Bacillus cereus is a rare cause of endocarditis, typically associated with intravenous drug abuse, rheumatic heart disease, prosthetic heart valves, pacemakers, or immunodeficiency. We present the first case of native valve Bacillus cereus endocarditis with no apparent risk factors. The patient had a fulminant course requiring emergent valve replacement.

In 1992, based on extensive review of the literature, we concluded that in patients with mechanical prosthetic heart valves,1 (1) long-term (permanent) therapy with oral anticoagulants offers the most consistent protection, and (2) levels of oral anticoagulants that prolong the prothrombin time (PT) ratio to an international normalized ratio (INR) of 2.5 to 3.5 are satisfactory for tilting disk...

From March 1990 to May 1993,309 patients underwent redo cardiac surgery operation at the Shahid Rajai Heart Hospital in Tehran. Early mortality rates in these patients showed a significant increase in comparison to patients undergoing open heart surgery for the first time. Late mortality (at least one month after surgery) in the patients was slightly increased also but less than early morta...

We report two patients with a history of prior mitral valve and aortic valve replacement with St. Jude prosthetic valves, who were referred for repeat valve replacement after noninvasive assessment was suggestive of prosthetic valve malfunction. Both patients were managed medically after evaluation with direct left ventricular apical puncture revealed normal hemodynamics in the first and mild a...

A large number of prosthetic heart valves (PHV) are being implanted in patients with both congenital and acquired valvular disease. Many of the recipients of such valves are women of childbearing age who desire to have children. The main issues involved with pregnancy in a patient with PHV include the selection of PHV in women during their childbearing age, risks to both the mother and the fetu...

Background. Thrombolytic therapy is a promising alternative to valve replacement in the management of prosthetic valve thrombosis. We sought to determine the shortand long-term results of treating thrombosed St. Jude heart valves with thrombolytic therapy as the primary treatment modality. Methods and Results. Between March 1978 and December 1991, 988 patients underwent implantation of St. Jude...

4 CLINICAL PARTICULARS 4.1 Therapeutic indications As an adjunct to oral anti-coagulation for prophylaxis of thromboembolism associated with prosthetic heart valves. In combination with aspirin for: a. Prophylaxis of deep venous thrombosis as an alternative to subcutaneous heparin, other than in hip surgery. b. Prophylaxis of recurrent venous thrombosis resistant to oral anticoagulation. c. Pro...