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Left ventricular performance and clinical outcome after repeat balloon aortic valvuloplasty

Article Abstract:

Balloon aortic valvuloplasty is a surgical procedure used for the treatment of patients with cardiac disease involving the valves of the heart and stenosis, or narrowing, of the blood vessels. In this procedure, a balloon is attached to the end of a catheter and inflated, dilating the blood vessel and restoring valve function. An assessment of clinical outcome was made for 17 patients having to undergo a repeat procedure an average of 8.7 months after the original attempt. Repeated procedures resulted in cardiac and circulatory changes that were similar to those from the original procedure. The use of larger balloons did not result in additional improvement in the area of the aortic valve. The clinical outcome of patients was poorer following the repeat procedure than after the initial procedure and 50 percent of patients died within two months. However, the outcomes were felt to be unrelated to adverse consequences of the procedure, since no disruptions in function or damage were seen at time of catheterization. Rather, the severity of illness in these patients was considered the cause of their poor outcomes, and repeat valvuloplasty is not advocated as a procedure to improve survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Heart, Heart valves, Balloon dilatation, Heart surgery, Cardiac catheterization, Heart catheterization

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Stunned myocardium in the toxic shock syndrome

Article Abstract:

Toxic shock syndrome may in rare cases cause an acute form of heart muscle disease known as 'stunned myocardium.' Toxic shock syndrome is thought to be caused by toxins produced by the bacterium Staphylococcus aureus and mostly affects menstruating women. 'Stunned myocardium' refers to a reversible dysfunction of the heart muscle itself. Whether this dysfunction in toxic shock patients is the result of the bacterial toxins or is brought about by infected heart cells, as with viruses, is unclear. A case study of a 17-year-old female with toxic shock syndrome suggests the bacterial toxins cause the cardiomyopathy by suppressing heart muscle action. Tissue samples from the patient and the patient's quick recovery once the toxins were cleared further support the bacterial-toxin explanation.

Causes of, Complications and side effects, Cardiomyopathy, Myocardial diseases, Toxic shock syndrome

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Cost-Effectiveness of Transesophageal Echocardiography To Determine the Duration of Therapy for Intravascular Catheter-Associated Staphylococcus aureus Bacteremia

Article Abstract:

Transesophageal echocardiography (TEE) can be used to determine whether antibiotic treatment has eliminated catheter-associated Staphylococcus aureus infection. If so, the patient can be treated with antibiotics for a shorter time period. An analysis of the use of TEE for this purpose found that it was much more cost-effective than two to four weeks of antibiotic therapy without TEE.

Analysis, Drug therapy, Medical care, Cost of, Health care costs, Staphylococcal infections, Transesophageal echocardiography

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