A retrospective descriptive study on 46 patients comorbid rheumatic valvular heart and cerebrovascular ischemic stroke at Viet Tiep Hai Phong Hospital in 2004. Results: this condition appears more common in women than in men (71.74% vs 28.16%), average age 52.70± 0.45. 95.65% of patients are over 30 years old. Most of patients had heart failure at grade NYHA III (89.13%). Causes of cerebrovascular ischemia were simple or combined mitral valve stenosis (100%). 73.91% of patients had first cerebrovascular stroke and 100% patients had sudden hemiplegia. Cerebrovascular stroke in patients with rheumatic heart valvular disease had more atria fibrillation in sinus rhythm (82.61% vs 17.39%). 82.35% patients with acute CVA had been treated by low molecular weight Heparin for 5-7 days in combination with anti-vitamin K. 91.30% patients used anti-vitamin K for the rest of their life. After treatment, clinical condition was improved: 8.69% hemiplegic patients recovered completely, 47.83% recovered partly and 43.48% had no improvement. Mortality rate of CAV was 0%
Heart Valve Diseases ; Stroke

Optimal surgical timing is of crucial importance for the treatment of valvular heart diseases. Clinical implications of functional tricuspid regurgitation (TR) are increasingly being recognized. In contrast to the well-established treatment strategies for left-sided valve disease, optimal surgical timing of functional TR has not yet been established. Several lines of evidence have accumulated over the past 10 years, and now is the perfect time to review the data. The present article reviews the clinical implications and treatment strategies of functional TR, particularly in relation to optimal surgical timing.
Heart Valve Diseases ; Tricuspid Valve Insufficiency*

No abstract available.
Heart Valve Diseases* ; Heart Valves* ; Heart*

Heart Valve Diseases ; therapy ; Humans

To observe the characteristics of the posterior aortic wall motions of the patients with various valvular heart diseases the aortic root echocardiogram of the 60 patients with various valvular diseases were examined. 15 cases in each group of patients with mitral stenosis, mitral insufficiency, mitral stenoinsufficiency or aortic insufficiency. Thirty normal subjects were served as a control group. In each, the total amplitude of the aortic posterior wall motion(OV), the amplitude of the motion evented at atrial systole(AV), AV/OV ratio, atrial emptying index(AEI), left atrial and aortic root dimensions (LAD and AOD), and LAD/AOD were measured. The results were as follows ; 1) The AV was significantly increased in mitral stenosis(P<0.01) and decreased in mitral insufficiency(P<0.05) compared with control group. 2) The OV was increase in mitral insufficiency and aortic insufficiency(p<0.01, p<0.05), but decreased in mitral stenosis(p<0.05). 3) The AV/OV was increased in mitral stenosis(p<0.01) and decreased in mitral insufficiency and aortic insufficiency(p<0.01). 4) The AEI was decreased in all patient groups(p<0.01) and LAD was increase in all compared with control group(p<0.01). 5) The AOD was increased only in aortic insufficiency(p<0.01). 6) The LAD/AOD ratio was increased in all patient groups(p<0.01).
Heart Valve Diseases* ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis

Participants in this study were 50 patients with heart valve diseases who were 16 – 60 years old. In whom, 30 patients have arterial embolism and 20 patients have not. It was found that fibrinogen level has been increased in the patients with vascular embolism. The platelet counts have been increased and there were changes in platelet aggregation. Use of anti-coagulations such as heparin, urokinase and vitamin K provides benefits for variable disease levels if they are used with proper doses.
Heart Valve Diseases ; Heart Valves ; Platelet Aggregation

To stydy the parameters of preload, afterload, and contractility of the heart, we evaluated 10 mitral stenosis, 5 mitral stenoinsufficiency, and 5 mitral stenosis with aortic insufficiency by measuring the external energy potential, external mechaical work, and external energy potential to PVa(Pressure-volume Area) ratio with non-invasive method, echocardiography and carotid pulse tracting. The results are summarized as follows; 1) External energy potential of mitral stenosis was significantly higher than that of MSI or MS with AI. 2) External mechanical work of MSI or MS with AI was significantly higher than that of Ms. 3) External energy potential to PVA ratio was signifiantly higher in the MS, but there was no significantly difference between the MSI and MS with AI. According to the above results, external energy potential to PVA ratio with echocardiogram and carotid pulse tracting was good parameters of preload, afterload, and contractility. And this method may used bed-side monitoring in the clinical area.
Echocardiography ; Heart ; Heart Valve Diseases* ; Mitral Valve Stenosis

Heart Valve Diseases ; therapy ; Heart Valve Prosthesis Implantation ; methods ; Humans

Heart Valve Diseases/therapy* ; Heart Valve Prosthesis Implantation ; Humans

Authors analysed systolic pressure-volume-stress relations by combined echo-pressure-cineangiographic measurement in 10 normal subjects(Group I) and 37 patients with chronic valvular heart diseases. Patients with chronic valvular heart diseases were divided into 3 groups : Group II ; mitral stenosis(n=9), Group III ; mitral stenosis with aortic regurgitation(n=19). The aims of this study are to find useful left ventricular(LV) contractility indices and evaluate left ventricular contractility at various volume loading states. Studied LV contractility indices were maximal elastance of isovolumic contraction(Eiso), endsystolic pressure-volume ratio(Ees) and slope of regression line in late systolic stress-volume loop(A). Eiso was estimated using an isovolumic contraction model of Sunagawa and A was analysed in a single ejecting beat. Endsystolic volume index(ESVI), end diastolic volume index(EDVI), stress at peak pressure(Speak), cardiac index, Vmax, mean Vcf and ejection fraction were determined also. The obtained results were as follows. 1) Significant correlations were found in whole group(n=47) between Eiso and Ees(r=0.88, P<0.005), Elso and cardiac index(r=0.83, P<0.005), Ees and CI(r=<0.76, p<0.005). Further, these correlation coefficiencies were not different between any two groups of Group I, Group II, Group III, Grouop IV and whole group (p<0.05); that is Eiso or Ees had a constant significance at various loading state. 2) Significant correlation between A and cardiac index was noted in Group I+II+III(n=28, r=0.48, p<0.01), but this correlation coefficiency was significantly different from that of Group IV(n=19, r=0.08); p<0.05. 3) In Group II(patients with mitral stenosis), cardiac index* and EDVI* and stress at peak pressure** were decreased significantly(*:p<0.05, **:p<0.005). But Eiso, Ees, A and all the other idices were not decreased. These findings suggested that left ventricular contractility is not reduced in mitral stenosis. 4) In Group IV(patients with amitral regurgitation with or without aortic regurgitation), **EDVI and ESVI** were increased while Eiso**, Ees, Vmax*, mean Vcf* and cardiac index** were decreased significantly. But ejection fraction and A were not decrease. These findings suggested that ejection fraction and A may not be decreased at volume overload, despite of impaired left ventricular contractility. In summary; Eiso or Ees was evaluated as an useful contractility index which appeared not to be influenced by various volume loading state, while eiection fraction and A to be influenced. Patients with mitral stenosis as a group have reduced cardiac performance which is not due to impairment of left ventricular contractility(muscle function) but to reduced preload.
Constriction, Pathologic ; Heart Valve Diseases* ; Humans ; Mitral Valve Stenosis