Cavitation phenomenon in mechanical prosthetic valves: Not only microbubbles
| Autor: | Abdulhalim Jamal Kinsara, Mohammed Aladmawi, Mawada Ahmed, Fatma Arshi, Maie Alshahid, Olga Vriz, Mohammed Alhumaid, Bandar Alamro, Domenico Galzerano, Gianni Pedrizzettid, Shisamma Emmanual |
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| Přispěvatelé: | Vriz, O., Arshi, F., Ahmed, M., Alhumaid, M., Galzerano, D., Emmanual, S., Kinsara, A. J., Aladmawi, M., Alamro, B., Alshahid, M., Pedrizzetti, G. |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty mechanical prosthetic valve echocardiography mechanical prosthetic valves microbubbles Diastole Hemodynamics 030204 cardiovascular system & hematology Ventricular Function Left 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Internal medicine Heart rate Humans Medicine Endocarditis Radiology Nuclear Medicine and imaging cardiovascular diseases Thrombus Microbubbles Ejection fraction business.industry Stroke Volume Middle Aged medicine.disease Blood pressure Echocardiography Heart Valve Prosthesis cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology |
| Zdroj: | Echocardiography. 37:876-882 |
| ISSN: | 1540-8175 0742-2822 |
| DOI: | 10.1111/echo.14692 |
| Popis: | Introduction Microbubbles (MBs) or cavitation is high-velocity, echo-bright findings present during the closing or opening of a mechanical valve (MVP). Cavitation bubble growth or gas emboli are less frequently described. We evaluated the hemodynamic parameters involved in the formation of gas emboli and the impact of gas emboli on requests for additional investigations. Methods and results Transthoracic echocardiographic studies (TTE) of 57 patients (31 males, mean age 46.8 ± 13.8 years) with gas emboli were evaluated after heart valve replacement surgery. The majority (72%, n = 42) had a mitral or combined mitral/aortic MVP, with 28% (n = 16) an aortic MVP. The last TTE with and without gas emboli were considered for the same patient and the no emboli group was the control group (42 patients). The patient's blood pressure (BP) and heart rate (HR) were available for each TTE. Comparing the two TTEs, the systolic and diastolic BP, transmitral and aortic gradients, and left ventricular ejection fraction were similar but the HR (80.9 ± 18.7 vs 72.5 ± 13.9 bpm, P = .02) was significantly higher in the group with gas emboli. A TEE was performed 52 times in 27 patients, due to gas emboli, with one case positive for thrombus/vegetation. For 19 patients, a brain CT was requested. In two patients, the indication for the brain CT was gas emboli but the result was negative. Conclusion Gas emboli are frequently present and associated to an increased HR. They can cause the misdiagnosis of endocarditis or thrombus formation with significant additional requests for diagnostic examinations. |
| Databáze: | OpenAIRE |
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