Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging: A Report From the American Society of Echocardiography Developed in Collaboration With the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography

Zoghbi, William A.; Jone, Pei-Ni; Chamsi-Pasha, Mohammed A.; Chen, Tiffany; Collins, Keith A.; Desai, Milind Y.; Grayburn, Paul; Groves, Daniel W.; Hahn, Rebecca T.; Little, Stephen H.; Kruse, Eric; Sanborn, Danita; Shah, Sangeeta B.; Sugeng, Lissa; Swaminathan, Madhav; Thaden, Jeremy; Thavendiranathan, Paaladinesh; Tsang, Wendy; Weir-McCall, Jonathan R.; Gill, Edward

doi:10.1016/j.echo.2023.10.004

Cited by 23 publications

(45 citation statements)

References 228 publications

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“…Postoperative stroke can occur due to embolisms from calcified plaques or valve handling with attached vegetation. Postoperatively, the incidence of stroke is variable, between 2 and 11% [ 49 , 62 ]. The diagnosis of postoperative stroke is made by close clinical examination upon awakening.…”

Section: Discussionmentioning

confidence: 99%

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Multidisciplinary Perspectives of Challenges in Infective Endocarditis Complicated by Septic Embolic-Induced Acute Myocardial Infarction

Stamate,

Ciobotaru,

Arbune

et al. 2024

Antibiotics

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Background: Infective endocarditis (IE) management is challenging, usually requiring multidisciplinary collaboration from cardiologists, infectious disease specialists, interventional cardiologists, and cardiovascular surgeons, as more than half of the cases will require surgical procedures. Therefore, it is essential for all healthcare providers involved in managing IE to understand the disease’s characteristics, potential complications, and treatment options. While systemic embolization is one of the most frequent complications of IE, the coronary localization of emboli causing acute myocardial infarction (AMI) is less common, with an incidence ranging from 1% to 10% of cases, but it has a much higher rate of morbidity and mortality. There are no guidelines for this type of AMI management in IE. Methods: This narrative review summarizes the current knowledge regarding septic coronary embolization in patients with IE. Additionally, this paper highlights the diagnosis and management challenges in such cases, particularly due to the lack of protocols or consensus in the field. Results: Data extracted from case reports indicate that septic coronary embolization often occurs within the first two weeks of the disease. The aortic valve is most commonly involved with vegetation, and the occluded vessel is frequently the left anterior descending artery. Broad-spectrum antibiotic therapy followed by targeted antibiotic therapy for infection control is essential, and surgical treatment offers promising results through surgical embolectomy, concomitant with valve replacement or aspiration thrombectomy, with or without subsequent stent insertion. Thrombolytics are to be avoided due to the increased risk of bleeding. Conclusions: All these aspects should constitute future lines of research, allowing the integration of all current knowledge from multidisciplinary team studies on larger patient cohorts and, subsequently, creating a consensus for assessing the risk and guiding the management of this potentially fatal complication.

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Section: Discussionmentioning

confidence: 99%

“…In selected situations, TTE evaluation is complemented by TOE for the further refinement of valve function and morphology. Cardiac magnetic resonance (MRI) and cardiac computed tomography (CT) have recently improved their role in cardiac valve evaluation [ 49 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Multidisciplinary Perspectives of Challenges in Infective Endocarditis Complicated by Septic Embolic-Induced Acute Myocardial Infarction

Stamate,

Ciobotaru,

Arbune

et al. 2024

Antibiotics

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“…A complementação tridimensional (3D) melhora a definição espacial, acrescentando a capacidade de determinar o caminho de um vazamento, que muitas vezes pode seguir um curso serpiginoso. 10 De forma superficial, as primeiras informações a serem verificadas e confirmadas são gravidade, localização, tamanho, forma e o número de vazamentos. Inicialmente, a prótese valvar é "escaneada" por meio de uma sistemática rotação da sonda de eco, que busca a presença de deiscência e/ou sinais paraprotéticos com o Doppler colorido.…”

Section: Introductionunclassified

“…Nesses casos, a abordagem transcateter está contraindicada e a avaliação de cirurgia convencional deve ser realizada o mais rápido possível (Vídeo 1). 6,10 Descartada essa complicação, os parâmetros do Doppler precisam ser avaliados, conforme encontramos na Tabela 1.…”

Section: Introductionunclassified

“…Parâmetros habitualmente utilizados na classificação ecocardiográfica de lesões de valvas nativas podem ser extrapolados com cautela para a avaliação do leak paraprotético. 1,10 Avaliações das curvas de Doppler das veias pulmonares em leaks na topografia mitral e da aorta ascendente na topografia da aórtica parecem úteis em um primeiro momento. A observação de gradientes transprotéticos elevados mesmo com aspectos normais dos folhetos ou elementos móveis também sinaliza a possibilidade de hiperfluxo e leak paraprotético importante.…”

Section: Introductionunclassified

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Como Eu Faço Abordagem para Avaliação de Leak Paraprotético Mitral

Bignoto

2024

Arq Bras Cardiol: Imagem cardiovasc.

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O leak paraprotético mitral é uma condição comum, embora seja frequentemente assintomática. Quando apresenta manifestações clínicas, como insuficiência cardíaca e/ou hemólise, o tratamento intervencionista está indicado. Recentemente, a abordagem transcateter ganhou destaque e, para isso, é necessária uma avaliação por métodos de imagem no planejamento. A ecocardiografia é o método mais utilizado e as informações a serem verificadas e confirmadas são gravidade, localização, tamanho, forma e o número de vazamentos (leaks). Uma vez definidas essas variáveis, o planejamento de abordagem é realizado, sendo a via transeptal a mais utilizada. A decisão do melhor lugar de punção septal depende de vários fatores, mas a localização precisa do pertuito é o mais importante. Uma vez realizado o posicionamento dos dispositivos, a avaliação ecocardiográfica intraoperatória determina o sucesso do procedimento e orienta necessidades de reposicionamento e ajustes, bem como sinaliza eventuais complicações que possam ocorrer.

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Severe Prosthetic Mitral Valve Regurgitation Hidden by Acoustic Shadowing: The Importance of Spectral Doppler in Prosthetic Valve Assessment

Carnazzo,

Al Ibraheem,

Calvin

2024

CASE

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Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging: A Report From the American Society of Echocardiography Developed in Collaboration With the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography

Cited by 23 publications

References 228 publications

Multidisciplinary Perspectives of Challenges in Infective Endocarditis Complicated by Septic Embolic-Induced Acute Myocardial Infarction

Multidisciplinary Perspectives of Challenges in Infective Endocarditis Complicated by Septic Embolic-Induced Acute Myocardial Infarction

Como Eu Faço Abordagem para Avaliação de Leak Paraprotético Mitral

Severe Prosthetic Mitral Valve Regurgitation Hidden by Acoustic Shadowing: The Importance of Spectral Doppler in Prosthetic Valve Assessment

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