Three cases of aortic regurgitation acquired as the result of bacterial endocarditis complicating Fallot's tetralogy and pulmonary atresia have been described. One also had mitral regurgitation from a 'jet lesion' of the anterior cusp of the mitral valve. Surgical treatment of all abnormalities with aortic valve repair or replacement was undertaken in each patient and was successful in two. Dif...

1 also called the pulmonary autograft procedure, involves replacement of the diseased aortic valve with the patient’s own pulmonary valve (autograft) and implantation of a biological valve (homograft) in the pulmonary position. It was first described and pioneered by Mr. Donald Ross in 1967 in London. The procedure was popularised in the 1980s when homografts became widely available on both sid...

BACKGROUND Transcatheter pulmonary valve (TPV) replacement is an emerging therapy intended to restore pulmonary valve function in patients with right ventricular outflow tract conduit dysfunction; the impact of this technique on ventricular strain and synchrony is not known. METHODS AND RESULTS Cardiac magnetic resonance and ECG data acquired at 1 center as part of the US Melody TPV trial wer...

The quadricuspid pulmonary valve is a rare congenital anomaly. It tends to be clinically quiescent. Its diagnosis by two-dimensional echocardiography could be very difficult because of the anatomical features. We report on the echocardiographic findings of a 66-year-old female patient with mitral and aortic regurgitation of rheumatic origin and severe pulmonary hypertension. There was an aneuri...

BACKGROUND The Melody valve is approved for percutaneous pulmonary valve replacement in dysfunctional right ventricular outflow tracts. The function of this valve when subjected to high-pressure loads in humans is unknown. The aim of this study was to describe the immediate and short-term results of Melody valves implanted in a high-pressure environment. METHODS AND RESULTS Definitions of a h...

The prevalence and clinical significance of aortic valve prolapse were determined prospectively in 2000 consecutive patients undergoing routine clinical cross sectional echocardiography. Two hundred and twelve patients were excluded because the aortic cusps were not adequately visualised. Aortic valve prolapse was defined as downward displacement of cuspal material below a line joining the poin...

BACKGROUND Proposed advantages to the Ross procedure included presumed increased freedom from reoperation and simpler reoperation for pulmonary conduit replacement if needed. It is increasingly apparent, however, that reoperations are frequent after the Ross procedure and that when required, they may be more complex than previously thought. METHODS AND RESULTS Between September 1991 and Augus...

as pre-existing abnormalities, such as tricuspid valve annular dilatation or pulmonary hypertension, may be present. The mechanism of tricuspid regugirtation plays an important role in the choice of treatment. If tricuspid regurgitation caused by the endocardial lead is managed by surgery, medical treatment is needed for other reasons. Defining the precise anatomical relationship between the tr...

To assess the flow characteristics of homograft valved conduits in the immediate postoperative period, 69 children with 71 homograft conduits underwent 2-dimensional and Doppler echocardiographic examination at 1 to 40 days (mean 8) after surgery. Of the 71 conduits studied, 19 were aortic and 52 were pulmonary homograft valved conduits. Two aortic homograft valved conduits were inserted in the...

Two cases of Shone syndrome with severe mitral and aortic valve problems and pulmonary hypertension were referred for heart-lung transplantation. Severely elevated pulmonary vascular resistance (PVR) was confirmed as was severe periprosthetic mitral and aortic regurgitation. Based on the severity of the valve lesions in both patients, surgery was decided upon and undertaken. Both experienced ea...