Tissue Doppler imaging was used with transthoracic and transesophageal echocardiography to determine its clinical usefulness beyond visualization of ventricular wall motion. Thirteen novel applications were found: acoustically difficult transthoracic studies, thrombus, mitral chordal motion, shunt detection using saline contrast, spontaneous echo contrast, intra-aortic balloon pump position and...

Transesophageal echocardiography (TEE) is especially suitable for examination of prosthetic valves because of the proximity of the esophagus to the heart and absence of interference with lungs and ribs. This article reviews normal and abnormal morphologic characteristics of prosthetic valves such as spontaneous echocontrast, microbubbles, strands, sutures, vegetations or thrombus. Doppler echoc...

Prosthetic valve thrombosis is one of the most severe complications after surgical valve replacement. There are many possible presentations: from asymptomatic to life-threatening complications. We report on a 61-year-old female patient with prosthetic replacement of the aortic and mitral valve in the in-house department of cardiac surgery 3 months ago. The patient was suffering from aphasia dur...

Recently, there have been more reports of cardiac valve infections due to the increasing number of intravenous (IV) drug abusers and chronic renal failure patients. Among cardiac valves, tricuspid valve is most commonly affected in the course of endocarditis. Appropriate management of these patients is a challenging and controversial issue in the field of cardiac surgery. Treatment options in s...

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...

Patients with native valve endocarditis treated surgically between 1968 and 1978 (n = 15) and all patients presenting with prosthetic valve endocarditis during this period (n = 21) were followed up for at least four years. Five of the patients with native valve endocarditis required urgent early surgical intervention, of whom two died. The remaining 10 underwent valve replacement after a course...

OBJECTIVES Proper valve selection is critical to ensure appropriate valve replacement for patients, because implantation of a small valve might place the patient at risk for persistent gradients. Labeled valve size is not the same as millimeter measure of prosthetic valve diameters or the annulus into which it will fit. Studies that use the labeled valve size in lieu of actual measured diameter...

The organism responsible for endocarditis of a prosthetic aortic valve was identified as Nocardia asteroides. The patient was treated with intravenous amikacin (250 mg four times a day) and intravenous imipenem (1.5 g four times a day). The valve was replaced under this new antibiotic regimen. This is the first report of survival after prosthetic valve nocardiosis.

Mycobacterium spp. are a rare cause of endocarditis. Herein, we describe a case of Mycobacterium mageritense prosthetic valve endocarditis. This organism produced an unusual brown pigment on solid media. Cultures of valve tissue for acid-fast bacilli might be considered in some cases of apparently culture-negative prosthetic valve endocarditis.

Acinetobacter spp. are uncommon etiologic agents of prosthetic valve endocarditis. Two patients with Acinetobacter calcoaceticus subsp. lwoffi prosthetic valve endocarditis are described. The patients were successfully treated with antibiotics (cefotaxime sodium and gentamicin sulfate); thus, we suggest medical treatment rather than early valve replacement in this particular type of infection.