29 results on '"Ko JM"'
Search Results
2. Anomalous cord from the raphe of a congenitally bicuspid aortic valve to the aortic wall producing either acute or chronic aortic regurgitation.
- Author
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Vowels TJ, Gonzalez-Stawinski GV, Ko JM, Trachiotis GD, Roberts BJ, Roberts CS, and Roberts WC
- Subjects
- Acute Disease, Adult, Aged, Aortic Valve surgery, Aortic Valve Insufficiency diagnosis, Aortic Valve Insufficiency surgery, Bicuspid Aortic Valve Disease, Chronic Disease, Diagnosis, Differential, Echocardiography, Transesophageal, Follow-Up Studies, Heart Valve Diseases diagnosis, Heart Valve Diseases surgery, Humans, Male, Middle Aged, Aortic Valve abnormalities, Aortic Valve Insufficiency etiology, Heart Valve Diseases complications, Heart Valve Prosthesis
- Abstract
Objectives: This report calls attention to an unappreciated cause of both acute and chronic aortic regurgitation (AR)., Background: Although stenosis develops in most patients with a congenitally bicuspid aortic valve (BAV), in others with this anomaly, pure AR (no element of stenosis) develops, some in the absence of infection or other clear etiology., Methods: We describe 5 men who underwent aortic valve replacement for pure AR associated with a BAV containing an anomalous cord attaching the raphe of the conjoined cusp near its free margin to the wall of the ascending aorta cephalad to the sinotubular junction., Results: Three of these 5 patients had a history of progressive dyspnea, and the anomalous cord, which was intact at operation, appeared to cause chronic AR by preventing proper coaptation of the 2 aortic valve cusps. The other 2 patients heard a "pop" during physical exertion and immediately became dyspneic, and at operation, the anomalous cord was found to have ruptured. Prolapse of the conjoined aortic valve cusp toward the left ventricular cavity resulted in severe acute AR., Conclusions: This variant of the purely regurgitant BAV may cause either chronic AR (when the anomalous cord does not rupture) or acute severe AR (when the cord ruptures)., (Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
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3. Natural history of unoperated aortic stenosis during a 50-year period of cardiac valve replacement.
- Author
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Roberts WC, Vowels TJ, Filardo G, Ko JM, Mathur RP, and Shirani J
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- Adolescent, Adult, Aged, Aged, 80 and over, Autopsy, Female, Heart Diseases pathology, Humans, Logistic Models, Male, Middle Aged, Organ Size, Risk Factors, Aortic Valve abnormalities, Aortic Valve Stenosis pathology
- Abstract
Although a number of publications have described the natural history of patients with aortic stenosis (AS), the definition of "natural history" varies widely. Those describing a large number of patients with AS without operative therapy with necropsy findings are rare. Two hundred sixty patients >15 years of age with AS were studied at necropsy over a 50-year period by the same investigator. Of the 260 patients, the valve in 37 (14%) was congenitally unicuspid, in 123 (47%), congenitally bicuspid, and in 100 (38%), tricuspid. Aortic valve structure varied with age of death (in years; unicuspid 52 ± 17, bicuspid 63 ± 12, and tricuspid 70 ± 14 years); gender (men/women: unicuspid 95%/5%, bicuspid 78%/22%, and tricuspid 63%/37%), and frequency of calcium in the mitral valve annulus and epicardial coronary arteries. The patients with cardiac-related symptoms compared with those without were more likely to have a congenitally malformed valve (unicuspid 17% vs 12%; bicuspid 51% vs 29%; tricuspid 31% vs 60%; unadjusted p = 0.013), to die from cardiac disease (86% vs 54%; unadjusted p = 0.001), and to have larger hearts (mean cardiac weight 606 ± 138 g vs 523 ± 121 g; unadjusted p = 0.009) and a larger quantity of calcium in the aortic valve cusps. In conclusion, the length of survival in adults with AS is related to valve structure, gender, presence of cardiac-related symptoms, cardiac mass, and quantity of calcium in the aortic valve cusps., (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Published
- 2013
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4. Necropsy findings early after transcatheter aortic valve implantation for aortic stenosis.
- Author
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Roberts WC, Stoler RC, Grayburn PA, Hebeler RF Jr, Ko JM, Brown DL, Brinkman WT, Mack MJ, and Guileyardo JM
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- Aged, 80 and over, Aortic Valve surgery, Aortic Valve Stenosis surgery, Autopsy, Fatal Outcome, Female, Humans, Male, Aortic Valve pathology, Aortic Valve Stenosis pathology, Bioprosthesis, Heart Valve Prosthesis Implantation adverse effects
- Abstract
Although transcatheter aortic valve implantation has been available for 10 years, reports of cardiovascular morphologic studies after the procedure are virtually nonexistent. The investigators describe such findings in 2 patients, both 86 years of age, who died early (hours or several days) after transcatheter aortic valve implantation. Although the prosthesis in each was seated well, and each of the 3 calcified cusps of the native aortic valves was well compressed to the wall of the aorta, thus providing a good bioprosthetic orifice, the ostium of the dominant right coronary artery in each was obliterated by the native right aortic valve cusp. Atherosclerotic plaques in the common iliac artery led to a major complication in 1 patient, who later died of hemorrhagic stroke. The other patient developed fatal cardiac tamponade secondary to perforation of the right ventricular wall by a pacemaker catheter., (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Published
- 2013
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5. Natural history of adults with congenitally malformed aortic valves (unicuspid or bicuspid).
- Author
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Roberts WC, Vowels TJ, and Ko JM
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Valve pathology, Aortic Valve surgery, Bicuspid Aortic Valve Disease, Cause of Death, Endocarditis etiology, Female, Heart Defects, Congenital complications, Heart Valve Diseases complications, Humans, Male, Middle Aged, Natural History, Young Adult, Aortic Valve abnormalities
- Abstract
Appreciation of the frequency of the congenitally malformed aortic valve has come about during the last 50 years, a period during which aortic valve replacement became a predictably successful operation. Study of patients at necropsy with either a congenitally unicuspid (1 true commissure) or bicuspid (2 true commissures) valve in whom no aortic valve operation has been performed has not been conducted during these 50 years, to our knowledge. We studied 218 patients at necropsy with congenitally malformed aortic valves: 28 (13%) had a unicuspid valve and 190 (87%), a bicuspid valve. Their ages at death ranged from 21 to 89 years (mean, 55 yr), and 80% were men. Of the 218 adults, the aortic valve functioned normally during life in 54 (25%) and abnormally in 164 (75%): aortic stenosis in 142 (65%), pure aortic regurgitation without superimposed infective endocarditis (IE) in 2 (1%), and IE superimposed on a previously normally functioning aortic valve in 20 (9%). IE occurred in a total of 31 (14%) of the 218 patients: involving a previously normally functioning valve in 20 (65%) and a previously stenotic valve in 11 (35%). Of the 218 patients, at least 141 (65%) died as a consequence of aortic valve disease (124 patients) or ascending aortic tears with or without dissection (17 patients). An estimated 1% of the population, maybe higher in men, has a congenitally malformed aortic valve. Data from this study suggest that about 75% of them will develop a major complication. Conversely, and encouragingly, about 25% will go through life without a complication.
- Published
- 2012
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6. Frequency of congenitally bicuspid aortic valves in patients ≥80 years of age undergoing aortic valve replacement for aortic stenosis (with or without aortic regurgitation) and implications for transcatheter aortic valve implantation.
- Author
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Roberts WC, Janning KG, Ko JM, Filardo G, and Matter GJ
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Valve Insufficiency epidemiology, Aortic Valve Stenosis epidemiology, Female, Heart Valve Prosthesis Implantation methods, Humans, Male, Middle Aged, Postoperative Complications, Young Adult, Aortic Valve abnormalities, Aortic Valve surgery, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Heart Valve Prosthesis
- Abstract
The purpose of the present report was to determine the frequency of a congenitally bicuspid aortic valve in patients ≥80 years of age old with aortic stenosis (AS) severe enough to warrant aortic valve replacement. Transcatheter aortic valve implantation (TAVI) has traditionally been reserved for patients ≥80 years of age with severe AS involving a 3-cuspid aortic valve. Traditionally, AS involving a 2-cuspid aortic valve has been a contraindication to TAVI. We examined operatively excised stenotic aortic valves in 364 patients aged ≥80 years to determine the frequency of an underlying congenitally bicuspid aortic valve. Of the 347 octogenarians and 17 nonagenarians, 78 (22%) and 3 (18%) had stenotic congenitally bicuspid aortic valves, respectively. In conclusion, because the results of TAVI are less favorable in patients with stenotic congenitally bicuspid valves than in patients with stenotic tricuspid aortic valves, proper identification of the underlying aortic valve structure is important when considering TAVI as a therapeutic procedure for AS in older patients., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
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7. Effect of coronary bypass and valve structure on outcome in isolated valve replacement for aortic stenosis.
- Author
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Roberts WC, Roberts CC, Vowels TJ, Ko JM, Filardo G, Hamman BL, Matter GJ, Henry AC 3rd, and Hebeler RF Jr
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Valve surgery, Aortic Valve Stenosis complications, Aortic Valve Stenosis mortality, Coronary Stenosis complications, Coronary Stenosis mortality, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Survival Rate trends, Texas epidemiology, Treatment Outcome, Young Adult, Aortic Valve pathology, Aortic Valve Stenosis surgery, Coronary Artery Bypass methods, Coronary Stenosis surgery, Heart Valve Prosthesis
- Abstract
Reports differ regarding the effect of concomitant coronary artery bypass grafting (CABG) in patients who undergo aortic valve replacement (AVR) for aortic stenosis (AS), and no reports have described the effect of aortic valve structure in patients who undergo AVR for AS. A total of 871 patients aged 24 to 94 years (mean 70) whose AVR for AS was their first cardiac operation, with or without first concomitant CABG, were included. Patients who underwent mitral valve procedures were excluded. In comparison with the 443 patients (51%) who did not undergo CABG, the 428 (49%) who underwent concomitant CABG were significantly older, were more often male, had lower transvalvular peak systolic pressure gradients and larger valve areas, had lower frequencies of congenitally malformed aortic valves, had lighter valves by weight, had higher frequencies of systemic hypertension, and had longer stays in the hospital after AVR. Early and late (to 10 years) mortality were similar by propensity-adjusted analysis in patients who did and did not undergo concomitant CABG. Congenitally unicuspid or bicuspid valves occurred in approximately 90% of those aged 21 to 50, in nearly 70% in those aged 51 to 70 years, and in just over 30% in those aged 71 to 95 years. Unadjusted and adjusted survival was significantly higher in patients with unicuspid or bicuspid valves compared to those with tricuspid valves. In conclusion, although concomitant CABG had no effect on the adjusted probability of survival, the type of aortic valve (unicuspid or bicuspid vs tricuspid) significantly affected the unadjusted and adjusted probability of survival., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
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8. Cardiac transplantation in adults with aortic valve disease with focus on the bicuspid aortic valve.
- Author
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Roberts WC, Roberts CC, Ko JM, Hall SA, and Capehart JE
- Subjects
- Adult, Aged, Aortic Valve surgery, Cardiomyopathies surgery, Heart Failure surgery, Humans, Male, Middle Aged, Stroke Volume, Aortic Valve abnormalities, Aortic Valve Stenosis surgery, Heart Transplantation, Heart Valve Prosthesis
- Abstract
The frequency of congenitally bicuspid aortic valves in patients having cardiac transplantation (CT) is unknown. We reviewed 243 explanted hearts in patients having CT at Baylor University Medical Center, Dallas from June 1997 through November 2011 to determine the frequency of a bicuspid aortic valve in this population. Of the 243 explanted hearts, 7 (2.9%) were found to have a congenitally bicuspid aortic valve: 3 had severe aortic valve stenosis and before CT had had the aortic valve replaced; the other 4 had normally functioning bicuspid valves and underwent CT for cardiomyopathy (ischemic in 1, idiopathic in 2, and hypertrophic in 1). Review of previously published reports of CT and aortic valve disease disclosed that 4 patients had had aortic valve replacement (AVR) from 2 to 8 years before CT, 3 had AVR or aortic valve repair of the donor heart at the time of CT, and 4 had AVR or transcatheter aortic valve implantation from 1 to 14 years after CT. Some of these aortic valve replacements, before, at the time of, or after CT were in patients with congenitally bicuspid aortic valves. In conclusion, congenitally bicuspid aortic valves were found in 7 of 243 explanted hearts in patients having CT at a single medical center in a 14-year period: 4 had functioned normally and 3 were severely stenotic. Previous reports of patients having AVR or repair before, during, and after CT were reviewed., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
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9. Presence of a congenitally bicuspid aortic valve among patients having combined mitral and aortic valve replacement.
- Author
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Roberts WC, Janning KG, Vowels TJ, Ko JM, Hamman BL, and Hebeler RF Jr
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Valve Insufficiency diagnosis, Aortic Valve Stenosis diagnosis, Echocardiography, Female, Follow-Up Studies, Heart Defects, Congenital complications, Heart Defects, Congenital diagnosis, Humans, Incidence, Male, Middle Aged, Mitral Valve Insufficiency diagnosis, Mitral Valve Stenosis diagnosis, Retrospective Studies, United States epidemiology, Aortic Valve abnormalities, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Heart Defects, Congenital epidemiology, Heart Valve Prosthesis, Mitral Valve Insufficiency surgery, Mitral Valve Stenosis surgery
- Abstract
Although bicuspid aortic valve occurs in an estimated 1% of adults and mitral valve prolapse in an estimated 5% of adults, occurrence of the 2 in the same patient is infrequent. During examination of operatively excised aortic and mitral valves because of dysfunction (stenosis and/or regurgitation), we encountered 16 patients who had congenitally bicuspid aortic valves associated with various types of dysfunctioning mitral valves. Eleven of the 16 patients had aortic stenosis (AS): 5 of them also had mitral stenosis, of rheumatic origin in 4 and secondary to mitral annular calcium in 1; the other 6 with aortic stenosis had pure mitral regurgitation (MR) secondary to mitral valve prolapse in 3, to ischemia in 2, and to unclear origin in 1. Of the 5 patients with pure aortic regurgitation, each also had pure mitral regurgitation: in 1 secondary to mitral valve prolapse and in 4 secondary to infective endocarditis. In conclusion, various types of mitral dysfunction severe enough to warrant mitral valve replacement occur in patients with bicuspid aortic valves. A proper search for mitral valve dysfunction in patients with bicuspid aortic valves appears warranted., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
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10. Accuracy of two-dimensional echocardiography in determining aortic valve structure in patients >50 years of age having aortic valve replacement for aortic stenosis.
- Author
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Ayad RF, Grayburn PA, Ko JM, Filardo G, and Roberts WC
- Subjects
- Aged, Aged, 80 and over, Aortic Valve surgery, Aortic Valve Stenosis physiopathology, Aortic Valve Stenosis surgery, Echocardiography standards, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Period, Reproducibility of Results, Retrospective Studies, Aortic Valve diagnostic imaging, Aortic Valve Stenosis diagnostic imaging, Echocardiography methods, Heart Valve Prosthesis
- Abstract
We sought to measure the accuracy of 2-dimensional transthoracic echocardiography in determining aortic valve structure in patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR). Few studies have compared aortic valve structure determined by echocardiogram to that determined by examination of the operatively excised stenotic aortic valve. Two-dimensional echocardiograms were reviewed and interpreted by an expert echocardiographer in blinded fashion in 100 patients >50 years of age (mean 70) who had undergone AVR for isolated AS ± aortic regurgitation and the aortic valve structure (unicuspid, bicuspid, tricuspid) was compared to that from examination of the operatively excised stenotic valve. After excluding 14 cases in which echocardiograms were uninterpretable because of heavy calcium and/or poor image quality, congenitally malformed valves were present in 44 patients (51%) and tricuspid valves in 42 of the 86 patients (49%). Ten of the 14 patients (71%) with uninterpretable echocardiograms had congenitally malformed valves. Valve structure by echocardiogram was concordant with morphologic interpretation in 57 of 86 patients (66% accuracy, kappa = 0.33). Accuracy trended toward improvement as degree of AS decreased. In patients with valve areas similar to those enrolled in the recent transcatheter aortic valve implantation trial (PARTNER; 0.7 ± 0.2 cm(2)), aortic valve structure was accurately determined by echocardiography in 21 of 35 patients (60%). In conclusion, aortic valve structure was interpretable by transthoracic echocardiogram in 86 of 100 patients and accurate in 57 of these 86 patients (66%)., (Copyright © 2011 Elsevier Inc. All rights reserved.)
- Published
- 2011
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11. Comparison of the structure of the aortic valve and ascending aorta in adults having aortic valve replacement for aortic stenosis versus for pure aortic regurgitation and resection of the ascending aorta for aneurysm.
- Author
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Roberts WC, Vowels TJ, Ko JM, Filardo G, Hebeler RF Jr, Henry AC, Matter GJ, and Hamman BL
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- Adult, Aged, Aged, 80 and over, Aortic Valve physiopathology, Blood Pressure physiology, Elastic Tissue pathology, Female, Humans, Male, Middle Aged, Mitral Valve pathology, Organ Size physiology, Retrospective Studies, Systole physiology, Tricuspid Valve pathology, Aorta pathology, Aorta surgery, Aortic Aneurysm surgery, Aortic Valve pathology, Aortic Valve surgery, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery
- Abstract
Background: There is debate concerning whether an aneurysmal ascending aorta should be replaced when associated with a dysfunctioning aortic valve that is to be replaced. To examine this issue, we divided the patients by type of aortic valve dysfunction-either aortic stenosis (AS) or pure aortic regurgitation (AR)-something not previously undertaken., Methods and Results: Of 122 patients with ascending aortic aneurysm (unassociated with aortitis or acute dissection), the aortic valve was congenitally malformed (unicuspid or bicuspid) in 58 (98%) of the 59 AS patients, and in 38 (60%) of the 63 pure AR patients. Ascending aortic medial elastic fiber loss (EFL) (graded 0 to 4+) was zero or 1+ in 53 (90%) of the AS patients, in 20 (53%) of the 38 AR patients with bicuspid valves, and in all 12 AR patients with tricuspid valves unassociated with the Marfan syndrome. An unadjusted analysis showed that, among the 96 patients with congenitally malformed valves, the 38 AR patients had a significantly higher likelihood of 2+ to 4+ EFL than the 58 AS patients (crude odds ratio: 8.78; 95% confidence interval: 2.95, 28.13)., Conclusions: These data strongly suggest that the type of aortic valve dysfunction-AS versus pure AR-is very helpful in predicting loss of aortic medial elastic fibers in patients with ascending aortic aneurysms and aortic valve disease.
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- 2011
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12. Massive acute infarction of the right ventricular wall without or only minimal infarction of the left ventricular wall after aortic valve replacement with or without simultaneous replacement of the ascending aorta.
- Author
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Roberts WC, Patterson BA, Ko JM, Sager RA, Clark JA, and Guileyardo JM
- Subjects
- Adult, Aged, Aorta surgery, Coronary Artery Bypass, Coronary Vessels pathology, Coronary Vessels surgery, Humans, Male, Middle Aged, Myocardial Infarction pathology, Postoperative Complications pathology, Aortic Valve surgery, Heart Valve Prosthesis Implantation adverse effects, Heart Ventricles pathology, Myocardial Infarction etiology, Postoperative Complications etiology
- Abstract
Certain clinical and cardiac morphologic findings are presented in two men who developed massive right ventricular (RV) infarction with only minimal or no left ventricular infarction early after aortic valve replacement. The ostium of the right coronary artery was severely narrowed in one patient by the ring of the bioprosthesis, and in the other patient the right coronary artery was completely severed at the time of valve replacement without insertion of a coronary bypass conduit. Such massive infarction of the RV free wall has not been reported previously., (Copyright 2010 Elsevier Inc. All rights reserved.)
- Published
- 2010
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13. Comparison of the quantity of calcific deposits in bovine pericardial bioprostheses in the mitral and aortic valve positions in the same patient late after double-valve replacement.
- Author
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Roberts WC, Velasco CE, Ko JM, and Matter GJ
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- Animals, Cattle, Female, Humans, Middle Aged, Time Factors, Young Adult, Aortic Valve surgery, Bioprosthesis, Calcium analysis, Heart Valve Prosthesis, Mitral Valve surgery
- Published
- 2009
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14. Identifying cardiovascular syphilis at operation.
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Roberts WC, Bose R, Ko JM, Henry AC, and Hamman BL
- Subjects
- Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Aortic Valve pathology, Aortic Valve surgery, Aortic Valve Insufficiency microbiology, Aortic Valve Insufficiency pathology, Aortic Valve Insufficiency surgery, Blood Vessel Prosthesis Implantation, Female, Humans, Intraoperative Period, Male, Middle Aged, Retrospective Studies, Syphilis Serodiagnosis, Syphilis, Cardiovascular drug therapy, Syphilis, Cardiovascular microbiology, Treatment Outcome, Aortic Valve microbiology, Syphilis, Cardiovascular pathology, Syphilis, Cardiovascular surgery, Vascular Surgical Procedures
- Abstract
To describe the morphologic features so the process can be easily identified during surgery, we studied 34 patients with cardiovascular syphilis, 32 of whom underwent excision and replacement of the ascending aorta or aortic valve or both. Of the 34 patients, 22 were treated at Baylor University Medical Center from 1998 to 2008 and 12 at non-Baylor University Medical Center hospitals from 1958 to 1987. In all 34 patients, the tubular portion of the aorta was diffusely thickened and the sinus portion of the aorta was apparently uninvolved. The process involved all 3 layers of the aorta, with thickening of the adventitia, mainly by fibrous tissue. Within the fibrous tissue were collections of plasma cells and lymphocytes, focal destruction of the media without thickening, and marked thickening of the intima by atherosclerotic-appearing lesions. Serologic tests for syphilis were done in only 14 patients (41%) and were positive (reactive) in 6 (43%) of them. The ascending aorta, however, was similar in all 34 patients. In conclusion, cardiovascular syphilis has not disappeared. Its identification during surgery can prompt appropriate antibiotic therapy postoperatively. Although the serologic test results for syphilis might be negative, antibiotic therapy is recommended for patients with panaortitis requiring resection of the ascending aorta with or without aortic regurgitation.
- Published
- 2009
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15. Comparison of heavier versus lighter operatively excised stenotic aortic valves in adults with aortic stenosis and implications for percutaneous aortic valve implantation without replacement.
- Author
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Roberts WC, Ko JM, and Filardo G
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Valve abnormalities, Female, Humans, Male, Middle Aged, Organ Size, Aortic Valve pathology, Aortic Valve surgery, Aortic Valve Stenosis pathology, Aortic Valve Stenosis surgery
- Abstract
To better understand aortic valves amenable to percutaneous aortic valve implantation, operatively excised stenotic aortic valves were examined and divided into 2 groups: heavier and lighter valves. Among 2,247 operatively excised stenotic aortic valves in adults aged >20 years without associated mitral stenosis or mitral valve replacement, 1,608 valves were weighed; 1,241 (77%) weighed <4 g, and 367 (23%) weighed > or =4 g. Of the valves from 1,038 men, 717 (69%) weighed <4 g, and 321 (31%) weighed > or =4 g; of the valves from 570 women, 524 (92%) weighed <4 g, and 46 (8%) weighed > or =4 g. The patients with heavier (> or =4 g) valves had higher transvalvular peak gradients (78 +/- 28 vs 55 +/- 27 mm Hg, p <0.0001), smaller valve areas (0.69 +/- 0.30 vs 0.75 +/- 0.27 cm(2), p <0.0001), and more often congenitally malformed valves (327 of 367 [89%] vs 638 of 1,241 [51%], p <0.0001). In patients aged 81 to 90 years, 44 of the 195 valves (23%) were congenitally unicuspid or bicuspid; in those aged 41 to 50 years, 112 of 128 valves (88%) were congenitally malformed. In conclusion, compared with patients whose stenotic aortic valves weighed <4 g, those with valves weighing > or =4 g were younger, had higher transvalvular peak systolic pressure gradients, had smaller valve areas, and usually (about 90%) had congenitally unicuspid or bicuspid valves. It seems reasonable to avoid percutaneous aortic valve implantation in patients with heavily calcified stenotic aortic valves, most of which are either congenitally unicuspid or bicuspid.
- Published
- 2009
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16. Comparison of interpretations of valve structure between cardiac surgeon and cardiac pathologist among adults having isolated aortic valve replacement for aortic valve stenosis (+/- aortic regurgitation).
- Author
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Roberts WC, Vowels TJ, and Ko JM
- Subjects
- Adult, Aortic Valve Insufficiency complications, Aortic Valve Stenosis complications, Aortic Valve Stenosis surgery, Heart Valve Prosthesis Implantation, Humans, Reproducibility of Results, Aortic Valve pathology, Aortic Valve Stenosis pathology, Pathology, Surgical, Thoracic Surgery
- Abstract
Most studies concerning aortic valve structure in patients having aortic valve replacement have utilized the valve structure (unicuspid, bicuspid, tricuspid) as that called by the cardiac surgeon performing the operation. We determined valve structure of 744 operatively excised stenotic aortic valves submitted to the surgical pathology laboratory of a single hospital over a 6-year period and then compared valve structure determined by a single cardiac pathologist (WCR) with that recorded in the operative report dictated by the operating surgeon. Compared with that determined from examination of the operatively excised valve by the cardiac pathologist, valve structure determined at operation was congruous in 59% (440 of 744 patients), incongruous in 20% (152 of 744), of uncertain structure in 1% (9 of 744), and not mentioned in 19% (143 of 744). Valve structure was virtually always congruous (278 of 280 cases, 99%) in patients with 3-cuspid valves, less so with bicuspid valves (156 of 280, 56%), and infrequently so with unicuspid valves (6 of 41, 15%). In conclusion, in patients having isolated aortic valve replacement for aortic valve stenosis, the structure of the valve by the operating surgeon was similar (99%) to that described by 1 of us (WCR) when a 3-cuspid aortic valve was excised, but less so when a congenitally unicuspid (15%) or bicuspid (56%) valve was excised.
- Published
- 2009
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17. Valve structure and survival in quadragenarians having aortic valve replacement for aortic stenosis (+/-aortic regurgitation) with versus without coronary artery bypass grafting at a single US medical center (1993 to 2005).
- Author
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Roberts WC, Ko JM, Filardo G, Kitchens BL, Henry AC, Hebeler RF Jr, Cheung EH, Matter GJ, and Hamman BL
- Subjects
- Adult, Aortic Valve surgery, Aortic Valve Insufficiency mortality, Aortic Valve Insufficiency surgery, Female, Humans, Male, Middle Aged, Retrospective Studies, Survival Analysis, Aortic Valve pathology, Aortic Valve Stenosis mortality, Aortic Valve Stenosis surgery, Coronary Artery Bypass, Heart Valve Prosthesis Implantation
- Abstract
The purpose of this study was to determine the effect of simultaneous coronary artery bypass grafting (CABG) and the influence of valve structure on both early and late survival in quadragenarians having aortic valve replacement (AVR) for aortic stenosis (AS) (with or without aortic regurgitation). We analyzed survival and valve structure in 48 adults (12 women), aged 40 to 49 years, having AVR for AS from 1993 through 2005 at Baylor University Medical Center, including 7 (15%) with and 41 (85%) without simultaneous CABG. Of the 48 quadragenarians, none died within 60 days of operation. Assessment of the relation between long-term survival and gender, aortic valve structure, preoperative severity of the AS, and concomitant CABG was not possible due to the low mortality. Four patients (9%) died >60 days after AVR: at 1.8, 6.3, 7.1, and 9.9 years, respectively. The aortic valve was congenitally unicuspid in 15 patients (31%), congenitally bicuspid in 32 (67%), and 3-cuspid in 1 (2%). In conclusion, of the 48 quadragenarians having AVR for AS, 47 (98%) had a congenitally malformed aortic valve, 60-day mortality was zero, and late mortality was low (8%).
- Published
- 2007
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18. Valve structure and survival in quinquagenarians having aortic valve replacement for aortic stenosis (+/-aortic regurgitation) with versus without coronary artery bypass grafting at a single US medical center (1993 to 2005).
- Author
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Roberts WC, Ko JM, Filardo G, Henry AC, Hebeler RF Jr, Cheung EH, Matter GJ, and Hamman BL
- Subjects
- Aortic Valve pathology, Aortic Valve Stenosis physiopathology, Bioprosthesis, Blood Pressure physiology, Female, Follow-Up Studies, Humans, Length of Stay, Male, Middle Aged, Organ Size, Survival Analysis, Systole physiology, Texas, Aortic Valve surgery, Aortic Valve Stenosis mortality, Aortic Valve Stenosis surgery, Coronary Artery Bypass, Heart Valve Prosthesis
- Abstract
The purpose of this study was to determine the effect of simultaneous coronary artery bypass grafting (CABG) and the influence of valve structure on both early and late survival in quinquagenarians having aortic valve replacement (AVR) for aortic stenosis (AS) (with or without aortic regurgitation). We analyzed survival and valve structure in 120 quinquagenarians having AVR for AS from 1993 through 2005 at Baylor University Medical Center, including 44 (37%) with and 76 (63%) without simultaneous CABG. Of the 120 patients, 2 (2%) died within 30 days of operation and none from 31 to 60 days postoperatively. Fifteen other patients (13%) died from >60 days to up to 13 years postoperatively. The unadjusted survival analysis showed that late survival was significantly better in the unicuspid/bicuspid valve structure group than in the tricuspid valve structure group (log-rank test p = 0.001), but that it was not affected by gender (male vs female), preoperative severity of the AS (transvalvular peak pressure gradient >50 vs < or =50 mm Hg), or by performance of CABG. The aortic valve was congenitally unicuspid in 18 patients (15%), congenitally bicuspid in 84 (70%), and 3-cuspid in 18 (15%). In conclusion, aortic valve structure affected the unadjusted late survival in quinquagenarians undergoing AVR for AS, but concomitant CABG, gender, and transvalvular peak systolic gradient had no effect.
- Published
- 2007
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19. Valve structure and survival in sexagenarians having aortic valve replacement for aortic stenosis (+/-aortic regurgitation) with versus without coronary artery bypass grafting at a single US medical center (1993 to 2005).
- Author
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Roberts WC, Ko JM, Filardo G, Henry AC, Hebeler RF Jr, Cheung EH, Matter GJ, and Hamman BL
- Subjects
- Aged, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis pathology, Coronary Artery Bypass statistics & numerical data, Echocardiography, Female, Heart Valve Prosthesis Implantation statistics & numerical data, Humans, Length of Stay, Male, Medical Records, Middle Aged, Retrospective Studies, Survival Analysis, Texas epidemiology, Aortic Valve pathology, Aortic Valve Stenosis mortality, Aortic Valve Stenosis surgery
- Abstract
The purpose of this study was to determine the effect of simultaneous coronary artery bypass grafting (CABG) and the influence of valve structure on both early and late survival in sexagenarians having aortic valve replacement (AVR) for aortic stenosis (AS) (with or without aortic regurgitation). We analyzed survival and valve structure in 289 sexagenarians having AVR for AS from 1993 through 2005 at Baylor University Medical Center, including 147 (51%) with and 142 (49%) without simultaneous CABG. Of the 282 patients with information available, 13 (4.6%) died within 30 days of operation and 1 additional patient, from 31 to 60 days after operation (5.0% 60-day mortality). Sixty-day mortality was similar (6% and 4%) in the groups with and without simultaneous CABG. A total of 66 patients (23%) died from >60 days up to 13 years postoperatively. The unadjusted survival analysis showed that late survival was not affected by gender (male versus female), aortic valve structure (unicuspid, bicuspid, and quadricuspid versus tricuspid) or preoperative severity of the AS (transvalvular peak pressure gradient >50 mm Hg versus < or =50 mm Hg), or by performance of CABG. The aortic valve was congenitally unicuspid in 10 patients (3%), congenitally bicuspid in 170 (59%), 3-cuspid in 107 (37%), congenitally quadricuspid in 1 patient, and the valve structure was indeterminate in 1 patient. In conclusion, gender, valve structure, preoperative severity of the AS, or performance of simultaneous CABG did not effect unadjusted survival in sexagenarians undergoing AVR for AS.
- Published
- 2007
- Full Text
- View/download PDF
20. Valve structure and survival in septuagenarians having aortic valve replacement for aortic stenosis (+/-aortic regurgitation) with versus without coronary artery bypass grafting at a single US medical center (1993 to 2005).
- Author
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Roberts WC, Ko JM, Filardo G, Henry AC, Hebeler RF Jr, Cheung EH, Matter GJ, and Hamman BL
- Subjects
- Aged, Aortic Valve Insufficiency diagnostic imaging, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Coronary Artery Bypass, Female, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Humans, Male, Survival Rate, Ultrasonography, United States, Aortic Valve surgery, Aortic Valve Insufficiency mortality, Aortic Valve Insufficiency pathology, Aortic Valve Stenosis mortality, Aortic Valve Stenosis pathology
- Abstract
The purpose of this study was to determine the effect of simultaneous coronary artery bypass grafting (CABG) and the influence of valve structure on both early and late survival in septuagenarians having aortic valve replacement (AVR) for aortic stenosis (AS) (with or without aortic regurgitation). We analyzed valve structure in 424 septuagenarians having AVR for AS from 1993 through 2005 at Baylor University Medical Center, including 254 (60%) with and 170 (40%) without simultaneous CABG. Of the 424 patients, 8 (2%) had a congenitally unicuspid aortic valve, 179 (42%), a congenitally bicuspid aortic valve, 235 (55%), a 3-cuspid valve, and in 2 patients (1%) the valve structure was indeterminate. Survival data were available in 418 of the 424 patients: 23 (5.5%) died within 30 days of AVR and 9 other patients from 31 to 60 days after AVR (7.7% 60-day mortality). Sixty-day mortality was not affected by congenital valve abnormality (unicuspid/bicuspid 8.5% vs tricuspid 7.0%). In contrast, late survival (up to 13-year follow-up) was affected by valve structure: it was longer in the unicuspid/bicuspid valve structure group than in the tricuspid valve structure (hazard ratio 0.54, 95% confidence intervals 0.36 to 0.81). The hazard ratio was estimated after adjusting for concomitant CABG. In conclusion, aortic valve structure affected late, but not early survival in septuagenarians undergoing AVR for AS.
- Published
- 2007
- Full Text
- View/download PDF
21. Valve structure and survival in octogenarians having aortic valve replacement for aortic stenosis (+/- aortic regurgitation) with versus without coronary artery bypass grafting at a single US medical center (1993 to 2005).
- Author
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Roberts WC, Ko JM, Garner WL, Filardo G, Henry AC, Hebeler RF Jr, Matter GJ, and Hamman BL
- Subjects
- Aged, 80 and over, Aortic Valve Insufficiency complications, Aortic Valve Insufficiency mortality, Aortic Valve Insufficiency pathology, Aortic Valve Stenosis complications, Aortic Valve Stenosis mortality, Aortic Valve Stenosis pathology, Coronary Disease complications, Coronary Disease surgery, Female, Humans, Male, Survival Analysis, Survival Rate, Aortic Valve pathology, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Coronary Artery Bypass mortality, Heart Valve Prosthesis Implantation mortality
- Abstract
The purpose of this study was to determine the effect of simultaneous coronary artery bypass grafting (CABG) and valve structure on both early and late survival in octogenarians having aortic valve replacement (AVR) for aortic stenosis (AS) (with or without aortic regurgitation). Although a number of reports are available in octogenarians having AVR for AS, none have described aortic valve structure. Most have limited numbers of patients and few have described late results. We analyzed survival and valve structure in 196 octogenarians having AVR for AS from 1993 to 2005 at Baylor University Medical Center, including 118 (60%) with and 78 (40%) without simultaneous CABG. Sixty-day mortality, which was identical to 30-day mortality, was similar (10% and 11%) in the groups with and without simultaneous CABG. Unadjusted analysis of late survival (up to 13 year follow-up) was not affected by gender (male vs female), aortic valve structure (bicuspid vs tricuspid) or preoperative severity of the AS (transvalvular peak pressure gradient > 50 vs < or =50 mm Hg), or by performance of CABG. Of the 196 patients, 54 (28%) had a congenitally bicuspid aortic valve, and 142 (72%) had a tricuspid aortic valve. In conclusion, gender, valve structure, preoperative severity of the AS, or performance of simultaneous CABG did not effect survival in octogenarians having AVR for AS.
- Published
- 2007
- Full Text
- View/download PDF
22. Clinical and morphologic features of the congenitally unicuspid acommissural stenotic and regurgitant aortic valve.
- Author
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Roberts WC and Ko JM
- Subjects
- Adult, Aged, Aortic Valve pathology, Aortic Valve Insufficiency pathology, Aortic Valve Stenosis pathology, Female, Humans, Male, Middle Aged, Aortic Valve abnormalities, Aortic Valve Insufficiency congenital, Aortic Valve Stenosis congenital
- Abstract
Five adults, aged 30-75 years, are described with stenotic and regurgitant unicuspid acommissural aortic valves. Because none of these patients had clinical, echocardiographic or hemodynamic evidence of mitral valve disease, a case is made that these valves were congenitally malformed and not the result of an acquired condition., (2007 S. Karger AG, Basel)
- Published
- 2007
- Full Text
- View/download PDF
23. Isolated aortic valve replacement without coronary bypass for aortic valve stenosis involving a congenitally bicuspid aortic valve in a nonagenarian.
- Author
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Roberts WC, Ko JM, and Matter GJ
- Subjects
- Aged, 80 and over, Aortic Valve surgery, Aortic Valve Stenosis etiology, Bioprosthesis, Calcinosis surgery, Heart Valve Diseases complications, Heart Valve Diseases congenital, Heart Valve Diseases surgery, Heart Valve Prosthesis, Humans, Male, Aortic Valve abnormalities, Aortic Valve Stenosis surgery, Coronary Artery Bypass, Heart Valve Prosthesis Implantation
- Published
- 2006
- Full Text
- View/download PDF
24. Causes of pure aortic regurgitation in patients having isolated aortic valve replacement at a single US tertiary hospital (1993 to 2005).
- Author
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Roberts WC, Ko JM, Moore TR, and Jones WH 3rd
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Dissection complications, Aortic Dissection pathology, Aortic Dissection physiopathology, Aortic Valve pathology, Aortic Valve physiopathology, Aortic Valve Insufficiency physiopathology, Aortitis complications, Aortitis pathology, Aortitis physiopathology, Coronary Artery Bypass adverse effects, Endocarditis, Bacterial complications, Endocarditis, Bacterial pathology, Endocarditis, Bacterial physiopathology, Female, Heart Defects, Congenital complications, Heart Defects, Congenital pathology, Heart Defects, Congenital physiopathology, Humans, Hypertension pathology, Hypertension physiopathology, Male, Marfan Syndrome complications, Marfan Syndrome pathology, Marfan Syndrome physiopathology, Middle Aged, Mitral Valve Stenosis complications, Mitral Valve Stenosis pathology, Mitral Valve Stenosis physiopathology, Retrospective Studies, Rheumatic Heart Disease complications, Rheumatic Heart Disease pathology, Rheumatic Heart Disease physiopathology, Aortic Valve surgery, Aortic Valve Insufficiency etiology, Aortic Valve Insufficiency surgery, Heart Valve Prosthesis statistics & numerical data, Hospitals, University statistics & numerical data
- Abstract
Background: The causes of aortic regurgitation (AR) severe enough to warrant aortic valve replacement (AVR) have received little attention in the last 20 years., Methods and Results: We analyzed the causes of pure AR in 268 patients > 20 years of age having isolated AVR at Baylor University Medical Center from 1993 to 2005 that was unassociated with mitral stenosis, mitral valve replacement, or a previous operation involving a cardiac valve or ascending aorta. In 122 patients (46%), the AR resulted from a problem with the aortic valve: congenital malformation unassociated with infective endocarditis, 66 patients (54%); infective endocarditis, 46 patients (38%; 15 with bicuspid valves); probable rheumatic heart disease, 8 patients (6%); and miscellaneous, 2 patients (2%). In the other 146 patients (54%), the AR was the consequence of a condition affecting the ascending aorta: dissection, 28 patients (19%); the Marfan syndrome or its forme fruste variety, 15 patients (10%); aortitis, 12 patients (8%), and in the remaining 91 patients (62%), the cause of the AR was not determined. This latter group was the oldest (mean age 66 years), 83 (91%) had hypertension, 26 (29%) had small calcific deposits in the valve cusps, and 46 (51%) had simultaneous coronary artery bypass grafting., Conclusions: The causes of pure AR severe enough to warrant isolated AVR are diverse. The most common category in this study was "cause unclear."
- Published
- 2006
- Full Text
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25. Comparison of valve structure, valve weight, and severity of the valve obstruction in 1849 patients having isolated aortic valve replacement for aortic valve stenosis (with or without associated aortic regurgitation) studied at 3 different medical centers in 2 different time periods.
- Author
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Roberts WC, Ko JM, and Hamilton C
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Aortic Valve abnormalities, Aortic Valve surgery, Aortic Valve Insufficiency, Aortic Valve Stenosis pathology, Blood Pressure, Coronary Artery Bypass, Female, Humans, Male, Middle Aged, Organ Size, Aortic Valve pathology, Aortic Valve Stenosis surgery, Heart Valve Prosthesis Implantation trends
- Abstract
Background: Aortic valve replacement (AVR) for patients with aortic stenosis (AS) has now been available for 45 years. During this period, indications for the procedure have changed., Methods and Results: Operatively excised stenotic aortic valves (with or without associated aortic regurgitation and without associated mitral valve disease) from 3 different medical centers (National Institutes of Health, Georgetown University Medical Center, and Baylor University Medical Center) were examined during 2 different time periods by the same physician to compare aortic valve structure, valve weight, age at operation, preoperative transvalvular peak pressure gradient, calculated aortic valve area, and whether simultaneous coronary artery bypass grafting (CABG) was performed. Compared with the first 3 decades (1961-1990) of AVR, patients having this operation during the fourth and fifth decades (1991-2004) had a lower frequency of congenitally malformed aortic valves, a higher frequency of tricuspid aortic valves, an older age, valves of lighter weight and lower transvalvular peak pressure gradients, and more often simultaneous CABG., Conclusions: Although patients having isolated AVR for AS in the present and last decade were older than in the first 3 decades of valve replacement surgery, congenitally malformed aortic valves continue to be more common than tricuspid aortic valves, but the degree of AS and therefore, valve weight was significantly lower than in the earlier decades.
- Published
- 2005
- Full Text
- View/download PDF
26. Frequency by decades of unicuspid, bicuspid, and tricuspid aortic valves in adults having isolated aortic valve replacement for aortic stenosis, with or without associated aortic regurgitation.
- Author
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Roberts WC and Ko JM
- Subjects
- Adult, Age Distribution, Aged, Aged, 80 and over, Analysis of Variance, Aortic Valve surgery, Aortic Valve Stenosis epidemiology, Aortic Valve Stenosis surgery, Catheterization, Female, Heart Diseases congenital, Hemodynamics, Humans, Male, Middle Aged, Retrospective Studies, Sex Factors, Aortic Valve abnormalities, Aortic Valve Insufficiency, Aortic Valve Stenosis etiology, Heart Valve Prosthesis Implantation
- Abstract
Background: Aortic valve stenosis (with or without aortic regurgitation and without associated mitral stenosis) in adults in the Western world has been considered in recent years to most commonly be the result of degenerative or atherosclerotic disease., Methods and Results: We examined operatively excised, stenotic aortic valves from 932 patients aged 26 to 91 years (mean+/-SD, 70+/-12), and none had associated mitral valve replacement or evidence of mitral stenosis: A total of 504 (54%) had congenitally malformed valves (unicuspid in 46 [unicommissural in 42; acommissural in 4] and bicuspid in 458); 417 (45%) had tricuspid valves (either absent or minimal commissural fusion); and 11 (1%) had valves of undetermined type. It is likely that the latter 11 valves also had been congenitally malformed. Of the 584 men, 343 (59%) had either a unicuspid or a bicuspid valve; of the 348 women, 161 (46%) had either a unicuspid or a bicuspid aortic valve., Conclusions: The data from this large study of adults having isolated aortic valve replacement for aortic stenosis (with or without associated aortic regurgitation) and without associated mitral stenosis or mitral valve replacement strongly suggest that an underlying congenitally malformed valve, at least in men, is more common than a tricuspid aortic valve.
- Published
- 2005
- Full Text
- View/download PDF
27. Relation of weights of operatively excised stenotic aortic valves to preoperative transvalvular peak systolic pressure gradients and to calculated aortic valve areas.
- Author
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Roberts WC and Ko JM
- Subjects
- Adult, Age Factors, Aged, Aortic Valve Insufficiency pathology, Aortic Valve Insufficiency surgery, Female, Humans, Male, Middle Aged, Organ Size, Pressure, Severity of Illness Index, Sex Factors, Statistics as Topic, Stroke Volume physiology, Systole physiology, Texas, Treatment Outcome, Aortic Valve pathology, Aortic Valve surgery, Aortic Valve Stenosis pathology, Aortic Valve Stenosis surgery, Heart Valve Prosthesis Implantation
- Abstract
Objectives: The purpose of this study was to correlate the weights of operatively excised stenotic aortic valves to preoperative transvalvular peak systolic gradients and to calculated aortic valve areas., Background: No previous publication has correlated the weights of stenotic aortic valves to the transvalvular gradients or to the calculated aortic valve areas., Methods: We weighed operatively excised stenotic aortic valves in 324 adults who had undergone preoperative left-sided cardiac catheterization., Results: As the weights of the operatively excised stenotic aortic valves increased (from <1 g to >6 g), the average transvalvular peak systolic pressure gradients progressively increased. For any valve weight, in general, the women had higher average transvalvular gradients (p = 0.005) and lower average valve areas (p = 0.008) than did the men. Correlation between aortic valve weight and transvalvular gradient improved further when gender was taken into account., Conclusions: Preoperative transvalvular peak systolic pressure gradients across stenotic aortic valves correlate better with the weights of the operatively excised valves than do the calculated valve areas.
- Published
- 2004
- Full Text
- View/download PDF
28. Weights of individual cusps in operatively-excised stenotic three-cuspid aortic valves.
- Author
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Roberts WC and Ko JM
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Valve abnormalities, Aortic Valve surgery, Aortic Valve Stenosis congenital, Aortic Valve Stenosis surgery, Female, Heart Defects, Congenital surgery, Heart Valve Prosthesis Implantation, Humans, Male, Middle Aged, Aortic Valve pathology, Aortic Valve Stenosis pathology, Body Weight, Heart Defects, Congenital pathology
- Abstract
We weighed each cusp separately in 260 operatively excised stenotic 3-cuspid aortic valves. All 3 cusps differed (by > 0.1 g) in weight in 69 patients (26%); all 3 cusps were similar (a < or = 0.1 g difference) in weight in 33 patients (13%); and 1 cusp differed from either of the other 2 cusps, which were similar in weight, in 158 patients (61%). The weight differences appeared to be caused by differing quantities of calcium on the aortic surfaces of the cusps., (Copyright 2004 Excerpta Medica, Inc.)
- Published
- 2004
- Full Text
- View/download PDF
29. Weights of individual cusps in operatively-excised congenitally bicuspid stenotic aortic valves.
- Author
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Roberts WC and Ko JM
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Valve abnormalities, Aortic Valve surgery, Aortic Valve Stenosis congenital, Aortic Valve Stenosis surgery, Female, Heart Defects, Congenital surgery, Heart Valve Prosthesis Implantation, Humans, Male, Middle Aged, Aortic Valve pathology, Aortic Valve Stenosis pathology, Body Weight, Heart Defects, Congenital pathology
- Abstract
We weighed each cusp separately in 200 operatively excised stenotic congenitally bicuspid aortic valves. It was found in 152 patients (76%) that the cusps differed (by > 0.2 g) in weight and in 48 patients (24%) that the cusps were of similar (a < or = 0.2 g difference) weights. In 161 of the 200 patients (80%), raphes were present in 1 cusp; the raphe and nonraphe cusps differed in weight in 120 patients (74%), with the raphe cusps being larger in 89 patients (74%), and were of similar weights in 41 patients (26%). Of the 39 patients with raphes in neither cusp, 32 cusps (82%) differed in weight and 7 (18%) were of similar weights. The weight of each cusp differed more as the total valve weights increased., (Copyright 2004 Excerpta Medica, Inc.)
- Published
- 2004
- Full Text
- View/download PDF
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