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Prosthetic Heart Valves

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Learning Cardiac Auscultation

Abstract

Recent technological advances have led to a proliferation of prosthetic heart valves, primarily for the treatment of mitral and aortic disease. Cardiac auscultation can be a powerful tool to differentiate the various types of mechanical and bioprosthetic valves, to identify prognostic factors, and to diagnose complications. In this chapter, we will review relevant cardiac anatomy and physiology, related tests including echocardiography, the characteristic auscultation profiles of various mitral and aortic prostheses, as well as diagnostic and prognostic factors, complications, indications for valve replacement, and the management of patients with prosthetic valves.

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References

  1. Aurigemma, GP, Gaasch, WH, Otto, CM, Yeon, SB. Management of patients with prosthetic heart valves [Internet]. Wolters Kluwer Health; 2013 [Updated 4 Jan 2013; cited 29 Mar 2013]. Available from: http://www.uptodate.com/contents/management-of-patients-with-prosthetic-heart-valves?view=print.

  2. Aurigemma, GP and Gaasch, WH. Complications of prosthetic heart valves [Internet]. Wolters Kluwer Health; 2013 [Updated 1 Nov 2012; cited 29 Mar 2013]. Available from: http://www.uptodate.com/contents/complications-of-prosthetic-heart-valves?view=print.

  3. Horstkotte D, Friedrichs W, Pippert H, et al. Benefits of endocarditis prevention in patients with prosthetic heart valves. Z Kardiol. 1986;75:8.

    CAS  PubMed  Google Scholar 

  4. Tornos P, Almirante B, Olona M, Permanyer G, Gonzalez T, Carbalo J, Pahissa A, Soler-Soler J. Clinical outcome and long-term prognosis of late prosthetic valve endocarditis: a 20 year experience. Clin Infect Dis. 1997;24:381–6.

    Article  CAS  PubMed  Google Scholar 

  5. Vongpatanasin W, Hillis LD, Lange RA. Prosthetic heart valves. N Engl J Med. 1996;335:407.

    Article  CAS  PubMed  Google Scholar 

  6. Hammermeister KE, Sethi GK, Henderson WG, et al. A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease. N Engl J Med. 1993;328:1289.

    Article  CAS  PubMed  Google Scholar 

  7. Bloomfield P, Wheatley DJ, Prescott RJ, Miller HC. Twelve-year comparison of a Bjork-Shiley mechanical heart valve with porcine bioprostheses. N Engl J Med. 1991;324:573.

    Article  CAS  PubMed  Google Scholar 

  8. Yacoub M, Rasmi NR, Sundt TM, et al. Fourteen-year experience with homovital homografts for aortic valve replacement. J Thorac Cardiovasc Surg. 1995;110:186.

    Article  CAS  PubMed  Google Scholar 

  9. O'Brien MF, Stafford EG, Gardner MA, et al. Allograft aortic valve replacement: long-term follow-up. Ann Thorac Surg. 1995;60:S65.

    Article  PubMed  Google Scholar 

  10. Hammermeister K, Sethi GK, Henderson WG, et al. Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. J Am Coll Cardiol. 2000;36:1152.

    Article  CAS  PubMed  Google Scholar 

  11. Yun KL, Miller DC, Moore KA, et al. Durability of the Hancock MO bioprosthesis compared with standard aortic valve bioprostheses. Ann Thorac Surg. 1995;60:S221.

    Article  CAS  PubMed  Google Scholar 

  12. Blot WJ, Ibrahim MA, Ivey TD, et al. Twenty-five-year experience with the Björk-Shiley convexoconcave heart valve: a continuing clinical concern. Circulation. 2005;111:2850.

    Article  PubMed  Google Scholar 

  13. Darwazzah AK. Recurrent pannus formation causing prosthetic aortic valve dysfunction: Is excision without valve re-replacement applicable? J Cardiothor Surg. 2012;7:62.

    Article  Google Scholar 

  14. Teshima H, Hayashida N, Yano H, Nishimi M, Tayama E, Fukunaga S, Akashi H, Kawara T, Aoyagi S. Obstruction of St. Jude Medical valves in the aortic position: histology and immunohistochemistry of pannus. J Thorac Cardiovasc Surg. 2003;126(2):401–7.

    Article  PubMed  Google Scholar 

  15. Teshima H, Fukunaga S, Takaseya T, Tomoeda H, Akashi H, Aoyagi S. Obstruction of St. Jude medical valves in the aortic position: plasma transforming growth factor type beta 1 in patients with pannus overgrowth. J Artif Organs. 2010;34(3):210–5.

    Article  Google Scholar 

  16. Puvimanasinghe JP, Steyerberg EW, Takkenberg JJ, et al. Prognosis after aortic valve replacement with a bioprosthesis: predictions based on meta-analysis and microsimulation. Circulation. 2001;103:1535.

    Article  CAS  PubMed  Google Scholar 

  17. Remadi JP, Baron O, Roussel C, et al. Isolated mitral valve replacement with St. Jude medical prosthesis: long- term results: a follow-up of 19 years. Circulation. 2001;103:1542.

    Article  CAS  PubMed  Google Scholar 

  18. Dürrleman N, Pellerin M, Bouchard D, et al. Prosthetic valve thrombosis: twenty-year experience at the Montreal Heart Institute. J Thorac Cardiovasc Surg. 2004;127:1388.

    Article  PubMed  Google Scholar 

  19. Roudaut R, Lafitte S, Roudaut MF, et al. Fibrinolysis of mechanical prosthetic valve thrombosis: a single-center study of 127 cases. J Am Coll Cardiol. 2003;41:653.

    Article  PubMed  Google Scholar 

  20. Barbetseas J, Pitsavos C, Aggeli C, et al. Comparison of frequency of left atrial thrombus in patients with mechanical prosthetic cardiac valves and stroke versus transient ischemic attacks. Am J Cardiol. 1997;80:526.

    Article  CAS  PubMed  Google Scholar 

  21. Cannegieter SC, Rosendaal FR, Wintzen AR, et al. Optimal oral anticoagulant therapy in patients with mechanical heart valves. N Engl J Med. 1995;333:11.

    Article  CAS  PubMed  Google Scholar 

  22. Cannegieter SC, Rosendaal FR, Briët E. Thromboembolic and bleeding complications in patients with mechanical heart valve prostheses. Circulation. 1994;89:635.

    Article  CAS  PubMed  Google Scholar 

  23. North RA, Sadler L, Stewart AW, et al. Long-term survival and valve-related complications in young women with cardiac valve replacements. Circulation. 1999;99:2669.

    Article  CAS  PubMed  Google Scholar 

  24. Guidelines for valvular heart disease with 2008 focus update [Internet]. American College of Cardiology; 2008 [Cited 29 Mar 2013]. Available from: http://cardiocompass.cardiosource.org/cc2/openCont1?smID=1465&hiliteDivID=sec6_1_7&q=indications%20for%20valve%20replacement.

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Correspondence to Christine K. Chan MS, MD .

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1 Electronic Supplementary Material

Video 21.1

Prosthetic valve sounds: AVR with a St. Jude valve, no gradient, soft SEM (Provided by Robin Winkler Doroshow, MD, Medstar Georgetown University Hospital, Washington, DC) (MP4 1203 kb)

Video 21.2

Prosthetic valve sounds, as described by Dr. W. Proctor Harvey (File 397 from Clinical Cardiology by W. Proctor Harvey, MD, MACC, Jules Bedynek, MD, and David Canfield and published by Laennec Publishing Inc., Fairfield, NJ. Used with permission and copyrighted by Laennec Publishing, Inc. All rights reserved) (MP4 44475 kb)

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Chan, C.K., Henricus, M.M., Ibrahim, G.S., Maniya, O.Z. (2015). Prosthetic Heart Valves. In: Taylor, A. (eds) Learning Cardiac Auscultation. Springer, London. https://doi.org/10.1007/978-1-4471-6738-9_21

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  • DOI: https://doi.org/10.1007/978-1-4471-6738-9_21

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6737-2

  • Online ISBN: 978-1-4471-6738-9

  • eBook Packages: MedicineMedicine (R0)

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