Background- Valvular heart disease is one of the common complications of acute rheumatic fever, which manifests its clinical complications one or two decades after the primary attack of the disease in adults. The disease may involve one or more valves as stenosis or regurgitation or both and may cause congestive heart failure due to chronic volume or pressure overload.Method- This prospective study was performed from March 1999 to February 2001 in university affiliated medical centers. 53 patients (28 females and 25 males) who suffered from valvular heart disease in the form of mitral and aortic stenosis or regurgitation were studied. Most of the patients were in functional class I or II (44) and the rest (9) in class III and IV. Non-cardiac surgery procedures were laparotomy, orthopedic surgery, and thoracotomy.Results- Class I patients were able to easily tolerate the surgery without any significant problems. Only 2 patients had atrial fibrillation with rapid ventricular response in this class. In class II, one case had paroxysmal supraventricular tachycardia after thoracotomy and 3 patients had atrial fibrillation with rapid ventricular response. Another patient in this class had acute pulmonary edema. In class III, one patient had atrial fibrillation with rapid ventricular response after vaginal delivery. Of the two class IV patients, one patient needed reoperation due to prosthetic valve malfunction in the 26th week of pregnancy and the other had no significant hemodynamic problem.Discussion- Supraventricular arrhythmia, which occurs as atrial fibrillation or paroxysmal supraventricular tachycardia or sinus tachycardia mostly in the first 24 hours after surgery, is preventable with sufficient analgesic prescription. Careful monitoring is necessary in patients with severe mitral or aortic stenosis and double valve disease during surgery or the first 24 hours after surgery. As a result, the important factor in patient prognosis is the functional class of heart disease rather than the type of valvular disease

Heart sound signal processing consists of different phases. After applying necessary preprocessing and segmenting heart sound cycles, some distinctive features of heart sound are extracted. Since the appropriate operation of the classifier has a high impact on the performance of the system, in this study we propose a proper classification algorithm. One of the commonly used methods to build accurate classifiers is to use a group of classifiers and make decision based on the outputs of these classifiers. By far, the performance of the ensemble methods has been investigated in different fields of classification problems by researchers. However, in the field of heart valve diagnosis there are almost no studies investigating these methods. In this study, we train several linear classifiers and the final decision is made according to the outputs of them based on the majority voting algorithm. The training samples of each classifier are chosen randomly with replacement from the whole training set. The proposed method is implemented for 5 datasets and also compared with 3 other methods using different criteria including sensitivity, specificity, diagnostic odds ratio, precision and error. Results show that the proposed method has higher accuracy and faster prediction time. The noise label problem and the robustness of the proposed method against this noise are also investigated. Statistical tests show that the proposed method significantly outperforms other methods. ]

Background: Valvular heart disease as a public health problem in developing countries. Studies reported a lower incidence of coronary artery disease (CAD) among patients with valvular heart disease. The relationship of valvular heart disease and coronary artery disease is still unknown. The aim of this study was to evaluate the association between valvular heart disease and coronary artery disease in patients with stable angina.Methods: This was a case-control study on 1062 patients with stable angina undergone angiography for certain elective indication in Shahid Chamran hospital, Isfahan University of Medical Sciences (IUMS), Iran, from September 2011 to September 2016. Besides, the echocardiography was evaluated within 6 months before and 6 months after the coronary angiography. Then relationship between coronary artery disease and having valvular heart disease was assessed.Findings: In this study, 1062 patients with mean age of 61.67±11.38 years were evaluated that 64% of them were men. About 61.3% had coronary artery disease and 33.9% had valvular heart disease. Patients with coronary artery disease were at lower risk for experiencing valvular heart disease. Patients with mitral stenosis or mitral regurgitation, aortic stenosis or regurgitation, and those with tricuspid valve regurgitation were less likely to have coronary artery disease. 22.0% of patients with coronary artery disease had one vessel involvement. In addition, patients with two vessels involvement had less valvular heart disease than patients with one or three vessels involvement.Conclusion: Patients with coronary artery disease were less likely to develop heart valve disease. Patients with coronary artery disease showed milder valvular heart disease.

Background: Congenital hereditary endothelial dystrophy (CHED) is a rare disease of the corneal endothelium. It is a nonprogressive clouding of the corneal, presenting at birth in most cases or shortly after it. This disease is categorized as an autosomal recessive disorder, which manifests with diffuse corneal edema, Descemet membrane thickening, and lack of endothelial cells. The primary abnormality in CHED is a degeneration of endothelial cells during or after the fifth month of gestation. The literature review has shown that CHED can occur with progressive, postlingual sensorineural hearing loss in Harboyan syndrome; however, it is not associated with any systemic abnormality. Case report: Our study reports a case of CHED and valvular heart disease in a neonate. To the best of our knowledge, no research has been performed to investigate the relationship between CHED and valvular heart disease. In addition, the patient’ s mother had vaginal discharge in the fifth month of gestation, which was, as stated in the previous studies, the period during which the abnormality occurs in CHED. The two aforementioned issues highlight the need for performing the present study. Conclusion: Occurrence of CHED and heart disease has not been reported, there is a need for more research into this subject.

Patients with valvular heart disease and suffering atrial fibrillation of more than 12 months duration have a low probability of remaining in sinus rhythm after valve surgery alone. We performed intra-operative radiofrequency ablation or cryoablation as an alternative to surgical maze ІІІ procedure to create linear lesion lines for conversion of this arrhythmia to sinus rhythm. A total of 30 patients with valvular heart disease and chronic persistent atrial fibrillation underwent different combinations of valve surgery and concomitant maze procedure with radiofrequency or cryo probes. These patients aged 48.10±9.84 years in radiofrequency ablation group and 51.10±13.93 years in cryoablation group. Both atrial ablation with radiofrequency probes, needed 26.15±3.67 min extra ischemic time and ablation by mean of cryo-probes needed an extra ischemic time of 29.62 ± 4.27 min. There was one in hospital death postoperatively because of respiratory failure but no other complication. 6 months after the operation, among 30 patients with both atrial ablations, 25 patients were in sinus rhythm, no patient had junctional rhythm and 5 patients had persistent atrial fibrillation. At 12 months follow up, freedom from atrial fibrillation was 85% in radiofrequency group and 80% in cryo group. Doppler echocardiography in these patients demonstrated atrial contractility in 70% of the patients. Intraoperative radiofrequency or cryoablation of both atriums are effective and less invasive alternatives for the original maze procedure to eliminate the atrial fibrillation, and can be done in patients with valvular heart disease without increasing the risk of operation.

Patients with valvular heart disease suffer from atrial fibrillation for more than 12 months after valve surgery and have a low probability of remaining in sinus rhythm. We performed an intra-operative procedure similar to surgical maze ІІІ procedure for conversion of this arrhythmia to sinus rhythm. We did this study to evaluate the efficacy of this procedure to restore the sinus rhythm in patients with valvular heart disease.28 patients with valvular heart disease and chronic persistent atrial fibrillation underwent different combinations of valve surgery and concomitant reduction of left and right atrial size and resection of both atrial auricles in Shahid Madani cardiothoracic center from September 2004 to October 2008. The procedure for atrial fibrillation treatment was performed with cardiopulmonary bypass and after mitral valve replacement. There was one in-hospital death postoperatively because of respiratory failure, but no other complication till 6 months after the operation. Out of 28 patients, 23 were in sinus rhythm one week after the operation, one patient had junctional rhythm after the operation that restored to sinus rhythm and 4 patients had persistent atrial fibrillation. During the 12-month follow up, atrial fibrillation was corrected in 82.14%. Doppler echocardiography in these patients with sinus rhythm demonstrated good atrial contractility. This procedure on both atria is effective and less invasive than the original maze procedure to eliminate the atrial fibrillation, and can be performed in patients with valvular heart disease without increasing the risk of operation.