The use of echocardiography, phonocardiography, and spectroanalysis has enhanced the ability to detect prosthetic valve dysfunction even before the onset of symptoms in many patients. Reduction in the intensity of the opening and closing clicks and the appearance of new murmurs have been the most frequently reported observations in predicting prosthetic valve dysfunction. Simultaneous echocardi...

IMPORTANCE In nonelderly patients with mitral disease requiring valve replacement, deciding between bioprosthetic and mechanical prosthetic valves is challenging because long-term survival and morbidity are not well defined. OBJECTIVE To quantify survival and major morbidity after mitral valve replacement in patients aged 50 to 69 years. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohor...

BACKGROUND Minimal data exist on the long-term survival of dialysis patients after cardiac valve surgery. Current practice guidelines of the American College of Cardiology/American Heart Association Task Force on the management of patients with valvular heart disease proscribe the use of bioprosthetic (tissue) valves in hemodialysis patients. METHODS AND RESULTS Dialysis patients hospitalized...

OBJECTIVES The purpose of this study was to determine the prevalence and severity of paravalvular regurgitation (PVR) in the Artificial Valve Endocarditis Reduction Trial (AVERT) cohort. BACKGROUND The initial AVERT cohort consisted of 807 patients randomized to receive either a Silzone-coated prosthetic valve or a conventional prosthetic valve; early clinical reports showed higher rates of v...

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...

Harken et al. had performed the first aortic valve replacement in subcoronary position in 1960 (Harken, 1960). The “caged ball” valve used in this operation pioneered to the prosthetic valves and in the last 50 years many valve types were begun to be used. The early and long term results of the patients undergone aortic valve surgery do not depend not only the patient-related factors and the ty...

Sixty percent of the patients going for valve replacement opt for mechanical valves and the remaining 40% choose bioprosthetics. Mechanical valves are known to have a higher risk of thrombosis; this risk further varies depending on the type of valve, its position, and certain individual factors. According to current guidelines, long-term anticoagulation is indicated in patients with metallic pr...