Aortic Insufficiency

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T Desai - One of the best experts on this subject based on the ideXlab platform.

  • Acute Aortic Insufficiency in a patient with presumed Reiter's syndrome.
    Annals of the rheumatic diseases, 1992
    Co-Authors: P Misukiewicz, R W Carlson, L Rowan, N Levitt, C Rudnick, T Desai
    Abstract:

    Cardiac disease is rare in patients with Reiter's syndrome. There have been 15 reported cases of Aortic Insufficiency in patients with Reiter's syndrome, with the Aortic Insufficiency developing over several years. This paper reports the case of a black HLA-B27 negative woman who presented with Reiter's syndrome and acute Aortic Insufficiency. An antecedent streptococcal infection is suggested as the inciting factor. To our knowledge, this is the first report of Reiter's syndrome in a black woman with acute Aortic Insufficiency.

Peter Barland - One of the best experts on this subject based on the ideXlab platform.

  • Sensorineural hearing loss in conjunction with Aortic Insufficiency in systemic lupus erythematosus.
    Scandinavian journal of rheumatology, 2001
    Co-Authors: Elena Peeva, Peter Barland
    Abstract:

    Sensorineural hearing loss may occur in SLE, but Aortic Insufficiency has been very rarely reported. We are describing two patients with well-established SLE who developed bilateral hearing loss and Aortic Insufficiency, associated with serological evidence of active lupus. Neither patient had evidence of keratitis, and thus did not satisfy criteria for Cogan's syndrome. The Aortic Insufficiency in one patient stabilized after treatment with high doses of steroids while in the second patient, who refused medical treatment, it progressed requiring surgical valve replacement. Our observations suggest that the Aortic valve and the inner ear may share some antigenic crossreactivity not shared by the cornea. In SLE patients, with sensorineural hearing loss, echocardiography should be performed looking for evidence of Aortic Insufficiency, which may be steroid responsive.

P Misukiewicz - One of the best experts on this subject based on the ideXlab platform.

  • Acute Aortic Insufficiency in a patient with presumed Reiter's syndrome.
    Annals of the rheumatic diseases, 1992
    Co-Authors: P Misukiewicz, R W Carlson, L Rowan, N Levitt, C Rudnick, T Desai
    Abstract:

    Cardiac disease is rare in patients with Reiter's syndrome. There have been 15 reported cases of Aortic Insufficiency in patients with Reiter's syndrome, with the Aortic Insufficiency developing over several years. This paper reports the case of a black HLA-B27 negative woman who presented with Reiter's syndrome and acute Aortic Insufficiency. An antecedent streptococcal infection is suggested as the inciting factor. To our knowledge, this is the first report of Reiter's syndrome in a black woman with acute Aortic Insufficiency.

Wilson Y. Szeto - One of the best experts on this subject based on the ideXlab platform.

  • Recurrent Aortic Insufficiency after emergency surgery for acute type A Aortic dissection with Aortic root preservation
    The Journal of thoracic and cardiovascular surgery, 2020
    Co-Authors: Markian M. Bojko, Andreas Habertheuer, Joseph E. Bavaria, Maham Suhail, Joey Harmon, Nimesh D. Desai, Rita K. Milewski, Matthew L. Williams, Wilson Y. Szeto
    Abstract:

    Abstract Objective Patients with acute type A Aortic dissection demonstrate a wide range of Aortic Insufficiency. Outcomes after valve resuspension and root repair are not well studied in the long term. We evaluated the long-term effects of preoperative Aortic Insufficiency in patients undergoing emergency root-preserving surgery for acute type A Aortic dissection. Methods From 2002 to 2017, 558 of 776 patients with acute type A Aortic dissection underwent native Aortic valve resuspension and root reconstruction. Patients were stratified into 4 groups by preoperative Aortic Insufficiency grade (n = 539): Aortic Insufficiency less than 2+ (n = 348), Aortic Insufficiency = 2+ (n = 72), Aortic Insufficiency = 3+ (n = 49), and Aortic Insufficiency = 4+ (n = 70). Multivariable ordinal longitudinal mixed effects and multi-state transition models were used to assess risk factors for recurrent Aortic Insufficiency. Results The prevalence of cardiogenic shock in patients presenting with preoperative Aortic Insufficiency less than 2+, 2+, 3+, and 4+ was 53 of 348 (15.2%), 12 of 72 (16.7%), 10 of 49 (20.4%), and 24 of 70 (34.3%), respectively (P = .002). Postoperatively, 94.0% of patients had Aortic Insufficiency 1+ or less at discharge. Operative mortality was 34 of 348 (9.8%), 10 of 72 (13.9%), 6 of 49 (12.2%), and 12 of 70 (17.1%) (P = .303). In an ordinal mixed effects model, preoperative Aortic Insufficiency was associated with more severe postoperative Aortic Insufficiency. The multi-state transition model demonstrated that severe Aortic Insufficiency was associated with progression from no to mild Aortic Insufficiency (hazard ratio, 2.14; 95% confidence interval, 1.35-3.38), and progression from mild to moderate Aortic Insufficiency (hazard ratio, 5.70; 95% confidence interval, 1.88-17.30). Conclusions Preoperative Aortic Insufficiency is an important predictor of recurrent Aortic Insufficiency in patients undergoing valve resuspension with root reconstruction for emergency acute type A Aortic dissection repair. Increased echocardiographic surveillance for recurrent Aortic Insufficiency may be warranted in this cohort.

Ehud Raanani - One of the best experts on this subject based on the ideXlab platform.

  • Pericardial Patch Augmentation Is Associated With a Higher Risk of Recurrent Aortic Insufficiency.
    The Annals of thoracic surgery, 2018
    Co-Authors: Eilon Ram, Yaron Moshkovitz, Ami Shinfeld, Alexander Kogan, Alexander Lipey, Sagit Ben Zekry, Ronny Ben-avi, Shany Levin, Ehud Raanani
    Abstract:

    Background This study assessed early and late clinical outcomes in patients who underwent Aortic valve repair or an Aortic valve-sparing operation and investigated predictors for failure. Methods Of 227 consecutive patients who underwent Aortic valve repair or a valve-sparing operation in our department between 2004 and 2016, 81 (36%) underwent Aortic root replacement with or without cusp repair, 97 (42%) ascending aorta replacement with or without cusp repair, and 49 (22%) isolated Aortic valve repair. Clinical and echocardiographic follow-up was complete. Results One patient (0.4%) died in-hospital. Mean clinical and echocardiographic follow-up was 69 ± 40 months (range, 1 to 147 months) and 53 ± 40 months (range, 1 to 147 months), respectively. Fifteen patients (6.6%) died during follow-up, with an overall 5-year survival rate of 94.4%. Recurrent significant (≥3) Aortic Insufficiency developed in 20 patients (8.8%), 17 of whom underwent reoperation, with a 5-year freedom from reoperation rate of 88%. Predictors for recurrent significant Aortic Insufficiency or reoperation were greater preoperative Aortic Insufficiency (grade III to IV vs I to II; relative risk [RR], 1.97; p = 0.023), cusp repair (RR, 2.92; p = 0.001), higher European System for Cardiac Operative Risk Evaluation score (RR, 1.16; p = 0.006), and valve repair with pericardial patch augmentation (RR, 2.34; p = 0.032). Conclusions Aortic valve repair and valve-sparing operations can be performed with good early and late clinical outcomes. In our experience, however, the rate of recurrent Aortic Insufficiency was significant, especially in patients who underwent cusp augmentation with glutaraldehyde-treated autologous pericardial patch.