Presentation
We present a case where difficulty was encountered in advancing the balloon catheter across the mitral valve by standard technique. [ncbi.nlm.nih.gov]
The clinical condition in-extremis was present in 42.1% of them. [scielo.br]
Entire Body System
- Asymptomatic
Although there was a gradual decrease of MVA at long-term follow-up, most patients remained asymptomatic and PASP was stable. [ncbi.nlm.nih.gov]
However, the ACC/AHA guidelines concluded that most asymptomatic patients with severe AS can undergo urgent noncardiac surgery at relatively low risk with careful intraoperative and postoperative management. [en.wikipedia.org]
Asymptomatic patients with MVA less than 1.5 cm 2 with new atrial fibrillation may also be considered for PMBV (Class IIb). [emedicine.medscape.com]
While patients can survive for years with asymptomatic AS, the prognosis following symptom onset is quite poor without intervention. [intervalveinc.com]
- Fatigue
For the Aortic Valve Balloon aortic valvuloplasty (BAV) is appropriate when severe aortic stenosis is causing serious symptoms (i.e. difficulty breathing, dizziness, and fatigue) and surgical replacement of the valve is not an option. [mountsinai.org]
That said, some common symptoms of compromised heart valves or heart valve disease are: Chest pain Palpitations or a fluttering in the chest Swelling/weight gain Weakness, dizziness or general fatigue Shortness of breath If you would like to know more [nwregionalheart.com]
Heart valve disease may cause the following symptoms: Dizziness Chest pain Trouble breathing Palpitations Swelling (edema) of the feet, ankles, or abdomen Rapid weight gain due to fluid retention Tiredness (fatigue) Less energy when doing regular activity [urmc.rochester.edu]
As a result, one can experience symptoms such as fatigue, shortness of breath, cough, dizziness and fainting and angina. These symptoms may be alleviated with restoration of valve function following a balloon valvuloplasty. [ehc.com.au]
- Streptococcal Infection
Due to a more severe initial rheumatic bout or to repeated bouts of rheumatic carditis secondary to recurrent streptococcal infections, the progression of MS in those areas tends to be much faster, leading to functional disability at a much earlier stage [cathlabdigest.com]
Rheumatic fever is a late sequela to Group A β-hemolytic streptococcal infection of the throat. [ahajournals.org]
Respiratoric
- Exertional Dyspnea
He became physically active and was free of exertional dyspnea at the 12-month follow-up. [ncbi.nlm.nih.gov]
Symptoms might include exertional dyspnea and fatigue related to inability of the RV to increase its cardiac output in response exercise. Eventually the RV will fail leading to poor cardiac output. [omicsonline.org]
Cardiovascular
- Heart Disease
KEYWORDS: Anticoagulation; Rheumatic heart disease; Thromboembolism; Watchman® [ncbi.nlm.nih.gov]
disease in developing and underdeveloped countries. 1 Rheumatic heart disease including mitral stenosis (MS) is one of the late manifestations of RF that could potentially result in debilitating symptoms and complications. [radcliffecardiology.com]
Guidelines on the management of valvular heart disease. The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J 2007; 28 :230–68. 11. Bonow RO, Carabello BA, Chatterjee K et al. [bjcardio.co.uk]
- Hypertension
Persistent pulmonary artery hypertension (PAH) after balloon mitral valvuloplasty (BMV) is not uncommon, and is generally associated with established pulmonary vascular disease, an inadequate result, or the development of mitral regurgitation. [ncbi.nlm.nih.gov]
In mitral stenosis, pulmonary hypertension (PH) is due to three components: (1) passive, due to left atrial hypertension; (2) vasoreactive, due to pulmonary arteriolar constriction; and (3) due to structural changes in pulmonary vascular disease. 24–26 [revportcardiol.org]
Musculoskeletal
- Fracture
One patient had exploratory laparotomy, one underwent stabilization of a hip fracture and two underwent resection of an abdominal aortic aneurysm. [onlinejacc.org]
We report an extremely rare complication of fracture of BMV coiled tip guidewire, which was successfully retrieved percutaneously with a relatively simple technique. Finally the procedure was completed without any complication. [ncbi.nlm.nih.gov]
Fracture of nodular calcium deposits – leaflet mobility improved – increased valve opening – blood flow increased during LV contraction. 10. [slideshare.net]
[…] particular may be seen with greater frequency in the elderly, as the circular cross section of the Inoue balloon means that force is applied not only to the fused commissures, but also to the surrounding leaflet structures, which are more liable to fracture [heart.bmj.com]
The mechanisms of successful percutaneous balloon dilation of the aortic valve described by Serruys and colleagues in 1993 include (1) cleavage or laceration of the dense collagenous valve stroma, (2) fracture and/or fragmentation of calcifications and [openheart.bmj.com]
Psychiatrical
- Loss of Initiative
[…] of MVA and/or loss of initial gain. [cathlabdigest.com]
Neurologic
- Excitement
"The Company is developing a proprietary aortic valvuloplasty balloon for the most exciting new market in cardiac device procedures. [intervalveinc.com]
Workup
The final diagnostic workup for the underlying malignancy continued the day after valvuloplasty. © 2015 Wiley Periodicals, Inc. [ncbi.nlm.nih.gov]
Other Pathologies
- Fibrinoid Necrosis
The initial rheumatic fever results only in an edematous inflammatory process, leading to the fibrinoid necrosis of the connective tissue and cellular reactions. [ahajournals.org]
Biopsy
- Aschoff Body
bodies at surgery or autopsy. 57 Questions on whether juvenile MS is a true variant of rheumatic MS remain to be answered. [ahajournals.org]
Treatment
Commissural fusion is now recognised as the principal pathology underlying mitral stenosis, and commissural splitting underlies successful interventional treatment. [ncbi.nlm.nih.gov]
It is frequently the preferred treatment for patients with mitral stenosis and pulmonic stenosis. [sharecare.com]
Prognosis
Insights into prognosis of valvular aortic stenosis. Circulation. 1994 Feb;89(2):642-50. [clinicaltrials.gov]
While patients can survive for years with asymptomatic AS, the prognosis following symptom onset is quite poor without intervention. [intervalveinc.com]
This is not surprising because functional status is a well-known determinant of prognosis in patients with severe AS treated medically ( 18,19 ). [interventions.onlinejacc.org]
Outlook (Prognosis) People with mild disease rarely get worse. However, those with moderate to severe disease will get worse. The outcome is often very good when surgery or balloon dilation is successful. [mountsinai.org]
Etiology
The most common etiology of tricuspid stenosis is rheumatic, and in most cases it is associated with valvular regurgitation. [ncbi.nlm.nih.gov]
The main reason for the treatment of patients in the group in extremis with BAV was the presence of a clinical condition of extreme gravity, whether or not with cardiac etiology, in the presence of severe aortic stenosis. [scielo.br]
Degenerative AS is MC etiology. Chronic inflammatory process. Commissural fusion is not the predominant feature in majority of older patients with calcific AS. Fracture of nodular calcium deposits – leaflet mobility improved – increased valve [slideshare.net]
Etiology Rheumatic mitral valve disease, manifested by commissural leaflet fusion, is the most common cause of mitral stenosis. [emedicine.medscape.com]
Epidemiology
Epidemiology Frequency Rheumatic heart disease remains uncommon in the United States today. It is much more prevalent in developing nations, where patients tend to present at a younger age. [emedicine.medscape.com]
Pathophysiology
Post-operative TMA mostly occurs in adult patients with cardiovascular surgery, with the distinct pathophysiology from classical thrombotic thrombocytopenic purpura (TTP) although the exact pathophysiology remains unclear. [ncbi.nlm.nih.gov]
Pathophysiology of AS A normal aortic valve leaflet consists of 3 layers ( Figure 1 ). [ahajournals.org]
Data on outcome among these patients is scarce, but there appears to be a law of diminishing returns, particularly in patients with less favourable valve anatomy. 15 The pathophysiology of mitral restenosis does not consist solely of commissural re-fusion [heart.bmj.com]
Pathophysiology Commisural fusion of the mitral valve leaflets results in loss of the mitral orifice size. This limits blood flow across the valve from the left atrium to the left ventricle. [emedicine.medscape.com]
Prevention
The leg in which the catheter was inserted is temporarily prevented from moving. The skin condition is monitored. The insertion site, which will be covered by a sandbag, is observed for bleeding until the catheter is removed. [medical-dictionary.thefreedictionary.com]
In patients with Osler's disease, valuvloplasty using autologous pericardium is considered effective for preventing the later recurrence of IE. [ncbi.nlm.nih.gov]
These medications may include anticoagulants to prevent clot formation and radioactive dye for X-rays. Your groin area is shaved and cleaned with an antiseptic. [wexnermedical.osu.edu]