China
Africa
Explore chapters and articles related to this topic
Relationship between body mass index and the degree of mitral valve stenosis: Supporting evidence for the obesity paradox phenomenon
Published in Ade Gafar Abdullah, Isma Widiaty, Cep Ubad Abdullah, Medical Technology and Environmental Health, 2020
A.N. Lestari, I.R. Alie, M.R. Akbar
In a guideline of echocardiographic examination of valve stenosis, Baumgartner et al. (2009) stated that there are other valve abnormalities that can be caused by mitral valve stenosis due to its rheumatic nature. Tricuspid valve disease, which is often associated with this case, is functional tricuspid regurgitation. Pulmonary valve stenosis can be very rare, although it is related to the rheumatic process. In mitral valve regurgitation due to rheumatism, the main mechanism is the restriction of movement of the valve leaflets (Baumgartner et al. 2009).
The cardiovascular system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Mary N Sheppard, C. Simon Herrington
A wide range of valve abnormalities, and all prosthetic valves, predispose to human infective endocarditis. The risk is greatest with valve lesions that involve high-pressure jets. Thus, mitral incompetence has a higher risk than mitral valve stenosis. The increased risk with regurgitant jets is due to direct damage to the endocardium by the local haemodynamic forces. It is, however, becoming more frequent for bacterial infection to become established on valves that were not clinically regarded as previously abnormal. In this context age-related changes in normal individuals predispose to small platelet thrombi on valve cusps at the lines and points of cusp apposition. Lambl's excrescences are probably the result of organization of such thrombi. Small thrombi that are not of a size to be either visible or of any haemodynamic consequence may act as a nidus on which highly virulent organisms such as Staphylococcus aureus can establish infection. Mural endocarditis is rare.
Interventional transoesophageal echocardiography
Published in John Edward Boland, David W. M. Muller, Interventional Cardiology and Cardiac Catheterisation, 2019
Mayooran Namasivayam, Martin Shaw
Percutaneous balloon mitral valvuloplasty is a useful therapy for rheumatic mitral valve stenosis (see Chapter 38). Prior to the procedure, the suitability of the mitral valve for ballooning using standard scoring systems, such as the Wilkins score,7 should be assessed. The optimal view for suitability scoring, if available, is often the short axis view of the mitral valve in the parasternal window on TTE, rather than TEE. Intra-procedurally, prior to proceeding, the left atrial appendage should be checked for thrombus, which represents a contraindication to balloon valvuloplasty. The initial approach to balloon valvuloplasty is similar to the MitraClip procedure with a trans-septal puncture. Following this, TEE should guide optimal positioning of the balloon and should document the degree of stenosis and/or the creation of any significant regurgitation following ballooning. Short axis imaging from a transgastric approach can be useful.
Hypoplastic left heart syndrome (HLHS): molecular pathogenesis and emerging drug targets for cardiac repair and regeneration
Published in Expert Opinion on Therapeutic Targets, 2021
Anthony T Bejjani, Neil Wary, Mingxia Gu
HLHS can be caused by several defects in the left heart, but the most common results from mitral valve stenosis and obstruction of flow into and/or out of the left ventricle, ultimately leading to a hypoplastic left ventricle [13]. In cases where the aortic valve is defective, increased afterload in the left ventricle leads to the dilation of the ventricle and decreased contractility. As a result, diminished blood flow results in hypoplasia of the left ventricle during fetal development [14]. Additionally, increased pressure in the left atrium can lead to the reversal of blood flow into the right atrium through the foramen ovale and into the right ventricle, which can become hypertrophic [15]. The resulting decrease in left ventricular pressure triggers hypoplasia of the left heart. Alternatively, mitral valve atresia or stenosis can lead to decreased preload in the left ventricle, causing hypoplasia [14].
Cardiovascular Imaging for the Advancement of the Structural Heart Field – A Fellow’s Perspective Journey
Published in Structural Heart, 2018
Other valvular disease interventions have also been driven and ultimately guided by clinical imaging. Identification of rheumatic mitral stenosis is traditionally done with 2-dimensional transthoracic echocardiography (2DTTE) and is also essential in the determination of candidacy for percutaneous valvuloplasty. Percutaneous mitral valvuloplasty, originally introduced by Inoue in 1984,6 is performed under fluoroscopy and transesophageal echocardiography (TEE). Three-dimensional planimetry yields the highest accuracy for measurement of mitral valve area. While rheumatic mitral valve stenosis has long been managed with valvuloplasty, only recently have percutaneous therapeutic options for mitral valve regurgitation become popular with the advent of the MitraClip system. This has changed the landscape for patients with mitral valve regurgitation. While a notoriously difficult valve for percutaneous replacement due to its unique and complex anatomy, there are several devices in the works to accomplish this task. CT angiography has emerged as the major imaging modality used for the planning of percutaneous mitral valve replacement; it enables determination of the mitral valve annulus, can size the neo-left ventricular outflow tract to prevent systolic anterior motion of the mitral valve following valve implantation.
The relationship between serum pregnancy-associated plasma protein-A level in patients with aortic valve stenosis: a case-control study
Published in Acta Cardiologica, 2021
E. Merve Girgin, Ayfer Colak, Ersin Cagri Simsek, Burak Toprak, Hülya Yalcin, Oner Ozdogan, Can Duman
In a study on MMPs, pathological valves from patients with aortic valve replacement were examined and it was shown that MMP-9 was significantly upregulated in lesion areas. This finding suggests that MMP-9 may play an important role in calcific aortic valve disease [22]. The increase in MMP levels was also shown in a number of studies in mitral valve stenosis patients, which has a similar pathogenesis with AS [23–27]. Similar to the abovementioned studies showing MMP association in valve diseases, we also found an association with PAPP-A levels in non-symptomatic AS in our study.