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Bicuspid aortic valve and diseases of the aorta
Published in Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček, Congenital Heart Disease in Adults, 2008
Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček
In childhood, aortic valve stenosis is most often managed by balloon valvuloplasty and/or surgical valvulotomy. The Ross procedure is performed rarely. Prosthetic valves are used only exceptionally in older children. In contrast, prosthetic valves are used predominantly in adult patients given the progression of degenerative changes involving the aortic valve. The prostheses may be mechanical (most often bileaflet); biological, made from a porcine aortic valve or pericardium (heterograft, xenograft); or human aortic valves (homograft, allograft). In some cases, the Ross procedure, with implantation of the patient’s own pulmonary autograft into the aortic position and a homograft into the pulmonary position, is also performed in adults. The advantage of this operation is that patients do not need anticoagulation.
The pharmacotherapeutic options in patients with catecholamine-resistant vasodilatory shock
Published in Expert Review of Clinical Pharmacology, 2022
Timothy E. Albertson, James A. Chenoweth, Justin C. Lewis, Janelle V. Pugashetti, Christian E. Sandrock, Brian M. Morrissey
Another early investigation by Derrick, et al. started with high dose infusions of AT-II into dogs generating systolic blood pressure of 250–300 mm Hg [72]. Many of the dogs died during infusion and most died of pulmonary edema which was reduced in another group of dogs by giving digitalis before infusion of the high doses of AT-II. These investigators then infused AT-II into 26 volunteer healthy prisoners and gave it subcutaneously in six subjects. After a single subcutaneous dose, blood pressures increased within 3 min and lasted for approximately 10 min with some variability in the response [72]. The intravenous (IV) dosing of AT-II during various surgeries including mitral valvulotomy, pericardiectomy, post-operative shock and after hysterectomy resulted in variable response. In addition, 10 patients with shock from sepsis, cerebral vascular accident, hemorrhage, myocardial infarction with presumed cardiogenic shock or neurogenic shock all showed increases in blood pressure with AT-II infusion. No randomization, controls or blinding of investigators occurred during these studies opening the opportunity for significant bias.
Percutaneous mitral balloon valvulotomy in pregnant women with mitral stenosis from rheumatic heart disease: a series of cases
Published in Journal of Obstetrics and Gynaecology, 2020
Neiberg de Alcantara Lima, Glaylton Silva Santos, Carol Cavalcante de Vasconcelos Lima, Mark D Schauer
Treatment of mitral valve disease in pregnancy is based in observational studies. We hereby discuss a series of three cases in which percutaneous mitral balloon valvulotomy (PMBV) was performed with cardiac and obstetric success.