Aortic Stenosis, Subvalvular
Aortic Valve Stenosis
Aortic Stenosis, Supravalvular
Aortic Valve
Chordae Tendineae
Mitral Valve Stenosis
Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause.
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Pulmonary Subvalvular Stenosis
Narrowing below the PULMONARY VALVE or well below it in the infundibuluar chamber where the pulmonary artery originates, usually caused by a defective VENTRICULAR SEPTUM or presence of fibrous tissues. It is characterized by restricted blood outflow from the RIGHT VENTRICLE into the PULMONARY ARTERY, exertional fatigue, DYSPNEA, and chest discomfort.
Mitral Valve Insufficiency
Cardiac Catheterization
Carotid Stenosis
Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. Ulcerations may form in atherosclerotic plaques and induce THROMBUS formation. Platelet or cholesterol emboli may arise from stenotic carotid lesions and induce a TRANSIENT ISCHEMIC ATTACK; CEREBROVASCULAR ACCIDENT; or temporary blindness (AMAUROSIS FUGAX). (From Adams et al., Principles of Neurology, 6th ed, pp 822-3)
Catheterization
Echocardiography
Mitral Valve Annuloplasty
Hemodynamics
Pulmonary Valve Stenosis
Treatment Outcome
Echocardiography, Transesophageal
Echocardiography, Doppler
Cardiomyopathy, Hypertrophic
A form of CARDIAC MUSCLE disease, characterized by left and/or right ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR; HYPERTROPHY, RIGHT VENTRICULAR), frequent asymmetrical involvement of the HEART SEPTUM, and normal or reduced left ventricular volume. Risk factors include HYPERTENSION; AORTIC STENOSIS; and gene MUTATION; (FAMILIAL HYPERTROPHIC CARDIOMYOPATHY).
Aortic Valve Insufficiency
Heart Ventricles
Constriction, Pathologic
Pyloric Stenosis
Severity of Illness Index
Bioprosthesis
Prosthesis, usually heart valve, composed of biological material and whose durability depends upon the stability of the material after pretreatment, rather than regeneration by host cell ingrowth. Durability is achieved 1, mechanically by the interposition of a cloth, usually polytetrafluoroethylene, between the host and the graft, and 2, chemically by stabilization of the tissue by intermolecular linking, usually with glutaraldehyde, after removal of antigenic components, or the use of reconstituted and restructured biopolymers.
Williams Syndrome
A disorder caused by hemizygous microdeletion of about 28 genes on chromosome 7q11.23, including the ELASTIN gene. Clinical manifestations include SUPRAVALVULAR AORTIC STENOSIS; MENTAL RETARDATION; elfin facies; impaired visuospatial constructive abilities; and transient HYPERCALCEMIA in infancy. The condition affects both sexes, with onset at birth or in early infancy.
Hypertrophy, Left Ventricular
Follow-Up Studies
Stroke Volume
Ventricular Function, Left
Discrete Subaortic Stenosis
Blood Flow Velocity
Prospective Studies
Tricuspid Valve Stenosis
Angiodysplasia
Acquired degenerative dilation or expansion (ectasia) of normal BLOOD VESSELS, often associated with aging. They are isolated, tortuous, thin-walled vessels and sources of bleeding. They occur most often in mucosal capillaries of the GASTROINTESTINAL TRACT leading to GASTROINTESTINAL HEMORRHAGE and ANEMIA.
Heart Valve Diseases
Balloon Valvuloplasty
Retrospective Studies
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Phonocardiography
Graphic registration of the heart sounds picked up as vibrations and transformed by a piezoelectric crystal microphone into a varying electrical output according to the stresses imposed by the sound waves. The electrical output is amplified by a stethograph amplifier and recorded by a device incorporated into the electrocardiograph or by a multichannel recording machine.
Coronary Angiography
Predictive Value of Tests
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Renal Artery Obstruction
Ventricular Dysfunction, Left
A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall.
Stents
Heart Murmurs
Heart sounds caused by vibrations resulting from the flow of blood through the heart. Heart murmurs can be examined by HEART AUSCULTATION, and analyzed by their intensity (6 grades), duration, timing (systolic, diastolic, or continuous), location, transmission, and quality (musical, vibratory, blowing, etc).
Endocardial Fibroelastosis
A condition characterized by the thickening of ENDOCARDIUM due to proliferation of fibrous and elastic tissue, usually in the left ventricle leading to impaired cardiac function (CARDIOMYOPATHY, RESTRICTIVE). It is most commonly seen in young children and rarely in adults. It is often associated with congenital heart anomalies (HEART DEFECTS CONGENITAL;) INFECTION; or gene mutation. Defects in the tafazzin protein, encoded by TAZ gene, result in a form of autosomal dominant familial endocardial fibroelastosis.
Postoperative Complications
Angioplasty, Balloon
Risk Factors
Tomography, X-Ray Computed
Electrocardiography
Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
Carotid Artery, Internal
Endarterectomy, Carotid
Arterial Occlusive Diseases
Ultrasonography, Doppler, Duplex
Magnetic Resonance Angiography
Laryngostenosis
Models, Cardiovascular
Multidetector Computed Tomography
Prosthesis Fitting
Risk Assessment
Sensitivity and Specificity
Heart Defects, Congenital
Echocardiography, Stress
Cardiomegaly
Enlargement of the HEART, usually indicated by a cardiothoracic ratio above 0.50. Heart enlargement may involve the right, the left, or both HEART VENTRICLES or HEART ATRIA. Cardiomegaly is a nonspecific symptom seen in patients with chronic systolic heart failure (HEART FAILURE) or several forms of CARDIOMYOPATHIES.
Coronary Disease
Ventricular Remodeling
Aortic Coarctation
Prognosis
Echocardiography, Doppler, Color
Aortography
Pyloric Stenosis, Hypertrophic
Cardiac Output
Fetal Therapies
Ventricular Pressure
The pressure within a CARDIAC VENTRICLE. Ventricular pressure waveforms can be measured in the beating heart by catheterization or estimated using imaging techniques (e.g., DOPPLER ECHOCARDIOGRAPHY). The information is useful in evaluating the function of the MYOCARDIUM; CARDIAC VALVES; and PERICARDIUM, particularly with simultaneous measurement of other (e.g., aortic or atrial) pressures.
Observer Variation
The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material).
Arterial Pressure
Disease Progression
Heart Sounds
The sounds heard over the cardiac region produced by the functioning of the heart. There are four distinct sounds: the first occurs at the beginning of SYSTOLE and is heard as a "lubb" sound; the second is produced by the closing of the AORTIC VALVE and PULMONARY VALVE and is heard as a "dupp" sound; the third is produced by vibrations of the ventricular walls when suddenly distended by the rush of blood from the HEART ATRIA; and the fourth is produced by atrial contraction and ventricular filling.
Syncope
A transient loss of consciousness and postural tone caused by diminished blood flow to the brain (i.e., BRAIN ISCHEMIA). Presyncope refers to the sensation of lightheadedness and loss of strength that precedes a syncopal event or accompanies an incomplete syncope. (From Adams et al., Principles of Neurology, 6th ed, pp367-9)
Coronary Artery Disease
Kaplan-Meier Estimate
A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)
Patient Selection
Angiography, Digital Subtraction
A method of delineating blood vessels by subtracting a tissue background image from an image of tissue plus intravascular contrast material that attenuates the X-ray photons. The background image is determined from a digitized image taken a few moments before injection of the contrast material. The resulting angiogram is a high-contrast image of the vessel. This subtraction technique allows extraction of a high-intensity signal from the superimposed background information. The image is thus the result of the differential absorption of X-rays by different tissues.
Exercise Test
Reproducibility of Results
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.
Chi-Square Distribution
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Hypoplastic Left Heart Syndrome
Dobutamine
Doppler Effect
Rheumatic Heart Disease
Therapies, Investigational
Death, Sudden
Intracranial Arteriosclerosis
Vascular diseases characterized by thickening and hardening of the walls of ARTERIES inside the SKULL. There are three subtypes: (1) atherosclerosis with fatty deposits in the ARTERIAL INTIMA; (2) Monckeberg's sclerosis with calcium deposits in the media and (3) arteriolosclerosis involving the small caliber arteries. Clinical signs include HEADACHE; CONFUSION; transient blindness (AMAUROSIS FUGAX); speech impairment; and HEMIPARESIS.
Reoperation
Angioplasty
Reconstruction or repair of a blood vessel, which includes the widening of a pathological narrowing of an artery or vein by the removal of atheromatous plaque material and/or the endothelial lining as well, or by dilatation (BALLOON ANGIOPLASTY) to compress an ATHEROMA. Except for ENDARTERECTOMY, usually these procedures are performed via catheterization as minimally invasive ENDOVASCULAR PROCEDURES.
Pulse
Ochronosis
The yellowish discoloration of connective tissue due to deposition of HOMOGENTISIC ACID (a brown-black pigment). This is due to defects in the metabolism of PHENYLALANINE and TYROSINE. Ochronosis occurs in ALKAPTONURIA, but has also been associated with exposure to certain chemicals (e.g., PHENOL, trinitrophenol, BENZENE DERIVATIVES).
Myocardium
Coronary Artery Bypass
Angina Pectoris
Echocardiography, Three-Dimensional
Echocardiography amplified by the addition of depth to the conventional two-dimensional ECHOCARDIOGRAPHY visualizing only the length and width of the heart. Three-dimensional ultrasound imaging was first described in 1961 but its application to echocardiography did not take place until 1974. (Mayo Clin Proc 1993;68:221-40)
Linear Models
Feasibility Studies
Multivariate Analysis
Alkaptonuria
Cardiac Valve Annuloplasty
Stroke
A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)
Pericardium
A conical fibro-serous sac surrounding the HEART and the roots of the great vessels (AORTA; VENAE CAVAE; PULMONARY ARTERY). Pericardium consists of two sacs: the outer fibrous pericardium and the inner serous pericardium. The latter consists of an outer parietal layer facing the fibrous pericardium, and an inner visceral layer (epicardium) resting next to the heart, and a pericardial cavity between these two layers.
Iliac Artery
Single-Payer System
An approach to health care financing with only one source of money for paying health care providers. The scope may be national (the Canadian System), state-wide, or community-based. The payer may be a governmental unit or other entity such as an insurance company. The proposed advantages include administrative simplicity for patients and providers, and resulting significant savings in overhead costs. (From Slee and Slee, Health Care Reform Terms, 1993, p106)
Vertebrobasilar Insufficiency
Localized or diffuse reduction in blood flow through the vertebrobasilar arterial system, which supplies the BRAIN STEM; CEREBELLUM; OCCIPITAL LOBE; medial TEMPORAL LOBE; and THALAMUS. Characteristic clinical features include SYNCOPE; lightheadedness; visual disturbances; and VERTIGO. BRAIN STEM INFARCTIONS or other BRAIN INFARCTION may be associated.
Fractional Flow Reserve, Myocardial
Simvastatin
A derivative of LOVASTATIN and potent competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HYDROXYMETHYLGLUTARYL COA REDUCTASES), which is the rate-limiting enzyme in cholesterol biosynthesis. It may also interfere with steroid hormone production. Due to the induction of hepatic LDL RECEPTORS, it increases breakdown of LDL CHOLESTEROL.
Preoperative Care
Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)
Magnetic Resonance Imaging, Cine
A type of imaging technique used primarily in the field of cardiology. By coordinating the fast gradient-echo MRI sequence with retrospective ECG-gating, numerous short time frames evenly spaced in the cardiac cycle are produced. These images are laced together in a cinematic display so that wall motion of the ventricles, valve motion, and blood flow patterns in the heart and great vessels can be visualized.
Cardiovascular Abnormalities
Carotid Artery Diseases
Age Factors
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
Cerebral Angiography
Heart Septal Defects, Ventricular
Developmental abnormalities in any portion of the VENTRICULAR SEPTUM resulting in abnormal communications between the two lower chambers of the heart. Classification of ventricular septal defects is based on location of the communication, such as perimembranous, inlet, outlet (infundibular), central muscular, marginal muscular, or apical muscular defect.
Ventricular Outflow Obstruction
Magnetic Resonance Imaging
Vascular Resistance
Carotid Arteries
Torsion, Mechanical
Ultrasonography
Heart Failure
A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.
ROC Curve
Survival Analysis
A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.
Eunuchism
Endomyocardial Fibrosis
A condition characterized by the thickening of the ventricular ENDOCARDIUM and subendocardium (MYOCARDIUM), seen mostly in children and young adults in the TROPICAL CLIMATE. The fibrous tissue extends from the apex toward and often involves the HEART VALVES causing restrictive blood flow into the respective ventricles (CARDIOMYOPATHY, RESTRICTIVE).
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cohort Studies
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
Aortic Valve Prolapse
Dilatation, Pathologic
Survival Rate
Cardiomyopathies
A group of diseases in which the dominant feature is the involvement of the CARDIAC MUSCLE itself. Cardiomyopathies are classified according to their predominant pathophysiological features (DILATED CARDIOMYOPATHY; HYPERTROPHIC CARDIOMYOPATHY; RESTRICTIVE CARDIOMYOPATHY) or their etiological/pathological factors (CARDIOMYOPATHY, ALCOHOLIC; ENDOCARDIAL FIBROELASTOSIS).
Ultrasonography, Doppler, Color
Ultrasonography applying the Doppler effect, with the superposition of flow information as colors on a gray scale in a real-time image. This type of ultrasonography is well-suited to identifying the location of high-velocity flow (such as in a stenosis) or of mapping the extent of flow in a certain region.
Ischemic Attack, Transient
Brief reversible episodes of focal, nonconvulsive ischemic dysfunction of the brain having a duration of less than 24 hours, and usually less than one hour, caused by transient thrombotic or embolic blood vessel occlusion or stenosis. Events may be classified by arterial distribution, temporal pattern, or etiology (e.g., embolic vs. thrombotic). (From Adams et al., Principles of Neurology, 6th ed, pp814-6)
Tricuspid Valve
Arteriovenous Shunt, Surgical
Pathological features of hypertrophic obstructive cardiomyopathy (HOCM) in the elderly. (1/45)
The pathological findings and available clinical data in 15 necropsy cases of HOCM, aged over 61 years, are reported. Three patients were in the eighth decade and 4 in the ninth; 8 were women. Five presented as sudden death, 2 died in congestive cardiac failure, and 7 died of unrelated conditions and HOCM was an apparently incidental postmortem finding. Compared with cases under 60 years, the hearts of the elderly patients were heavier and less likely to show typical asymmetrical hypertrophy, the free wall of the left ventricle also being thickened in two-thirds of the cases over 60 years. Most of the elderly cases showed a distinctive band of fibrous thickening over the upper part of the interventricular septum. This lesion had a "mirror image" relation to the lower part of the aortic surface of the anterior mitral cusp, with the histological features of a friction lesion. It appears to be a morphological expression of the systolic contact of anterior mitral cusp and interventricular septum seen on cineangiography and thus diagnostic of HOCM. Once formed, the fibrous band appears to persist even if the obstructive element disappears. It is, therefore, a valuable diagnostic feature indicating a diagnosis of HOCM in an age group where the morphology is usually not the classical asymmetrical form and in which this diagnosis is usually not considered. (+info)Subaortic stenosis diagnosed in the course of a twins pregnancy: a controversial management. (2/45)
Fixed subaortic stenosis, commonly associated with other congenital cardiac defects, is the cause of 10 per cent of cases of congenital obstruction of the left ventricular outflow. Corrective surgery is frequently a successful treatment, recommendations being based on the transaortic gradient in Europe while in the USA the most prevalent opinion is surgical repair independently of the gradient. We present a case of adult clinical onset of a fixed subaortic stenosis during pregnancy, in which hemodynamic changes are significant, that was medically treated and followed in the outpatient clinic of our hospital, and review the state of the art of the management and surgical indications of this condition. (+info)Ultrastructural features of degenerated cardiac muscle cells in patients with cardiac hypertrophy. (3/45)
Degenerated cardiac muscle cells were present in hypertrophied ventricular muscle obtained at operation from 12 (38%) of 32 patients with asymmetric septal hypertrophy (hypertrophic cardiomyopathy) or aortic valvular disease. Degenerated cells demonstrated a wide variety of ultrastructural alterations. Mildly altered cells were normal-sized or hypertrophied and showed focal changes, including preferential loss of thick (myosin) filaments, streaming and clumping of Z band material, and proliferation of the tubules of sarcoplasmic reticulum. Moderately and severely degenerated cells were normal-sized or atrophic and showed additional changes, including extensive myofibrillar lysis and loss of T tubules. The appearance of the most severely degenerated cells usually reflected the cytoplasmic organelle (sarcoplasmic reticulum, glycogen, or mitochondria) which underwent proliferation and filled the myofibril-free areas of these cells. Moderately and severely degenerated cells were present in areas of fibrosis, had thickened basement membranes, and had lost their intercellular connections. These observations suggest that degenerated cardiac muscle cells have poor contractile function and may be responsible for impaired cardiac performance in some patients with chronic ventricular hypertrophy. (+info)Neurally-mediated increase in calcineurin activity regulates cardiac contractile function in absence of hypertrophy. (4/45)
OBJECTIVE: The calcineurin pathway has been involved in the development of cardiac hypertrophy, yet it remains unknown whether calcineurin activity can be regulated in myocardium independently from hypertrophy and cardiac load. METHODS: To test that hypothesis, we measured calcineurin activity in a rat model of infrarenal aortic constriction (IR), which affects neurohormonal pathways without increasing cardiac afterload. RESULTS: In this model, there was no change in arterial pressure over the 4-week experimental period, and the left ventricle/body weight ratio did not increase. At 2 weeks after IR, calcineurin activity was increased 1.8-fold (P<0.05) and remained elevated at 4 weeks (1.7-fold, P<0.05). Similarly, the cardiac activity of calcium calmodulin kinase II (CaMKII) was increased significantly after IR, which confirms a regulation of Ca(2+)-dependent enzymes in this model. In cardiac myocytes, the increased activity of calcineurin was accompanied by a significant decrease in L-type Ca(2+) channel activity (I(Ca)) and contraction velocity (-dL/dt). Cardiac denervation prevented the activation of calcineurin after IR, which demonstrates that a neurohormonal mechanism is responsible for the changes in enzymatic activity. In addition, cardiac denervation suppressed the effects of IR on I(Ca) and -dL/dt, which shows that calcineurin activation is related to altered contractility. However, action potential duration, the densities of inward rectifier K(+) currents (I(K1)), and outward K(+) currents (I(to) and I(K)) were not altered in IR myocytes. CONCLUSIONS: Calcineurin can be activated in the heart through a neural stimulus, which induces alterations in Ca(2+) currents and contractility. These effects occur in the absence of myocyte hypertrophy, electrophysiological changes in action potential, and K(+) channel currents. (+info)Rheologic genesis of discrete subvalvular aortic stenosis: a Doppler echocardiographic study. (5/45)
To determine whether morphologic structures or abnormal flow patterns predispose to pathologic proliferation of subvalvular tissue, 26 patients (mean age 19.8 +/- 10.3 years) were studied greater than or equal to 6 months after operation for isolated discrete subvalvular aortic stenosis. The aortic root diameter and the mitral-aortic separation were measured with sector echocardiography. Flow patterns in the left ventricular outflow tract of these patients and control subjects were evaluated with a color flow mapping system optimized for the detection of turbulence. All control subjects had laminar flow throughout systole in the left ventricular outflow tract. By contrast, turbulence originating well below the site where the shelf had previously been resected was observed in 20 (77%) of the 26 patients. In 16 of these 20 patients turbulence was caused by a ridge, which in 13 patients could be identified as the offshoot of a ventricular band. In four patients the turbulence was caused by malalignment of the muscular and membranous septum, resulting in protrusion of the muscular septum into the outflow tract. Except for the latter four patients, the aortic root diameter was 84 +/- 10% of values predicted by body surface area, with values in six patients falling below the third percentile (p less than 0.01). The mitral-aortic separation was 9.7 +/- 3.5 mm, values in 21 patients falling above the 97th percentile (p less than 0.001). These data support the theory that discrete subvalvular aortic stenosis may be caused by a chronic flow disturbance, preferably in a small and long outflow tract. Left ventricular bands, if reaching the outflow tract, may be a factor.(ABSTRACT TRUNCATED AT 250 WORDS) (+info)Echocardiographic assessment of subvalvular aortic stenosis before and after operation. (6/45)
The development of two-dimensional and Doppler echocardiography has provided a noninvasive technique for the diagnosis and serial assessment of patients with subvalvular aortic stenosis. The clinical records and echocardiographic data were reviewed of all patients with subaortic stenosis diagnosed between 1983 and 1991. Of the 77 patients identified (45 male and 32 female), 28 had isolated subaortic stenosis and 49 had associated cardiac lesions. The most frequently encountered associated lesions were ventricular septal defect (n = 19) and coarctation of the aorta/interrupted aortic arch (n = 14). Serial echocardiographic studies, performed in 38 of the 77 patients, documented significant progression of the left ventricular outflow tract gradient in 25 patients (66%) and development of aortic regurgitation in 25 patients (66%). Surgical resection was performed in 36 patients. The preoperative outflow tract peak gradient was 62.9 +/- 31 mm Hg (range 0 to 153), whereas the immediate postoperative gradient was 14.4 +/- 14 mm Hg (range 0 to 67). The two patients with a significant residual gradient (37 and 67 mm Hg, respectively) in the immediate postoperative period had severe subaortic stenosis preoperatively with marked left ventricular hypertrophy and intracavitary gradient. The immediate postoperative echocardiograms demonstrated no worsening of aortic regurgitation in any patient and regression of regurgitation in one patient from mild to none. Intermediate-term follow-up studies were available for review in 13 postoperative patients at a mean of 4 years postoperatively. In 2(15%) of these 13 patients, subaortic stenosis recurred; however, the degree of aortic regurgitation did not increase in any patient.(ABSTRACT TRUNCATED AT 250 WORDS) (+info)Left subclavian artery to descending aorta bypass for coarctation physiology after descending aortic repair. (7/45)
Stenosis of the aorta observed after descending aorta replacement for traumatic aortic injury was managed by a placement of a bypass between the left subclavian artery and the distal descending aorta with success. (+info)Subaortic stenosis caused by an unusual fibrous blood-filled cyst of the left ventricle with outflow tract obstruction associated with a ventricular septal defect. (8/45)
A large blood-filled cyst formed from a fibrous tissue tag of a right ventricular septal aneurysm was successfully resected. This cyst, which was causing subaortic stenosis, was attached to the margin of the closed ventricular septal defect and not to the mitral valve itself nor the papillary muscle of the left ventricle. (+info)
Fate of patients with fixed subaortic stenosis after surgical removal. | Heart
Supravalvar AS vs valvar and subvalvular AS
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Subaortic Stenosis Diagnosed in the Course of a Twins Pregnancy: C
Subaortic Stenosis Diagnosed in the Course of a Twins Pregnancy: C
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Subaortic Stenosis
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A to Z: Aortic Stenosis
Home - Aortic Stenosis Treatments
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List of dog diseases
The major clinical sign is fainting (syncope). Heart defects Subvalvular aortic stenosis (Subaortic stenosis; SAS) is a ... Pulmonic stenosis* is a congenital heart disease in dogs characterized by right ventricular outflow tract obstruction. Most ... Cauda equina syndrome*, also known as degenerative lumbosacral stenosis, in dogs is a compression of the cauda equina by a ... Tetralogy of Fallot* is a congenital heart defect in dogs that includes four separate defects: pulmonic stenosis, a ventricular ...
Newfoundland dog
Another genetic problem is subvalvular aortic stenosis (SAS). This is a common heart defect in Newfoundlands involving ...
Valsalva maneuver
At the same time, the Valsalva maneuver (phase II) decreases the intensity of most other murmurs, including aortic stenosis and ... namely those of dynamic subvalvular left ventricular outflow obstruction. ... due to decreased left atrial return and increased aortic volume, respectively. Venous blood can once more enter the chest and ...
Golden Retriever
They may suffer from heart disease, especially subvalvular aortic stenosis, and cardiomyopathy and joint diseases, including ...
SAS
... the space between the arachnoid mater and pia mater in the brain Subvalvular aortic stenosis (non-human), an abnormal, ...
List of diseases (S)
... syndrome Subcortical laminar heterotopia Subependymal nodular heterotopia Subpulmonary stenosis Subvalvular aortic stenosis ... Subacute cerebellar degeneration Subacute sclerosing leucoencephalitis Subacute sclerosing panencephalitis Subaortic stenosis ...
Aortic valve area calculation
The measurement using echocardiogram may be inaccurate in cases of Aortic subvalvular stenosis, because there is not a uniform ... Aortic valve area calculation is an indirect method of determining the area of the aortic valve (aortic valve area). The ... "Survival in elderly patients with severe aortic stenosis is dramatically improved by aortic valve replacement: results from a ... A valve area of less than 1.0 cm2 is considered to be severe aortic stenosis. There are many ways to calculate the valve area ...
Subvalvular aortic stenosis (canine)
Canine subvalvular aortic stenosis (SAS) is an abnormal, congenital heart murmur caused by subaortic stenosis (SAS). There is a ... "Subaortic Stenosis in Dogs & Cats , CVCA". Chesapeake Veterinary Cardiology Associates. Retrieved 2019-12-22. "Aortic Stenosis ... Prognosis of canines with aortic stenosis depends on the severity of the disease. Mild stenosis usually does not affect ... Aortic stenosis is often initially detected upon hearing a heart murmur during a routine physical examination by a veterinarian ...
Systolic heart murmur
Subvalvular aortic stenosis is usually due to hypertrophic cardiomyopathy (HCM), with murmur loudest over the left sternal ... Aortic outflow obstruction (Aortic stenosis) Can be due to aortic valve stenosis or hypertrophic cardiomyopathy (HCM), with a ... The second most common cause is congenital bicuspid aortic valves (normal valve is tricuspid). In aortic stenosis, heaving ... Supravalvular aortic stenosis is loudest at a point slightly higher than in that of valvular AS and may radiate more to the ...
List of MeSH codes (C14)
... aortic stenosis, subvalvular MeSH C14.280.484.150.070.160 - cardiomyopathy, hypertrophic MeSH C14.280.484.150.070.210 - ... aortic valve insufficiency MeSH C14.280.484.150 - aortic valve stenosis MeSH C14.280.484.150.060 - aortic stenosis, ... pulmonary valve stenosis MeSH C14.280.484.716.525 - leopard syndrome MeSH C14.280.484.716.700 - pulmonary subvalvular stenosis ... aortic aneurysm, thoracic MeSH C14.907.109.139.175 - aortic rupture MeSH C14.907.109.239 - aortic arch syndromes MeSH C14.907. ...
Mitral valve stenosis
Severe mitral regurgitation usually results from a tear in one of the valve leaflets or the subvalvular apparatus. It can lead ... This happens in ventricular diastole (after closure of the aortic valve), when the pressure in the ventricle precipitously ... Mitral stenosis typically progresses slowly (over decades) from the initial signs of mitral stenosis to NYHA functional class ... Any decrease in area below 2 cm2 causes mitral stenosis. Early diagnosis of mitral stenosis in pregnancy is very important as ...
Hypertrophic cardiomyopathy
This sign can be used to differentiate HCM from aortic stenosis. In individuals with aortic stenosis, after a premature ... surgical correction of hypertrophic obstructive cardiomyopathy with extended myectomy and reconstruction of the subvalvular ... and the aortic valve is open. In individuals with aortic stenosis or with HCM with an outflow tract gradient, there will be a ... Because of the fixed obstruction that the stenotic aortic valve represents, the post-PVC ascending aortic pressure will ...
Heart valve
... tricuspid valve stenosis, pulmonary valve stenosis and aortic valve stenosis. Stenosis of the mitral valve is a common ... The function of the subvalvular apparatus is to keep the valves from prolapsing into the atria when they close. The subvalvular ... For example, valvular disease of the aortic valve, such as aortic stenosis or aortic regurgitation, may cause breathlessness, ... This condition is often undiagnosed until calcific aortic stenosis has developed, and this usually happens around ten years ...
Newfoundland dog
Another genetic problem is subvalvular aortic stenosis (SAS). This is a common heart defect in Newfoundlands involving ...
Valsalva maneuver
At the same time, the Valsalva maneuver (phase II) decreases the intensity of most other murmurs, including aortic stenosis and ... namely those of dynamic subvalvular left ventricular outflow obstruction. ... due to decreased left atrial return and increased aortic volume, respectively. Venous blood can once more enter the chest and ...
Subvalvular aortic stenosis (canine) - Wikipedia
Canine subvalvular aortic stenosis (SAS) is an abnormal, congenital heart murmur caused by subaortic stenosis (SAS). There is a ... "Subaortic Stenosis in Dogs & Cats , CVCA". Chesapeake Veterinary Cardiology Associates. Retrieved 2019-12-22. "Aortic Stenosis ... Prognosis of canines with aortic stenosis depends on the severity of the disease. Mild stenosis usually does not affect ... Aortic stenosis is often initially detected upon hearing a heart murmur during a routine physical examination by a veterinarian ...
Heart Disease: Subvalvular Aortic Stenosis (SAS)
You are here: Home / About the Breed / Health & Research / Heart Disease: Subvalvular Aortic Stenosis (SAS) ... Heart Disease: Subvalvular Aortic Stenosis (SAS) *New OFA-ACVIM Advanced Cardiac Database (ACA) ... Subvalvular aortic stenosis (SAS), the most common congenital heart disease in Golden Retrievers, Newfoundlands and Rottweilers ...
'Acquired' discrete subvalvular aortic stenosis: natural history and...
Most reported cases have had a measurable left ventricular-aortic gradient that progressed in severity. This report describes ... 35 patients in whom no significant left ventricular-aortic obstruction was noted at initial cardiac catheterizat … ... Discrete subvalvular aortic stenosis is a progressive lesion. ... Discrete subvalvular aortic stenosis is a progressive lesion. ... "Acquired" discrete subvalvular aortic stenosis: natural history and hemodynamics J Am Coll Cardiol. 1989 Nov 15;14(6):1539-44. ...
Subvalvular Aortic Stenosis (SAS) in Rottweilers Research | Purina® Pro Club®
Subvalvular Aortic Stenosis (SAS) in Rottweilers research aims to identify the gene mutation. SAS is a cardiac heart disease in ... Subvalvular aortic stenosis is the formation of an abnormal ring or ridge of tissue (stenosis) below the aortic valve in the ... Breeders and owners of normal and affected Rottweilers may take part in the subvalvular aortic stenosis research underway at ... SilverHill Rottweiler breeder Cathy Rubens is no stranger to subvalvular aortic stenosis (SAS), one of the most common ...
Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children |...
Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children ... Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children ... Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children ...
Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children |...
Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children ... Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children ... By multivariable analysis, prior aortic stenosis (AS) intervention (HR 22.4, p,0.001) was strongly associated with AoV repair ... Aortic valve (AoV) repair or replacement for predominant AR occurred in 31 patients (20%) during or after DSS resection. ...
Subvalvular aortic stenosis | Genetic and Rare Diseases Information Center (GARD) - an NCATS Program
... resources and questions answered by our Genetic and Rare Diseases Information Specialists for Subvalvular aortic stenosis ... PubMed is a searchable database of medical literature and lists journal articles that discuss Subvalvular aortic stenosis. ... discrete fibromuscular subaortic stenosis (fibromuscular tissue encircling the LVOT) and tunnel subaortic stenosis ( ... Fixed subaortic stenosis (FSS) is a rare heart malformation characterized by the obstruction by membranous or fibromuscular ...
Subvalvular Aortic Stenosis: Fibromuscular Type with Severe Left Ventricular Outflow Tract Obstruction | Springer for Research ...
Subvalvular Aortic Stenosis: Fibromuscular Type with Severe Left Ventricular Outflow Tract Obstruction. ... Sadeghian H., Savand-Roomi Z. (2015) Subvalvular Aortic Stenosis: Fibromuscular Type with Severe Left Ventricular Outflow Tract ... Schneider DJ, Moore J. Aortic stenosis. In: Allen HA, Driscoll D, Shaddy RE, Feltes TF, editors. Moss and Adams heart disease ... Aortic stenosis. In: Moller JH, Hoffman JIE, editors. Pediatric cardiovascular medicine. 1st ed. Philadelphia: Churchill ...
Subvalvular Aortic Stenosis I Ohio State Medical Center
Learn more about treatment for subaortic stenosis here at Ohio State. ... Subvalvular aortic stenosis is a heart defect of the left ventricle. ... Subvalvular Aortic Stenosis. Subvalvular aortic stenosis is a congenital heart defect that limits blood flow out of the heart. ... Symptoms of subvalvular aortic stenosis. Children who have subvalvular aortic stenosis may not have symptoms, but the condition ...
Discrete subvalvular aortic stenosis in adults. | IMSEAR
Full text: Available Index: IMSEAR (South-East Asia) Main subject: Aorta / Aortic Stenosis, Subvalvular / Recurrence / Female ... Full text: Available Index: IMSEAR (South-East Asia) Main subject: Aorta / Aortic Stenosis, Subvalvular / Recurrence / Female ... Discrete subvalvular aortic stenosis is a relatively rare condition in adults. It is often diagnosed during first decade of ... Isolated form of discrete subvalvular aortic stenosis may however silently progress from innocent murmurs of childhood and ...
Rheologic genesis of discrete subvalvular aortic stenosis: a Doppler echocardiographic study
... were studied greater than or equal to 6 months after operation for isolated discrete subvalvular aortic stenosis. The aortic … ... To determine whether morphologic structures or abnormal flow patterns predispose to pathologic proliferation of subvalvular ... were studied greater than or equal to 6 months after operation for isolated discrete subvalvular aortic stenosis. The aortic ... Rheologic genesis of discrete subvalvular aortic stenosis: a Doppler echocardiographic study J Am Coll Cardiol. 1992 Mar 15;19( ...
Causes Of Sudden Death In Dogs - Go Pets America
Subvalvular Aortic Stenosis. Subvalvular aortic stenosis is one of the most common congenital heart defects in dogs and is an ... A Single Codon Insertion In PICALM Is Associated With Development Of Familial Subvalvular Aortic Stenosis In Newfoundland Dogs ... 2. Subvalvular Aortic Stenosis. 3. Arrhythmogenic Right Ventricular Cardiomyopathy. 4. Bacterial Endocarditis. 5. Myocarditis. ... subaortic stenosis, myocarditis, and others. A major cause is cardiac ion channel dysfunction (channelopathy). Abnormally ...
Internet Scientific Publications
Discrete Subvalvular Aortic Stenosis With Recurrent Patent Ductus Arteriosus. A Gürbüz, L Y?l?k, U Yetkin, ? Yürekli, Z Apal?, ... Discrete subvalvular aortic stenosis in childhood. Study of 51 patients. Am J Cardiol 1976;38(1):53-61.. 10. Penkoske PA, ... 5. Tokel K, Ozme S, Cil E, Ozkutlu S, Celiker A, Saraçlar M, Bilgiç A, Ozer S. "Acquired" subvalvular aortic stenosis after ... 8. Tokel K, Ozme S, Cil E, Ozkutlu S, Celiker A, Saraçlar M, Bilgiç A, Ozer S. "Acquired" subvalvular aortic stenosis after ...
AKC Canine Health Foundation
Subvalvular aortic stenosis (SAS) is one of the most common diagnosed heart defects in dogs and the Rottweiler breed has a high ... Subvalvular aortic stenosis (SAS) is one of the most common diagnosed heart defects in dogs and the Rottweiler breed has a high ... Home > Research > Participate in Research > Identification of Genetic Markers for Subvalvular Aortic Stenosis in Rottweilers ... Identification of Genetic Markers for Subvalvular Aortic Stenosis in Rottweilers 08/16/2018 ...
The CHIP-Family study to improve the psychosocial wellbeing of young children with congenital heart disease and their families:...
AKC Canine Health Foundation
... is a heart defect characterized by a fibrous ridge located below the aortic valve. Affected dogs are at risk of developing ... Subvalvular Aortic Stenosis (SAS) is a heart defect characterized by a fibrous ridge located below the aortic valve. Affected ... Home > Research > Research Portfolio > Genetic Markers for Familial Subvalvular Aortic Stenosis in Newfoundlands ... 02388-MOU: Genetic Markers for Familial Subvalvular Aortic Stenosis in Newfoundlands. Grant Status: Open ...
Case Based Pediatrics Chapter
... mitral stenosis and regurgitation (MS and MR), aortic stenosis and regurgitation (AS and AR), atrioventricular (AV) canal ... Pulmonic Stenosis PS is a right ventricular outflow tract obstruction presenting as 1) valvular; 2) subvalvular; or 3) ... Aortic Stenosis AS is the obstruction of the left ventricle outflow tract. AS accounts for 7% of CHD and is described by ... A large PDA results in pulmonary overcirculation and low aortic diastolic pressure, leading to extensive aortic runoff and ...
HCMR - Novel Markers of Prognosis in Hypertrophic Cardiomyopathy - Full Text View - ClinicalTrials.gov
Family Studies of Inherited Heart Disease - Full Text View - ClinicalTrials.gov
Pediatric Aortic Valve Insufficiency: Background, Pathophysiology, Epidemiology
Aortic valve insufficiency results from leakage and backflow of blood that is ejected from the left ventricle (LV) into the ... Management of aortic stenosis: is cardiac catheterization necessary?. Am J Cardiol. 1991 May 1. 67(11):1031-2. [Medline]. ... Anatomy of the aortic valve. The aortic valve is composed of 3 thin leaflets (ie, cusps) that project from the wall of the ... Aortic valve-sparing operations in patients with aneurysms of the aortic root or ascending aorta. Ann Thorac Surg. 2002 Nov. 74 ...
A Long-Term Safety Extension Study of Mavacamten in Adults Who Have Completed MAVERICK-HCM or EXPLORER-HCM - Full Text View -...
3v Caps Liquid Pump | PetCareRx
Echocardiographic Atlas of Adult Congenital Heart Disease | Hakimeh Sadeghian | Springer
Subvalvular Aortic Stenosis (Membranous Type with Circular Web) with Severe Left Ventricular Outflow Tract and Moderate Aortic ... Recurrence of Subvalvular Aortic Stenosis After Surgery with Mild Left Ventricular Outflow Tract Obstruction and Moderate ... Recurrence of Subvalvular Aortic Stenosis After Surgery with Severe Left Ventricular Outflow Tract Obstruction and Severe ... Subvalvular Aortic Stenosis (Membranous Type Without Attachment to Anterior Mitral Leaflet) with Severe Left Ventricular ...
Golden Retriever Dog Breed Information
Boxer - All About Dogs
Cardiology Flashcards by Eugenia Lee | Brainscape
Pulmonary stenosis. >> Aortic stenosis. Cyanotic. - R>>L Shunts. >> Tetralogy of Fallot. >> Ebsteins anomaly. - Others. >> ... Subvalvular. - Supravalvular. - Idiopathic hypertrophic subalrtic stenosis (IHSS) = HOCM 36 What is the management of aortic ... Narrow mitral/aortic valves. - Small ascending aorta. - Contracted aorta. >> Culminates to systemic hypoperfusion. >> DUCTAL- ... Critical pulmonary stenosis. - Pulmonary atresia. - Tricuspid atresia. - Tetralogy of Fallot. - Transposition of great vessels ...
Hypertrophic cardiomyopathy - Symptoms and causes - Mayo Clinic
Hypertrophic cardiomyopathy - Symptoms and causes - Mayo Clinic
Acute Hemodynamic Effects of Sildenafil in Patients With Severe Aortic Stenosis
... clinicaltrials.gov Pulmonary hypertension is common in patients with aortic stenosis and is associated with worse operative and ... Aortic Valve Stenosis. A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis ... Aortic Stenosis, Subvalvular. A pathological constriction occurring in the region below the AORTIC VALVE. It is characterized ... Aortic stenosis is a major cause of morbidity around the world. Progressive aortic stenosis leads to cardiac hypertrophy as a ...
List of dog diseases - Wikipedia
The major clinical sign is fainting (syncope). Heart defects Subvalvular aortic stenosis (Subaortic stenosis; SAS) is a ... Pulmonic stenosis* is a congenital heart disease in dogs characterized by right ventricular outflow tract obstruction. Most ... Cauda equina syndrome*, also known as degenerative lumbosacral stenosis, in dogs is a compression of the cauda equina by a ... Tetralogy of Fallot* is a congenital heart defect in dogs that includes four separate defects: pulmonic stenosis, a ventricular ...
RegurgitationAortaSupravalvular stenosisNarrowed aortic valveBelow the aortic valveObstructionBicuspidAneurysmCongenital heart dOutflowPatent ductus artEndocarditisHypertrophyInsufficiencyPatients with severe aortic stenosisTricuspidSeverePulmonic stenosisSeverityEchocardiographyCardiacProximity to the aortic valveCardiomyopathyResectionGeneticLeft ventricularValvular diseaseSubaortic membraneSurgical aortic valve replaDiscrete subaorticMurmurCalcificationMembraneSupravalvarCommon congenitalPresented for aortic valve replaDopplerVentricular septalDevelopment of aorticQuadricuspid aortic valveGradientHeartInterventionWhose aorticPrognosticEjection
Regurgitation16
- Objectives To characterise long-term outcomes after discrete subaortic stenosis (DSS) resection and to identify risk factors for reoperation and aortic regurgitation (AR) requiring repair or replacement. (bmj.com)
- Moreover, images compatible with mild aortic regurgitation and a recurrent PDA showing a shunting via Color Doppler (Figure 1). (ispub.com)
- Aortography showed severe aortic stenosis and aortic regurgitation as well as high output recurrent PDA (Figure 2). (ispub.com)
- Pulmonary arteriotomy and aortotomy incisions were closed and cardiopulmonary bypass was ended without facing a problem perioperative transesophageal echocardiography revealed mild aortic regurgitation and operation was finished successfully (Figure 6). (ispub.com)
- In fact, more than half of patients who present with pure aortic regurgitation (AR) without any associated cardiac anomalies have aortic valve insufficiency caused by aortic root disease. (medscape.com)
- Aortic regurgitation. (medscape.com)
- In long-standing aortic regurgitation, this compensatory mechanism begins to deteriorate. (medscape.com)
- When LV function cannot continue to compensate for volume overload, the LV dilates, and LV end-diastolic volume increases, even without further increase in aortic regurgitation volume. (medscape.com)
- Even for patients who are treated with the valvotomy only, an aortic valve replacement is ultimately often necessary because of calcification or valve regurgitation. (pted.org)
- Description of the problem What every clinician needs to know Aortic regurgitation (AR), also known as aortic insufficiency (AI), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during diastole, from the aorta into the left ventricle. (oncologynurseadvisor.com)
- Quadricuspid aortic valve: a rare cause of aortic regurgitation and stenosis. (biomedsearch.com)
- Transthoracic echocardiography revealed dilation of the left ventricle, valvular and subvalvular aortic stenosis, bicuspid aortic valve, aortic regurgitation, and mitral valve prolapse. (biomedsearch.com)
- The results of cardiac catheterization and aortography showed severe aortic regurgitation, an aortic valve gradient of 76 mmHg, a bicuspid aortic valve, a subaortic membrane, and an ascending aortic aneurysm. (biomedsearch.com)
- The patient was diagnosed as having a quadricuspid aortic valve associated with aortic regurgitation, severe aortic stenosis, and an ascending aortic aneurysm. (biomedsearch.com)
- Supravalvar aortic stenosis is unlikely to be associated with aortic regurgitation, while it can occur in valvular and subvalvular variety. (cardiophile.org)
- In fact aortic regurgitation may be seen in almost half of those with subvalvular membranous aortic stenosis. (cardiophile.org)
Aorta28
- The blood is pumped at a higher speed and pressure across the stenosis into the aorta, creating a heart murmur. (wikipedia.org)
- Associated lesions included ventricular septal defect in 7, patent ductus arteriosus in 12, coarctation of the aorta in 8, pulmonary stenosis in 3, atrioventricular canal in 2 and miscellaneous lesions in 3 cases. (nih.gov)
- Normally, blood passes through the aortic valve en route to the aorta. (osu.edu)
- An echocardiogram is performed the following day and demonstrates a coarctation of the aorta and bicuspid aortic valve. (hawaii.edu)
- A MRI shows a discrete narrowing of the distal aortic arch just beyond the origin of the left subclavian artery and also reveals an aberrant right subclavian artery originating from the proximal descending aorta below the coarctation. (hawaii.edu)
- Aortic valve insufficiency results from leakage and backflow of blood that is ejected from the left ventricle (LV) into the ascending aorta back into the left ventricle. (medscape.com)
- The aortic valve is composed of 3 thin leaflets (ie, cusps) that project from the wall of the proximal ascending aorta. (medscape.com)
- In the embryonic stage, the truncus arteriosus connects to the dorsal aspect of the aorta via 6 pairs of aortic arches. (medscape.com)
- Regardless of etiology, aortic valve insufficiency results in volume overload on the LV because the LV is forced to pump the entire diastolic volume received from the left atrium and the regurgitant volume from the aorta through an incompetent aortic valve. (medscape.com)
- Diminutive Porcelain Ascending Aorta with Supravalvular Aortic Stenosis. (bioportfolio.com)
- Aortic stenosis is a condition of the heart in which there is a narrowing of the one of the valves of the heart that controls the flow of blood from the left ventricle of the heart to the aorta, a large artery that takes blood to the rest of the body. (ufaw.org.uk)
- aortic hiatus ( hiatus aor´ticus ) the opening in the diaphragm through which the aorta and thoracic duct pass. (thefreedictionary.com)
- small neurovascular structures on either side of the aorta in the region of the aortic arch. (thefreedictionary.com)
- It can result from some defect or malformation of a heart valve (valvular aortic stenosis), by an obstruction in that part of the aorta known as the ascending aorta (supravalvular aortic stenosis), or by an obstruction in the outflow path of blood leaving the left ventricle through the descending aorta (subvalvular aortic stenosis). (petwave.com)
- aortic septal defect a congenital anomaly in which there is abnormal communication between the ascending aorta and the pulmonary artery just above the semilunar valves. (thefreedictionary.com)
- At the junction of the aorta and the left ventricle is the aortic semilunar valve, which contains three cusps. (thefreedictionary.com)
- Some patients with a bicuspid aortic valve may also develop dilation (enlargement) of the aorta. (pted.org)
- In Discrete Subvalvar Aortic Stenosis (DSVAS), a fibrous ridge obstructs the outflow tract from the left ventricle into the aorta. (pted.org)
- In this form of aortic stenosis, an hour glass-like narrowing or, less frequently, a more irregular narrowing, exist in the aorta above the aortic valve. (pted.org)
- Surgical repair involves removing the obstructing portion and the remaining parts of the aorta are sutured together (see animation at right) or as an alternative for long stenosis, the aorta is patch enlarged. (pted.org)
- Aortic stenosis may be due to the malformation of the aorta or a defect in the left ventricle. (pugvillage.com)
- There are also rare cases when stenosis or narrowing of the aorta is attributed to a defect in the valve which is located between the aorta and the left ventricle. (pugvillage.com)
- The clinical manifestations of Aortic Stenosis highly depend on the degree of the narrowing of the aorta. (pugvillage.com)
- After advancement through the femoral artery and aorta, the prosthetic valve is radially expanded for implantation in the dilated aortic valve. (google.es)
- Aortic stenosis (AS) is narrowing of the aortic valve, obstructing blood flow from the left ventricle to the ascending aorta during systole. (merckmanuals.com)
- Cine SSFP in an oblique sagittal plane parallel to the left ventricular outflow tract and proximal aorta demonstrating a defect in the aortic wall (tunnel) with flow from the ascending aorta to the left ventricle, adjacent to the aortic valve. (springer.com)
- Valvular and subvalvular aortic stenosis is a systolic murmur with maximal intensity over the subaortic or aortic valve area and radiating into the ascending aorta. (b-naturals.com)
- SAS shows up in the dog's heart as abnormal tissue growth -- often forming a ridge or ring below the aortic valve, which restricts blood flow from the heart into the aorta. (moderndogmagazine.com)
Supravalvular stenosis2
- A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. (bioportfolio.com)
- These include hypertrophic cardiomyopathy (HOCM) and fixed supravalvular stenosis and fixed subvalvular stenosis. (clinicaladvisor.com)
Narrowed aortic valve1
- For infants, the most common treatment of valvar aortic stenosis is a balloon valvuloplasty, in which the narrowed aortic valve is relieved by the inflation of a balloon. (pted.org)
Below the aortic valve5
- It is a common congenital heart defect that consists of abnormal tissue located just below the aortic valve that creates an obstruction the heart has to overcome to pump blood out to the body. (wikipedia.org)
- In subvalvular aortic stenosis, a narrowed area below the aortic valve limits blood flow, increasing the workload for the left ventricle. (osu.edu)
- Subvalvular Aortic Stenosis (SAS) is a heart defect characterized by a fibrous ridge located below the aortic valve. (akcchf.org)
- The location of this membrane can range from just below the aortic valve where it sometimes fuses with the leaflets, to lower within the LVOT where it can become attached to the anterior mitral valve leaflet (Figure 1 ) ( 12 ). (frontiersin.org)
- SAS is rare in human children, but when it is diagnosed, surgical removal of the ridge or ring below the aortic valve is one option for improving the child's health. (moderndogmagazine.com)
Obstruction11
- This report describes 35 patients in whom no significant left ventricular-aortic obstruction was noted at initial cardiac catheterization, but who later were shown to have significant subvalvular aortic stenosis. (nih.gov)
- Sadeghian H., Savand-Roomi Z. (2015) Subvalvular Aortic Stenosis: Fibromuscular Type with Severe Left Ventricular Outflow Tract Obstruction. (springer.com)
- Subvalvular aortic stenosis (AS) is a rare congenital heart defect in which the left ventricle is narrowed below the level of the aortic valve resulting in obstruction to blood flow out of the heart. (osu.edu)
- Isolated form of discrete subvalvular aortic stenosis may however silently progress from innocent murmurs of childhood and adolescence to symptomatic left ventricular outflow tract obstruction in adults . (bvsalud.org)
- Valvar aortic stenosis is a spectrum, with significant valve obstruction treated in infancy or childhood. (pted.org)
- Often, the subvalvular ridge may remain relatively small with only mild obstruction. (pted.org)
- Aortic sclerosis is a degenerative aortic valve disease with thickening of aortic valve structures by fibrosis and calcification initially without causing significant obstruction. (merckmanuals.com)
- 11,12 Brock's findings supported the notion that left ventricular outflow tract obstruction could arise as a consequence of ventricular hypertrophy, and underscored the importance of distinguishing between aortic stenosis and obstruction at the subvalvular level. (revespcardiol.org)
- Subvalvular aortic stenosis, which may have a dynamic component, may be due to a fibrous membrane, muscular obstruction, or a combination of the 2 (1,2) . (onlinejacc.org)
- Fifty-three percent of dogs in this study had evidence of LVOTO, with obstruction consisting of a complex of lesions including dynamic or fixed subvalvular LVOTO, significantly narrowed left ventricular outflow tract or valvular aortic stenosis. (biomedsearch.com)
- It may be noted that discrete subvalvular membranous aortic stenosis is different from dynamic subaortic obstruction seen in hypertrophic obstructive cardiomyopathy. (cardiophile.org)
Bicuspid8
- Comparative study of bicuspid vs. tricuspid aortic valve stenosis. (bioportfolio.com)
- To examine differences and similarities in bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) stenosis occurring during the same age and whether any differences impact outcomes following aor. (bioportfolio.com)
- To observe the clinical outcomes of the different valve sizing strategies treating type-0 Bicuspid Aortic Stenosis (BAS) with self-expandable transcatheter aortic valve implantation (TAVI). (bioportfolio.com)
- The other end of the spectrum is mild stenosis or commonly just a bicuspid aortic valve. (pted.org)
- Similarly, a bicuspid valve which may remain non-stenotic for decades, only to calcify and develop severe stenosis in the 6th to 7th decade of life. (pted.org)
- The two major risk factors for developing AS are age and bicuspid aortic valve. (clinicaladvisor.com)
- About 2% of the U.S. population is born with a bicuspid (instead of a tricuspid) aortic valve, of whom about one third will develop clinically significant AS. (clinicaladvisor.com)
- Cardiac septal defects are the most common form of congenital heart disease if bicuspid aortic valve is excluded. (springer.com)
Aneurysm1
- May be congenital affecting the aortic trunk and the arch sometimes associated with aneurysm of an aortic sinus. (thefreedictionary.com)
Congenital heart d4
- Subvalvular aortic stenosis (SAS), the most common congenital heart disease in Golden Retrievers, Newfoundlands and Rottweilers, is a troublesome disease. (grca.org)
- Aortic valve insufficiency can be due to, or associated with, congenital heart disease. (medscape.com)
- Discrete subaortic stenosis (DSS) is a congenital heart disease that results in the formation of a fibro-membranous tissue, causing an increased pressure gradient in the left ventricular outflow tract (LVOT). (frontiersin.org)
- Discrete subaortic stenosis (DSS) is a congenital heart disease characterized by the formation of a fibrous membrane obstructing the left ventricular outflow tract (LVOT). (frontiersin.org)
Outflow3
- These data support the theory that discrete subvalvular aortic stenosis may be caused by a chronic flow disturbance, preferably in a small and long outflow tract. (nih.gov)
- Congenital abnormalities of left ventricular inflow and outflow include abnormalities of the left atrium, mitral valve (supravalvar, valvar, and subvalvar), and abnormalities of the left ventricular outflow tract, the aortic valve, and supravalvar area. (springer.com)
- In the year preceding publication of Teare's account, Dr Paul Wood of the National Heart Hospital described in a letter a condition he called functional muscular subvalvar aortic stenosis due to gross hypertrophy of the outflow tract. (revespcardiol.org)
Patent ductus art3
- A combined pathology of patent ductus arteriosus and discrete subvalvular aortic stenosis was found recently. (ispub.com)
- Because of the unexpected finding of discrete membranous subaortic stenosis in the infants and young children who had undergone surgery for a large patent ductus arteriosus and because of the treacherous worsening of the effects of the discrete membranous subaortic stenosis as childhood progressed, it is important that those patients with a persistent systolic murmur after ductal ligation not be discharged from cardiac follow-up as cured. (ispub.com)
- Murmurs on the left side of the heart are most often caused by myxomatous mitral valve disease (MMVD), stenoses of aortic or pulmonary valves, or patent ductus arteriosus (PDA). (mercola.com)
Endocarditis3
- however, the possibility of aortic endocarditis exists. (wikipedia.org)
- Causes of acquired aortic valve insufficiency include endocarditis, trauma, systemic diseases, and connective tissue syndromes. (medscape.com)
- Quadricuspid Aortic Valve is related to aortic valve insufficiency and endocarditis . (malacards.org)
Hypertrophy3
- Compare this with the concentric hypertrophy observed in aortic stenosis. (medscape.com)
- Progressive aortic stenosis leads to cardiac hypertrophy as a compensatory response. (bioportfolio.com)
- The increased pressure load imposed by aortic stenosis results in compensatory hypertrophy of the left ventricle (LV) without cavity enlargement (concentric hypertrophy). (merckmanuals.com)
Insufficiency6
- Many mechanisms contribute to aortic valve insufficiency. (medscape.com)
- This article primarily focuses on aortic valve insufficiency caused by abnormalities in the aortic valve leaflets. (medscape.com)
- Recently, the percentage of individuals with aortic valve insufficiency caused by aortic root disease has been steadily increasing compared with the percentage of those with valvular disease. (medscape.com)
- Moderate aortic insufficiency, especially if some degree of stenosis persists, is poorly tolerated by the left ventricle and will likely result in aortic valve replacement. (pted.org)
- However, because of its proximity to the aortic valve, it can often result in the development of aortic insufficiency. (pted.org)
- When aortic insufficiency develops most cardiologists recommend surgical removal of the sub-valvular stenosis in order to halt any further progression of the aortic insufficiency. (pted.org)
Patients with severe aortic stenosis2
- We hypothesize that Sildenafil will produce a clinically significant decrease in pulmonary artery pressure in patients with severe aortic stenosis. (bioportfolio.com)
- Patients with severe aortic stenosis referred for a clinically ordered right and left heart catheterization will be eligible. (bioportfolio.com)
Tricuspid1
- The majority of native valve pathology in adults involves the mitral, aortic, and occasionally tricuspid valv. (bioportfolio.com)
Severe11
- Signs of heart failure may also be seen in severe cases of aortic stenosis. (wikipedia.org)
- It comprises three anatomical subforms: discrete fixed membranous subaortic stenosis (membranous tissue encircling the LVOT), discrete fibromuscular subaortic stenosis (fibromuscular tissue encircling the LVOT) and tunnel subaortic stenosis (fibromuscular diffuse tunnel-like narrowing of the LVOT), the two latter forms being generally more severe than the membranous form. (nih.gov)
- In severe cases that also affect the function of the aortic valve, valve repair or replacement may be necessary. (osu.edu)
- Serial cardiac catheterization during the growing years appears to be the most accurate way of detecting worsening discrete membranous subaortic stenosis, so that the membrane can be excised before severe complications occur ( 6 ). (ispub.com)
- Her transthoracic echocardiography showed severe aortic stenosis ( mean gradient of 62 mm Hg) and an image compatible with a membrane at subaortic region. (ispub.com)
- Prospective cohort study to test the hypothesis that patients identified with severe aortic stenosis are under-diagnosed and under-treated. (bioportfolio.com)
- This review examines the treatment options for women with severe aortic stenosis. (bioportfolio.com)
- Epicardial Adipose Tissue Thickness Independently Predicts Severe Aortic Valve Stenosis. (bioportfolio.com)
- Symptoms of severe stenosis may include angina, labored breathing in response to exertion, or fainting (syncope). (pted.org)
- With time, the ventricle can no longer compensate, causing secondary LV cavity enlargement, reduced ejection fraction (EF), decreased cardiac output, and a misleadingly low gradient across the aortic valve (low-gradient severe AS). (merckmanuals.com)
- Severe aortic stenosis (AS) represents a contemporary health issue with a serious impact on health care providers. (onlinejacc.org)
Pulmonic stenosis1
- Pulmonic Stenosis is a systolic murmur with maximal intensity over the pulmonic valve area and pulmonary artery. (b-naturals.com)
Severity5
- Prognosis of canines with aortic stenosis depends on the severity of the disease. (wikipedia.org)
- Most reported cases have had a measurable left ventricular-aortic gradient that progressed in severity. (nih.gov)
- The degree of murmur, and its duration correlates with the severity of aortic stenosis. (ufaw.org.uk)
- As severity increases, murmur intensity may lessen because aortic flow decreases. (clinicaladvisor.com)
- Objectives The aim of this study was to assess the role of the dimensionless index (DI) in a registry of patients with aortic stenosis (AS) to objectively establish prognostic DI thresholds for various degrees of AS severity. (onlinejacc.org)
Echocardiography3
- The 35 patients had documentation of subvalvular aortic stenosis 3 months to 19 years after their initial study based on repeat catheterizations in 26, echocardiography in 6 or discovery at surgery in 3 cases. (nih.gov)
- The aortic root diameter and the mitral-aortic separation were measured with sector echocardiography. (nih.gov)
- Video 1: Transesophageal echocardiography, five-chamber view, showing the calcified aortic valve and subaortic membrane. (icr-heart.com)
Cardiac5
- In 24 of the 35 cases, absence of a significant left ventricular-aortic gradient (less than or equal to 10 mm Hg) was documented at initial cardiac catheterization. (nih.gov)
- There were eight children with coarctation and no left ventricular-aortic gradient who developed significant subvalvular stenosis at a median of 2 years 9 months after initial cardiac catheterization. (nih.gov)
- Quadricuspid aortic valve is a rare congenital condition that occurs not only as an isolated anomaly, but also with other cardiac defects. (biomedsearch.com)
- Low FR was an independent predictor of mortality (p = 0.013) after adjusting for age, clinical prognostic factors, European System for Cardiac Operative Risk Evaluation II, dimensionless velocity index, left ventricular mass index, left ventricular ejection fraction, heart rate, time, type of aortic valve intervention, and SVi (p = 0.59). (onlinejacc.org)
- It also helps to evaluate cardiac defects such as, atrial septal defects, AV valve stenoses, coronary artery defects, occult DCM, coronary artery disease, feline heartworm disease, persistent left cranial vena cava, canine hypertrophic cardiomyopathy and feline diastolic dysfunction may be identified. (omicsonline.org)
Proximity to the aortic valve1
- Left ventriculogram using a pigtail catheter shows the presence of a subaortic membrane in proximity to the aortic valve. (onlinejacc.org)
Cardiomyopathy2
- Heart disease - This includes conditions such as subvalvular aortic stenosis, dilated cardiomyopathy and congestive heart failure. (lovetoknow.com)
- The Boxer has a couple major health concerns, including subvalvular aortic stenosis, boxer cardiomyopathy, and canine hip dysplasia. (dogpack.com)
Resection4
- Aortic valve (AoV) repair or replacement for predominant AR occurred in 31 patients (20%) during or after DSS resection. (bmj.com)
- Certain overt and subtle morphological abnormalities may underlie the initial expression as well as high recurrence rates after surgical resection of sub aortic membrane . (bvsalud.org)
- Its open aortic resection is safer and more likely to achieve a better haemodynamic result. (ispub.com)
- While the echocardiographic appearance of the valve did not suggest aortic stenosis, the valve was resected at that time, and a St. Jude bileaflet 19-mm mechanical prosthesis was placed in the aortic position in conjunction with resection of the subaortic membrane. (lww.com)
Genetic4
- Another genetic problem is subvalvular aortic stenosis (SAS). (wikipedia.org)
- How about a genetic test that can identify carriers of subvalvular aortic stenosis (SAS)? (grca.org)
- Many times, aortic stenosis is congenital, which means that it is present at birth but is not necessarily genetic in origin. (petwave.com)
- This study looks for a causative genetic mutation for subvalvular aortic stenosis in Newfoundlands. (morrisanimalfoundation.org)
Left ventricular1
- In 11 patients, a left ventricular-aortic pressure gradient was not obtained or not sought in the absence of clinical evidence of an obstructive lesion. (nih.gov)
Valvular disease3
- Aortic valve stenosis (AVS) is the most frequent valvular disease. (bioportfolio.com)
- Aortic stenosis (AS) is most common valvular disease. (renalandurologynews.com)
- Description of the problem After aortic stenosis, mitral incompetence is the second most frequent valvular disease in hospitalized patients. (oncologynurseadvisor.com)
Subaortic membrane1
- the subaortic membrane (2.7 m/s), and the mechanical valve in the aortic position (4 m/s) with a peak gradient of 64 mm·Hg. (lww.com)
Surgical aortic valve repla1
- It is known that female sex is associated with poorer outcomes after surgical aortic valve replacement. (bioportfolio.com)
Discrete subaortic2
Murmur6
- Canine subvalvular aortic stenosis (SAS) is an abnormal, congenital heart murmur caused by subaortic stenosis (SAS). (wikipedia.org)
- Aortic stenosis is often initially detected upon hearing a heart murmur during a routine physical examination by a veterinarian. (wikipedia.org)
- The murmur of AS is systolic ejection murmur heard loudest over the aortic area, radiating to the neck. (clinicaladvisor.com)
- Murmur of subvalvular aortic stenosis is unlikely to radiate to the carotids. (cardiophile.org)
- Murmur of supravalvar aortic stenosis may radiate more to the right carotid. (cardiophile.org)
- Murmur of valvular aortic stenosis radiates to both carotids. (cardiophile.org)
Calcification2
- The pathobiology of calcific aortic valve disease is characterized by three primary processes: lipid accumulation, inflammation, and calcification. (renalandurologynews.com)
- Epicardial fat tissue (EAT) is associated with coronary as well as aortic valve calcification. (bioportfolio.com)
Membrane2
- Figure 5: Perioperative view of our case showing subvalvular discrete membrane. (ispub.com)
- Subvalvular AS caused by a congenital membrane or fibrous ring just beneath the aortic valve is uncommon. (merckmanuals.com)
Supravalvar2
- Movie 9.6 Supravalvar aortic stenosis. (springer.com)
- Anisosphygmia with right brachial pulse more prominent than left, may occur in supravalvar aortic stenosis, due to the direction of the jet towards the right brachiocephalic artery. (cardiophile.org)
Common congenital3
- SilverHill Rottweiler breeder Cathy Rubens is no stranger to subvalvular aortic stenosis (SAS), one of the most common congenital heart diseases in dogs. (purinaproclub.com)
- Subvalvular aortic stenosis is one of the most common congenital heart defects in dogs and is an inherited defect of Newfoundlands and Golden retrievers . (gopetsamerica.com)
- Subvalvular aortic stenosis, the most common congenital heart disorder in dogs, is particularly common in Newfoundlands. (morrisanimalfoundation.org)
Presented for aortic valve repla1
- A 75-year-old woman, body surface area of 2.1 m 2 , presented for aortic valve replacement (AVR) secondary to reported dysfunction of her St. Jude 19-mm mechanical prosthetic valve (St. Jude Medical, St. Paul, MN) in the aortic position. (lww.com)
Doppler1
- Doppler allows estimation of the pressure created in the heart by the stenosis. (wikipedia.org)
Ventricular septal1
- Of 30 patients with associated lesions, 23 had surgical intervention before development of subvalvular aortic stenosis, but only 5 of 17 patients with ventricular septal defect had surgical repair or palliation specifically for the interventricular communication before development of subvalvular aortic stenosis. (nih.gov)
Development of aortic1
- Furthermore the development of aortic stenosis is partially depende. (bioportfolio.com)
Quadricuspid aortic valve2
- An important gene associated with Quadricuspid Aortic Valve is CYP21A2 (Cytochrome P450 Family 21 Subfamily A Member 2). (malacards.org)
- 75 A quadricuspid aortic valve (QAV) is a rare congenital heart defect characterized by the presence of. (malacards.org)
Gradient2
- Methods We retrospectively followed prospectively assessed consecutive patients with low-gradient, low aortic valve area AS who underwent aortic valve intervention between 2010 and 2014 for all-cause mortality. (onlinejacc.org)
- Conclusions In patients with low-gradient, low valve area aortic stenosis undergoing aortic valve intervention, low FR, not low SVi, was an independent predictor of medium-term mortality. (onlinejacc.org)
Heart13
- Puppies and adult dogs diagnosed with subaortic stenosis can suffer from heart failure and sudden death. (wikipedia.org)
- Subvalvular aortic stenosis is a congenital heart defect that limits blood flow out of the heart. (osu.edu)
- Subvalvular aortic stenosis is a congenital heart defect that occurs during fetal development. (osu.edu)
- Anyone who has ever been diagnosed with and/or treated for subvalvular aortic stenosis should have lifelong care from a cardiologist who specializes in congenital heart defects. (osu.edu)
- Subvalvular aortic stenosis (SAS) is one of the most common diagnosed heart defects in dogs and the Rottweiler breed has a high prevalence for SAS. (akcchf.org)
- heart failure , but this has not been tested in patients with aortic stenosis. (bioportfolio.com)
- Acute decompensation with heart failure, angina or syncope may be the first indication of undiagnosed aortic stenosis, but should be uncommon when the disorder is known and managed by watchful waiting. (bioportfolio.com)
- Stenosis of the aortic or pulmonary valves means the valves have narrowed, causing the heart to work harder to pump blood through the smaller openings. (mercola.com)
- Sub-Aortic stenosis (SAS) is a type of heart disease that is usually fatal. (shilohshepherds.info)
- Aortic stenosis is the most common heart valve disease requiring intervention in high income countries. (bioportfolio.com)
- Mitral stenosis Related condition Predominantly caused by rheumatic heart disease (RHD), though up to 50% of patients will have no knowledge of previous RHD. (oncologynurseadvisor.com)
- In 2005, he became ill again and received an artificial heart valve when he was operated for subvalvular aortic stenosis at the Rikshospitalet. (theroyalforums.com)
- Newfoundland dogs are beloved for their sweet nature and massive, furry size, but the breed is prone to an inherited heart disease, subvalvular aortic stenosis, or SAS, which also affects golden retrievers and children. (ucdavis.edu)
Intervention2
- 1 cm 2 ) aortic stenosis (AS) following aortic valve intervention. (onlinejacc.org)
- however, its prognostic value, especially in the medium term, following aortic valve intervention has shown inconsistent results (2-4) . (onlinejacc.org)
Whose aortic2
- Also, the valvuloplasty technique is not very effective in adults whose aortic valve leaflets have become calcified. (pted.org)
- We describe a 10-year-old boy whose aortic stenosis was diagnosed during infancy. (biomedsearch.com)
Prognostic1
- Management of patients with isolated aortic stenosis considering negative prognostic factors. (bioportfolio.com)
Ejection1
- Ejection click is in favour valvular aortic stenosis. (cardiophile.org)