A 77-year-old man who had a mechanical prosthetic mitral valve and aortic valve implanted in 1993 presented dyspnea and anemia, and was diagnosed of mitral prosthesis paravalvular leak. The patient was considered at high operative risk owing to his age, severe pulmonary hypertension, chronic renal failure, and previous cardiac surgery. Surgical treatment in his reference hospital was therefore ...

BACKGROUND Our objectives were to identify correlates of mortality and congestive heart failure after aortic valve replacement (AVR) according to preoperative left ventricular (LV) function and to describe the incidence, time course, and correlates of LV recovery and mass regression postoperatively. METHODS AND RESULTS A total of 3112 patients with AVR were assessed in a follow-up clinic with...

A 58 year old woman with symptomatic severe bicuspid aortic valve stenosis underwent aortic valve replacement with a mechanical prosthesis. On post-operative day four, the patient developed sudden onset of sustained narrow complex tachycardia with a heart rate of 170 180 (Figure 1). She complained of palpitations, but her blood pressure remained stable. The tachycardia was able to be briefly te...

A 66-year old man with severe functional mitral regurgitation (Figure 1A) secondary to chronic ischemic cardiomyopathy (previous myocardial infarction and coronary artery bypass grafting) and advanced heart failure (left ventricular ejection fraction: 25%; New York Heart Association [NYHA] functional class III) was considered to be at very high surgical risk and was finally accepted by the Hear...

A 59-year-old male was referred for surgery resulting from a paravalvular leak at the mitral position. The patient underwent his first mitral valve replacement with a Bjork-Shiley valve 33 years before this situation arose. He underwent his second mitral valve replacement with a St. Jude Medical mechanical prosthesis for valve thrombosis 10 years later. Serial echocardiography had always shown ...

A 43-year—old man was admitted to the coronary care unit because of recurrent syncope. His medical history included pulmonic valve angioplasty at age 9 years, mechanical mitral valve replacement because of severe mitral regur-gitation caused by congenital atrioventricular canal, and pacemaker implantation because of complete atrioventricular block. On admission he was orthopneic, his blood pres...

OBJECTIVE This prospective study aimed to determine to what extent clinical symptoms and neurohumoral activation are improved in patients with severe aortic valve stenosis after transcatheter aortic valve implantation (TAVI) with the CoreValve prosthesis. METHODS From June 2008 to June 2009 consecutive patients with symptomatic severe aortic valve stenosis (area<1 cm(2)), age>or=75 years with...

Heart valve diseases are usually treated by surgical intervention addressed for the replacement of the damaged valve with a biosynthetic or mechanical prosthesis. Although this approach guarantees a good quality of life for patients, it is not free from drawbacks (structural deterioration, nonstructural dysfunction, and reintervention). To overcome these limitations, the heart valve tissue engi...

INTRODUCTION In spite of significant recent advances in imaging modalities for studying cardiac hemodynamics, present day in vivo measurement techniques can only resolve large scale blood flow features. Understanding flow patterns in the heart at physiological conditions and scales sufficiently fine for establishing quantitatively links between disease and patientspecific hemodynamics continues...

(Semi) supine exercise testing has an established role in the evaluation of patients with valvular heart disease and can help clinical decision making. Stress echocardiography has the advantages of its wide availability, low cost, and versatility for the assessment of disease severity. However, exercise-induced changes in valve hemodynamics, left ventricular outflow obstruction and pulmonary ar...