Should We Worry About Bicuspid Aortic Valve?

Discussion The aortic valve usually has 3 leaflets. In bicuspid aortic valve (BAV) there are 2 asymmetric leaflets with a fish-mouthed orifice between them which may not open fully. It occurs in about 0.5-2% of the population making it one of the most common congenital heart anomalies and the most common one in adults. Transmission is autosomal dominant yet males are more likely to have BAV, indicating potential reduced penetrance in females. “BAVs are different, however, in that the tissue pathology is not limited to the valves’ leaflets but extends from the left ventricular outflow tract to the ascending thoracic aorta” and therefore can be associated with other congenital heart disease. With BAV, a murmur may be heard which classically is a grade 1-2/6 systolic ejection murmur best at the right upper sternal border associated with an early systolic click. BAV may not be clinically apparent though. Learning Point BAV is usually considered a benign condition as it may not cause any problems. However as patients age, BAV does have an increased risk of aortic valve stenosis (AVS) and/or aortic valve insufficiency (AVI), calcification of the leaflets, aortic root dilatation, aortic aneurysm, aortic dissection and can also be a nidus for infective endocarditis. AVS is associated with BAV in 70-85% of pediatric patients and about 50% of adult patients. AVS can cause left ventricular outlet obstruction with compensatory ventricular hypertrophy and potentially ca...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news

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RARITAN, NJ, March 28, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson today announced the VOYAGER PAD study met its primary efficacy and principal safety endpoints, demonstrating the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily) plus aspirin (100 mg once daily) was superior to aspirin alone in reducing the risk of major adverse limb and cardiovascular (CV) events by 15 percent in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization, with similar rates of TIMI[1] major bleeding. VOYAGER PAD is the only study to show a significant benefit...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
Authors: Oh JH PMID: 32216175 [PubMed]
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
CONCLUSIONS: More neonatal surgeries (491 vs. 74 patients) were performed than those in the past (1984-1999). The surgical outcomes were much better than before. Our surgical outcomes revealed that the Republic of Korea has been transformed from a country receiving help to a country that helps other low socioeconomic status countries. PMID: 32212426 [PubMed - as supplied by publisher]
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
CONCLUSIONS: Based on our experience, IIA embolization does cause buttock claudication of a certain degree. However, the most of them experienced mild discomfort rather than such symptoms severely affect their quality of life. Considering the risks of general anesthesia and complications of surgical procedures, IIA reconstruction along with EVAR may not be necessary. PMID: 32214071 [PubMed - as supplied by publisher]
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
CONCLUSION: This study showed the frequency and pattern of chromosomal abnormalities of MDS patients in upper northern Thailand were different from other populations. MDS with isolated chromosome 5 abnormalities had clinical characteristics corresponding with patients in good prognosis risk group. However, MDS patients with chromosome 7 and complex abnormalities showed higher percentage blast of BM which high risk to progression to acute myeloid leukemia (AML). Combined CC and FISH techniques detect chromosomal abnormalities with greater frequency than when either technique is used alone.. PMID: 32212788 [PubMed - in process]
Source: Asian Pacific Journal of Cancer Prevention - Category: Cancer & Oncology Tags: Asian Pac J Cancer Prev Source Type: research
Abstract Aortic structure and function are controlled by the coordinated actions of different aortic cells and the extracellular matrix. Several pathways have been identified that control the aortic wall in a cell-type-specific manner and play diverse roles in various phases of aortic injury, repair, and remodeling. This complexity of signaling in the aortic wall poses challenges to the development of therapeutic strategies for treating aortic aneurysms and dissections. Here, in part II of this Recent Highlights series on aortic aneurysms and dissections, we will summarize recent studies published in Arteriosclero...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
AbstractAimsThe PREPARE ‐MVR study (PRediction of Early PostoperAtive Right vEntricular failure in Mitral Valve repair (MVR) and to explore the associations between/Repair patients) sought to investigate the alterations of right ventricular (RV) contraction pattern in patients undergoing mitral valve replacement/repair ( MVR) and to explore the associations between pre‐operative RV mechanics and early post‐operative RV dysfunction (RVD).Methods and resultsWe prospectively enrolled 42 patients (63  ± 11 years, 69% men) undergoing open‐heart MVR. Transthoracic three‐dimensional (3D) echocardio...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
This study discusses the rare possible etiologies of USNHL that can be easily missed if these are not ruled out properly. We present these cases to consider these heterogeneous and distinct ca uses of USNHL because of rarity of these etiologies. If such an etiology is diagnosed in time, they may be managed effectively.
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research
AbstractWarthin tumour is the second most common benign neoplasm of salivary glands. Despite its relatively characteristic histology, it may sometimes mimic other lesions. Here, we report two female non-smoker patients diagnosed with low-grade mucoepidermoid carcinoma with oncocytic epithelium and prominent lymphoid (Warthin-like) stroma and with molecularly confirmedMAML2 rearrangement. In addition, we screened a consecutive series of 114 Warthin tumour cases by means ofMAML2 break apart fluorescence in situ hybridization to assess its value in differential diagnosis.MAML2 rearrangement was detected in both mucoepidermoid...
Source: Virchows Archiv - Category: Pathology Source Type: research
AbstractPreoperative hyperbilirubinemia is associated with increased mortality and morbidity after cardiac surgery. However, this clinical significance is unclear with transcatheter aortic valve replacement (TAVR) procedures. The aims of this study were to determine the prevalence and prognostic implications of preoperative elevations of serum total bilirubin on TAVR outcomes. In 611 consecutive patients who underwent an elective TAVR procedure, 576 patients had recorded serum total bilirubin levels. Hyperbilirubinemia was defined as any value of serum total bilirubin  ≥ 1.2 mg/dL obtained within 30-d...
Source: Heart and Vessels - Category: Cardiology Source Type: research
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