperpigmented leaflets was higher (11.5 GPa) than the ones from wild-type (7.5 GPa) and hypopigmented (5.5 GPa) leaflets. These results suggest that melanocytes may contribute to the mechanical properties of the heart valves. The arrangement of extracellular matrix molecules such as Collagen I and Versican B is responsible for the mechanical characteristics of the leaflets. Melanocytes were found to reside primarily in areas of Versican B expression. The patterns of expression of Collagen I and Versican B were not, however, disrupted in hyper or hypopigmented leaflets. Melanocytes may affect other extracellular matrix molecules to alter the valves' microenvironment.

  7. Delayed onset of tricuspid valve flow in repaired tetralogy of Fallot: an additional mechanism of diastolic dysfunction and interventricular dyssynchrony

    Directory of Open Access Journals (Sweden)

    Benson Lee N

    2011-08-01

    Full Text Available Abstract Background Diastolic dysfunction of the right ventricle (RV is common after repair of tetralogy of Fallot. While restrictive physiology in late diastole has been well known, dysfunction in early diastole has not been described. The present study sought to assess the prevalence and mechanism of early diastolic dysfunction of the RV defined as delayed onset of the tricuspid valve (TV flow after TOF repair. Methods The study population consisted of 31 children with repaired TOF (mean age ± SD, 12.3 ± 4.1 years who underwent postoperative cardiovascular magnetic resonance (CMR. The CMR protocol included simultaneous phase-contrast velocity mapping of the atrioventricular valves, which enabled direct comparison of the timing and patterns of tricuspid (TV and mitral (MV valve flow. The TV flow was defined to have delayed onset when its onset was > 20 ms later than the onset of the MV flow. The TV and MV flow from 14 normal children was used for comparison. The CMR results were correlated with the findings on echocardiography and electrocardiography. Result Delayed onset of the TV flow was observed in 16/31 patients and in none of the controls. The mean delay time was 64.81 ± 27.07 ms (8.7 ± 3.2% of R-R interval. The delay time correlated with the differences in duration of the TV and MV flow (55.94 ± 32.88 ms (r = 0.90, p Conclusions Early diastolic dysfunction with delayed onset of TV flow is common after TOF repair, and is associated with reduced RV ejection fraction. It is a further manifestation of interventricular dyssynchrony and represent an additional mechanism of ventricular diastolic dysfunction.

  8. The advantages of live/real time three-dimensional transesophageal echocardiography in the assessment of tricuspid valve infective endocarditis.

    Science.gov (United States)

    Sungur, Aylin; Hsiung, Ming C; Meggo Quiroz, Luis D; Oz, Tuğba Kemaloğlu; Haj Asaad, Ayman; Joshi, Deepak; Dönmez, Cevdet; Güvenç, Tolga S; Nanda, Navin C

    2014-11-01

    Currently, tricuspid valve infective endocarditis (TVIE) is encountered in daily clinical practice more frequently due to the increasing prevalence of illicit intravenous drug use and the implantation of intracardiac devices. In this study, we compared findings from intra-operative live/real time three-dimensional transesophageal echocardiograms (3DTEE) and two-dimensional transesophageal echocardiograms (2DTEE) of 10 patients who underwent surgery for native tricuspid valve (TV) endocarditis. Unlike 2DTEE, 3DTEE allowed en face visualization of the 3 TV leaflets from both, atrial and ventricular aspects, in 9 of the 10 cases. In the remaining patient, in whom 3DTEE could not identify all 3 leaflets en face, the TV was found essentially destroyed at surgery. Using 3DTEE, the number of vegetations was accurately reported when compared with the surgical record. Furthermore, the orientation of each vegetation was the same as noted in the surgical findings. 2DTEE missed the identification of vegetations in 5 patients. The attachment site of vegetations to the TV were also not characterized by 2DTEE in 5 patients. In all 10 cases, 3DTEE characterized the vegetations more accurately with larger dimensions, including those in the azimuthal axis, and volumes. In addition, a perivalvular abscess that lead to surgical intervention was identified by 3DTEE, however, missed by 2DTEE. In conclusion, 3DTEE allows en face visualization of the TV apparatus permitting accurate description of the number and dimensions of vegetations identified by our surgical standard, which ultimately informs patients' prognosis and dictates the timing and planning for surgical intervention. Its use should be in conjunction with 2DTEE when evaluating TVIE.

  9. Prognosis of patients with carcinoid heart disease after valvular surgery.

    Science.gov (United States)

    Manoly, Imthiaz; McAnelly, Sarah-Louise; Sriskandarajah, Sanjeevan; McLaughlin, Kenneth Edward

    2014-08-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. We addressed the following question: in patients who are diagnosed with carcinoid heart disease (CHD), do valvular surgeries improve their prognosis? Fifty percent of the patients with clinically diagnosed carcinoid syndrome had cardiac involvement which was present either as valvular dysfunction or as cardiac metastases. These patients often require surgery due to their heightened risk of cardiac disease. Altogether 217 relevant papers were identified as a result of the below-mentioned search, of which 10 papers represented the best evidence to answer the question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses were tabulated. Of the patients who were identified to have carcinoid heart disease in different studies, 193 patients had valve procedure, mainly replacements at tricuspid, mitral and aortic valve positions and either valvuloplasty or replacement at pulmonary valve. Tricuspid and pulmonary valves represented the majority of the excised valves among patients undergoing valvular surgery for CHD. The pathology of carcinoid valve was attributed to the presence of plaque, causing thickening and retraction. Pure regurgitation was the most common finding in all the valves except pulmonary valve which had both stenosis and insufficiency. Thirty-day mortality was 17% (range 1-63%) and long-term survivors were reported to be alive at an average of 58 months (28-80 months) after the valve surgery. The evidence demonstrates that surgical intervention can lead to improved prognosis and reduce the symptoms of heart failure. Postoperative mortality was mainly due to the carcinoid disease itself and not as a complication of the surgery. Therefore, surgery could be considered for symptomatic palliation in carefully selected individuals.

  10. GRAVES’ DISEASE INDUCED REVERSIBLE SEVERE RIGHT HEART FAILURE

    Directory of Open Access Journals (Sweden)

    Kathyayani

    2015-07-01

    Full Text Available A middle aged man presented with evidence of right - sided heart failure in atrial fibrillation (AF and was found to have severe Tricuspid Regurgitation (TR with pulmonary artery hypertension (PAH, with normal left ventricular function. The common possible seconda ry causes of PAH were ruled out, but during investigation he was found to have elevated thyroid function tests compatible with the diagnosis of Graves’ disease. The treatment of Graves’ disease was started with anti - thyroid drugs and associated with a sign ificant reduction in the pulmonary arterial pressure. This case report is presented to highlight one of the rare and underdiagnosed presentations of Graves’ disease. Thyrotoxicosis can present with profound cardiovascular complications. In recent times, th ere have been few reports of secondary PAH with TR in patients with hyperthyroidism. Previously asymptomatic Graves’ disease having the signs and symptoms of right heart failure is a rare presentation and the association could be easily missed. This case p resentation emphasizes that the diagnosis of thyroid heart disease with heart failure secondary to Graves’ disease should be considered in any patient regardless of age, gender with clinical features of heart failure of unknown etiology and timely initiation of anti - thyroid drugs is necessary to treat these reversible cardiac failures.

  11. Frequency of metastatic tumors in the heart

    Directory of Open Access Journals (Sweden)

    Rafajlovski Saša I.

    2005-01-01

    Full Text Available Introduction. Secondary or metastatic tumors in the heart occur more frequently than primary ones, and, according to the published series, their frequency found in autopsic material ranges from 1.6% to 20.6%. Metastatic tumors in the heart are rarely clinically symptomatic, and, therefore, they are rarely diagnosed within the lifetime. They are mostly diagnosed at autopsy. The aim of this study was to analyze the frequency of metastatic tumors of the heart, their primary localization, as well as the localization of the metastases found in the autopsic material within the period 1972−2004. Metods. During the autopsy of the patients died of metastatic tumors, we microscopically and macroscopically analyzed all the organs and tissues to determine the metastases of primary tumors in other organs, especially in the heart and pericardium. Results. Within the period from 1972−2004, 11 403 autopsies were performed. In 2 928 (25.6% out of 11 403 autopsies, the presence of malignant tumor was diagnosed, and in 79 (2.7% of these cases, metastasis of the heart was found out. Only in 5 of the cases, the presence of metastasis in the heart was diagnosed during the lifetime. The most frequent metastases in the heart were caused by pulmonary carcinoma (18 cases, leukemia and malignant lymphoma (8 cases, each, then pancreatic and breast carcinoma, while the metastases of other carcinomas were rather rare. In 40 (60.76% cases, the metastasis was localized in the myocardium, but more often in the left ventricle, in 24 (30.38% cases in the pericardium, in 4 cases in the epicardium and in the 3 of them in the mitral and tricuspid valve. Only in one case of renal carcionoma, metastasis was found in the right atrium and it occurred by spreading (dissemination through the lumen of the inferior vena cava. Conclusion. Metastatic tumors of the heart are rather rare, and rarely clinically symptomatic, and, thus, rarely diagnosed during life. The methods of choice for

  12. Plastic Pollution from Ships

    OpenAIRE

    Čulin, Jelena; Bielić, Toni

    2016-01-01

    The environmental impact of shipping on marine environment includes discharge of garbage. Plastic litter is of particular concern due to abundance, resistance to degradation and detrimental effect on marine biota. According to recently published studies, a further research is required to assess human health risk. Monitoring data indicate that despite banning plastic disposal at sea, shipping is still a source of plastic pollution. Some of the measures to combat the problem are discussed.

  13. Handbook of Plastic Welding

    DEFF Research Database (Denmark)

    Islam, Aminul

    The purpose of this document is to summarize the information about the laser welding of plastic. Laser welding is a matured process nevertheless laser welding of micro dimensional plastic parts is still a big challenge. This report collects the latest information about the laser welding of plasti...... as a knowledge handbook for laser welding of plastic components. This document should provide the information for all aspects of plastic laser welding and help the design engineers to take all critical issues into consideration from the very beginning of the design phase....

  14. Plastics and health risks.

    Science.gov (United States)

    Halden, Rolf U

    2010-01-01

    By 2010, the worldwide annual production of plastics will surpass 300 million tons. Plastics are indispensable materials in modern society, and many products manufactured from plastics are a boon to public health (e.g., disposable syringes, intravenous bags). However, plastics also pose health risks. Of principal concern are endocrine-disrupting properties, as triggered for example by bisphenol A and di-(2-ethylhexyl) phthalate (DEHP). Opinions on the safety of plastics vary widely, and despite more than five decades of research, scientific consensus on product safety is still elusive. This literature review summarizes information from more than 120 peer-reviewed publications on health effects of plastics and plasticizers in lab animals and humans. It examines problematic exposures of susceptible populations and also briefly summarizes adverse environmental impacts from plastic pollution. Ongoing efforts to steer human society toward resource conservation and sustainable consumption are discussed, including the concept of the 5 Rs--i.e., reduce, reuse, recycle, rethink, restrain--for minimizing pre- and postnatal exposures to potentially harmful components of plastics.

  15. Synaptic Plasticity and Nociception

    Institute of Scientific and Technical Information of China (English)

    ChenJianguo

    2004-01-01

    Synaptic plasticity is one of the fields that progresses rapidly and has a lot of success in neuroscience. The two major types of synaptie plasticity: long-term potentiation ( LTP and long-term depression (LTD are thought to be the cellular mochanisms of learning and memory. Recently, accumulating evidence suggests that, besides serving as a cellular model for learning and memory, the synaptic plasticity involves in other physiological or pathophysiological processes, such as the perception of pain and the regulation of cardiovascular system. This minireview will focus on the relationship between synaptic plasticity and nociception.

  16. Increased transcript level of poly(ADP-ribose) polymerase (PARP-1) in human tricuspid compared with bicuspid aortic valves correlates with the stenosis severity

    Energy Technology Data Exchange (ETDEWEB)

    Nagy, Edit, E-mail: edit.nagy@karolinska.se [Department of Medicine, Karolinska Institutet, Stockholm (Sweden); Department of Cardiology, Karolinska University Hospital, Stockholm (Sweden); Caidahl, Kenneth [Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (Sweden); Department of Clinical Physiology, Karolinska University Hospital, Stockholm (Sweden); Franco-Cereceda, Anders [Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (Sweden); Department of Throracic Surgery, Karolinska University Hospital, Stockholm (Sweden); Baeck, Magnus [Department of Medicine, Karolinska Institutet, Stockholm (Sweden); Department of Cardiology, Karolinska University Hospital, Stockholm (Sweden)

    2012-04-13

    Highlights: Black-Right-Pointing-Pointer Oxidative stress has been implicated in the pathomechanism of calcific aortic valve stenosis. Black-Right-Pointing-Pointer We assessed the transcript levels for PARP-1 (poly(ADP-ribose) polymerase), acts as a DNA damage nick sensor in stenotic valves. Black-Right-Pointing-Pointer Early stage of diseased tricuspid valves exhibited higher mRNA levels for PARP-1 compared to bicuspid valves. Black-Right-Pointing-Pointer The mRNA levels for PARP-1 inversely correlated with the clinical stenosis severity in tricuspid valves. Black-Right-Pointing-Pointer Our data demonstrated that DNA damage pathways might be associated with stenosis severity only in tricuspid valves. -- Abstract: Oxidative stress may contribute to the hemodynamic progression of aortic valve stenosis, and is associated with activation of the nuclear enzyme poly(ADP-ribose) polymerase (PARP) 1. The aim of the present study was to assess the transcriptional profile and the topological distribution of PARP-1 in human aortic valves, and its relation to the stenosis severity. Human stenotic aortic valves were obtained from 46 patients undergoing aortic valve replacement surgery and used for mRNA extraction followed by quantitative real-time PCR to correlate the PARP-1 expression levels with the non invasive hemodynamic parameters quantifying the stenosis severity. Primary isolated valvular interstitial cells (VICs) were used to explore the effects of cytokines and leukotriene C{sub 4} (LTC{sub 4}) on valvular PARP-1 expression. The thickened areas of stenotic valves with tricuspid morphology expressed significantly higher levels of PARP-1 mRNA compared with the corresponding part of bicuspid valves (0.501 vs 0.243, P = 0.01). Furthermore, the quantitative gene expression levels of PARP-1 were inversely correlated with the aortic valve area (AVA) (r = -0.46, P = 0.0469) and AVA indexed for body surface area (BSA) (r = -0.498; P = 0.0298) only in tricuspid aortic valves

  17. DONOR HEART VALVES RECONSTRUCTION BEFORE TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    S. V. Gautier

    2013-01-01

    Full Text Available Aim of study. The demonstration of our own experience in heart transplantation after valve reconstruction. Methods and results. From May 2012 to March 2013 3 mitral valve annuloplasties were performed to recipi- ents, requiring urgent HT and having extremely unfavorable prognosis of survival without HT. The recipients were classified as United Network for Organ Sharing (UNOS IB, and all of them were on inotropic support. In one case, HT was performed after reconstruction of rheumatic mitral stenosis, in two other cases – after dege- nerative mitral regurgitation. The technical aspects are reviewed of ex-vivo mitral and tricuspid valves repair with concomitant heart transplantation. All patients were discharged from the hospital having excellent postope- rative recovery. Conclusion. Taking into consideration the demonstrated satisfactory result of surveillance and presence of significant experience in performing of reconstructive valve surgery among no-HT cardiosurgical patients, an increase in the pool of suitable donor organs is expected due to the liberalization of the selection criteria and the possibility of the innovative valve reconstruction procedures ex vivo. 

  18. Hypoplastic left heart syndrome

    Science.gov (United States)

    HLHS; Congenital heart - hypoplastic left heart; Cyanotic heart disease - hypoplastic left heart ... Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in ...

  19. 风湿性左心瓣膜病变术中行三尖瓣矫治的临床价值%Clinical significance of tricuspid surgery in patients with rheumatic disease undergoing left-side valve surgery

    Institute of Scientific and Technical Information of China (English)

    陆小虎; 吴延虎; 张石江; 邵永丰; 秦建伟

    2012-01-01

    Objective To explore the clinical value of tricuspid dilatation as a criterion for rheumatic tricuspid regurgitatioa Methods A total o{ 104 patients with rheumatic disease underwent left-side valve surgery. Taking the tricuspid annular dimension ≥70 mm measured intraoperatively as the criterion. 30 patients with the tricuspid annular dimension <70 mm( group A) received left-side valve surgery only and 74 patients with the tricuspid annular dimension ≥70 mm( group B) received left side valve surgery plus tricuspid annuloplasty or tricuspid replacement. Results Cardiac function after surgery was inproved in both groups, which was more in group B than that in group A. Tricuspid regurgitation grade was significantly decreased postoperatively in group B, but which was worse in group A. Conclusion The tricuspid annular dimension 5≥ 70 mm may be taken as a criterion for tricuspid annuloplasty or tricuspid replacement.%目的 探讨以三尖瓣环扩大作为风湿性左心瓣膜病变术中三尖瓣关闭不全矫治指征的临床价值.方法 风湿性左心瓣膜疾病行手术治疗的患者104例分为单纯左心瓣膜置换30例(A组)和左心瓣膜置换加三尖瓣手术74例(B组)两组.B组术中测量三尖瓣环直径≥70 mm者行三尖瓣成形或置换手术.结果 两组术后心功能均较术前好转.B组术后心功能明显好于A组.B组术后三尖瓣返流程度明显改善,而A组三尖瓣返流程度较术前加重.结论 三尖瓣环直径≥70 mm可以作为风湿性左心瓣膜病变术中三尖瓣成形或置换手术的一个指征.

  20. Heart transplantation

    OpenAIRE

    Cheng, Allen; Slaughter, Mark S.

    2014-01-01

    Heart failure remains a major global problem with approximately 6 million individuals suffering from heart failure in the United States alone. The surgical technique of heart transplantation, popularized by Dr. Norman Shumway, has led to its success and currently remains the best treatment options for patients with end-stage. However, with the continued limitation of donor organs and the rapid development of ventricular assist device technology, the number of patients bridged to transplant wi...

  1. Heart attack

    Science.gov (United States)

    ... Saunders; 2014:chap 51. Read More Arrhythmias Cardiogenic shock Diabetes Hardening of the arteries Heart failure - overview High blood pressure Implantable cardioverter-defibrillator Lipoprotein- ...

  2. Mildly raised tricuspid regurgitant velocity 2.5-3.0 m/s in pregnant women with sickle cell disease is not associated with poor obstetric outcome - An observational cross-sectional study.

    Science.gov (United States)

    Soh, May C; Sankaran, Srividhya; Chung, Natali Ya; Nelson-Piercy, Catherine; Howard, Jo; Robinson, Sue E; Oteng-Ntim, Eugene

    2016-12-01

    Pulmonary hypertension is associated with 36% mortality in pregnancy, and 6-10% of patients with sickle cell disease have pulmonary hypertension. Tricuspid regurgitant velocity ≥2.5 m/s on echocardiography is a well validated means of screening for pulmonary hypertension in the non-pregnant population. This is a pilot study to determine if this is a useful non-invasive screening test for pulmonary hypertension in pregnancy, and whether raised tricuspid regurgitant velocity ≥2.5 m/s was associated with poor outcomes. This is a cross-sectional study over a five-year period in a tertiary referral centre with a specialised multidisciplinary clinic for pregnant women with sickle cell disease. Women with sickle cell disease, no prior pulmonary hypertension and singleton pregnancies who had echocardiography with a measurable tricuspid regurgitant velocity in pregnancy were included. There were 34 pregnancies, of which eight had tricuspid regurgitant velocity ≥2.5 m/s. There were no significant differences in their characteristics, sickle cell-related complications or medical co-morbidities. The women with tricuspid regurgitant velocity ≥2.5 m/s had similar obstetric and perinatal outcomes as those with a tricuspid regurgitant velocity <2.5 m/s.

  3. Halos of Plastic

    Institute of Scientific and Technical Information of China (English)

    Maya Reid

    2012-01-01

    The halos that span South Africa's coastline are anything but angelic. Fanning out around four major urban centers-Cape Town, Port Elizabeth, East London and Durban-they are made up of innumerable bits and pieces of plastic. As a form of pollution, their shelflife is unfathomable. Plastic is essentially chemically inactive. It's designed to never break down.

  4. Biodegradation of plastics.

    Science.gov (United States)

    Shimao, M

    2001-06-01

    Widespread studies on the biodegradation of plastics have been carried out in order to overcome the environmental problems associated with synthetic plastic waste. Recent work has included studies of the distribution of synthetic polymer-degrading microorganisms in the environment, the isolation of new microorganisms for biodegradation, the discovery of new degradation enzymes, and the cloning of genes for synthetic polymer-degrading enzymes.

  5. Application of real-time three-dimensional transesphaogeal echocardiography in quantitation of tricuspid valve annulus diameter%经食管实时三维超声心动图对三尖瓣环径测量位点的研究

    Institute of Scientific and Technical Information of China (English)

    孔令秋; 康彧; 唐红; 张尔永; 肖锡俊; 郭应强; 宋海波

    2013-01-01

    Objective To verify the feasibility and accuracy in the measurement of tricuspid valve annulus diameter(TVD) in the right ventricular outflow tract view.Methods Seventy five patients under the valve replacement surgery for the left heart valve lesions were divided into mild,moderate and severe group according to the severity of the regurgitation.The TVD was get on the apical four-chamber heart viewpreoperatively by transthoracic echocardiography(TTE),noted as TTE-TVD,meanwhile it was also get by the transesophageal echocardiography on the four-chamber view (TEE-TVD),right ventricular inflow (RVIT-TVD) and outflow tract view(RVOT-TVD).The changes of tricuspid regurgitation severtity was observed preoperatively.And the morphology of tricuspid annulus were observed using both real-time three dimensional transesophageal echocardiography (RT-3D TEE) and the quantitative software.Results Comparison in the groups:no statistically significant difference (P >0.05) was found between TTE-TVD,TEE-TVD and RVIT-TVD;while the RVOT-TVD was significant greater than that in the same group from other views (P < 0.05).Comparison between the groups:no significant difference was found between mild and moderate regurgitation group on the same view.There was a significant difference of the TVD between the severe regurgitation group and the former two groups on each view(P <0.05).The severity of tricuspid regurgitation in intraoperative anesthesia was reduced.The "saddle" tricuspid ring evolved into the narrow planar structure on the RT-3D TEE.For the expansion of the annulus,it departure from the tricuspid septal leaflet.Conclusions TVD measured on the right ventricular outflow tract view reflect the maximum expansion of the tricuspid valve annulus diameter,and can effectively guide the decision-making choices of the surgeon.%目的 探讨在右室流出道切面测量三尖瓣环径(TVD)的可行性与准确性.方法 75例因左心瓣膜损害而行瓣膜置换术患者,根据

  6. DESIGNERS’ KNOWLEDGE IN PLASTICS

    DEFF Research Database (Denmark)

    Eriksen, Kaare

    2013-01-01

    The Industrial designers’ knowledge in plastics materials and manufacturing principles of polymer products is very important for the innovative strength of the industry, according to a group of Danish plastics manufacturers, design students and practicing industrial designers. These three groups...... answered the first Danish national survey, PD13[1], investigating the importance of industrial designers’ knowledge in plastics and the collaboration between designers and the polymer industry. The plastics industry and the industrial designers collaborate well, but both groups frequently experience...... that the designers’ lack of knowledge concerning polymer materials and manufacturing methods can be problematic or annoying, and design students from most Danish design universities express the need for more contact with the industry and more competencies and tools to handle even simple topics when designing plastic...

  7. Consciousness and neural plasticity

    DEFF Research Database (Denmark)

    In contemporary consciousness studies the phenomenon of neural plasticity has received little attention despite the fact that neural plasticity is of still increased interest in neuroscience. We will, however, argue that neural plasticity could be of great importance to consciousness studies....... If consciousness is related to neural processes it seems, at least prima facie, that the ability of the neural structures to change should be reflected in a theory of this relationship "Neural plasticity" refers to the fact that the brain can change due to its own activity. The brain is not static but rather...... the relation between consciousness and brain functions. If consciousness is connected to specific brain structures (as a function or in identity) what happens to consciousness when those specific underlying structures change? It is therefore possible that the understanding and theories of neural plasticity can...

  8. Heart transplant

    Science.gov (United States)

    ... factors include the type and severity of your heart disease, and how sick you are at the time you are listed. The amount of time you spend on a waiting list is usually NOT a factor for how soon you get a heart, except in the case of children. Most, but ...

  9. Heart failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970284 Effects of enalapril on heart rate variabilityin patients with congestive heart failure. ZHANGYouhua(章友华), et a1. Dept Cardiol, Cardiovasc Instit& Fuwai Hosp, CAMS & PUMC, Beijing, 100037. ChinCir J 1996; 11(2): 729-732.

  10. Heart Anatomy

    Science.gov (United States)

    ... from the left ventricle into the aorta, your body's largest artery. See also on this site: The Heartbeat The Conduction System (illustration) Electrical impulses from your heart muscle (the myocardium) cause your heart to contract. This electrical signal begins in the sinoatrial (SA) node, located at ...

  11. Simple, heart-smart substitutions

    Science.gov (United States)

    Coronary artery disease - heart smart substitutions; Atherosclerosis - heart smart substitutions; Cholesterol - heart smart substitutions; Coronary heart disease - heart smart substitutions; Healthy diet - heart ...

  12. Cerebral Lipiodol Embolism after Lymphatic Embolization for Plastic Bronchitis.

    Science.gov (United States)

    Kirschen, Matthew P; Dori, Yoav; Itkin, Maxim; Licht, Daniel J; Ichord, Rebecca; Vossough, Arastoo

    2016-09-01

    An adolescent with plastic bronchitis due to congenital heart disease had altered mental status after an interventional lymphatic procedure in which lipiodol contrast was used. Neuroimaging revealed cerebral lipiodol embolization due to direct shunting between lymphatic channels and pulmonary veins. Cerebral lipiodol embolization is a potential neurologic morbidity associated with interventional lymphatic procedures. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Tricuspid Valve Endocarditis With Group B Streptococcus After an Elective Abortion: The Need for New Data

    Directory of Open Access Journals (Sweden)

    Erica E. Palys

    2006-01-01

    Full Text Available Streptococcus agalactiae, commonly known as Group B streptococcus (GBS, was originally discovered as a cause of bovine mastitis. GBS colonizes the genital tract of up to 40% of women and has become a major pathogen in neonatal meningitis. GBS endocarditis is thought to be an uncommon manifestation of this infection and carries a higher mortality compared to other streptococcal pathogens. Studies have shown that endocarditis after abortion has an incidence of about one per million. However, this figure was published prior to routine use of echocardiography for diagnosis. The American Heart Association has recently declared transesophageal echocardiography the gold standard for endocarditis diagnosis. This case report illustrates that, given the potentially devastating consequences of endocarditis, there is a need for updated studies to adequately assess the true incidence of this infection. Pending the outcome of these studies, routine GBS screening and prophylactic antibiotics prior to abortion should be recommended.

  14. Tricuspid valve endocarditis with Group B Streptococcus after an elective abortion: the need for new data.

    Science.gov (United States)

    Palys, Erica E; Li, John; Gaut, Paula L; Hardy, W David

    2006-01-01

    Streptococcus agalactiae, commonly known as Group B streptococcus (GBS), was originally discovered as a cause of bovine mastitis. GBS colonizes the genital tract of up to 40% of women and has become a major pathogen in neonatal meningitis. GBS endocarditis is thought to be an uncommon manifestation of this infection and carries a higher mortality compared to other streptococcal pathogens. Studies have shown that endocarditis after abortion has an incidence of about one per million. However, this figure was published prior to routine use of echocardiography for diagnosis. The American Heart Association has recently declared transesophageal echocardiography the gold standard for endocarditis diagnosis. This case report illustrates that, given the potentially devastating consequences of endocarditis, there is a need for updated studies to adequately assess the true incidence of this infection. Pending the outcome of these studies, routine GBS screening and prophylactic antibiotics prior to abortion should be recommended.

  15. Radionuclide ventriculography for non-invasive diagnosis and quantification of tricuspid regurgitation

    Energy Technology Data Exchange (ETDEWEB)

    Kress, P.; Seibold, H.; Wieshammer, S.; Richter, P.; Stauch, M.; Waitzinger, J.; Bitter, F.; Adam, W.E.

    1987-08-01

    A series of 33 patients with TR on physical examination and cardiac catheterization underwent RNV and was compared with 48 patients with right ventricular enlargement or pressure load on the right ventricle. In addition, the specificity of the method was evaluated in 470 consecutive patients with various forms of heart disease. In 18 out of 20 subjects with isolated TR a regurgitant index below the lower normal limit was found. The remaining 2 cases with minor TR had a regurgitant index within the normal range, which is 0.89 to 1.97 in this laboratory. In patients with additional volume load on the left ventricle, the sensitivity of the method was found to be low, as could be expected from the principle of the method. The time-activity curve over the liver was usually in phase with that recorded over the atria in subjects with TR. Therefore, the additional examination of a region of interest over the liver was particularly useful in these patients with concomitant aortic or mitral valve regurgitation. None of the 48 patients with right ventricular enlargement or pressure load on the right ventricle had a falsely positive result. A total of 17 out of 470 consecutive patients had a regurgitant index below the normal range; left ventricular function was severely impaired in 9 of these patients. The remaining subjects had a regurgitant index slightly below the lower normal limit. In conclusion, RNV has a high sensitivity in the diagnosis of TR in patients without left heart valvular regurgitation and a high specificity in patients without severely impaired left ventricular function and without left-to-right shunt through an atrial septal defect. As in patients with right ventricular volume load from an atrial septal defect, RNV appears to allow the quantification of TR. This, however, cannot be proven directly since a golden standard for quantification of TR is not available. (orig./TRV).

  16. Loss of the cytoskeletal protein Pdlim7 predisposes mice to heart defects and hemostatic dysfunction.

    Directory of Open Access Journals (Sweden)

    Jennifer Krcmery

    Full Text Available The actin-associated protein Pdlim7 is essential for heart and fin development in zebrafish; however, the expression and function of this PDZ-LIM family member in the mammal has remained unclear. Here, we show that Pdlim7 predominantly localizes to actin-rich structures in mice including the heart, vascular smooth muscle, and platelets. To test the requirement for Pdlim7 in mammalian development and function, we analyzed a mouse strain with global genetic inactivation of Pdlim7. We demonstrate that Pdlim7 loss-of-function leads to significant postnatal mortality. Inactivation of Pdlim7 does not disrupt cardiac development, but causes mild cardiac dysfunction in adult mice. Adult Pdlim7(-/- mice displayed increased mitral and tricuspid valve annulus to body weight ratios. These structural aberrations in Pdlim7(-/- mice were supported by three-dimensional reconstructions of adult cardiac valves, which revealed increased surface area to volume ratios for the mitral and tricuspid valve leaflets. Unexpectedly, we found that loss of Pdlim7 triggers systemic venous and arterial thrombosis, leading to significant mortality shortly after birth in Pdlim7(+/- (11/60 and Pdlim7(-/- (19/35 mice. In line with a prothrombotic phenotype, adult Pdlim7(-/- mice exhibit dramatically decreased tail bleed times compared to controls. These findings reveal a novel and unexpected function for Pdlim7 in maintaining proper hemostasis in neonatal and adult mice.

  17. Wine and heart health

    Science.gov (United States)

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... more often just to lower your risk of heart disease. Heavier drinking can harm the heart and ...

  18. How the Heart Works

    Science.gov (United States)

    ... Works Explore How the Heart Works What Is... Anatomy Contraction Circulation Electrical System Heart Disease Related Topics Arrhythmia Congenital Heart Defects Coronary Heart Disease Heart Valve Disease How the Lungs Work Send a link to NHLBI to someone ...

  19. Heart Disease (For Kids)

    Science.gov (United States)

    ... CPR: A Real Lifesaver Kids Talk About: Coaches Heart Disease KidsHealth > For Kids > Heart Disease Print A A ... chest pain, heart attacks, and strokes . What Is Heart Disease? The heart is the center of the cardiovascular ...

  20. Men and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Men and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir Source: Interactive Atlas of Heart Disease and Stroke Heart Disease Facts in Men Heart disease is the leading ...

  1. About Heart Failure

    Science.gov (United States)

    ... talk about your health and the medicines About Heart Failure Heart failure is a disease where the heart cannot do ... very important for your health. common causes of heart failure are diseases or conditions that damage the heart. ...

  2. What Is Heart Failure?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Is Heart Failure? Heart failure is a condition in which the heart can' ... force. Some people have both problems. The term "heart failure" doesn't mean that your heart has stopped ...

  3. Heart Disease

    Science.gov (United States)

    ... Atherosclerosis is also the most common cause of cardiovascular disease. It can be caused by correctable problems, such as an unhealthy diet, lack of exercise, being overweight and smoking. Causes of heart arrhythmia ...

  4. Heart Attack

    Science.gov (United States)

    ... tear in the heart artery (spontaneous coronary artery dissection). Certain factors contribute to the unwanted buildup of ... logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2017 Mayo Foundation for Medical ...

  5. Informative document waste plastics

    NARCIS (Netherlands)

    Nagelhout D; Sein AA; Duvoort GL

    1989-01-01

    This "Informative document waste plastics" forms part of a series of "informative documents waste materials". These documents are conducted by RIVM on the indstruction of the Directorate General for the Environment, Waste Materials Directorate, in behalf of the program of

  6. A Plastic Menagerie

    Science.gov (United States)

    Hadley, Mary Jane

    2010-01-01

    Bobble heads had become quite popular, depicting all sorts of sports figures, animals, and even presidents. In this article, the author describes how her fourth graders made bobble head sculptures out of empty plastic drink bottles. (Contains 1 online resource.)

  7. Cortical plasticity and rehabilitation.

    Science.gov (United States)

    Moucha, Raluca; Kilgard, Michael P

    2006-01-01

    The brain is constantly adapting to environmental and endogenous changes (including injury) that occur at every stage of life. The mechanisms that regulate neural plasticity have been refined over millions of years. Motivation and sensory experience directly shape the rewiring that makes learning and neurological recovery possible. Guiding neural reorganization in a manner that facilitates recovery of function is a primary goal of neurological rehabilitation. As the rules that govern neural plasticity become better understood, it will be possible to manipulate the sensory and motor experience of patients to induce specific forms of plasticity. This review summarizes our current knowledge regarding factors that regulate cortical plasticity, illustrates specific forms of reorganization induced by control of each factor, and suggests how to exploit these factors for clinical benefit.

  8. Mechanical plasticity of cells

    Science.gov (United States)

    Bonakdar, Navid; Gerum, Richard; Kuhn, Michael; Spörrer, Marina; Lippert, Anna; Schneider, Werner; Aifantis, Katerina E.; Fabry, Ben

    2016-10-01

    Under mechanical loading, most living cells show a viscoelastic deformation that follows a power law in time. After removal of the mechanical load, the cell shape recovers only incompletely to its original undeformed configuration. Here, we show that incomplete shape recovery is due to an additive plastic deformation that displays the same power-law dynamics as the fully reversible viscoelastic deformation response. Moreover, the plastic deformation is a constant fraction of the total cell deformation and originates from bond ruptures within the cytoskeleton. A simple extension of the prevailing viscoelastic power-law response theory with a plastic element correctly predicts the cell behaviour under cyclic loading. Our findings show that plastic energy dissipation during cell deformation is tightly linked to elastic cytoskeletal stresses, which suggests the existence of an adaptive mechanism that protects the cell against mechanical damage.

  9. Targeting tumour Cell Plasticity

    Institute of Scientific and Technical Information of China (English)

    Elizabeth D. WILLIAMS

    2009-01-01

    @@ Her research is focused on understanding the mechanisms of tumour progression and metastasis, particularly in uro-logical carcinomas (bladder and prostate). Tumour cell plasticity, including epithelial-mesenchymal transition, is a cen-tral theme in Dr Williams' work.

  10. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008275 Relationship of calcineure in mRNA level in peripheral blood and cardiac muscle of patients with heart failure.WANG Mengmeng(王萌萌),et al.Dept Cardiol,Shandong Prov Hosp,Shandong Univ,Jinan 250021.Chin Cir J 2008;23(2):113-116.Objective To study the relationship of calcineurin mRNA level between peripheral lymphocytes and cardiac muscles of patients with chronic heart failure.Methods

  11. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008037 Factors associated with efficacy of cardiac resynchronization therapy for patients with congestive heart failure. SHI Haoying(史浩颖), et al. Dept Cardiol, Zhongshan Hosp Fudan Univ, Shanghai 200032. Chin J Cardiol 2007;35(12):1099-1163. Objective The efficacy of cardiac resynchronization therapy (CRT) in patients with congestive heart failure and the potential factors associated with responder or nonresponder were investigated. Methods Fifty

  12. 个体化改良三尖瓣Edwards MC3成形环植入术治疗中重度三尖瓣关闭不全%Evaluation of modified individually Edwards MC3 tricuspid valve annuloplasty for treating the patients with moderate-severe tricuspid regurgitation

    Institute of Scientific and Technical Information of China (English)

    夏春秋; 王春战; 于晓强; 仲崇俊

    2014-01-01

    Objective To comparatively analyze the clinical outcome of modified individually Edwards MC3 tricuspid valve annuloplasty for treating the patients with secondary moderate-severe tricuspid regurgitation. Methods We performed tricuspid valve annuloplasty with Edwards MC3 ring in 72 patients who suffered from moderate to severe secondary tricuspid valve regurgitation from 2005 to 2007 in our hospital. The patients were divided into two groups. 36 patients received Edwards MC3 tricuspid valve annuloplasty by classical method (classical method group) and 36 patients by modified method (modified method group). Results Fifty nine patients received the follow-up study at endtime of 5 years. There were no significant differences in two groups of patients about fundamental condition and left-sided valve operation (P > 0.05). The follow-up patients of modified method group had smaller tricuspid valve diameter than the patients of classical method group [(26.1 ± 1.8) mm vs (27.5 ± 2.2)mm, P < 0.05]. And the moderate-severe tricuspid regurgitation in modified method group was less than that in classical method group (6.5% vs 28.6%, P < 0.05). Conclusion The individually modified tricuspid valve annuloplasty with Edwards MC3 annuloplasty ring is effective for treating the secondary moderate-severe tricuspid regurgitation, but need longer-term follow-up study.%目的:对比分析个体化改良Edwards MC3成形环三尖瓣成形术治疗继发中重度三尖瓣关闭不全的临床结果。方法:2005年3月至2007年6月,我们采用Edwards MC3成形环,对72例左心瓣膜手术合并中、重度三尖瓣关闭不全的患者行三尖瓣环成形手术。患者分为两组,经典组采用经典的Edwards MC3三尖瓣成形术,改良组采用个体化非等分法行三尖瓣环成形术,共59例患者获得5年随访。结果:两组患者基本情况、左心手术情况比较差异均无统计学意义(P>0.05);术后随访的改良组三尖

  13. Laser cutting plastic materials

    Energy Technology Data Exchange (ETDEWEB)

    Van Cleave, R.A.

    1980-08-01

    A 1000-watt CO/sub 2/ laser has been demonstrated as a reliable production machine tool for cutting of plastics, high strength reinforced composites, and other nonmetals. More than 40 different plastics have been laser cut, and the results are tabulated. Applications for laser cutting described include fiberglass-reinforced laminates, Kevlar/epoxy composites, fiberglass-reinforced phenolics, nylon/epoxy laminates, ceramics, and disposable tooling made from acrylic.

  14. Localization of plastic deformation

    Energy Technology Data Exchange (ETDEWEB)

    Rice, J R

    1976-04-01

    The localization of plastic deformation into a shear band is discussed as an instability of plastic flow and a precursor to rupture. Experimental observations are reviewed, a general theoretical framework is presented, and specific calculations of critical conditions are carried out for a variety of material models. The interplay between features of inelastic constitutive description, especially deviations from normality and vertex-like yielding, and the onset of localization is emphasized.

  15. 以三尖瓣瓣环径结合体表面积作为三尖瓣成形手术指征有效性的初步临床观察%Preliminary clinical observation of tricuspid annuloplasty adopting tricuspid annulus diameter and body surface area as surgical indication

    Institute of Scientific and Technical Information of China (English)

    马小五; 张平洋; 张幼祥

    2013-01-01

    目的 应用实时三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)观察采用三尖瓣瓣环径结合体表面积作为三尖瓣成形术指征,是否有助于减少二尖瓣置换术(mitral valve replacement,MVR)患者术后中重度三尖瓣反流(tricuspid regurgitation,TR)的发生.方法 回顾性分析2009年3月至2011年12月我院心外科收治的118例术前TR<中度的MVR患者.术前三尖瓣瓣环径/体表面积均≥21 mm/m2,根据术中三尖瓣成形的有无和术后2年复查TR程度分为成形组(A、B亚组)和非成形组(C、D亚组),分别收集各组术前及术后2年的3-DE检查数据右心室舒张末期容积(RVEDV),右心室收缩末期容积(RVESV)及右心室毎搏量(RVSV).结果 三尖瓣成形组B组患者的术后RT-3DE指标RVEDV(124.9±23.9) ml、RVESV(59.2±11.6) ml 和RVSV(56.9±9.8) ml,三尖瓣非成形组D组患者的术后RT-3DE指标RVEDV(128.7±21.8) ml、RVESV(60.1±10.0) ml 和RVSV(57.8±10.7) ml,两者与术前RT-3DE指标比较差异均有统计学意义(P<0.05);A、B组间、C、D组间术后2年的RT-3DE指标间比较差异亦有统计学意义(P<0.01).三尖瓣非成形组术后三尖瓣中-重度反流的发生率较高.结论对术前TR<中度的MVR患者,采用三尖瓣瓣环径结合体表面积作为三尖瓣成形手术参考指标可能有效地减少这些患者术后中或重度TR的发生.%Objective To observe whether the adoptation of tricuspid annulus diameter and body surface area (BSA) as surgical indication for tricuspid annuloplasty will reduce the occurrence of moderate severe tricuspid regurgitation (TR) in patients with real-time three-dimensional echocardiography (RT-3DK) after mitral valve replacemetT(MVR). Methods Between March 2009 and December 2011, MVR was performed in 118 patients with TR<moderate and tricuspid annulus diameter/body surface area≥21 mm/m2 in the Department of our Cardiovascular Surgery. According to the adoptation of the tricuspid

  16. Unobtrusive heart rate monitor based on a fiber specklegram sensor and a single-board computer

    Science.gov (United States)

    Benevides, Alessandro B.; Frizera, Anselmo; Cotrina, Anibal; Ribeiro, Moisés. R. N.; Segatto, Marcelo E. V.; Pontes, Maria José

    2015-09-01

    This paper proposes a portable and unobtrusive heart rate monitor based on fiber specklegram sensors. The proposed module uses the Raspberry Pi module to perform the image acquisition and the fiber specklegram sensor, which is based on multimode plastic optical fibers. The heart rate is obtained by welch power spectral density estimate and the heart beats are identified by means of a threshold analysis.

  17. Update for 2014 on clinical cardiology, geriatric cardiology, and heart failure and transplantation.

    Science.gov (United States)

    Barón-Esquivias, Gonzalo; Manito, Nicolás; López Díaz, Javier; Martín Santana, Antonio; García Pinilla, José Manuel; Gómez Doblas, Juan José; Gómez Bueno, Manuel; Barrios Alonso, Vivencio; Lambert, José Luis

    2015-04-01

    In the present article, we review publications from the previous year in the following 3 areas: clinical cardiology, geriatric cardiology, and heart failure and transplantation. Among the new developments in clinical cardiology are several contributions from Spanish groups on tricuspid and aortic regurgitation, developments in atrial fibrillation, syncope, and the clinical characteristics of heart disease, as well as various studies on familial heart disease and chronic ischemic heart disease. In geriatric cardiology, the most relevant studies published in 2014 involve heart failure, degenerative aortic stenosis, and data on atrial fibrillation in the geriatric population. In heart failure and transplantation, the most noteworthy developments concern the importance of multidisciplinary units and patients with preserved systolic function. Other notable publications were those related to iron deficiency, new drugs, and new devices and biomarkers. Finally, we review studies on acute heart failure and transplantation, such as inotropic drugs and ventricular assist devices. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  18. Development of plastic surgery

    Directory of Open Access Journals (Sweden)

    Pećanac Marija Đ.

    2015-01-01

    Full Text Available Introduction. Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient Times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern Era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

  19. Sorting Plastic Waste in Hydrocyclone

    Directory of Open Access Journals (Sweden)

    Ernestas Šutinys

    2011-02-01

    Full Text Available The article presents material about sorting plastic waste in hydrocyclone. The tests on sorting plastic waste were carried out. Also, the findings received from the performed experiment on the technology of sorting plastic waste are interpreted applying an experimental model of the equipment used for sorting plastics of different density.Article in Lithuanian

  20. Ultrasound for critical care physicians: now my heart is even more full

    Directory of Open Access Journals (Sweden)

    Jalil B

    2015-02-01

    Full Text Available No abstract available. Article truncated after first page. A 49-year-old man with type 2 diabetes, intravenous drug abuse and heart failure presented to the emergency room with 2 weeks of progressively worsening chest pain, lower extremity swelling and shortness of breath. The patient was found to have an elevated troponin as well as brain natriuretic peptide and the absence of ischemic electrocardiogram findings. The patient was admitted to the medical ICU for hypoxic respiratory failure and shock of uncertain etiology. Clinically he seemed to be in decompensated heart failure and a bedside echocardiogram was performed (Figures 1 and 2. What is the best explanation for the echocardiographic findings shown above? 1. Atrial myxoma; 2. Cardiac amyloidosis; 3. Cardiac lymphoma; 4. Takotsubo cardiomyopathy; 5. Tricuspid valve endocarditis ...

  1. Evaluation of Modified Cosgrove-Edwards Tricuspid Valve Annuloplasty for Treating the Patients With Secondary Tricuspid Regurgitation%改良三尖瓣成形术对继发性三尖瓣关闭不全的疗效评价

    Institute of Scientific and Technical Information of China (English)

    潘世伟; 胡盛寿; 王巍; 郑哲; 胡晓鹏; 孙寒松; 许建屏; 李鹏; 汪胜

    2011-01-01

    Objective:To evaluate the clinical outcomes of modified Cosgrove-Edwards tricuspid valve annuloplasty for treating the patients with secondary tricuspid regurgitation.Methods:We performed tricuspid valve annuloplasty with homemade flexible “C” shape ring in 51 consecutive patients who suffered from moderate to severe secondary tricuspid valve regurgitation from 2002 to 2007 in our hospital.The patients were divided into two groups.14 patients received classic Cosgrove-Edwards tricuspid valve annuloplasty before 2004 (CE group), and 37 patients received modified Cosgrove-Edwards tricuspid valve annuloplasty after 2004 ( MCE group).During the operation, we found that 14 patients combined with rheumatic changes in their tricuspid valve and 37 patients without it.50 patients survived and received the follow-up study at the mean time of (47.08 ± 22.08 ) months.Results: ①The patients in MCE group received smaller sized tricuspid ring than those in CE group (28.1 ± 2.1 vs.29.5 ± 1.5) in the operation, the patients had smaller post-operative tricuspid valve diameter (26.2 ± 1.7 ) mm vs.( 27.7 ± 2.0) mm, and less post-operative moderate tricuspid regurgitation,2.8% vs.21.4% ,P <0.05 respectively.②The patients with rheumatic disease had more previous history of valve operation than those without it,50.0% vs.13.5% ,had decreased pulmonary systolic pressure (54.6 ± 22.2) mmHg vs.( 72.5 ± 22.6 ) mmHg and smaller tricuspid valve diameter ( 37.0 ± 6.2 ) mm vs.(48.2 ± 8.3)mm before the operation,P <0.05 respectively.Conclusion :The modified tricuspid valve annuloplasty with smaller flexible ring is effective for treating the secondary tricuspid regurgitation.An individualized annuloplasty should be performed according to the pathological changes in different patient.%目的:改良Cosgrove-Edwards(CE)三尖瓣成形术对继发性三尖瓣关闭不全(TI)的临床疗效评价.方法:2002-08至2007-12,连续对51例左心系统瓣膜病变,合并中量

  2. Univentricular hearts in Denmark 1977 to 2009

    DEFF Research Database (Denmark)

    Idorn, L; Olsen, M; Jensen, A S

    2012-01-01

    ), and to improvements in treatment. We aimed to explore changes in incidence, to estimate changes in survival, and to describe predictors of mortality in UVH patients. METHODS: Using a population-based design we identified all UVH cases in Denmark from 1977 to 2009. RESULTS: 703 UVH live births and 106 UVH TOP were...... identified. A dramatic decrease in birth incidence of UVH patients and a corresponding increase in UVH TOP was observed in recent years. Mean incidence rate of UVH (live births and UVH TOP) was 0.39 per 1000 births. In adjusted analysis survival improved significantly from birth era 1977-1989 to 1990......-1999 (HR 2.65, 95% confidence interval (CI), 2.06-3.42) but not significantly from 1990-1999 to 2000-2009 (HR 0.77, 95% CI, 0.57-1.05). In the birth era 2000-2009, the lowest five-year survival was seen with hypoplastic left heart syndrome (HLHS) (18.8%), whereas the best survival was seen with tricuspid...

  3. [Right heart failure after pacemaker implantation].

    Science.gov (United States)

    Gallego Galiana, Juan; López Castellanos, Genoveva; Gioia, Francesca; Ruiz Ortega, Raúl Antonio; Cobo Reinoso, Maria Eugenia; Manzano Espinosa, Luis

    2015-06-22

    Severe tricuspid regurgitation (TR) secondary to interference pacemaker (PM) cable is a rare cause of progressive right heart failure (HF), which can worsen patient outcomes. We present 3 clinical cases of right HF secondary to TR after PM implantation. In these patients the clinic is right HF, which can appear early, as in our second patient, or after years of implementation of the PM, as in the first and third patients. The diagnosis is confirmed by echocardiography, the most accurate 3D, followed by transesophageal. The 2D transthoracic can not detect it, because it has low sensitivity for TR associated with PM. Medical treatment is always the first choice, since any other procedure carries significant morbidity and mortality. Probably this is a condition that we will diagnose with increasing frequency, because there are more and more patients with devices and, at the same time, the diagnostic tools are improving. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  4. Familial congenital heart disease in Bandung, Indonesia

    Directory of Open Access Journals (Sweden)

    Sri Endah Rahayuningsih

    2013-01-01

    Full Text Available Background Congenital heart disease (CHD may occur in several members of a family. Studies have shown that familial genetic factor play a role in CHD.Objective To identify familial recurrences of CHD in families with at least one member treated for CHD in Dr. Hasan Sadikin Hospital, Bandung Indonesia.Methods In this descriptive study, subjects were CHD patients hospitalized or treated from January 2005 to December 2011. We constructed family pedigrees for five families.Results During the study period, there were 1,779 patients with CHD. We found 5 families with 12 familial CHD cases, consisting of 8 boys and 4 girls. Defects observed in these 12 patients were tetralogy of Fallot, transposition of the great arteries, persistent ductus arteriosus, ventricular septal defect, tricuspid atresia, pulmonary stenosis, and dilated cardiomyopathy. Persistent ductus arteriosus was the most frequently observed defect (4 out of 12 subjects. None of the families had a history of consanguinity. The recurrence risk of CHD among siblings was calculated to be 0.67%, and the recurrence risk of CHD among cousins was 0.16%.Conclusion Familial CHD may indicate the need for genetic counseling and further pedigree analysis.

  5. Familial congenital heart disease in Bandung, Indonesia

    Directory of Open Access Journals (Sweden)

    Sri Endah Rahayuningsih

    2013-03-01

    Full Text Available Background Congenital heart disease (CHD may occur in several members of a family. Studies have shown that familial genetic factor play a role in CHD. Objective To identify familial recurrences of CHD in families with at least one member treated for CHD in Dr. Hasan Sadikin Hospital, Bandung Indonesia. Methods In this descriptive study, subjects were CHD patients hospitalized or treated from January 2005 to December 2011. We constructed family pedigrees for five families. Results During the study period, there were 1,779 patients with CHD. We found 5 families with 12 familial CHD cases, consisting of 8 boys and 4 girls. Defects observed in these 12 patients were tetralogy of Fallot, transposition of the great arteries, persistent ductus arteriosus, ventricular septal defect, tricuspid atresia, pulmonary stenosis, and dilated cardiomyopathy. Persistent ductus arteriosus was the most frequently observed defect (4 out of 12 subjects. None of the families had a history of consanguinity. The recurrence risk of CHD among siblings was calculated to be 0.67%, and the recurrence risk of CHD among cousins was 0.16%. Conclusion Familial CHD may indicate the need for genetic counseling and further pedigree analysis. [Paediatr Indones. 2013;53:173-6.

  6. [Personal experience with 2,500 closed heart mitral commissurotomies].

    Science.gov (United States)

    Popa, I P; Făgărăşanu, D; Pavelescu, I; Stefănescu, T; Proinov, F; Constantinescu, M; Litarczek, G; Fotiade, B; Constantinescu, D; Bălan, A; Petrilă, T

    1977-01-01

    Between 1953 and 1976 a total of 2527 mitral commissurotomies have been performed in the Clinic for Cardio-Vascular Surgery of the "Fundeni" Hospital. This group included cases with pure mitral stenosis (predominantly following rheumatic disease), but also cases of mitral stenosis associated with other cardiac lesions in which the major hemodynamic element was the mitral obstruction. Criteria are discussed for surgery, the preoperative preparation of the patient, incidents, accidents and complications, as well as technical difficulties of the digital and/or instrumental mitral commissurotomies on closed heart, either carried out for the first time in the respective patient, or as iterative intervention. Comparing the results in relation with the functional stage of the disease (62.5% of the patients were classified in the III-IV evolutive degree, according to the NIHA classification), pulmonary hypertension (61.6% of the patients had medium or severe pulmonary hypertension), associated lesions (present in 17% of the cases--mitral failure predominated, together with tricuspid or aortic failures), it is appreciated that the technique of mitral commissurotomy on closed heart is an useful therapeutic method (88.6% very good and good results, a global death rate of 3.9%) that can be applied in a large category of patients, although there is a trend toward open-heart surgery, with all medico-economical major implications.

  7. Three-dimensional Echocardiography in Valvular Heart Disease.

    Science.gov (United States)

    Kurklinsky, Andrew; Mankad, Sunil

    2012-01-01

    Recent technologic advances in 3-dimensional (3D) echocardiography, using parallel processing to scan a pyramidal volume, have allowed for a superior ability to describe valvular anatomy using both transthoracic and transesophageal echocardiography. Although still in evolution and at an early phase of adaptation with respect to its clinical application, 3D echocardiography has emerged as an important clinical tool in the assessment of valvular heart disease. Three-dimensional echocardiography provides unique perspectives of valvular structures by presenting "en face" views of valvular structures, allowing for a better understanding of the topographical aspects of pathology, and a refined definition of the spatial relationships of intracardiac structures. Three-dimensional echocardiography makes available indices not described by 2D echocardiography and has been demonstrated to be superior to 2D echocardiography in a variety of valvular disease scenarios. The information gained from 3D echocardiography has especially made an impact in guiding clinical decisions in the evaluation of mitral valve (MV) disease. The decision of early surgery in degenerative MV disease is based on the suitability of repair, and the suitability of repair is generally based on echocardiography. The superior understanding of MV anatomy afforded by 3D echocardiography has been shown to be quite valuable in this setting. This review will describe the contemporary use of 3D echocardiography in the assessment of valvular heart disease, including MV, aortic, tricuspid, and prosthetic valve abnormalities. This article illustrates how 3D echocardiography can complement current echocardiography techniques in the management of valvular heart disease.

  8. Heart failure - tests

    Science.gov (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic versus diastolic, valvular) Monitor your heart failure ...

  9. Problem: Heart Valve Stenosis

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  10. Healthy Heart Quizzes

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  11. Problem: Heart Valve Regurgitation

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  12. Travel and Heart Disease

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  13. Cirurgia conservadora da endocardite bacteriana aguda da valva tricúspide Conservative operation for bacterial endocardites of the tricuspide valve

    Directory of Open Access Journals (Sweden)

    Iseu Affonso da Costa

    1988-08-01

    Full Text Available É relatado o caso de 1 paciente que apresentou endocardite aguda da valva tricúspide pós-aborto, cujo agente causal era o S. aureus. Como não houvesse resposta favorável ao tratamento antibiótico (gentamicina, vancomicina e oxacilina, optou-se pela intervenção, vinte dias após a internação. Foi praticada excisão de uma vegetação única e do tecido valvar adjacente, na comissura ântero-posterior e plicatura anular. O resultado foi favorável, com cura clínica. O exame ecocardiográfico confirmou a presença da vegetação no pré-operatório e o funcionamento conservado da valva, após a plastia. O tratamento cirúrgico, com retirada do tecido infectado e preservação da valva constitui uma alternativa aplicável a certos casos de endocardite aguda das valvas atrioventriculares.One case of acute bacterial endocarditis of the tricuspid valve caused by S. aureus and following a septic abortion is presented. Surgical treatment was indicated after failure of antibiotics. Operation consisted of excision of a large vegetation adherent to the anterior and posterior cusps at the commisure and of the affected valvar tissue. Annular plicature at the segment corresponding to the posterior cuspid was employed to maintain competence. Clinical result was very satisfactory with resolution of sepsis. Dopplerecocardiography revealed the presence of the vegetation before the operation and showed a small regurgitation after valvoplasty. Conservative operation upon the atrioventricular valves must be kept in mind as an alternative in the treatment of acute bacterial endocarditis.

  14. Two-dimensional echocardiographic determination of right atrial emptying volume: a noninvasive index in quantifying the degree of tricuspid regurgitation.

    Science.gov (United States)

    DePace, N L; Ren, J F; Kotler, M N; Mintz, G S; Kimbiris, D; Kalman, P

    1983-09-01

    Contrast echocardiography and inferior vena cava ultrasonography are useful techniques in diagnosing tricuspid regurgitation (TR) but are not helpful in estimating the severity. Using a computerized light-pen method for tracing the right atrial (RA) border during systole and diastole in the apical 4-chamber view, single-plane volume determinations were calculated in 10 normal subjects (Group I), 18 patients with atrial fibrillation (AF) and no TR (Group II), 14 patients with mitral stenosis and mild TR (Group IIIa), and 8 patients with mitral stenosis and severe TR (Group IIIb). TR was quantitated as absent, mild or severe by contrast right ventriculography. The RA end-systolic volume was 36.4 +/- 13.1 ml in Group I patients, 59.1 +/- 16.8 ml in Group II patients, 76.9 +/- 55.4 ml in Group IIIa patients, and 154.6 +/- 57.3 ml in Group IIIb patients (all Groups versus Group I, p less than 0.001). The mean RA emptying volume, which equals RA end-systolic volume--RA end-diastolic volume, was 15.3 +/- 5.0 for Group I, 17.7 +/- 3.0 for Group II, 30.4 +/- 8.0 for Group IIIa, and 71.6 +/- 25.4 for Group IIIb. All 8 patients with severe TR but none of the 14 patients with mild TR had an RA emptying volume greater than 40 ml (p less than 0.001). In addition, all 28 patients in Groups I and II but only 4 of 14 patients in Group III had an RA emptying volume less than 26 ml (p less than 0.01). The mean RA pressure measured at cardiac catheterization correlated with RA emptying volume (r = 0.71, p less than 0.001). Thus, RA emptying volume is useful for separating severe TR from mild TR in patients with mitral stenosis.

  15. 先天性三尖瓣口无功能的超声心动图诊断%Diagnosis of congenitally unguarded tricuspid valve orifice by echocardiography

    Institute of Scientific and Technical Information of China (English)

    吴力军; 张玉奇; 陈亚青; 陈丽君; 张志芳

    2016-01-01

    目的 分析先天性三尖瓣口无功能(congenitally unguarded tricuspid valve orifice,CUTVO)的超声心动图特征,评价超声心动图对CUTVO的诊断价值.方法 回顾性分析9例经心外科手术或尸解诊断为CUTVO患儿的超声心动图资料.结果 CUTVO声像图特征主要表现为三尖瓣叶完全或部分缺如,三尖瓣腱索及乳头肌缺如或发育不良,三尖瓣环及房室连接关系正常;三尖瓣口严重反流,右心房、右心室明显增大.本组单纯性CUTVO2例,合并其他心血管系统畸形7例,其中肺动脉闭锁伴室间隔完整5例,房间隔缺损及动脉导管未闭1例,肌部室间隔缺损1例.9例患儿中,超声诊断符合7例,误诊2例(22.2%),其中1例误诊为三尖瓣下移畸形,1例误诊为Uhl's病.结论 超声心动图技术可以准确诊断CUTVO,但需与三尖瓣下移畸形及Uhl's病鉴别.%Objective To review the imaging characteristics and evaluate the diagnostic value of echocardiography for congenitally unguarded tricuspid valve orifice (CUTVO).Methods Doppler echocardiography was performed and these images were compared with operative and necropsy findings in 9 children with CUTVO.Results CUTVO was characterized by the absence of the tricuspid valvar leaflets with normal atrioventricular junction and tricuspid annulus,severe tricuspid regurgitation,and dilated right atrium and right ventricles.The associated malformations included pulmonary atresia with intact ventricular septum (5 cases),patent ductus arteriosus and atrial septal defect (1 case),and muscular ventricular septal defect (1 case).Seven of 9 cases were diagnosed correctly,and other 2 cases were miss-diagnosed,in which 1 case misdiagnosed as Ebstein anomaly,and 1 case misdiagnosed as Uhl's disease.Conclusions Congenitally unguarded tricuspid valve orifice can be diagnosed accurately by Doppler echocardiography.This malformation should be distinguished from Ebstein anomaly and Uhl's disease.

  16. Echocardiographic Assessment of Embryonic and Fetal Mouse Heart Development: A Focus on Haemodynamics and Morphology

    Directory of Open Access Journals (Sweden)

    Nathan D. Hahurij

    2014-01-01

    Full Text Available Background. Heart development is a complex process, and abnormal development may result in congenital heart disease (CHD. Currently, studies on animal models mainly focus on cardiac morphology and the availability of hemodynamic data, especially of the right heart half, is limited. Here we aimed to assess the morphological and hemodynamic parameters of normal developing mouse embryos/fetuses by using a high-frequency ultrasound system. Methods. A timed breeding program was initiated with a WT mouse line (Swiss/129Sv background. All recordings were performed transabdominally, in isoflurane sedated pregnant mice, in hearts of sequential developmental stages: 12.5, 14.5, and 17.5 days after conception (n=105. Results. Along development the heart rate increased significantly from 125 ± 9.5 to 219 ± 8.3 beats per minute. Reliable flow measurements could be performed across the developing mitral and tricuspid valves and outflow tract. M-mode measurements could be obtained of all cardiac compartments. An overall increase of cardiac systolic and diastolic function with embryonic/fetal development was observed. Conclusion. High-frequency echocardiography is a promising and useful imaging modality for structural and hemodynamic analysis of embryonic/fetal mouse hearts.

  17. Development of pediatric and congenital heart surgery in latin america: accomplishments and remaining challenges.

    Science.gov (United States)

    Kreutzer, Christian; Capelli, Horacio; Sandoval, Nestor; Jatene, Marcelo; Kreutzer, Guillermo

    2011-04-01

    In the last 70 years, congenital heart surgery has dramatically evolved, and Latin America has completed this journey with unique regional features. Since the first ligation of a patent arterial duct by Enrique Finochietto in 1941 in Buenos Aires, the development of congenital heart surgery was deeply influenced by funding restrictions and scarcity of technology. However, the determined work of cardiovascular surgery pioneers as Hugo Filipozzi, Euriclides Zerbini, and Adib Jatene in Brazil; Helmut Jaeger in Chile; Hugo Baz and Clemente Robles in Mexico; Alberto Bejarano in Colombia; and Mario Brea and Fernando Tricerri in Argentina made cardiac surgery with cardiopulmonary bypass available by the late 1950s. In the following five decades new generations of cardiovascular surgeons received the legacy of these outstanding leaders and made several important contributions to the field in tetralogy of Fallot, transposition of the great arteries, tricuspid atresia, single ventricle, truncus arteriosus, heart transplantation, and many others. Many centers in Latin America routinely perform congenital heart disease surgery with excellent results, covering the entire spectrum from the newborn to the adult congenital heart patient. The most important challenge that remains is to provide access to care to all children with congenital heart disease in Latin America, since currently only 42% of them receive surgical treatment.

  18. Comparison of the offset distance of the tricuspid septal leaflet in neonates with Ebstein's anomaly and neonates with pulmonary atresia with intact ventricular septum.

    Science.gov (United States)

    Kim, Min Jeong; Yu, Jeong Jin; Kang, So Yeon; Seo, Chang Deok; Baek, Jae Suk; Kim, Young-Hwue; Ko, Jae-Kon

    2015-01-01

    An indexed offset distance of the tricuspid septal leaflet ⩾8 mm/m2 is a quantitative criterion for the diagnosis of Ebstein's anomaly. The purpose of this study was to investigate the validity of this criterion for the discrimination of Ebstein's anomaly from pulmonary atresia with intact ventricular septum in neonatal patients. A total of 122 neonatal patients, 56 with Ebstein's anomaly and 66 with pulmonary atresia with intact ventricular septum, were enrolled. Diagnosis of each anomaly was based on typical morphologic features. Echocardiographic variables, including the offset distance of the tricuspid septal leaflet, were measured via an offline analysis of images recorded before 1 month of age. The offset distance of the tricuspid septal leaflet was indexed by the body surface area, and the indexed offset distances in the Ebstein's anomaly and pulmonary atresia with intact ventricular septum groups were 34.2 mm/m2 (7.1-119.1 mm/m2) and 7.2 mm/m2 (0.0-25.6 mm/m2), respectively. The indexed offset distance was ⩾8 mm/m2 in 29 (43.9%) of the patients with pulmonary atresia with intact ventricular septum; clinical and echocardiographic characteristics were comparable between these 29 patients and the remaining 37 patients with pulmonary atresia with intact ventricular septum. When an indexed offset distance ⩾8 mm/m2 was applied as a cut-off for the diagnosis of Ebstein's anomaly, the sensitivity was 0.963 and the specificity was 0.561. In conclusion, indexed offset distance ⩾8 mm/m2 cannot be used as a cut-off for the diagnosis of complicated Ebstein's anomaly in neonatal patients with pulmonary atresia with intact ventricular septum.

  19. Recurrent plastic bronchitis in a child with 2009 influenza A (H1N1) and influenza B virus infection.

    Science.gov (United States)

    Kim, Sun; Cho, Hwa Jin; Han, Dong Kyun; Choi, Yoo Duk; Yang, Eun Seok; Cho, Young Kuk; Ma, Jae Sook

    2012-09-01

    Plastic bronchitis is an uncommon disorder characterized by the formation of bronchial casts. It is associated with congenital heart disease or pulmonary disease. In children with underlying conditions such as allergy or asthma, influenza can cause severe plastic bronchitis resulting in respiratory failure. A review of the literature showed nine cases of plastic bronchitis with H1N1 including this case. We report a case of a child with recurrent plastic bronchitis with eosinophilic cast associated with influenza B infection, who had recovered from plastic bronchitis associated with an influenza A (H1N1) virus infection 5 months previously. To the best of our knowledge, this is the first case of recurrent plastic bronchitis related to influenza viral infection. If patients with influenza virus infection manifest acute respiratory distress with total lung atelectasis, clinicians should consider plastic bronchitis and early bronchoscopy should be intervened. In addition, management for underlying disease may prevent from recurrence of plastic bronchitis.

  20. Plastic casting resin poisoning

    Science.gov (United States)

    ... the stool Heart and blood vessels Low blood pressure (develops rapidly) Collapse Skin Irritation Burns Holes in the skin or ... signs, including temperature, pulse, breathing rate, and blood pressure. ... oxygen, a tube through the mouth into the throat, and a ...

  1. 应用Edwards MC3成形环治疗三尖瓣中重度关闭不全临床观察%Clinical observation of Edwards MC3 ring in tricuspid valve annuloplasty

    Institute of Scientific and Technical Information of China (English)

    陈振强; 叶生爱; 程亮; 张辉; 赵扬; 杨海基; 张颖

    2009-01-01

    目的 观察Edwards MC3三尖瓣成形环治疗三尖瓣中、重度关闭不全的临床效果.方法 51例风湿性心瓣膜病伴中、重度三尖瓣关闭不全患者按手术方式不同分为3组,分别为MC3组21例,Caxtmntier组12例和De Vega组18例.术后对所有患者均进行随访,分别于术后1周、3个月、6个月、1年、3年行超声心动图检查,观察三尖瓣反流情况,比较3组的手术效果.结果 3组均无手术死亡,术后心功能分级均较术前提高1~3级.3组患者术前和术后1周、3个月、6个月、1年、3年三尖瓣反流差别均有统计学意义(均P<0.05),MC3组三尖瓣反流明显小于其他2组;3组患者1年内反流复发率呈升高趋势,在1年后反流基本趋于稳定,与De Vega和Carpentier组相比,MC3组1年内三尖瓣反流复发率明显降低;随术前三尖瓣中、重度反流病程的延长,术后复发率明显升高.结论 应用Edwards MC3三尖瓣成形环治疗三尖瓣中、重度关闭不全的近、中期效果优于De Vega成形术和硬质Carpentier三尖瓣成形环成形术,但其远期效果还有待进一步观察.%Objective To observe the clinical effect of Edwards MC3 tricuspid in valve annuloplasty for moderate and severe tricuspid regurgitation(TR). Methods Fifty-one patients with moderate and severe TR were divided into 3 groups. Twenty-one patients were given Edwards MC3 ring tricuspid valve annuloplasty; 12 Carpentier ring tricuspid valve annuloplasty and 18 De Vega tricuspid valve annuloplasty after LCVR were enrolled in this study. The TR grade of these patients were examined by 2D echocardiography preoperatively, 1 week, 3 months, 6 months,1 year and 3 years after surgery. Results There was no morbidity and mortality in three groups. The NYHA clincal function class was improved. The patients of MC3 tricuspid valve annuloplasty showed less residual tricuspid regurgitation than Carpentier ring and De Vega tricuspid valve annuloplasty 3 years after operation

  2. Heart Health: The Heart Truth Campaign 2009

    Science.gov (United States)

    ... Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table of ... of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) and ...

  3. Women's Heart Disease: Heart Attack Symptoms

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

  4. Women's Heart Disease: Heart Disease Risk Factors

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table of ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk factors. ...

  5. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    2009170 Curcumin attenuates left ventricular dysfunction and remodeling in rabbits with chronic heart failure. TANG Yanhong(唐艳红),et al.Dept Cardiol,Renmin Hosp,Wuhan Univ,Wuhan 430060.Chin J Cardiol,2009;37(3):262-267.

  6. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008411 Expression of S100B during heart failure in rats. JIANG Zhenni(蒋珍妮), et al. Dept Cardiol, 2nd Affili Hosp, Zhejiang Univ, Coll Med Hangzhou 310009. Chin J Emerg Med 2008;17(5):475-478. Objective To evaluate the value of S100B gene on cardiovascular remodeling in rats with abdominal aorta coarctation.

  7. 经食道超声心动图在三尖瓣成形术中的应用%Transesophageal echocardiography in tricuspid Valve plasty

    Institute of Scientific and Technical Information of China (English)

    徐晓茜; 刘慧; 邹翰琴; 周克松; 刘志辉

    2011-01-01

    Objective To research transeaophageal echocardiography in tricuspid valve plasty.Methods 62 patients with tricuspid surgery were examined with intraoperative transesophageal echocardiography.The patients were fullly monitored with IOTEE on the entire surgical procedure.Results There were 62 cases of tricuspid annuloplasty in patients with severe regurgitation preoperatively.The reflux of 16 cases (25.8%)disappeared.There were 43 cases (69.3%) wih mild regurgitation.Conclusion Transesophageal echocardiography for tricuspid annuloplasty can solve problems in surgery, evaluate the efficacy, improve the success rate, reduce complications and avoid the second operation.%目的 探讨经食道起声心动图(TEE)在三尖瓣成形术中的应用价值.方法 对62例三尖瓣成形手术患者术中行食道超声心动图检查.TEE全程监测整个手术过程,术前观察三尖瓣及其附属结构的形态、功能及反流程度,瓣膜成形完成心脏复跳后,再次观察成形瓣膜及其附属结构的形态、功能及反流情况.结果 62例三尖瓣成形术患者术前均为重度关闭不全,成形术后16例(25.8%)反流完全消失,43例(69.3%)为轻度反漉,3例(4.8%)因无法成形,接受瓣膜置换术.结论 经食道超声心动图用于三尖瓣成形术中监测,能够及时发现、解决术中的问题,评价手术效果,提高手术成功率,减少手术并发症,避免二次手术,具有重要的临床价值.

  8. Tumor-mimicking large vegetation attached to the tricuspid valve without predisposing factors: A case report on CT and echocardiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jung Min; Choe, Yeon Hyeon; Hwang, Hye Won; Kim, Jung Sun; Kim, Wook Sung; Peck, Kyong Ran; Park, Sung Ji [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-10-15

    We report the CT and echocardiographic findings of a tumor-mimicking large vegetation attached to the tricuspid valve (TV) of a 45-year-old man without predisposing factors. Echocardiography revealed a mobile homogeneous echogenic mass attached to the TV. Cardiac CT showed a 4.5 × 2.3 cm irregular low-density mass with scant enhancement in the right ventricle. Based on clinical findings of fever, positive blood culture results for Streptococcus viridans, and pathologic confirmation of the lesion, a diagnosis of infective endocarditis and vegetation was made.

  9. SABIC Innovative Plastics: Be the World Best Plastic Resin Manufacturer

    Institute of Scientific and Technical Information of China (English)

    Jenny Du

    2007-01-01

    @@ "SABIC Innovative Plastics is a global supplier of plastic resins, manufacturing and compounding polycarbonate, ABS, SAN, ASA, PPE, PC/ABS, PBT and PEI resins, as well as the LNP* line of high performance specialty compounds," said Hiroshi Yoshida, the Global Market Director for Electronics of SABIC Innovative Plastics based in Tokyo at the press conference held by SABIC Innovative Plastics, November 8th 2007, Shanghai.

  10. 右房室瓣成形环治疗右房室瓣关闭不全的近期疗效分析%Short-term result of prosthetic ring annuloplasty used in patients with tricuspid valve insufficiency

    Institute of Scientific and Technical Information of China (English)

    唐燕华; 徐建军; 胡大仁; 王一明

    2008-01-01

    Objective To discuss the short-term results of tricuspid valve annuloplasty with prosthetic ring.Methods Tricuspid valve annuloplasty with prosthetic ring was performed in 34 patients with organic or functionaltricuspid valve insufficiency. At the same time atrial septal defect and ventrieular septal defect were closed valve re-placement was done. Results There was no in-hospital death. Echocardiography was done about one week after oper-ations,which showed that fight ventricle or pulmonary artery were smaller than that before operation in all patients andresidual tricuspid valve insufficiency was found mild in 11 cases, moderate in 2 cases. Conclusion Tricuspid valveannuloplnsy should be performed in patients with organic or functional tricuspid valve insufficiency. Better short-termresults may be got when prosthetic ring was used to small tricuspid annulus.%目的 总结人工瓣环治疗右房室瓣关闭不全的近期疗效.方法 对34例器质性或功能性右房室瓣中度或重度关闭不全患者使用人工瓣环行右房室瓣环缩术,同时行房问隔、室间隔及瓣膜修补术.结果 无手术及住院死亡,术后1周复查超声心动图示右心室、肺动脉明显缩小.右房室瓣关闭良好21例,残余轻度返流11例,中度返流2例.结论 对器质性或功能性右房室瓣关闭不全应积极行瓣膜成形术,人工瓣成形环的应用可取得可靠的临床效果.

  11. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  12. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... the type of defect, and the type of surgery that was done. Many children recover completely and lead normal, active lives.

  13. Diabetic Heart Disease

    Science.gov (United States)

    ... be coronary heart disease (CHD), heart failure, and diabetic cardiomyopathy. Diabetes by itself puts you at risk for heart disease. Other risk factors include Family history of heart disease Carrying extra ...

  14. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... slow down or stop. A risk factor for heart disease is something that increases your chance of getting ...

  15. Heart Diseases and Disorders

    Science.gov (United States)

    ... Resources Heart Diseases & Disorders Back to Patient Resources Heart Diseases & Disorders Millions of people experience irregular heartbeats, called ... harmless and happen in healthy people free of heart disease. However, some abnormal heart rhythms can be serious ...

  16. Overview of Heart Tumors

    Science.gov (United States)

    ... develop in the sac that surrounds the heart (pericardium). Tumors in the pericardium may squeeze (constrict) the heart, preventing it from ... Heart wall Fibroma Hemangioma Rhabdomyoma Outside surface Lipoma Pericardium (outer sac covering heart) Pericardial cyst Base of ...

  17. Classes of Heart Failure

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Classes of Heart Failure Updated:Sep 28,2016 Doctors usually classify patients' ... Blood Pressure Tracker Find additional helpful resources here Heart Failure • Home • About Heart Failure Introduction Types of Heart ...

  18. Preserving in Plastic.

    Science.gov (United States)

    Wahla, James

    1985-01-01

    Outlines steps for casting insects in permanent molds prepared from commercially available liquid plastic. Also describes dry mountings in glass, acrylic, and petri dishes. The rationale for specimen use, hints for producing quality results, purchasing information, and safety precautions are considered. (DH)

  19. Informative document waste plastics

    NARCIS (Netherlands)

    Nagelhout D; Sein AA; Duvoort GL

    1989-01-01

    This "Informative document waste plastics" forms part of a series of "informative documents waste materials". These documents are conducted by RIVM on the indstruction of the Directorate General for the Environment, Waste Materials Directorate, in behalf of the program of acti

  20. Discrete dislocation plasticity

    NARCIS (Netherlands)

    van der Giessen, E.; Finel, A; Maziere, D; Veron, M

    2003-01-01

    Conventional continuum mechanics models of inelastic deformation processes axe size scale independent. In contrast, there is considerable experimental evidence that plastic flow in crystalline materials is size dependent over length scales of the order of tens of microns and smaller. At present ther

  1. Progress in neural plasticity

    Institute of Scientific and Technical Information of China (English)

    POO; Mu-Ming

    2010-01-01

    One of the properties of the nervous system is the use-dependent plasticity of neural circuits.The structure and function of neural circuits are susceptible to changes induced by prior neuronal activity,as reflected by short-and long-term modifications of synaptic efficacy and neuronal excitability.Regarded as the most attractive cellular mechanism underlying higher cognitive functions such as learning and memory,activity-dependent synaptic plasticity has been in the spotlight of modern neuroscience since 1973 when activity-induced long-term potentiation(LTP) of hippocampal synapses was first discovered.Over the last 10 years,Chinese neuroscientists have made notable contributions to the study of the cellular and molecular mechanisms of synaptic plasticity,as well as of the plasticity beyond synapses,including activity-dependent changes in intrinsic neuronal excitability,dendritic integration functions,neuron-glia signaling,and neural network activity.This work highlight some of these significant findings.

  2. New plastic recycling technology

    Science.gov (United States)

    Greater than 60% of the total plastic content of municipal solid waste is comprised of polyolefins (high-density, low-density, and linear polyethylene and polypropylene. Polyethylene (PE) is the largest-volume component but presents a challenge due to the absence of low-energy de...

  3. Persisting Plastic Addiction

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The policy on curbing plastic shopping bag use implemented three years ago has produced mixed results In a bustling farmers’market tucked in a narrow street in Xisanqi residential community in north Beijing,stalls selling vegetables,fruits and other foods line the sidewalk.

  4. Heart of Lymphoma: Primary Mediastinal Large B-Cell Lymphoma with Endomyocardial Involvement

    Directory of Open Access Journals (Sweden)

    Elisa Rogowitz

    2013-01-01

    Full Text Available Primary mediastinal B-cell lymphoma (PMBCL is an uncommon aggressive subset of diffuse large B-cell lymphomas. Although PMBCL frequently spreads locally from the thymus into the pleura or pericardium, it rarely invades directly through the heart. Herein, we report a case of a young Mexican female diagnosed with PMBCL with clear infiltration of lymphoma through the cardiac wall and into the right atrium and tricuspid valve leading to tricuspid regurgitation. This was demonstrated by cardiac MRI and transthoracic echocardiogram. In addition, cardiac MRI and CT scan of the chest revealed the large mediastinal mass completely surrounding and eroding into the superior vena cava (SVC wall causing a collar of stokes. The cardiac and SVC infiltration created a significant therapeutic challenge as lymphomas are very responsive to chemotherapy, and treatment could potentially lead to vascular wall rupture and hemorrhage. Despite the lack of conclusive data on chemotherapy-induced hemodynamic compromise in such scenarios, her progressive severe SVC syndrome and respiratory distress necessitated urgent intervention. In addition to the unique presentation of this rare lymphoma, our case report highlights the safety of R-CHOP treatment.

  5. Clinical application of radionuclide cardiac study to the right heart diseases

    Energy Technology Data Exchange (ETDEWEB)

    Shimizu, Tatsuro; Ozaki, Masaharu; Ikezono, Tohru (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1984-12-01

    We experienced the four cases of rare right heart diseases: those are two-chambered right ventricle, ball thrombus in right ventricle, right ventricular hypertrophy and tricuspid valve regurgitation due to multiple pulmonary infarction, and right ventricular and right atrial infarction. The preoperative or ante mortem diagnosis of these diseases is difficult, especially by use of a noninvasive technique. This report shows the usefulness of radionuclide cardiac study for diagnosis of these cases. In the two-chambered right ventricle, abnormal muscle bundle was visualized by /sup 201/TlCl and was observed as the filling defect by sup(99m)Tc-HSA radionuclide angiography. The ball thrombus showed the filling defect of sup(99m)Tc-HSA in the right ventricle but was not extracted by /sup 201/TlCl in the site of the defect area. In the multiple pulmonary infarction, the right ventricular free wall was visualized by /sup 201/TlCl, and during right ventricular systole, regurgitation from right atrium to inferior vena cava was noticed by means of sup(99m)Tc-HSA radionuclide angiography. These findings suggested right ventricular hypertrophy and tricuspid valve regurgitation. In the right ventricular and right atrial infarction, right ventricular ejection fraction and right atrial fractional emptying were lower than those of normal controls.

  6. Inspection of an artificial heart by the neutron radiography technique

    CERN Document Server

    Pugliesi, R; Andrade, M L G; Menezes, M O; Pereira, M A S; Maizato, M J S

    1999-01-01

    The neutron radiography technique was employed to inspect an artificial heart prototype which is being developed to provide blood circulation for patients expecting heart transplant surgery. The radiographs have been obtained by the direct method with a gadolinium converter screen along with the double coated Kodak-AA emulsion film. The artificial heart consists of a flexible plastic membrane located inside a welded metallic cavity, which is employed for blood pumping purposes. The main objective of the present inspection was to identify possible damages in this plastic membrane, produced during the welding process of the metallic cavity. The obtained radiographs were digitized as well as analysed in a PC and the improved images clearly identify several damages in the plastic membrane, suggesting changes in the welding process.

  7. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005186 The diagnostic application of bedside measurement of plasma brain natriuretic in patients with heart failure. SHAO Le-wen (邵乐文) , Advanced Ward Dept, 1st Hosp, Med Sch, Zhejiang Univ, Hangzhou 310003. Chin J Intern Med, 2005;44(2): 99-101. Objective: To investigate differential diagnosis value of ultra-rapid bedside measurement of brain na-triuretic peptide (BNP) in patients with dyspnea.

  8. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010316 Tissue doppler imaging observation on effect of long-term use of gingko biloba tabtet on left ventricular function in patients with chronic heart failure. ZHANG Hui(张辉),et al. Dept Cardiovasc Med, 2nd Hosp, Hebei Med Univ,Shijiazhuang 050000. Chin J Integr Tradit & West Med 2010;30(5):478-481. Objective To quantitatively observe the effect of long-term

  9. Developmental origin and lineage plasticity of endogenous cardiac stem cells.

    Science.gov (United States)

    Santini, Maria Paola; Forte, Elvira; Harvey, Richard P; Kovacic, Jason C

    2016-04-15

    Over the past two decades, several populations of cardiac stem cells have been described in the adult mammalian heart. For the most part, however, their lineage origins and in vivo functions remain largely unexplored. This Review summarizes what is known about different populations of embryonic and adult cardiac stem cells, including KIT(+), PDGFRα(+), ISL1(+)and SCA1(+)cells, side population cells, cardiospheres and epicardial cells. We discuss their developmental origins and defining characteristics, and consider their possible contribution to heart organogenesis and regeneration. We also summarize the origin and plasticity of cardiac fibroblasts and circulating endothelial progenitor cells, and consider what role these cells have in contributing to cardiac repair.

  10. A QSPR for the plasticization efficiency of polyvinylchloride plasticizers.

    Science.gov (United States)

    Chandola, Mridula; Marathe, Sujata

    2008-01-01

    A simple quantitative structure property relationship (QSPR) for correlating the plasticization efficiency of 25 polyvinylchloride (PVC) plasticizers was obtained using molecular modeling. The plasticizers studied were-aromatic esters (phthalate, terephthalate, benzoate, trimellitate), aliphatic esters (adipate, sebacate, azelate), citrates and a phosphate. The low temperature flex point, Tf, of plasticized polyvinylchloride resins was considered as an indicator of plasticization efficiency. Initially, we attempted to predict plasticization efficiency of PVC plasticizers from physical and structural descriptors derived from the plasticizer molecule alone. However, the correlation of these descriptors with Tf was not very good with R=0.78 and r2=0.613. This implied that the selected descriptors were unable to predict all the interactions between PVC and plasticizer. Hence, to account for these interactions, a model containing two polyvinylchloride (PVC) chain segments along with a plasticizer molecule in a simulation box was constructed, using molecular mechanics. A good QSPR equation correlating physical and structural descriptors derived from the model to Tf of the plasticized resins was obtained with R=0.954 and r2=0.909.

  11. Cirurgia conservadora da valva tricúspide na endocardite infecciosa Conservative operation of tricuspide valve for the treatment of infective endocarditis

    Directory of Open Access Journals (Sweden)

    Pablo M. A Pomerantzeff

    1993-12-01

    Full Text Available O comprometimento valvar direto do coração pela endocardite infecciosa, com indicação cirúrgica, tem sido classicamente tratada por excisão da valva e tecidos adjacentes comprometidos, associada ou não a implante de prótese. Dois casos de operação conservadora em endocardite infecciosa da valva tricúspide com 42 e 3 meses de evolução são descritos. Os autores discutem as vantagens de, quando possível, não retirar toda a valva tricúspide na endocardite bacteriana.Valve replacement and excision without using a prosthesis are the two mostfrequently used surgical techniques for the treatment of infective endocarditis of the tricuspid valve. Conservative operation with preservation of the native valve and resection of the infected tissue is a more recent approach, which is becoming the procedure of choice whenever feasible, specialy in intravenous drug abusers. Two cases of tricuspid valve reconstruction with good results are reported. One of the patients has also been aorto coronary bypassed at the same operation time.

  12. Effect of electronic device implantation on tricuspid valve function%心脏置入电子装置对三尖瓣功能的影响

    Institute of Scientific and Technical Information of China (English)

    蔡英; 周晓茜; 李莹; 庞秀峰; 周俊彦; 顾宇英; 刘学波

    2015-01-01

    Objective To study the effect of electronic device implantation on tricuspid valve regur‐gitation and its mechanism .Methods Four hundred and twenty patients who underwent perma‐nent pacemaker and defibrillator implantation were divided into normal tricuspid valve function group (n=316)and abnormal tricuspid valve function group (n=104) .Their clinical and echocar‐diographic data were compared and analyzed by Spearman correlation analysis .Results The re‐gurgitation area/right atrium area (TR/RA) was significantly higher in tricuspid valve regurgita‐tion patients after operation than before operation (P<0 .01) ,in patients who underwent single or double‐channel pacemaker implantation than in those who underwent CRTP implantation (P<0.01) ,in normal tricuspid valve function group after operation than before operation (P<0 .05 , P<0 .01) ,and in 13 -24 ,25 -36 and≥37 months than in 0 -12 months after operation ( P<0.05 ,P<0 .01) .Spearman correlation analysis showed that the postoperative tricuspid valve re‐gurgitation was positively related with the preoperative tricuspid valve regurgitation ,implanted pacemaker time ,right atrium diameter ,and NT‐proBNP (r= 0 .405 ,P= 0 .005;r= 0 .246 ,P=0.005;r=0 .144 ,P=0 .043 ;r=0 .153 ,P=0 .028) .Conclusion Electronic device implantation can cause different degrees of TR regardless of preoperative tricuspid valve regurgitation .%目的:探讨心脏置入电子装置术后对三尖瓣反流的影响因素及可能的发生机制。方法选取置入永久性心脏起搏器、置入式心脏除颤器、临床资料及随访心脏超声资料完整的患者共420例进行回顾性分析,根据术前心脏超声检查三尖瓣反流的程度将患者分为正常组316例与异常组104例,对2组及正常组中单腔起搏器、双腔起搏器、三腔起搏器、置入式心脏除颤器患者的临床资料及心脏超声资料进行比较,并行相关性分析。结果所有患者中,与术

  13. Characteristics, outcome and predictors of one year mortality rate in patients with acute heart failure

    Directory of Open Access Journals (Sweden)

    Banović Marko

    2011-01-01

    Full Text Available Background/Aim. Acute heart failure (AHF is one of the most common diseases in emergency medicine, associated with poor prognosis and high in-hospital and longterm mortality. The aim of this study was to investigate characteristics, outcomes and one year mortality of patients with AHF in the local population. Methods. This prospective study consisted of 64 consecutive unselected patients treated in the Coronary Care Unit of the Emergency Centre (Clinical Center of Serbia, Belgrade and were followed for one year after the discharge. Results. Mean age of the patients was 63.6 ± 12.6 years and 59.4% were males. Acute congestion (43.8% and pulmonary edema (39.1% were the most common presentations of AHF. Mean left ventricular ejection fraction (LVEF was 39.7% ± 9.25%, while 44.4% of the patients had LVEF ≥ 50%. At discharge, 55.9% of the patients received therapy with β-blockers, 94.9% diuretics, out of which 47.7% spironolactone, 94.9% patients were given ACE-inhibitors or angiotensin receptor blokcers (ARB. The 12-month all-cause mortality was 26.5%. Independent predictors of one year mortality were previous hospitalization due to heart disease, reduced LVEF, reduced fraction of shortening (FS and a higher tricuspid velocity. Conclusion. One year mortality of our patients with AHF was high, similar to the known European studies. Independent predictors of one year mortality were previous hospitalization due to heart disease, reduced LVEF and LVFS and a higher tricuspid velocity.

  14. Sustainable reverse logistics for household plastic waste

    OpenAIRE

    Bing, X

    2014-01-01

    Summary of the thesis titled “Sustainable Reverse Logistics for Household Plastic Waste” PhD Candidate: Xiaoyun Bing Recycled plastic can be used in the manufacturing of plastic products to reduce the use of virgin plastics material. The cost of recycled plastics is usually lower than that of virgin plastics. Therefore, it is environmentally and economically beneficial to improve the plastic recycling system to ensure more plastic waste from households is properly collected and pr...

  15. Plasticity modeling & computation

    CERN Document Server

    Borja, Ronaldo I

    2013-01-01

    There have been many excellent books written on the subject of plastic deformation in solids, but rarely can one find a textbook on this subject. “Plasticity Modeling & Computation” is a textbook written specifically for students who want to learn the theoretical, mathematical, and computational aspects of inelastic deformation in solids. It adopts a simple narrative style that is not mathematically overbearing, and has been written to emulate a professor giving a lecture on this subject inside a classroom. Each section is written to provide a balance between the relevant equations and the explanations behind them. Where relevant, sections end with one or more exercises designed to reinforce the understanding of the “lecture.” Color figures enhance the presentation and make the book very pleasant to read. For professors planning to use this textbook for their classes, the contents are sufficient for Parts A and B that can be taught in sequence over a period of two semesters or quarters.

  16. Modeling study of the failing heart and its interaction with an implantable rotary blood pump.

    Science.gov (United States)

    Ramachandran, Deepa P; Luo, Chuan; Ma, Tony S; Clark, John W

    2011-01-01

    The effectiveness of clinical diagnosis and treatment of heart failure is a direct function of clinical signs that can be measured in a patient within cost and safety constraints. Large-scale mathematical modeling can be a key tool in revealing important, measurable clinical signs of heart failure, furthering medical understanding and development of treatment. In the first part of this study we have created two models of left heart failure--diastolic and systolic, using our human cardiovascular-respiratory system (H-CRS) model, and we present a comparison of the two types with emphasis on novel and differentiating clinical signs, such as tricuspid flow and septal motion. In the event of compromised left ventricular performance, mechanical left ventricular assist devices (LVAD) are often implanted to augment or completely replace the pumping action of the left ventricle (LV). One such type is the implantable rotary blood pump (iRBP). Several design issues related to the iRBP are difficult to study experimentally due to procedure complexity and limitations in animal models of heart failure [2]. Therefore, modeling has become a key tool in iRBP development. In the second part of this study, we have introduced an iRBP model based on [1]-[2] in the systolic failing heart to study the interactions. We consider optimal motor settings for different levels of LV assistance, the effects of the iRBP on the right heart, septum, and pulmonary circulation. Our model results align with those reported in [1]-[2]. Improvement in cardiac output, pulmonary congestion, and heart work are seen with the iRBP. We observe lowered septal assistance to RV and LV ejection with increasing pump speeds, elevating right ventricular (RV) work, reducing LVET, and causing ventricular mechanical dyssynchrony in ejection. These results suggest right heart compromise via the septum's reduced role with the introduction of an iRBP. This work emphasizes the critical role of modeling in heart failure and

  17. Low temperature creep plasticity

    Directory of Open Access Journals (Sweden)

    Michael E. Kassner

    2014-07-01

    Full Text Available The creep behavior of crystalline materials at low temperatures (T < 0.3Tm is discussed. In particular, the phenomenological relationships that describe primary creep are reviewed and analyzed. A discussion of the activation energy for creep at T < 0.3Tm is discussed in terms of the context of higher temperature activation energy. The basic mechanism(s of low temperature creep plasticity are discussed, as well.

  18. New perspectives in plastic biodegradation.

    Science.gov (United States)

    Sivan, Alex

    2011-06-01

    During the past 50 years new plastic materials, in various applications, have gradually replaced the traditional metal, wood, leather materials. Ironically, the most preferred property of plastics--durability--exerts also the major environmental threat. Recycling has practically failed to provide a safe solution for disposal of plastic waste (only 5% out of 1 trillion plastic bags, annually produced in the US alone, are being recycled). Since the most utilized plastic is polyethylene (PE; ca. 140 million tons/year), any reduction in the accumulation of PE waste alone would have a major impact on the overall reduction of the plastic waste in the environment. Since PE is considered to be practically inert, efforts were made to isolate unique microorganisms capable of utilizing synthetic polymers. Recent data showed that biodegradation of plastic waste with selected microbial strains became a viable solution. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Microelectronics plastic molded packaging

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, D.R. [Ktech Corp., Albuquerque, NM (United States); Palmer, D.W.; Peterson, D.W. [Sandia National Lab., Albuquerque, NM (United States)] [and others

    1997-02-01

    The use of commercial off-the-shelf (COTS) microelectronics for nuclear weapon applications will soon be reality rather than hearsay. The use of COTS for new technologies for uniquely military applications is being driven by the so-called Perry Initiative that requires the U.S. Department of Defense (DoD) to accept and utilize commercial standards for procurement of military systems. Based on this philosophy, coupled with several practical considerations, new weapons systems as well as future upgrades will contain plastic encapsulated microelectronics. However, a conservative Department of Energy (DOE) approach requires lifetime predictive models. Thus, the focus of the current project is on accelerated testing to advance current aging models as well as on the development of the methodology to be used during WR qualification of plastic encapsulated microelectronics. An additional focal point involves achieving awareness of commercial capabilities, materials, and processes. One of the major outcomes of the project has been the definition of proper techniques for handling and evaluation of modern surface mount parts which might be used in future systems. This program is also raising the familiarity level of plastic within the weapons complex, allowing subsystem design rules accommodating COTS to evolve. A two year program plan is presented along with test results and commercial interactions during this first year.

  20. Interfacial interactions between plastic particles in plastics flotation.

    Science.gov (United States)

    Wang, Chong-qing; Wang, Hui; Gu, Guo-hua; Fu, Jian-gang; Lin, Qing-quan; Liu, You-nian

    2015-12-01

    Plastics flotation used for recycling of plastic wastes receives increasing attention for its industrial application. In order to study the mechanism of plastics flotation, the interfacial interactions between plastic particles in flotation system were investigated through calculation of Lifshitz-van der Waals (LW) function, Lewis acid-base (AB) Gibbs function, and the extended Derjaguin-Landau-Verwey-Overbeek potential energy profiles. The results showed that van der Waals force between plastic particles is attraction force in flotation system. The large hydrophobic attraction, caused by the AB Gibbs function, is the dominant interparticle force. Wetting agents present significant effects on the interfacial interactions between plastic particles. It is found that adsorption of wetting agents promotes dispersion of plastic particles and decreases the floatability. Pneumatic flotation may improve the recovery and purity of separated plastics through selective adsorption of wetting agents on plastic surface. The relationships between hydrophobic attraction and surface properties were also examined. It is revealed that there exists a three-order polynomial relationship between the AB Gibbs function and Lewis base component. Our finding provides some insights into mechanism of plastics flotation.

  1. Congenital heart defects in oculodentodigital dysplasia: Report of two cases.

    Science.gov (United States)

    Izumi, Kosuke; Lippa, Andrew M; Wilkens, Alisha; Feret, Holly A; McDonald-McGinn, Donna M; Zackai, Elaine H

    2013-12-01

    Oculodentodigital dysplasia is caused by mutations in the GJA1 gene. Oculodentodigital dysplasia presents with a spectrum of clinical features including craniofacial, ocular, dental, and limb anomalies. Although recent findings implicate the major role of GJA1 during cardiac organogenesis, congenital heart defects are infrequently reported in oculodentodigital dysplasia. Here we report on two patients with GJA1 mutations presenting with cardiac malformations and type III syndactyly. Patient 1 presented with pulmonary atresia, an intact septum, right ventricular hypoplasia and tricuspid stenosis. The infant had a small nose, thin columella and bilateral 4-5 syndactyly of the fingers. A de novo c.226C>T (p.Arg76Cys) mutation was identified. Patient 2 presented at 6 months with a ventricular septal defect. The child had hypoplastic alae nasi with a thin columella and bilateral 4-5 syndactyly of the digits. A de novo missense mutation, c.145C>G (p.Gln49Glu) was found. Our two patients underscore the importance of cardiac evaluations as part of the initial workup for patients with findings of oculodentodigital dysplasia. Conversely, those patients with type III syndactyly and congenital heart defect should be screened for GJA1 mutations. © 2013 Wiley Periodicals, Inc.

  2. ECHOCARDIOGRAPHIC PROFILE OF VALVULAR LESIONS IN CHILDREN WITH ACUTE RHEUMATIC FEVER / RHEUMATIC HEART DISEASE IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ramu

    2015-03-01

    Full Text Available CONTEXT (B ACKGROUND: Rheumatic Heart disease is still a leading cause of valvular disease in developing countries like India and constitutes 10 to 50% of the cardiac patients in Indian hospitals. Echocardiography is a very sensitive investigation for the diagnosis of Rheumatic Carditis and its sequalae like Mitral, Aortic and Tricuspid valve disease as well as sub clinical Carditis. AIMS & OBJECTIVES: To study the profile, severity and gender based differences of valvular lesions on the Trans Thoracic Echocardiographic records of children diagnosed as Acute Rheumatic fever/ Rheumatic Heart disease. MATERIALS & METHODS: This study was conducted during D ecember’2014 by reviewing the records of trans thoracic Echocardiographic reports of our 36 cases (childhood Acute Rheumatic fever/ Rheumatic Heart disease cases for type and degree of valvular involvement according to AHA guidelines. RESULTS: Mitral valv e was involved most often (23 cases – 63.89%. Severe Mitral regurgitation is the common type of valvular lesions both in Boys and Girls (19.44% and 25% respectively. Isolated Aortic valve/ Tricuspid valve involvement was not found in our study. Mixed les ions were seen most often than pure isolated valvular lesions. CONCLUSION: Mitral valve was most commonly affected, while Regurgitant lesions were more common than Stenotic lesions and most severe in children less than 15 years age group. Aortic Regurgitat ion (AR was found more commonly in Girls than Boys in our study. But all these cases of AR had some other valvular involvement as Mixed lesions. Therefore Echocardiography should be done routinely for patients with Rheumatic Heart Disease, focusing on you nger population to facilitate diagnosis and definitive treatment before complications set in.

  3. Types of Heart Failure

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Types of Heart Failure Updated:Feb 9,2017 Left-sided heart failure ... making. This content was last reviewed April 2015. Heart Failure • Home • About Heart Failure Introduction Types of Heart ...

  4. Use of recycled plastics in wood plastic composites - a review.

    Science.gov (United States)

    Kazemi Najafi, Saeed

    2013-09-01

    The use of recycled and waste thermoplastics has been recently considered for producing wood plastic composites (WPCs). They have great potential for WPCs manufacturing according to results of some limited researches. This paper presents a detailed review about some essential properties of waste and recycled plastics, important for WPCs production, and of research published on the effect of recycled plastics on the physical and mechanical properties of WPCs.

  5. 三尖瓣成形对于左心瓣膜置换术后远期三尖瓣返流的预防作用%The Effect of Tricuspid Valvuloplasty on Preventing Tricuspid Regurgitation Long after Left-sided Valve Replacement

    Institute of Scientific and Technical Information of China (English)

    李虔桢; 陈道中; 陈良万; 吴锡阶

    2011-01-01

    Objective To discuss the effect of tricuspid valvuloplasty on preventing tricuspid re gurgitation(TR) long after left-sided valve replacement. Methods From January 2001 to June 2006 a to tal of 105 patients complicating slightly TR or not, were undergone left-sided valve replacement. The pa tients were divided into tricuspid-valvuloplasty group (group TA) and un-tricuspid-valvuloplasty group (group NTA) according to whether performed tricuspid valvuloplasty or not. Each patients was per formed echocardiography long term(≥5 years) after surgery, RV, RA, PA, TV AD and the degree of TR were compared bet-ween two groups. Results There were no demographic differences bet-ween two groups previous surgery. Long after surgery, the RV, RA, PAP and TV AD of group TA were im proved; the PAP of group NTA was improved too, but the RV and RA was not improved, and the TVAD was increased; The TVAD of group NTA was greater than group TA, -while the number and the degree of TR in group NTA was obviously serious than in group TA. Conclusion TR may take place in patients complicating slightly TR or not long after left-sided valve replacement. Tricuspid valvuloplasty can effec tively prevent TR long after surgery.%目的 探讨三尖瓣成形(TA)对于左心瓣膜置换术后远期三尖瓣返流(TR)的预防作用.方法 总结2001年1月-2006年6月105例术前无TR或合并轻度TR的左心瓣膜矫治手术病例.根据术中是否行TA术将患者分为成形组(TA组,n=46)和非成形组(NTA组,n=59).随访≥5年,复查超声心动图并比较右心室前后径(RV)、右心房前后径(RA)、肺动脉压力(PAP)、三尖瓣环直径(TVAD)及TR程度.结果 术前TA组与NTA组各指标无显著差别;远期随访TA组RV、RA、PAP、TVAD均比术前改善(P<0.05);NTA组PAP较术前改善(P <0.05),RV及RA与术前无明显差别,TVAD较术前扩大(P<0.05);NTA组中TVAD明显大于TA组,TR加重例数、程度明显高于TA组.结论 术前无TR或合并轻度TR的左心瓣

  6. Direct liquefaction of plastics and coprocessing of coal with plastics

    Energy Technology Data Exchange (ETDEWEB)

    Huffman, G.P.; Feng, Z.; Mahajan, V. [Univ. of Kentucky, Lexington, KY (United States)

    1995-12-31

    The objectives of this work were to optimize reaction conditions for the direct liquefaction of waste plastics and the coprocessing of coal with waste plastics. In previous work, the direct liquefaction of medium and high density polyethylene (PE), polypropylene (PPE), poly(ethylene terephthalate) (PET), and a mixed plastic waste, and the coliquefaction of these plastics with coals of three different ranks was studied. The results established that a solid acid catalyst (HZSM-5 zeolite) was highly active for the liquefaction of the plastics alone, typically giving oil yields of 80-95% and total conversions of 90-100% at temperatures of 430-450 {degrees}C. In the coliquefaction experiments, 50:50 mixtures of plastic and coal were used with a tetralin solvent (tetralin:solid = 3:2). Using approximately 1% of the HZSM-5 catalyst and a nanoscale iron catalyst, oil yields of 50-70% and total conversion of 80-90% were typical. In the current year, further investigations were conducted of the liquefaction of PE, PPE, and a commingled waste plastic obtained from the American Plastics Council (APC), and the coprocessing of PE, PPE and the APC plastic with Black Thunder subbituminous coal. Several different catalysts were used in these studies.

  7. Plastic Surgery and Suicide: A Clinical Guide for Plastic Surgeons.

    Science.gov (United States)

    Reddy, Vikram; Coffey, M Justin

    2016-08-01

    Several studies have identified an increased risk of suicide among patient populations which a plastic surgeon may have a high risk of encountering: women undergoing breast augmentation, cosmetic surgery patients, and breast cancer patients. No formal guidelines exist to assist a plastic surgeon when faced with such a patient, and not every plastic surgery team has mental health clinicians that are readily accessible for consultation or referral. The goal of this clinical guide is to offer plastic surgeons a set of practical approaches to manage potentially suicidal patients. In addition, the authors review a screening tool, which can assist surgeons when encountering high-risk patients.

  8. Pathophysiology of cardiorenal syndrome in decompensated heart failure: role of lung-right heart-kidney interaction.

    Science.gov (United States)

    Guazzi, M; Gatto, P; Giusti, G; Pizzamiglio, F; Previtali, I; Vignati, C; Arena, R

    2013-11-30

    Cardiorenal syndrome (CRS) is defined as an interaction of cardiac disease with renal dysfunction that leads to diuretic resistance and renal function worsening, mainly with heart failure (HF) exacerbation. Hemodynamic variables linking heart and kidney are renal blood flow (cardiac output) and perfusion pressure, i.e., the aortic - renal venous pressure gradient. CRS has traditionally been interpreted as related to defective renal perfusion and arterial underfilling and, more recently, to elevation in central venous pressure transmitted back to renal veins. Our suggestion is that in a setting where aortic pressure is generally low, due to heart dysfunction and to vasodrepressive therapy, the elevated central venous pressure (CVP) contributes to lower the renal perfusion pressure below the threshold of kidney autoregulation (≤80mm Hg) and causes renal perfusion to become directly pressure dependent. This condition is associated with high neurohumoral activation and preglomerular vasoconstriction that may preserve pressure, but may decrease filtration fraction and glomerular filtration rate and enhance proximal tubular sodium absorption. Thus, congestion worsens and drives the vicious cycle of further sodium retention and HF exacerbation. Lowering CVP by targeting the lung-right heart interaction that sustains elevated CVP seems to be a more rational approach rather than reducing intravascular volume. This interaction is crucial and consists of a cascade with stepwise development of pulmonary post-capillary hypertension, precapillary arteriolar hypertone, right ventricular overload and enlargement with tricuspid incompetence and interference with left ventricular filling (interdependence). The resultant CVP rise is transmitted to the renal veins, eventually drives CRS and leads to a positive feedback loop evolving towards HF refractoriness.

  9. Tree plastic bark

    OpenAIRE

    Casado Arroyo, Carlos

    2016-01-01

    “Tree plastic bark" consiste en la realización de una intervención artística en un entorno natural concreto, generando de esta manera un Site Specific(1). Como hace alusión Rosalind Krauss en sus reflexiones “La escultura en el campo expandido”(2), comenta que su origen esta claramente ligado con el concepto de monumentalidad. La escultura es un monumento, se crea para conmemorar algún hecho o personaje relevante y está realizada para una ubicación concreta. La investigación parte de la id...

  10. Fabrication of plastic biochips

    Energy Technology Data Exchange (ETDEWEB)

    Saaem, Ishtiaq; Ma, Kuo-Sheng; Alam, S. Munir; Tian Jingdong [Department of Biomedical Engineering and Institute for Genome Sciences and Policy, Duke University, Durham, North Carolina 27708 (United States); Department of Medicine and Human Vaccine Institute, Duke University, Durham, North Carolina 27708 (United States); Department of Biomedical Engineering and Institute for Genome Sciences and Policy, Duke University, Durham, North Carolina 27708 (United States)

    2010-07-15

    A versatile surface functionalization procedure based on rf magnetron sputtering of silica was performed on poly(methylmethacrylate), polycarbonate, polypropylene, and cyclic olefin copolymers (Topas 6015). The hybrid thermoplastic surfaces were characterized by x-ray photoelectron spectrometer analysis and contact angle measurements. The authors then used these hybrid materials to perform a sandwich assay targeting an HIV-1 antibody using fluorescent detection and biotinylated peptides immobilized using the bioaffinity of biotin-neutravidin. They found a limit of detection similar to arrays on glass surfaces and believed that this plastic biochip platform may be used for the development of disposable immunosensing and diagnostic applications.

  11. Plastic food packaging and health

    Directory of Open Access Journals (Sweden)

    Raika Durusoy

    2011-02-01

    Full Text Available Plastics have a wide usage in our daily lives. One of their uses is for food packaging and food containers. The aim of this review is to introduce different types of chemicals that can leach from food packaging plastics into foods and cause human exposure and to mention their effects on health. The types of plastics were reviewed under the 13 headings in Turkish Codex Alimentarius and plastics recycling symbols were provided to enable the recognition of the type of plastic when applicable. Chemicals used during the production and that can cause health risks are investigated under the heading of the relevant type of plastic. The most important chemicals from plastic food packaging that can cause toxicity are styrene, 1,3-butadiene, melamine, formaldehyde, acrylamide, di-2-ethylhexyl phthalate, di-2-ethylhexyl adipate, vinyl chloride and bisphenol A. These chemicals have endocrine disrupting, carcinogenic and/or development disrupting effects. These chemicals may leach into foods depending on the chemical properties of the plastic or food, temperature during packaging, processing and storage, exposure to UV and duration of storage. Contact with fatty/oily or acidic foods, heating of the food inside the container, or drinking hot drinks from plastic cups, use of old and scratched plastics and some detergents increase the risk of leaching. The use of plastic containers and packaging for food and beveradges should be avoided whenever possible and when necessary, less harmful types of plastic should be preferred. [TAF Prev Med Bull 2011; 10(1.000: 87-96

  12. The commercialization of plastic surgery.

    Science.gov (United States)

    Swanson, Eric

    2013-09-01

    The last decade has brought a major challenge to the traditional practice of plastic surgery from corporations that treat plastic surgery as a commercial product and market directly to the public. This corporate medicine model may include promotion of a trademarked procedure or device, national advertising that promises stunning results, sales consultants, and claims of innovation, superiority, and improved safety. This article explores the ethics of this business practice and whether corporate medicine is a desirable model for patients and plastic surgeons.

  13. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye will be injected into your ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  14. Heart-Healthy Exercise

    Science.gov (United States)

    ... American Heart Association Cardiology Patient Page Heart-Healthy Exercise Lauren Healey Mellett , Gisele Bousquet Download PDF https:// ... if you already have heart disease. How Can Exercise Help? There are many modifiable risk factors for ...

  15. Heart pacemaker - discharge

    Science.gov (United States)

    ... pacemaker can be used for patients with heart failure. It has three leads to help the heart beat in a more coordinated manner. Some pacemakers also can deliver electric shocks to the heart that can stop life-threatening ...

  16. Honolulu Heart Program

    Science.gov (United States)

    2016-04-13

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Heart Failure, Congestive; Myocardial Infarction; Asthma; Emphysema; Lung Diseases, Obstructive; Aortic Aneurysm, Abdominal; Bronchitis; Dementia; Hypertension; Chronic Obstructive Pulmonary Disease; Heart Failure

  17. Heart Health Tests

    Science.gov (United States)

    ... is easier to treat. Blood tests and heart health tests can help find heart diseases or identify ... diseases. There are several different types of heart health tests. Your doctor will decide which test or ...

  18. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  19. Heart and Down Syndrome

    Science.gov (United States)

    ... Associated Conditions » The Heart & Down Syndrome The Heart & Down Syndrome Abnormalities of the cardiovascular system are common in ... the Most Common Heart Defects in Children With Down Syndrome? The most common defects are Atrioventricular Septal Defect ( ...

  20. Congenital heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001114.htm Congenital heart disease To use the sharing features on this page, please enable JavaScript. Congenital heart disease (CHD) is a problem with the heart's structure ...

  1. Cyanotic heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001104.htm Cyanotic heart disease To use the sharing features on this page, please enable JavaScript. Cyanotic heart disease refers to a group of many different heart ...

  2. Heart Disease Risk Factors

    Science.gov (United States)

    ... Hearts® WISEWOMAN Program Other Chronic Disease Topics Diabetes Nutrition Obesity Physical Activity Stroke Heart Disease Risk Factors Recommend ... Hearts® WISEWOMAN Program Other Chronic Disease Topics Diabetes Nutrition Obesity Physical Activity Stroke File Formats Help: How do ...

  3. Heart disease and depression

    Science.gov (United States)

    ... gov/ency/patientinstructions/000790.htm Heart disease and depression To use the sharing features on this page, ... a heart attack or heart surgery Signs of Depression It is pretty common to feel down or ...

  4. Living with Heart Failure

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Living With Heart Failure Currently, heart failure has no cure. You'll ... avoid harmful side effects. Take Steps To Prevent Heart Failure From Getting Worse Certain actions can worsen your ...

  5. Who Needs Heart Surgery?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Who Needs Heart Surgery? Heart surgery is used to treat ... will work with you to decide whether you need heart surgery. A cardiologist specializes in diagnosing and ...

  6. Revealing Hearts

    DEFF Research Database (Denmark)

    Saghaug, Kristin Falck; Pattison, George; Lindgren, Peter

    2014-01-01

    Some small business owners want to balance personal values as well as economic values. “I have to follow my heart” or “it must be meaningful” some of them say. But how might they be able to know what gives meaning to the heart? The philosophical theologian Paul Tillich finds that the problem...... with reference to Tillich’s account of the meaning of revelation through culture and art, summed up in the statement that “(...) revelation is the manifestation of the ground of being for human knowledge” (Tillich, 1951, p.94), which, we argue, can be extended to everyday experiences, for example, in business...... life. In Tillich’s own terms, even preliminary concerns may point at an ultimate concern (Tillich, 1964), which can also be understood as ‘knowledge of the heart’. Our account is also connected to wider discussions concerning the nature of intuition....

  7. Unnatural history of the right ventricle in patients with congenitally malformed hearts.

    Science.gov (United States)

    Lopez, Leo; Cohen, Meryl S; Anderson, Robert H; Redington, Andrew N; Nykanen, David G; Penny, Daniel J; Deanfield, John E; Eidem, Benjamin W

    2010-12-01

    The long-term outcome of patients with congenitally malformed hearts involving abnormal right ventricular morphology and haemodynamics is variable. In most instances, the patients are at risk for right ventricular failure, in part due to morphological differences between the right and left ventricles and their response to chronic volume and pressure overload. In patients after repair of tetralogy of Fallot, and after balloon valvotomy for valvar pulmonary stenosis, pulmonary regurgitation is the most significant risk factor for right ventricular dysfunction. In patients with a dominant right ventricle after Fontan palliation, and in those with systemic right ventricles in association with surgically or congenitally corrected transposition, the right ventricle is not morphologically capable of dealing with chronic exposure to the high afterload of the systemic circulation. In patients with Ebstein's malformation of the tricuspid valve, the degree of atrialisation of the right ventricle determines how well the right ventricle will function as the pump for the pulmonary vascular bed.

  8. Multiscale modeling and synaptic plasticity.

    Science.gov (United States)

    Bhalla, Upinder S

    2014-01-01

    Synaptic plasticity is a major convergence point for theory and computation, and the process of plasticity engages physiology, cell, and molecular biology. In its many manifestations, plasticity is at the hub of basic neuroscience questions about memory and development, as well as more medically themed questions of neural damage and recovery. As an important cellular locus of memory, synaptic plasticity has received a huge amount of experimental and theoretical attention. If computational models have tended to pick specific aspects of plasticity, such as STDP, and reduce them to an equation, some experimental studies are equally guilty of oversimplification each time they identify a new molecule and declare it to be the last word in plasticity and learning. Multiscale modeling begins with the acknowledgment that synaptic function spans many levels of signaling, and these are so tightly coupled that we risk losing essential features of plasticity if we focus exclusively on any one level. Despite the technical challenges and gaps in data for model specification, an increasing number of multiscale modeling studies have taken on key questions in plasticity. These have provided new insights, but importantly, they have opened new avenues for questioning. This review discusses a wide range of multiscale models in plasticity, including their technical landscape and their implications.

  9. Plastics recycling: challenges and opportunities

    National Research Council Canada - National Science Library

    Jefferson Hopewell; Robert Dvorak; Edward Kosior

    2009-01-01

    .... Advances in technologies and systems for the collection, sorting and reprocessing of recyclable plastics are creating new opportunities for recycling, and with the combined actions of the public...

  10. Americium behaviour in plastic vessels

    Energy Technology Data Exchange (ETDEWEB)

    Legarda, F.; Herranz, M. [Departamento de Ingenieria Nuclear y Mecanica de Fluidos, Escuela Tecnica Superior de Ingenieria de Bilbao, Universidad del Pais Vasco (UPV/EHU), Alameda de Urquijo s/n, 48013 Bilbao (Spain); Idoeta, R., E-mail: raquel.idoeta@ehu.e [Departamento de Ingenieria Nuclear y Mecanica de Fluidos, Escuela Tecnica Superior de Ingenieria de Bilbao, Universidad del Pais Vasco (UPV/EHU), Alameda de Urquijo s/n, 48013 Bilbao (Spain); Abelairas, A. [Departamento de Ingenieria Nuclear y Mecanica de Fluidos, Escuela Tecnica Superior de Ingenieria de Bilbao, Universidad del Pais Vasco (UPV/EHU), Alameda de Urquijo s/n, 48013 Bilbao (Spain)

    2010-07-15

    The adsorption of {sup 241}Am dissolved in water in different plastic storage vessels was determined. Three different plastics were investigated with natural and distilled waters and the retention of {sup 241}Am by these plastics was studied. The same was done by varying vessel agitation time, vessel agitation speed, surface/volume ratio of water in the vessels and water pH. Adsorptions were measured to be between 0% and 70%. The adsorption of {sup 241}Am is minimized with no water agitation, with PET or PVC plastics, and by water acidification.

  11. Understanding chronic heart failure

    OpenAIRE

    Fenton, Matthew; Burch, Michael

    2007-01-01

    The key principles of chronic heart failure and the development of clinical management strategies are described. The physiological changes in chronic heart failure and the clinical management of children with heart failure are considered, but the treatment of heart failure related to congenital heart disease or the intensive care management of heart failure are not mentioned as both topics require consideration in their own right. A greater understanding of the maladaptive responses to chroni...

  12. [Erythropoietin in plastic surgery].

    Science.gov (United States)

    Günter, C I; Rezaeian, F; Harder, Y; Lohmeyer, J A; Egert, S; Bader, A; Schilling, A F; Machens, H-G

    2013-04-01

    EPO is an autologous hormone, which is known to regulate erythropoiesis. For 30 years it has been used for the therapy of diverse forms of anaemia, such as renal anaemia, tumour-related anaemias, etc. Meanwhile, a multitude of scientific publications were able to demonstrate its pro-regenerative effects after trauma. These include short-term effects such as the inhibition of the "primary injury response" or apoptosis, and mid- and long-term effects for example the stimulation of stem cell recruitment, growth factor production, angiogenesis and re-epithelialisation. Known adverse reactions are increases of thromboembolic events and blood pressure, as well as a higher mortality in patients with tumour anaemias treated with EPO. Scientific investigations of EPO in the field of plastic surgery included: free and local flaps, nerve regeneration, wound healing enhancement after dermal thermal injuries and in chronic wounds.Acute evidence for the clinical use of EPO in the field of plastic surgery is still not satisfactory, due to the insufficient number of Good Clinical Practice (GCP)-conform clinical trials. Thus, the initiation of more scientifically sound trials is indicated.

  13. Optogenetics and synaptic plasticity.

    Science.gov (United States)

    Xie, Yu-feng; Jackson, Michael F; Macdonald, John F

    2013-11-01

    The intricate and complex interaction between different populations of neurons in the brain has imposed limits on our ability to gain detailed understanding of synaptic transmission and its integration when employing classical electrophysiological approaches. Indeed, electrical field stimulation delivered via traditional microelectrodes does not permit the targeted, precise and selective control of neuronal activity amongst a varied population of neurons and their inputs (eg, cholinergic, dopaminergic or glutamatergic neurons). Recently established optogenetic techniques overcome these limitations allowing precise control of the target neuron populations, which is essential for the elucidation of the neural substrates underlying complex animal behaviors. Indeed, by introducing light-activated channels (ie, microbial opsin genes) into specific neuronal populations, optogenetics enables non-invasive optical control of specific neurons with milliseconds precision. These approaches can readily be applied to freely behaving live animals. Recently there is increased interests in utilizing optogenetics tools to understand synaptic plasticity and learning/memory. Here, we summarize recent progress in applying optogenetics in in the study of synaptic plasticity.

  14. 三尖瓣下移畸形合并难治性右心衰竭及下肢溃疡1例%Ebstein's anomaly with refractory right-sided heart failure and leg ulcers:a case report

    Institute of Scientific and Technical Information of China (English)

    徐飞; 周忠江

    2015-01-01

    三尖瓣下移畸形又称Ebstein畸形,是一种较为罕见的先天性心脏病,主要病理改变为:三尖瓣(主要隔瓣和后瓣)不附着在瓣环上,而是螺旋形下移至右心室,同时瓣膜及瓣下结构异常。由于右室发育不全及功能障碍和三尖瓣关闭不全导致的右心容量负荷增加,表现为劳累后气急乏力、心悸、发绀和心力衰竭。本文就三尖瓣下移畸形合并难治性右心衰竭及下肢溃疡1例进行报告。%Ebstein malformation is a congenital heart disease characterized pathologically by displacement of the septal leaflet of the tricuspid valve towards the apex of the right ventricle of the heart. Hypoplasia, dysfunction of the right ventricle and tricuspid regurgitation cause an increased volume load of the right heart and result in the clinical manifestations of chest tightness, shortness of breath and fatigue after activities, palpitation, cyanosis and heart failure. We report a case of Ebstein’s anomaly with refractory right heart failure and leg ulcers.

  15. Heart failure - home monitoring

    Science.gov (United States)

    ... failure - discharge Heart failure - fluids and diuretics Heart failure - what to ask ... Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, ...

  16. Casting a look at pediatric plastic bronchitis.

    Science.gov (United States)

    Jasinovic, Tin; Kozak, Frederick K; Moxham, J Paul; Chilvers, Mark; Wensley, David; Seear, Michael; Campbell, Andrew; Ludemann, Jeffrey P

    2015-10-01

    To review clinical presentations and management strategies for children with plastic bronchitis. Retrospective chart review. Seven patients required rigid bronchoscopy to remove bronchial casts over a 17-year study period. Mean age at presentation was 60 months. Mean follow-up was 53 months. Co-morbidities included: congenital heart disease (n=3), chronic pulmonary disorders (n=2) and sickle cell disease (n=1). 4 patients required multiple bronchoscopies for recurrent casts. Adjunctive topical therapies were administered in all 7 patients, without complication. Rigid bronchoscopy for cast removal was performed in 2 patients who were on extra-corporal membrane oxygenation (ECMO), using special precautions to safeguard the ECMO catheters. Bronchial casts in children may present acutely or sub-acutely. Recurrent casts are unusual; however, in combination with severe cardiac disease may lead to mortality. Adjunctive topical therapies are still under investigation. Special safeguards for ECMO catheters are imperative. This case series complements and adds to the International Plastic Bronchitis Registry. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. The emerging burden of hospital admissions of adults with congenital heart disease.

    Science.gov (United States)

    Verheugt, Carianne L; Uiterwaal, Cuno S P M; van der Velde, Enno T; Meijboom, Folkert J; Pieper, Petronella G; Sieswerda, Gertjan Tj; Plokker, Herbert W M; Grobbee, Diederick E; Mulder, Barbara J M

    2010-06-01

    To assess the extent and the characteristics of hospital admissions in registered adult patients with congenital heart disease. Observational cohort study. The Netherlands. 5798 adult patients with congenital heart disease from the Dutch CONCOR national registry linked to the Dutch National Medical Registration (Prismant). All hospital admissions from the years 2001 up until 2006. During 28 990 patient-years, 2908 patients (50%) were admitted to hospital. Median age at admission was 39 years (range 18-86 years); 46% were male. Admission rate in CONCOR patients was high among all ages (range 11-68%) and exceeded that of the general Dutch population two to three times; this difference was most pronounced in the older age groups. Altogether there were 8916 admissions, 5411 (61%) of which were for cardiovascular indications. Among cardiovascular admissions, referrals for arrhythmias were most common (31%). Of 4926 interventions, 2459 (50%) were cardiovascular, most often reparative interventions or cardioversion (53%). Most non-cardiovascular admissions were obstetric. Among defects, univentricular heart and tricuspid atresia had the highest incidence and duration of admission. Healthcare utilisation in registered and medically supervised adult patients with congenital heart disease is high and increases with age. Admission rates are at least two times higher than in the general population, and most marked in the older age groups. With the ageing of this population, a major increase in healthcare utilisation is imminent in the near future. Timely preparation of healthcare resources is crucial to sustain optimal care.

  18. Free Floating Right Heart Thrombus Associated with Acute Pulmonary Embolism: An Unsettled Therapeutic Difficulty

    Science.gov (United States)

    Nkoke, Clovis; Faucher, Olivier; Camus, Lise; Flork, Laurence

    2015-01-01

    Free floating right heart thrombus is a rare phenomenon in the context of acute pulmonary embolism and it is associated with a poor outcome. The increased use of echocardiography has led to an increased detection of right heart thrombi. However, optimal management of free floating right heart thrombus remains controversial with no clear consensus. We present the case of a 74-year-old woman who presented to the emergency department with acute onset dyspnea on minimal exertion which had developed over a period of 1 day. A computed tomography of the chest demonstrated massive bilateral proximal pulmonary embolism. A bedside transthoracic echocardiography performed showed a moderately dilated, poorly functioning right ventricle with visible highly mobile serpiginous thrombus moving to and fro across the tricuspid valve. Thrombolytic therapy was immediately initiated with tenecteplase which resulted in excellent results. Although there is no clear consensus for the management of right heart thrombus associated with pulmonary embolism, thrombolysis is readily available and can be effective in carefully selected patients. PMID:26078887

  19. Free Floating Right Heart Thrombus Associated with Acute Pulmonary Embolism: An Unsettled Therapeutic Difficulty

    Directory of Open Access Journals (Sweden)

    Clovis Nkoke

    2015-01-01

    Full Text Available Free floating right heart thrombus is a rare phenomenon in the context of acute pulmonary embolism and it is associated with a poor outcome. The increased use of echocardiography has led to an increased detection of right heart thrombi. However, optimal management of free floating right heart thrombus remains controversial with no clear consensus. We present the case of a 74-year-old woman who presented to the emergency department with acute onset dyspnea on minimal exertion which had developed over a period of 1 day. A computed tomography of the chest demonstrated massive bilateral proximal pulmonary embolism. A bedside transthoracic echocardiography performed showed a moderately dilated, poorly functioning right ventricle with visible highly mobile serpiginous thrombus moving to and fro across the tricuspid valve. Thrombolytic therapy was immediately initiated with tenecteplase which resulted in excellent results. Although there is no clear consensus for the management of right heart thrombus associated with pulmonary embolism, thrombolysis is readily available and can be effective in carefully selected patients.

  20. Lamin A/C mutation affecting primarily the right side of the heart

    Directory of Open Access Journals (Sweden)

    Laura Ollila

    2013-04-01

    Full Text Available LMNA mutations are amongst the most important causes of familial dilated cardiomyopathy. The most important cause of arrhythmogenic right ventricular cardiomyopathy (ARVC is desmosomal pathology. The aim of the study was to elucidate the role of LMNA mutations among Finnish cardiomyopathy patients. We screened 135 unrelated cardiomyopathy patients for LMNA mutations. Because of unusual phenotype, two patients were screened for the known Finnish ARVC-related mutations of desmosomal genes, and their Plakophilin-2b gene was sequenced. Myocardial samples from two patients were examined by immunohistochemical plakoglobin staining and in one case by electron microscopy. We found a new LMNA mutation Phe237Ser in a family of five affected members with a cardiomyopathy affecting primarily the right side of the heart. The phenotype resembles ARVC but does not fulfill the Task Force Criteria. The main clinical manifestations of the mutation were severe tricuspid insufficiency, right ventricular enlargement and failure. Three of the affected patients died of the heart disease, and the two living patients received heart transplants at ages 44 and 47. Electron microscopy showed nuclear blebbing compatible with laminopathy. Immunohisto - chemical analysis did not suggest desmosomal pathology. No desmosomal mutations were found. The Phe237Ser LMNA mutation causes a phenotype different from traditional cardiolaminopathy. Our findings suggest that cardiomyopathy affecting primarily the right side of the heart is not always caused by desmosomal pathology. Our observations highlight the challenges in classifying cardiomyopathies, as there often is significant overlap between the traditional categories.

  1. Sustainable reverse logistics for household plastic waste

    NARCIS (Netherlands)

    Bing, X.

    2014-01-01

    Summary of the thesis titled “Sustainable Reverse Logistics for Household Plastic Waste” PhD Candidate: Xiaoyun Bing Recycled plastic can be used in the manufacturing of plastic products to reduce the use of virgin plastics material. The cost of recycled plastics is usually lower than th

  2. Sustainable reverse logistics for household plastic waste

    NARCIS (Netherlands)

    Bing, X.

    2014-01-01

    Summary of the thesis titled “Sustainable Reverse Logistics for Household Plastic Waste” PhD Candidate: Xiaoyun Bing Recycled plastic can be used in the manufacturing of plastic products to reduce the use of virgin plastics material. The cost of recycled plastics is usually lower than

  3. Sustainable reverse logistics for household plastic waste

    NARCIS (Netherlands)

    Bing, X.

    2014-01-01

    Summary of the thesis titled “Sustainable Reverse Logistics for Household Plastic Waste” PhD Candidate: Xiaoyun Bing Recycled plastic can be used in the manufacturing of plastic products to reduce the use of virgin plastics material. The cost of recycled plastics is usually lower than th

  4. Plastics recycling: challenges and opportunities.

    Science.gov (United States)

    Hopewell, Jefferson; Dvorak, Robert; Kosior, Edward

    2009-07-27

    Plastics are inexpensive, lightweight and durable materials, which can readily be moulded into a variety of products that find use in a wide range of applications. As a consequence, the production of plastics has increased markedly over the last 60 years. However, current levels of their usage and disposal generate several environmental problems. Around 4 per cent of world oil and gas production, a non-renewable resource, is used as feedstock for plastics and a further 3-4% is expended to provide energy for their manufacture. A major portion of plastic produced each year is used to make disposable items of packaging or other short-lived products that are discarded within a year of manufacture. These two observations alone indicate that our current use of plastics is not sustainable. In addition, because of the durability of the polymers involved, substantial quantities of discarded end-of-life plastics are accumulating as debris in landfills and in natural habitats worldwide. Recycling is one of the most important actions currently available to reduce these impacts and represents one of the most dynamic areas in the plastics industry today. Recycling provides opportunities to reduce oil usage, carbon dioxide emissions and the quantities of waste requiring disposal. Here, we briefly set recycling into context against other waste-reduction strategies, namely reduction in material use through downgauging or product reuse, the use of alternative biodegradable materials and energy recovery as fuel. While plastics have been recycled since the 1970s, the quantities that are recycled vary geographically, according to plastic type and application. Recycling of packaging materials has seen rapid expansion over the last decades in a number of countries. Advances in technologies and systems for the collection, sorting and reprocessing of recyclable plastics are creating new opportunities for recycling, and with the combined actions of the public, industry and governments it

  5. Plastics recycling: challenges and opportunities

    Science.gov (United States)

    Hopewell, Jefferson; Dvorak, Robert; Kosior, Edward

    2009-01-01

    Plastics are inexpensive, lightweight and durable materials, which can readily be moulded into a variety of products that find use in a wide range of applications. As a consequence, the production of plastics has increased markedly over the last 60 years. However, current levels of their usage and disposal generate several environmental problems. Around 4 per cent of world oil and gas production, a non-renewable resource, is used as feedstock for plastics and a further 3–4% is expended to provide energy for their manufacture. A major portion of plastic produced each year is used to make disposable items of packaging or other short-lived products that are discarded within a year of manufacture. These two observations alone indicate that our current use of plastics is not sustainable. In addition, because of the durability of the polymers involved, substantial quantities of discarded end-of-life plastics are accumulating as debris in landfills and in natural habitats worldwide. Recycling is one of the most important actions currently available to reduce these impacts and represents one of the most dynamic areas in the plastics industry today. Recycling provides opportunities to reduce oil usage, carbon dioxide emissions and the quantities of waste requiring disposal. Here, we briefly set recycling into context against other waste-reduction strategies, namely reduction in material use through downgauging or product reuse, the use of alternative biodegradable materials and energy recovery as fuel. While plastics have been recycled since the 1970s, the quantities that are recycled vary geographically, according to plastic type and application. Recycling of packaging materials has seen rapid expansion over the last decades in a number of countries. Advances in technologies and systems for the collection, sorting and reprocessing of recyclable plastics are creating new opportunities for recycling, and with the combined actions of the public, industry and governments it

  6. Screening for trisomy 21 by fetal tricuspid regurgitation, nuchal translucency and maternal serum free beta-hCG and PAPP-A at 11 + 0 to 13 + 6 weeks.

    Science.gov (United States)

    Falcon, O; Auer, M; Gerovassili, A; Spencer, K; Nicolaides, K H

    2006-02-01

    To examine whether in pregnancies with fetal trisomy 21 the level of maternal serum free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at 11 + 0 to 13 + 6 weeks' gestation is independent of the presence or absence of tricuspid regurgitation and to estimate the performance of a screening test that combines tricuspid regurgitation with fetal nuchal translucency (NT) thickness and serum free beta-hCG and PAPP-A. The study population comprised 77 trisomy 21 and 232 chromosomally normal fetuses from singleton pregnancies at 11 + 0 to 13 + 6 weeks of gestation. In all cases the fetal karyotype was determined by chorionic villus sampling (CVS), which was carried out at the request of the parents after first-trimester screening for trisomy 21 by fetal NT and maternal serum free beta-hCG and PAPP-A. Immediately before chorionic villus sampling, fetal echocardiography was performed and the presence or absence of tricuspid regurgitation was determined by pulsed wave Doppler ultrasonography. The distribution of fetal NT, maternal serum free beta-hCG and PAPP-A in trisomy 21 fetuses with absent and present tricuspid regurgitation was examined. We examined two screening strategies: first, integrated first-trimester screening in all patients and second, first-stage screening of all patients using fetal NT and maternal serum free beta-hCG and PAPP-A followed by second-stage assessment of tricuspid regurgitation only in those with an intermediate risk of 1 in 101 to 1 in 1000 after the first stage. Tricuspid regurgitation was observed in 57 (74.0%) of the trisomy 21 fetuses and in 16 (6.9%) of the chromosomally normal fetuses. There were no significant differences in median maternal age, median gestational age, free beta-hCG multiples of the median (MoM) and PAPP-A MoM in trisomy 21 fetuses with and without tricuspid regurgitation. The modeled detection rates of trisomy 21 for fixed false positive rates of 1%, 2% and 5% in screening

  7. Plastic in North Sea Fish

    NARCIS (Netherlands)

    Foekema, E.M.; Gruijter, de C.; Mergia, M.T.; Franeker, van J.A.; Murk, A.J.; Koelmans, A.A.

    2013-01-01

    To quantify the occurrence of ingested plastic in fish species caught at different geographical positions in the North Sea, and to test whether the fish condition is affected by ingestion of plastics, 1203 individual fish of seven common North Sea species were investigated: herring, gray gurnard, wh

  8. The scope of plastic surgery

    African Journals Online (AJOL)

    2013-08-03

    Aug 3, 2013 ... areas of surgery (especially general surgery), plastic surgeons are arguably the .... Who do you feel are experts in laparoscopic surgery? e (general surgeons) a. Maxillofacial .... of pressure sore. ORIF = open reduction internal fixation. ... Plastic versus cosmetic surgery: What's the difference? Plast Reconstr.

  9. New Life for Old Plastics

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Recycling joint venture utilizes innovative technology to reuse plastics Recycling,despite its green connotations,can be a messy business.In China,more than 400,000 companies are engaged in plastic recycling,but 70 percent of them are family enterprises,

  10. Computational strain gradient crystal plasticity

    DEFF Research Database (Denmark)

    Niordson, Christian Frithiof; Kysar, Jeffrey W.

    2014-01-01

    of plane crystal plasticity are studied: pure shear of a single crystal between rigid platens as well as plastic deformation around cylindrical voids in hexagonal close packed and face centered cubic crystals. Effective in-plane constitutive slip parameters for plane strain deformation of specifically...

  11. Architecture of European Plastic Surgery

    NARCIS (Netherlands)

    Nicolai, J. -P. A.; Banic, A.; Molea, G.; Mazzola, R.; Poell, J. G.

    2006-01-01

    The architecture of European Plastic Surgery was published in 1996 [Nicolai JPA, Scuderi N. Plastic surgical Europe in an organogram. Eur J Plast Surg 1996; 19: 253-6.] It is the objective of this paper to update information of that article. Continuing medical education (CME), science, training,

  12. Plastics for corrosion inhibition

    CERN Document Server

    Goldade, Victor A; Makarevich, Anna V; Kestelman, Vladimir N

    2005-01-01

    The development of polymer composites containing inhibitors of metal corrosion is an important endeavour in modern materials science and technology. Corrosion inhibitors can be located in a polymer matrix in the solid, liquid or gaseous phase. This book details the thermodynamic principles for selecting these components, their compatibility and their effectiveness. The various mechanisms of metal protection – barrier, inhibiting and electromechanical – are considered, as are the conflicting requirements placed on the structure of the combined material. Two main classes of inhibited materials (structural and films/coatings) are described in detail. Examples are given of structural plastics used in friction units subjected to mechano-chemical wear and of polymer films/coatings for protecting metal objects against corrosion.

  13. Take heart!

    CERN Multimedia

    Alizée Dauvergne

    2010-01-01

    Recently, ten new semi-automatic defibrillators were installed at various locations around CERN. This is a preventive measure intended to provide cardiac arrest victims with the best possible response. The first responder could be you!   The Director-General has welcomed the initiative of the Medical Service and Fire Brigade for the installation of ten new semi-automatic defibrillators. You have probably seen them on your way to the restaurant, for example:  brand new semi-automatic defibrillators, ready for an emergency. Housed in a white wall-mounted case, the bright red defibrillators are marked with a white heart symbol crossed by a lightning bolt (see photo). The defibrillator is designed so that anyone can use it. “Anyone can use it, you don’t need to be a health professional,” says Dr Reymond from CERN's Medical Service. Together with the CERN Fire Brigade, he is behind the initiative to have these units put in place. And with good reason, as the unit...

  14. Universal features of amorphous plasticity

    Science.gov (United States)

    Budrikis, Zoe; Castellanos, David Fernandez; Sandfeld, Stefan; Zaiser, Michael; Zapperi, Stefano

    2017-07-01

    Plastic yielding of amorphous solids occurs by power-law distributed deformation avalanches whose universality is still debated. Experiments and molecular dynamics simulations are hampered by limited statistical samples, and although existing stochastic models give precise exponents, they require strong assumptions about fixed deformation directions, at odds with the statistical isotropy of amorphous materials. Here, we introduce a fully tensorial, stochastic mesoscale model for amorphous plasticity that links the statistical physics of plastic yielding to engineering mechanics. It captures the complex shear patterning observed for a wide variety of deformation modes, as well as the avalanche dynamics of plastic flow. Avalanches are described by universal size exponents and scaling functions, avalanche shapes, and local stability distributions, independent of system dimensionality, boundary and loading conditions, and stress state. Our predictions consistently differ from those of mean-field depinning models, providing evidence that plastic yielding is a distinct type of critical phenomenon.

  15. Phenotypic Plasticity and Species Coexistence.

    Science.gov (United States)

    Turcotte, Martin M; Levine, Jonathan M

    2016-10-01

    Ecologists are increasingly interested in predicting how intraspecific variation and changing trait values impact species interactions and community composition. For many traits, much of this variation is caused by phenotypic plasticity, and thus the impact of plasticity on species coexistence deserves robust quantification. Partly due to a lack of sound theoretical expectations, empirical studies make contradictory claims regarding plasticity effects on coexistence. Our critical review of this literature, framed in modern coexistence theory, reveals that plasticity affects species interactions in ways that could impact stabilizing niche differences and competitive asymmetries. However, almost no study integrates these measures to quantify the net effect of plasticity on species coexistence. To address this challenge, we outline novel empirical approaches grounded in modern theory.

  16. Imaging brain plasticity after trauma

    Institute of Scientific and Technical Information of China (English)

    Zhifeng Kou; Armin Iraji

    2014-01-01

    The brain is highly plastic after stroke or epilepsy;however, there is a paucity of brain plasticity investigation after traumatic brain injury (TBI). This mini review summarizes the most recent evidence of brain plasticity in human TBI patients from the perspective of advanced magnetic resonance imaging. Similar to other forms of acquired brain injury, TBI patients also demonstrat-ed both structural reorganization as well as functional compensation by the recruitment of other brain regions. However, the large scale brain network alterations after TBI are still unknown, and the ifeld is still short of proper means on how to guide the choice of TBI rehabilitation or treat-ment plan to promote brain plasticity. The authors also point out the new direction of brain plas-ticity investigation.

  17. Size effects in crystal plasticity

    DEFF Research Database (Denmark)

    Borg, Ulrik

    2007-01-01

    Numerical analyses of plasticity size effects have been carried out for different problems using a developed strain gradient crystal plasticiy theory. The theory employs higher order stresses as work conjugates to slip gradients and uses higher order boundary conditions. Problems on localization...... of plastic flow in a single crystal, grain boundary effects in a bicrystal, and grain size effects in a polycrystal are studied. Single crystals containing micro-scale voids have also been analyzed at different loading conditions with focus on the stress and deformation fields around the voids, on void...... growth and interaction between neighboring voids, and on a comparison between the developed strain gradient crystal plasticity theory and a discrete dislocation plasticity theory. Furthermore, voids and rigid inclusions in isotropic materials have been studied using a strain gradient plasticity theory...

  18. Hypoplastic left heart syndrome (image)

    Science.gov (United States)

    Hypoplastic left heart syndrome is a congenital heart condition that occurs during the development of the heart in the ... womb. During the heart's development, parts of the left side of the heart (mitral valve, left ventricle ...

  19. Nano-Ceramic Coated Plastics

    Science.gov (United States)

    Cho, Junghyun

    2013-01-01

    Plastic products, due to their durability, safety, and low manufacturing cost, are now rapidly replacing cookware items traditionally made of glass and ceramics. Despite this trend, some still prefer relatively expensive and more fragile ceramic/glassware because plastics can deteriorate over time after exposure to foods, which can generate odors, bad appearance, and/or color change. Nano-ceramic coatings can eliminate these drawbacks while still retaining the advantages of the plastic, since the coating only alters the surface of the plastic. The surface coating adds functionality to the plastics such as self-cleaning and disinfectant capabilities that result from a photocatalytic effect of certain ceramic systems. These ceramic coatings can also provide non-stick surfaces and higher temperature capabilities for the base plastics without resorting to ceramic or glass materials. Titanium dioxide (TiO2) and zinc oxide (ZnO) are the candidates for a nano-ceramic coating to deposit on the plastics or plastic films used in cookware and kitchenware. Both are wide-bandgap semiconductors (3.0 to 3.2 eV for TiO2 and 3.2 to 3.3 eV for ZnO), so they exhibit a photocatalytic property under ultraviolet (UV) light. This will lead to decomposition of organic compounds. Decomposed products can be easily washed off by water, so the use of detergents will be minimal. High-crystalline film with large surface area for the reaction is essential to guarantee good photocatalytic performance of these oxides. Low-temperature processing (nano-ceramic coatings (TiO2, ZnO) on plastic materials (silicone, Teflon, PET, etc.) that can possess both photocatalytic oxide properties and flexible plastic properties. Processing cost is low and it does not require any expensive equipment investment. Processing can be scalable to current manufacturing infrastructure.

  20. Biodegradability of degradable plastic waste.

    Science.gov (United States)

    Agamuthu, P; Faizura, Putri Nadzrul

    2005-04-01

    Plastic waste constitutes the third largest waste volume in Malaysian municipal solid waste (MSW), next to putrescible waste and paper. The plastic component in MSW from Kuala Lumpur averages 24% (by weight), whereas the national mean is about 15%. The 144 waste dumps in the country receive about 95% of the MSW, including plastic waste. The useful life of the landfills is fast diminishing as the plastic waste stays un-degraded for more than 50 years. In this study the compostability of polyethylene and pro-oxidant additive-based environmentally degradable plastics (EDP) was investigated. Linear low-density polyethylene (LLDPE) samples exposed hydrolytically or oxidatively at 60 degrees C showed that the abiotic degradation path was oxidative rather than hydrolytic. There was a weight loss of 8% and the plastic has been oxidized as shown by the additional carbonyl group exhibited in the Fourier transform infra red (FTIR) Spectrum. Oxidation rate seemed to be influenced by the amount of pro-oxidant additive, the chemical structure and morphology of the plastic samples, and the surface area. Composting studies during a 45-day experiment showed that the percentage elongation (reduction) was 20% for McD samples [high-density polyethylene, (HDPE) with 3% additive] and LL samples (LLDPE with 7% additive) and 18% reduction for totally degradable plastic (TDP) samples (HDPE with 3% additive). Lastly, microbial experiments using Pseudomonas aeroginosa on carbon-free media with degradable plastic samples as the sole carbon source, showed confirmatory results. A positive bacterial growth and a weight loss of 2.2% for degraded polyethylene samples were evident to show that the degradable plastic is biodegradable.

  1. The proposed new classification of coronary microcirculation as the predictor of the heart failure progression in idiopathic dilated cardiomyopathy.

    Science.gov (United States)

    Gil, Katarzyna E; Pawlak, Agnieszka; Frontczak-Baniewicz, Małgorzata; Gil, Robert J; Nasierowska-Guttmejer, Anna

    2015-01-01

    The appropriate condition of the coronary microcirculation is essential for proper cardiac muscle activity. The understanding of the pathological microcirculation changes in different stages of idiopathic dilated cardiomyopathy (IDCM) could provide a reliable background for proper therapeutic decisions and prognosis. The study population consisted of 116 patients (86.2% males, mean age 50.4±13.2 years) with IDCM and heart failure. In samples from left ventricular endomyocardial biopsy, the coronary microcirculation was evaluated by staining with hematoxylin and eosin, Masson's trichrome, and anti-CD34 antibody. The microvessel density (MVD) was calculated. Also, the electron microscopic evaluation of the extracellular matrix capillaries was performed. Samples were assigned to one of four types according to the microcirculation condition: 1, normal microvessels (MVs) (18 patients); 2, mostly normal, some MVs with slightly decreased lumen diameter and thickened wall, absent/mild intravascular fibrosis, and MVD decrease (37 patients); 3, MVs with moderately decreased lumen diameter and thickened wall, moderate intravascular fibrosis, and MVD decrease (45 patients); and 4, MVs with significantly decreased lumen diameter and thickened wall, significant intravascular fibrosis, and MVD decrease (16 patients). Taking all types of the proposed classification into consideration, in type 4, clinical (incidence of New York Heart Association 3 and 4, dyspnea on exertion, pulmonary congestion) and echocardiographic (left atrial and right ventricular diameter, left ventricular mass and ejection fraction, tricuspid annular plane systolic excursion, early diastolic mitral annular velocity measured at the interventricular-septal annulus [E'med], ratio of early diastolic mitral inflow velocity to E'med) parameters were worst. Only atrial fibrillation, diabetes, tricuspid annular plane systolic excursion, and the type of the microcirculation significantly correlated with the

  2. Retrospective review of congenital heart disease in 976 dogs.

    Science.gov (United States)

    Oliveira, P; Domenech, O; Silva, J; Vannini, S; Bussadori, R; Bussadori, C

    2011-01-01

    Knowledge of epidemiology is important for recognition of cardiovascular malformations. Review the incidence of congenital heart defects in dogs in Italy and assess breed and sex predispositions. Nine hundred and seventy-six dogs diagnosed with congenital heart disease (CHD) of 4,480 dogs presented to Clinica Veterinaria Gran Sasso for cardiovascular examination from 1997 to 2010. A retrospective analysis of medical records regarding signalment, history, clinical examination, radiography, electrocardiography, echocardiography, angiography, and postmortem examination was performed. Breed and sex predisposition were assessed with the odds ratio test. CHD was observed in 21.7% of cases. A total of 1,132 defects were observed with single defects in 832 cases (85%), 2 concurrent defects in 132 cases (14%), and 3 concurrent defects in 12 cases (1%). The most common defects were pulmonic stenosis (PS; 32.1%), subaortic stenosis (SAS; 21.3%), and patent ductus arteriosus (20.9%), followed by ventricular septal defect (VSD; 7.5%), valvular aortic stenosis (AS; 5.7%), and tricuspid dysplasia (3.1%). SAS, PS, and VSD frequently were associated with other defects. Several breed and sex predispositions were identified. The results of this study are in accordance with previous studies, with slight differences. The breed and sex predilections identified may be of value for the diagnosis and screening of CHD in dogs. Additionally, the relatively high percentage of concurrent heart defects emphasizes the importance of accurate and complete examinations for identification. Because these data are from a cardiology referral center, a bias may exist. Copyright © 2011 by the American College of Veterinary Internal Medicine.

  3. What Causes Heart Disease?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Causes Heart Disease? Research suggests that coronary heart disease (CHD) begins with damage to the lining and ... causing coronary microvascular disease (MVD). Coronary MVD is heart disease that affects the heart's tiny arteries. The cause ...

  4. Heart Disease in Women

    Science.gov (United States)

    ... United States, 1 in 4 women dies from heart disease. The most common cause of heart disease in both men and women is narrowing or ... It's the major reason people have heart attacks. Heart diseases that affect women more than men include Coronary ...

  5. 超声多普勒成像评价甲状腺功能亢进性心脏病右室心功能%Doppler Imaging in Evaluating Right Ventricular Function in Hyperthyroid Heart Disease

    Institute of Scientific and Technical Information of China (English)

    胡倩; 张文华

    2011-01-01

    目的 应用超声脉冲多普勒(PW)、组织多普勒成像(TDI)联合技术评价甲状腺功能亢进性心脏病(甲亢心)右室心功能.方法 选取60例甲亢患者,根据是否并发甲亢心(本研究只选取心脏结构正常的房性心律失常患者)分为单纯甲亢组(37例)和甲亢心组(23例),并选取30例正常人为对照组.应用PW测量三尖瓣口舒张期峰值血流速度E峰;应用TDI于心尖四腔切面三尖瓣环间隔处和侧壁处测量收缩期峰值速度(Sm)、舒张期峰值速度(Em),并计算E/Em.结果 (1)与对照组比较,单纯甲亢组侧壁处Sm增高,两组之间差异有统计学意义(P0.05),而甲亢心组较对照组E/Em明显增高,两组之间差异有统计学意义(P<0.05).结论 PW与TDI联合应用可以较为准确地评价甲亢心患者右室心功能.%Objective To evaluate the right ventricular function of hyperthyroid heart disease by Pulse wave (PW) and tissue Doppler imaging(TDI). Methods Sixty patients having hyperthyroidism,with hyperthyroid heart disease(This study only chose those who had normal heart structure but had atrial tachyarrhythmia. )or without were divided into simple hyperthyroidism group(n = 37)and hyperthyroid heart disease group(n = 23). Thirty normal volunteers served as control group. Tricuspid inflow velocity(E)was measured by Doppler echocardiography. TDI-derived systolic tricuspid annular velocity(Sm), diastolic tricuspid annular velocity(Em) and the ratio of diastolic tricuspid inflow velocity to Em(E/Em)were caculated. Results ①Compared with control group, Sm was higher in simple hyperthyroidism group(P<0.05). Compared with simple hyperthyroidism group,Sm was lower in heart disease group(P<0. 05). ②Compared with control group,Em of tricuspid annular lateral wall was lower in hyperthyroid heart disease group(P<0. 0S). ③The E/Em ratio in hyperthyroid heart disease group was significantly higher than that in control group(P<0. 05),however there was no

  6. Plasticity and beyond microstructures, crystal-plasticity and phase transitions

    CERN Document Server

    Hackl, Klaus

    2014-01-01

    The book presents the latest findings in experimental plasticity, crystal plasticity, phase transitions, advanced mathematical modeling of finite plasticity and multi-scale modeling. The associated algorithmic treatment is mainly based on finite element formulations for standard (local approach) as well as for non-standard (non-local approach) continua and for pure macroscopic as well as for directly coupled two-scale boundary value problems. Applications in the area of material design/processing are covered, ranging from grain boundary effects in polycrystals and phase transitions to deep-drawing of multiphase steels by directly taking into account random microstructures.

  7. International policies to reduce plastic marine pollution from single-use plastics (plastic bags and microbeads): A review.

    Science.gov (United States)

    Xanthos, Dirk; Walker, Tony R

    2017-02-18

    Marine plastic pollution has been a growing concern for decades. Single-use plastics (plastic bags and microbeads) are a significant source of this pollution. Although research outlining environmental, social, and economic impacts of marine plastic pollution is growing, few studies have examined policy and legislative tools to reduce plastic pollution, particularly single-use plastics (plastic bags and microbeads). This paper reviews current international market-based strategies and policies to reduce plastic bags and microbeads. While policies to reduce microbeads began in 2014, interventions for plastic bags began much earlier in 1991. However, few studies have documented or measured the effectiveness of these reduction strategies. Recommendations to further reduce single-use plastic marine pollution include: (i) research to evaluate effectiveness of bans and levies to ensure policies are having positive impacts on marine environments; and (ii) education and outreach to reduce consumption of plastic bags and microbeads at source.

  8. Heart rate variability in isolated rabbit hearts.

    Science.gov (United States)

    Frey, B; Heger, G; Mayer, C; Kiegler, B; Stöhr, H; Steurer, G

    1996-11-01

    The presence of heart rate variability (HRV) in patients with cardiac denervation after heart transplantation raised our interest in HRV of isolated, denervated hearts. Hearts from seven adult white ELCO rabbits were transferred to a perfusion apparatus. All hearts were perfused in the working mode and in the Langendorff mode for 20 minutes each. HRV was analyzed in the frequency domain. A computer simulated test ECG at a constant rate of 2 Hz was used for error estimation of the system. In the isolated, denervated heart, HRV was of random, broadband fluctuations, different from the well-characterized oscillations at specific frequencies in intact animals. Mean NN was 423 +/- 51 ms in the Langendorff mode, 406 +/- 33 ms in the working heart mode, and 500 ms in the test ECG. Total power was 663 +/- 207 ms2, 817 +/- 318 ms2, and 3.7 ms2, respectively. There was no significant difference in any measure of HRV between Langendorff and working heart modes. The data provide evidence for the presence of HRV in isolated, denervated rabbit hearts. Left atrial and ventricular filling, i.e., the working heart mode, did not alter HRV, indicating that left atrial or ventricular stretch did not influence the sinus nodal discharge rate.

  9. Small intestinal submucosa tricuspid valve tube graft shows growth potential, remodelling and physiological valve function in a porcine model†

    DEFF Research Database (Denmark)

    Lyager, Diana Mathilde Røpcke; Ilkjaer, Christine; Tjornild, Marcell J

    2017-01-01

    examination. No statistical comparisons were made due to low numbers. RESULTS: : Compared to the original tube graft, leaflet area and leaflet height decreased after 6 months (32  ±  0 vs 14.7  ±   4 cm 2 and 3.2  ±   0 vs 1.7  ±   0.3 cm, respectively). Both imaging modalities showed septal dehiscence in all...... regurgitation and heart failure. These data suggest that surgical reinforcement, e.g. adjunct annuloplasty, should be considered to improve durability....

  10. Chyloptysis causing plastic bronchitis

    Directory of Open Access Journals (Sweden)

    Alice Stoddart

    2014-01-01

    Full Text Available Chyloptysis is a rare clinical problem that is associated with conditions affecting lymphatic channels in the thorax. Diagnosis is usually made when the patients present with expectoration of milky-white sputum or of thick tenacious mucus in the shape of smaller bronchi (bronchial cast. Typically the symptoms resolve after coughing up of the bronchial casts. Pleural, mediastinal, pulmonary or lymphatic abnormalities result in chyloptysis. Lymphangiography and detection of lipids (cholesterol or triglycerides in sputum help to establish the diagnosis. However, lymphangiography may not be positive in all patients. We report 2 patients with chyloptysis and bronchial casts with different etiologies. Abnormal lymphatics were demonstrated in one of our cases, but the second patients lymphangiogram was normal. In this patient we suspect that high venous filling pressures due to congestive heart failure had a causative effect in the setting of compromised lymphatic drainage in the thorax due to a prior history of radiation therapy to the chest for lymphoma.

  11. Phenotypic plasticity, costs of phenotypes, and costs of plasticity

    DEFF Research Database (Denmark)

    Callahan, Hilary S; Maughan, Heather; Steiner, Uli

    2008-01-01

    Why are some traits constitutive and others inducible? The term costs often appears in work addressing this issue but may be ambiguously defined. This review distinguishes two conceptually distinct types of costs: phenotypic costs and plasticity costs. Phenotypic costs are assessed from patterns...... of covariation, typically between a focal trait and a separate trait relevant to fitness. Plasticity costs, separable from phenotypic costs, are gauged by comparing the fitness of genotypes with equivalent phenotypes within two environments but differing in plasticity and fitness. Subtleties associated with both...... types of costs are illustrated by a body of work addressing predator-induced plasticity. Such subtleties, and potential interplay between the two types of costs, have also been addressed, often in studies involving genetic model organisms. In some instances, investigators have pinpointed the mechanistic...

  12. The mechanism of functional tricuspid regurgitation:insight from two and three-dimensional echocardiography%功能性三尖瓣反流机制的二维及三维超声心动图探索

    Institute of Scientific and Technical Information of China (English)

    孟红; 潘世伟; 胡小鹏; 逄坤静; 李建蓉; 吕秀章; 王浩; 王燕; 李澎

    2012-01-01

    Objective To explore determinants of functional tricuspid regurgitation with twodimensional (2D) and three-dimensional (3D) echocardiography,and to provide theoretical basis for surgery treatments.Methods Fifty-six subjects with left-sided valular diseases and tricuspid regurgitation underwent 2D and 3D echocardiography examinations.The tricuspid annulus diameter,the valvular tethering height and right ventricular volume and ejection fraction were measured.Results Based on the degree of tricuspid regurgitation,the patients were grouped into mild regurgitation (group 1) and moderate or more regurgitation (group 2).Comparing the two groups by t test,the tricuspid annulus diameter,the largest distance of tricuspid valvular tethering and the end-diastolic right ventricle volume had significantly enlarged in group 2 ( P <0.01 ).And the degrees of tricuspid regurgitation had good correlations with the annulus diameter,the valvular tethering,the right ventricular volume and pulmonary artery systolic pressure.Also,the 3D echocardiography revealed there were some valvular pathologies aggravating regurgitation.Conclusions The degree of functional tricuspid regurgitation is mainly determined by the annulus dilation and pulmonary hypertension.Further more,the 3D echocardiography can give us more details of the valves.%目的 应用超声心动图探索功能性三尖瓣反流的发生机制,并为手术治疗提供理论基础.方法 对56例左心瓣膜疾病合并三尖瓣反流的患者进行超声检查,测量三尖瓣瓣环直径、瓣叶闭合高度、闭合长度、心室三维容积和射血分数.结果 根据术前反流程度将56例患者分为轻度组(组1)和中度及以上组(组2),组2的瓣环直径、闭合高度、右室容积均明显大于组1( P<0.01).与反流程度重要相关的因素分别是瓣环直径、闭合高度、右室舒张末容积、肺动脉高压.术前三维超声发现合并瓣叶器质性改变会加重反流.结论 合并左心

  13. Biodegradable plastics from renewable sources.

    Science.gov (United States)

    Flieger, M; Kantorová, M; Prell, A; Rezanka, T; Votruba, J

    2003-01-01

    Plastic waste disposal is a huge ecotechnological problem and one of the approaches to solving this problem is the development of biodegradable plastics. This review summarizes data on their use, biodegradability, commercial reliability and production from renewable resources. Some commercially successful biodegradable plastics are based on chemical synthesis (i.e. polyglycolic acid, polylactic acid, polycaprolactone, and polyvinyl alcohol). Others are products of microbial fermentations (i.e. polyesters and neutral polysaccharides) or are prepared from chemically modified natural products (e.g., starch, cellulose, chitin or soy protein).

  14. Plastics recycling: challenges and opportunities

    OpenAIRE

    Hopewell, Jefferson; Dvorak, Robert; Kosior, Edward

    2009-01-01

    Plastics are inexpensive, lightweight and durable materials, which can readily be moulded into a variety of products that find use in a wide range of applications. As a consequence, the production of plastics has increased markedly over the last 60 years. However, current levels of their usage and disposal generate several environmental problems. Around 4 per cent of world oil and gas production, a non-renewable resource, is used as feedstock for plastics and a further 3–4% is expended to pro...

  15. Circadian Regulation of Synaptic Plasticity

    Directory of Open Access Journals (Sweden)

    Marcos G. Frank

    2016-07-01

    Full Text Available Circadian rhythms refer to oscillations in biological processes with a period of approximately 24 h. In addition to the sleep/wake cycle, there are circadian rhythms in metabolism, body temperature, hormone output, organ function and gene expression. There is also evidence of circadian rhythms in synaptic plasticity, in some cases driven by a master central clock and in other cases by peripheral clocks. In this article, I review the evidence for circadian influences on synaptic plasticity. I also discuss ways to disentangle the effects of brain state and rhythms on synaptic plasticity.

  16. PLASMA GASIFICATION OF WASTE PLASTICS

    Directory of Open Access Journals (Sweden)

    Tadeusz Mączka

    2013-01-01

    Full Text Available The article presents the process of obtaining liquid fuels and fuel gas in the process of plasma processing of organic materials, including waste plastics. The concept of plasma pyrolysis of plastics was presented and on its basis a prototype installation was developed. The article describes a general rule of operating the installation and its elements in the process and basic operation parameters determined during its start-up. Initial results of processing plastics and the directions further investigations are also discussed. The effect of the research is to be the design of effective technology of obtaining fuels from gasification/pyrolysis of organic waste and biomass.

  17. Recycling of Reinforced Plastics

    Science.gov (United States)

    Adams, R. D.; Collins, Andrew; Cooper, Duncan; Wingfield-Digby, Mark; Watts-Farmer, Archibald; Laurence, Anna; Patel, Kayur; Stevens, Mark; Watkins, Rhodri

    2014-02-01

    This work has shown is that it is possible to recycle continuous and short fibre reinforced thermosetting resins while keeping almost the whole of the original material, both fibres and matrix, within the recyclate. By splitting, crushing hot or cold, and hot forming, it is possible to create a recyclable material, which we designate a Remat, which can then be used to remanufacture other shapes, examples of plates and tubes being demonstrated. Not only can remanufacturing be done, but it has been shown that over 50 % of the original mechanical properties, such as the E modulus, tensile strength, and interlaminar shear strength, can be retained. Four different forms of composite were investigated, a random mat Glass Fibre Reinforced Plastic (GFRP) bathroom component and boat hull, woven glass and carbon fibre cloth impregnated with an epoxy resin, and unidirectional carbon fibre pre-preg. One of the main factors found to affect composite recyclability was the type of resin matrix used in the composite. Thermoset resins tested were shown to have a temperature range around the Glass Transition Temperature (Tg) where they exhibit ductile behaviour, hence aiding reforming of the material. The high-grade carbon fibre prepreg was found to be less easy to recycle than the woven of random fibre laminates. One method of remanufacturing was by heating the Remat to above its glass transition temperature, bending it to shape, and then cooling it. However, unless precautions are taken, the geometric form may revert. This does not happen with the crushed material.

  18. Insuficiência tricúspide pós trauma associada a agnesia de músculo papilar anterior Post-traumatic tricuspid insufficiency associated with agenesis of the anterior papillary muscle

    Directory of Open Access Journals (Sweden)

    Ronaldo Ducceschi FONTES

    2000-09-01

    Full Text Available Relatamos o caso de paciente do sexo masculino com 36 anos de idade com sinais e sintomas de insuficiência cardíaca direita. A história revelou trauma torácico há aproximadamente cinco anos. Submetido a operação para tratamento de insuficiência tricúspide, notou-se ausência do músculo papilar anterior da valva tricúspide, fenda na cúspide anterior e dilatação do anel tricuspídeo. Foi realizada sutura da fenda localizada na cúspide anterior e feita sua sustentação utilizando-se tira de pericárdio bovino fixada na face atrial e base do músculo papilar posterior. A operação foi completada com anuloplastia de Revuelta. O paciente obteve nítida melhora dos sintomas no pós-operatório imediato, mantendo-se em classe funcional I (NYHA, após 22 meses de evolução.Tricuspid regurgitation arising from chest trauma five years earlier was successfully corrected by valve reconstruction in a 36 year-old man. During correction a fissure of the anterior leaflet, absence of the anterior papillary muscle, chordae tendineae and tricuspid annulus dilatation were found. Tricuspid valvuloplasty was feasible using an anchored suture of the anterior leaflet fissure, artificial bovine chordae, pericardium implantation and Revuelta ring annuloplasty. There were no complications and no early or late mortality. At 22 months follow-up tricuspid valve function has remained with mild regurgitation. The patient is in good clinical condition.

  19. Spherical rotary piston machine as an artificial heart.

    Science.gov (United States)

    Wipf, S L

    1991-01-01

    A positive displacement pump with six rotary pistons was proposed as an artificial heart. The pump's design was characterized by high symmetry and compactness. Thus, a spherical volume of 4 1/4 inch diameter sufficed for a pump delivering 10 L/min at 120 pulses/min with the pistons turning at 30 rpm. The pistons and four connecting gears were the only moving parts. The pump functions in two separate halves as left and right ventricles, with two of the six pistons each having inlet and outlet passages, and one of them replacing mitral and pulmonary valves with the other, tricuspid and aortic valves. The function of the intraventricular septum was provided by the other four pistons whose interiors also accommodated driving motors each capable of 0.4 Nm torque for a combined power of 5 watts. There were no stagnant regions in the pumping volume, and at all internal surfaces in contact with blood, there was periodic shear stress not exceeding approximately 300 Pa.

  20. Plasticity and creep of metals

    CERN Document Server

    Rusinko, Andrew

    2011-01-01

    Here is a systematic presentation of the postulates, theorems and principles of mathematical theories of plasticity and creep in metals, and their applications. Special attention is paid to analysis of the advantages and shortcomings of the classical theories.