Internationally renowned cardiologists Drs. Catherine M. Otto and Robert O. Bonow help you to apply all of the latest scientific knowledge and clinical strategies with Valvular Heart Disease, a companion to Braunwalds Heart Disease. This indispensable resource for your everyday practice provides all of the knowledge you need to give your patients the most accurate diagnoses, the best possible heart disease treatment options, and the expert care they deserve. Apply todays best medical and surgical approaches with comprehensive, expert guidance on todays full range of clinical heart disease treatments. Provide appropriate care to pediatric and pregnant patients with focused chapters on the unique needs of these special populations. Update your knowledge of these increasingly common heart diseases with brand-new chapters covering 3-dimensional anatomy of the aortic and mitral valves clinical and genetic risk factors for calcific valve disease risk assessment for aortic and mitral valve surgery image-guided transcatheter valve procedures optimal timing of valve interventions state-of-the-art valve surgery and much more. Apply the most current standards of practice with summaries of the ACC/AHA and new ESC valvular heart disease guidelines in each chapter. Vividly visualize heart valve anatomy and dysfunction, as well as important techniques and procedures, thanks to a multitude of detailed illustrations, full-color images, and online video content. Search the full text and access all the images online at Expert Consult. Your purchase entitles you to access the web site until the next edition is published, or until the current edition is no longer offered for sale by Elsevier, whichever occurs first. Elsevier reserves the right to offer a suitable replacement product (such as a downloadable or CD-ROM-based electronic version) should access to the web site be discontinued.
Author(s): Catherine M. Otto MD FACC FAHA, Robert O. Bonow MD MS MACC FAHA
Series: Expert Consult Title: Online + Print
Edition: 4
Publisher: Saunders
Year: 2013
Language: English
Pages: 488
Tags: Медицинские дисциплины;Кардиология;
Front cover......Page 1
Inside front cover......Page 2
Half title page......Page 3
Series page......Page 4
Valvular Heart Disease: A Companion to Braunwald's Heart Disease......Page 5
Copyright page......Page 6
Contributors......Page 7
Foreword......Page 11
Preface......Page 13
Acknowledgments......Page 15
Table of Contents......Page 17
Video Contents......Page 19
Rheumatic Disease......Page 23
Endomyocardial Fibrosis......Page 25
Functional Mitral Regurgitation......Page 26
Congenital Disease......Page 27
Carcinoid Tumors......Page 28
Etiology and Frequency of Disease by Valve......Page 29
Aortic Stenosis and Regurgitation......Page 30
Mitral Regurgitation......Page 31
Prevention......Page 32
References......Page 33
Mitral Valve Leaflets......Page 36
Degenerative Mitral Valve Disease......Page 38
Ischemic Mitral Regurgitation......Page 39
Mechanism of Ischemic Mitral Regurgitation......Page 41
Mitral Leaflet Tethering in Ischemic Mitral Regurgitation.......Page 42
Leaflet Growth in Ischemic Mitral Regurgitation.......Page 43
Mitral Stenosis......Page 44
Aortic Valve Anatomy......Page 45
Aortic Valve Physiology......Page 46
Left Ventricular Outflow Tract......Page 47
Three-Dimensional Assessment of the Aortic Valve......Page 48
Conclusion......Page 49
References......Page 50
Risk Factors Converge on a Pathogenic Response to Chronic Injury......Page 52
Clinical Observations in Humans......Page 54
Experimental Models......Page 55
Wnt/β-Catenin Signaling......Page 56
Angiotensin II......Page 59
Inflammatory Cell Infiltrate and Proinflammatory Cytokines......Page 60
Notch1 Signaling......Page 64
Matrix-Degrading Enzymes......Page 65
Epigenetic Regulation of Osteogenic Signaling......Page 69
Fibrosis and Matrix Modulation of Calcification......Page 70
Translation of Biological Findings to Therapeutic Interventions......Page 71
References......Page 72
Bicuspid Aortic Valves......Page 75
Older Age......Page 76
Hypertension......Page 77
Dyslipidemia......Page 78
Renal Dysfunction......Page 79
Genetic Associations with CAVD......Page 80
CAVD and Clinical Outcomes......Page 81
References......Page 82
Aortic Stenosis......Page 85
Concentric Hypertrophy and Left Ventricular Function......Page 87
Mechanisms of Hypertrophy in Aortic Stenosis versus Mitral Regurgitation......Page 88
Aortic Regurgitation: A Hybrid Disease......Page 89
References......Page 90
Echocardiographic Valve Anatomy......Page 92
Velocity Data and Pressure Gradients......Page 94
Continuity Equation......Page 98
Pressure Half-Time......Page 99
Stenosis Severity with Changes in Flow Rate......Page 100
Qualitative Measures of Regurgitation Severity......Page 101
Distal Flow Reversals......Page 102
Proximal Flow Convergence......Page 105
Volumes and Ejection Fraction......Page 106
Diastolic Function......Page 109
References......Page 111
Pressures......Page 113
Angiocardiography......Page 114
Fick Technique......Page 115
Basic Principles......Page 116
Pressure Gradients......Page 117
General Concepts.......Page 119
Low-Gradient Aortic Stenosis......Page 120
Pulmonic Valve......Page 121
Valve Area......Page 122
Angiocardiography......Page 123
Angiocardiography......Page 124
Angiocardiography......Page 125
Left Ventricular Diastolic Function......Page 126
References......Page 127
Cardiac Magnetic Resonance......Page 129
Cardiac Computed Tomography......Page 130
Valvular Stenosis......Page 131
Aortic Stenosis......Page 132
Mitral Stenosis......Page 133
Valvular Regurgitation......Page 134
Aortic Regurgitation......Page 135
Pulmonic and Tricuspid Valve Regurgitation......Page 136
Coronary Artery Disease in Patients with Valvular Heart Disease......Page 137
References......Page 139
Diagnosis of Valve Disease......Page 141
Diagnosis and Prevention of Rheumatic Fever......Page 143
Prevention of Infective Endocarditis......Page 144
Anticoagulation Clinics......Page 145
Anticoagulation with Native Valve Disease......Page 147
Monitoring Disease Progression......Page 148
Primary Treatment......Page 149
Medical Treatment of Symptomatic Disease......Page 150
Arrhythmias......Page 151
Patient Education......Page 152
References......Page 153
How Risk Algorithms Are Constructed......Page 156
What Can Be Predicted?......Page 157
Available Risk Algorithms for Aortic Stenosis......Page 158
Risk Algorithms in Transcatheter Aortic Valve Implantation......Page 159
References......Page 160
Pressure Gradients......Page 161
Other Indices of Stenosis Severity......Page 162
Exercise Physiology......Page 163
Physical Examination......Page 164
Stress Testing......Page 165
Asymptomatic Patients......Page 167
Risk Stratification in Asymptomatic Patients......Page 168
Aortic Sclerosis and Mild to Moderate Aortic Stenosis......Page 171
Hemodynamic Progression......Page 172
Surgery in Asymptomatic Patients......Page 173
Intervention in the Elderly......Page 175
Aortic Stenosis with Left Ventricular Dysfunction......Page 177
Left Ventricular Systolic Function......Page 178
Management of Arterial Hypertension......Page 179
References......Page 180
Diagnosis......Page 185
Pathophysiology......Page 186
Physical Examination......Page 188
Echocardiography......Page 190
Cardiac Magnetic Resonance.......Page 191
Natural History......Page 192
Patients with Normal Left Ventricular Systolic Function......Page 193
Prevention of Endocarditis......Page 194
Concomitant Aortic Root Disease......Page 195
References......Page 197
Embryology......Page 201
Anatomy, Pathology, and Classification Schemes......Page 202
Prevalence......Page 203
Coarctation of the Aorta......Page 204
Coronary Artery Anomalies......Page 205
Valvular Complications......Page 206
Disease Course and Outcomes......Page 208
Aortic Stenosis......Page 209
Pregnancy......Page 210
Hemodynamics and Flow......Page 211
Aortic Medial Disease and Ascending Aortic Dilation......Page 212
Pathophysiology and Molecular Biology of Bicuspid Aortic Valve Aortopathy......Page 214
Late Aortic Complications Following Bicuspid Aortic Valve Replacement......Page 215
Surgical Treatment of the Bicuspid Aortic Valve and Ascending Aorta......Page 216
Acknowledgement......Page 217
References......Page 218
Tissue Valves: Stented......Page 221
Mechanical Valves......Page 222
Ross Procedure......Page 223
Guidelines for Valve Choice......Page 224
Aortic Valve Repair......Page 226
Risks of Aortic Valve Replacement......Page 227
Indications......Page 228
Aortic Root Replacement with Composite Valve-Graft (Modified Bentall Procedure)......Page 229
Valve-Sparing Aortic Root Replacement (David and Yacoub Procedures)......Page 230
Aortic Root Enlargement......Page 231
Aortic Valve Replacement after Coronary Artery Bypass Grafting Surgery......Page 233
Porcelain Aorta......Page 234
AVR with Sutureless Prosthetic Valve......Page 236
Aortic Valve Replacement in the Elderly......Page 237
References......Page 238
Balloon-Expandable Percutaneous Aortic Valves......Page 241
“Next-Generation” Valves......Page 242
The PARTNER Trial......Page 243
United Kingdom Transcatheter Aortic Valve Implantation Registry......Page 245
Patient Selection......Page 247
Current TAVI “State of the Art”......Page 250
Balloon Aortic Valvuloplasty......Page 251
References......Page 253
Valvular Heart Disease in the Era of Transcatheter Valve Procedures......Page 255
Multidetector Computed Tomography......Page 257
Transthoracic and Transesophageal Echocardiography......Page 259
Balloon Aortic Valvuloplasty......Page 260
Pulmonic Valve Balloon Valvuloplasty......Page 263
Transcatheter Aortic Valve Implantation......Page 266
Transcatheter Pulmonic Valve Implantation......Page 268
Transcatheter Repair of Paravalvular Regurgitation......Page 269
Summary......Page 270
References......Page 274
Left Atrium......Page 277
Exercise Physiology......Page 278
Chest Radiography and Electrocardiography......Page 279
Assessment of Valve Morphology......Page 280
Consequences of Mitral Stenosis......Page 281
Stress Testing......Page 282
Prevention of Rheumatic Fever......Page 283
Open Surgical Commissurotomy......Page 284
Technique......Page 285
Monitoring of the Procedure and Assessment of Immediate Results......Page 286
Immediate Results......Page 287
Risks......Page 288
Long-Term Results......Page 289
Treatment Strategy......Page 291
References......Page 296
Anatomy of the Normal and Myxomatous Mitral Valve......Page 300
Etiology and Pathology of Mitral Valve Prolapse......Page 301
Genetic Factors......Page 303
Epidemiology and Natural History......Page 304
Echocardiographic Diagnosis......Page 305
Localization of Prolapse and Flail by Echocardiography......Page 307
Assessment of Mitral Regurgitation......Page 308
Electrocardiography......Page 309
Management of the Asymptomatic Patient......Page 310
Infective Endocarditis......Page 311
Sudden Cardiac Death and Ventricular Arrhythmia......Page 312
References......Page 313
Secondary Mitral Regurgitation in the Presence of Coronary Artery Disease......Page 317
Dynamic Changes......Page 318
Dilated Cardiomyopathy......Page 319
Atrial Functional Mitral Regurgitation......Page 320
Echocardiography......Page 321
In the Setting of Coronary Artery Disease......Page 326
Reperfusion and Percutaneous Revascularization......Page 327
Surgical Techniques......Page 328
References......Page 329
Acute Volume Overload Stage......Page 332
Natural History......Page 333
Predictors of Outcome......Page 335
Advances in Surgical Intervention......Page 336
Early Mortality......Page 339
Prediction of Postoperative Left Ventricular Dysfunction......Page 341
Effect of Surgical Correction on Outcome......Page 343
Etiology of Mitral Regurgitation......Page 346
Clinical Evaluation......Page 347
Symptomatic Patients: Normal Left Ventricular Function......Page 348
Asymptomatic Patients: Normal Left Ventricular Function......Page 350
Ischemic Mitral Regurgitation: Indications for Operation......Page 351
Functional Mitral Regurgitation: Indications for Operation......Page 353
References......Page 355
21 Mitral Valve Repair and Replacement......Page 357
Mitral Leaflets and Commissures......Page 358
Etiology and Lesions......Page 359
Mitral Valve Surgery......Page 360
Surgical Approach......Page 361
Mitral Valve Repair......Page 364
Degenerative Mitral Valve Disease......Page 366
Ischemic Mitral Regurgitation......Page 368
Outcomes of Mitral Valve Replacement......Page 369
References......Page 370
Classification of Percutaneous Repair Therapies......Page 372
Mitraclip......Page 373
Other Devices......Page 374
Indirect Annuloplasty......Page 376
Direct Annuloplasty and Hybrid Techniques......Page 378
Left Ventricular Remodeling Techniques......Page 379
Transcatheter Mitral Valve Replacement......Page 380
References......Page 382
The Mitral Valve Complex......Page 384
Nomenclature......Page 385
Presurgical Preparation......Page 386
Doppler Echocardiography Quantification......Page 387
Loading Conditions......Page 390
Color Doppler Imaging......Page 392
Three-Dimensional Transesophageal Echocardiography......Page 393
Carpentier Type II (Excessive Leaflet Motion)......Page 394
Prosthetic Valves......Page 395
Tricuspid Regurgitation......Page 397
Native Valve Assessment......Page 398
Guidelines and Outcome......Page 400
References......Page 403
Response of the Right Heart to Pressure and/or Volume Overload......Page 406
Etiology......Page 407
Diagnosis......Page 410
Natural History......Page 411
Timing of Surgery......Page 412
Tricuspid Regurgitation with Mitral Valve Disease......Page 413
Atrial Septal Defect.......Page 414
Diagnosis......Page 415
Natural History......Page 417
Medical, Interventional, and Surgical Treatment......Page 418
Medical and Surgical Treatment......Page 421
Summary......Page 422
References......Page 423
Historical Background......Page 427
Incidence of Infective Endocarditis and Associated Mortality......Page 428
Groups at High Risk for Development of Infective Endocarditis, and the Determination of Prognosis......Page 429
Prophylaxis......Page 430
Pathophysiology and Pathogenesis......Page 431
Clinical Manifestations......Page 433
The Evolution of the Duke Criteria......Page 434
Transthoracic and Transesophageal Echocardiography......Page 435
Vegetations......Page 436
Other Imaging Modalities in the Diagnosis of Infective Endocarditis......Page 437
Specific Complications......Page 438
Embolization......Page 439
Common Features of Management......Page 440
Mortality, Morbidity, and Role of Surgical Intervention......Page 441
Culture-Negative Endocarditis......Page 443
Prosthetic Valve Endocarditis......Page 444
Other Causes of Gram-Negative Endocarditis......Page 446
Endocarditis Due to Other Fungi......Page 447
References......Page 448
26 Prosthetic Heart Valves......Page 451
Mechanical Valves......Page 452
Durability and Long-Term Outcomes......Page 454
Stented Heterograft Valves......Page 455
Stentless Heterograft Valves......Page 456
Homografts......Page 457
Comparison of Mechanical and Tissue Valves......Page 458
Anticoagulant Therapy......Page 459
Anticoagulation in Pregnant Women......Page 460
Clinical Assessment......Page 461
Echocardiography......Page 462
Structural Valve Deterioration......Page 463
Paravalvular Regurgitation......Page 464
Infective Endocarditis......Page 465
Prosthetic Valve Thrombosis......Page 466
References......Page 467
Peripartum and Postpartum Changes......Page 470
Epidemiology......Page 471
Risk Factors for Adverse Outcomes......Page 472
Clinical Monitoring......Page 475
Timing of Surgical Intervention......Page 476
Aortic Stenosis......Page 477
Aortic Regurgitation......Page 478
Outcomes......Page 479
Anticoagulation......Page 480
References......Page 481
Appendix 1 ACC/AHA Guidelines Classification and Levels of Evidence......Page 484
Appendix 2 ESC Guidelines Classification and Levels of Evidence......Page 485
A......Page 486
C......Page 487
I......Page 488
M......Page 489
R......Page 490
V......Page 491
Y......Page 492
Inside back cover......Page 494
