| Chang Nen-Chung |
------>authors3_c= ------>paper_class1=1 ------>Impact_Factor=None ------>paper_class3=1 ------>paper_class2=4 ------>vol=3 ------>confirm_bywho=ncchang ------>insert_bywho=ncchang ------>Jurnal_Rank=None ------>authors4_c= ------>comm_author=1 ------>patent_EDate=None ------>authors5_c= ------>publish_day=1 ------>paper_class2Letter=3 ------>page2=239 ------>medlineContent= ------>unit=E0109 ------>insert_date=20081122 ------>iam=1 ------>update_date=None ------>author=??? ------>change_event=4 ------>ISSN= ------>authors_c= ------>score=148 ------>journal_name=J Taiwan Soc Echocardiogr, Dec 1,2009, 2009;3(4):237-239// ------>paper_name=Acute Aortic syndrome versus Acute Coronary Syndrome. ------>confirm_date=20091116 ------>tch_id=075008 ------>pmid=18972628 ------>page1=237 ------>fullAbstract=BACKGROUND: There are few reports regarding acute coronary syndromes (ACS) in patients with prosthetic heart valves (PHV), mostly attributing the ACS to a PHV-derived coronary embolus. OBJECTIVE: To characterize a case-series of ACS patients with PHV. METHODS: All patients in our institution with previous PHV surgery and ACS during 1996-2005 were retrospectively analysed. RESULTS: We identified 40 patients from the 15,878 patient database, whose mean age was 72.5 +/- 12.5 years and of whom 21 were male. The majority (n=28) had mechanical valves; 24 patients (60%) had an aortic prosthetic valve, 9 patients (22.5%) had a mitral valve prosthesis and 7 patients (17.5%) had both. The majority of patients had > or = 2 risk factors for atherosclerotic disease. The median time from the PHV implantation to the subsequent ACS was 8.0 (4.7-12.1) years. Most patients had non-ST-segment elevation ACS rather than ST-segment elevation ACS (32 patients versus 8 patients). 12 patients (30%) had moderate to severe left ventricular dysfunction and 2 of them presented with cardiogenic shock. Atrial fibrillation on hospital admission was noted in 13 patients (32.5%). ACS management included coronary angiography in 32 patients (80%) which revealed coronary disease in 93%. Only 2 patients had normal coronary arteries and PHV-derived coronary emboli. The most frequent in-hospital complication was heart failure (n=11, 27.5%). CONCLUSIONS: Patients with PHV and ACS are a rare subgroup, more likely to be elderly with risk factors for atherosclerotic disease and to present with non-ST-segment-elevation ACS. The pathogenesis for ACS is commonly coronary atherosclerotic disease rather than PHV-derived emboli. ------>tmu_sno=None ------>sno=19783 ------>authors2=Shih Chun-Ming ------>authors3=Huang Chun-Yao ------>authors4= ------>authors5= ------>authors6= ------>authors6_c= ------>authors=Chang Nen-Chung ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c= ------>publish_area=0 ------>updateTitle=Acute coronary syndromes in patients with prosthetic heart valves-a case-series. ------>language=2 ------>check_flag=None ------>submit_date=None ------>country=None ------>no=4 ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2009 ------>submit_flag=None ------>publish_month=12 |