{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T17:57:43Z","timestamp":1758477463063},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1998,1]]},"abstract":"\n Background<\/jats:italic>\n \u2014The clinical relevance of Doppler microembolic signals (MES) in patients with prosthetic cardiac valves was evaluated by merging and statistically reanalyzing patient data from four research institutions (Departments of Neurology, Universities of Aachen, Halle, and Mu\u0308nster, Germany; Department of Medicine and Therapeutics, University of Glasgow, Scotland, and Department of Cardiothoracic Surgery, Western Infirmary, Glasgow, Scotland).\n <\/jats:p>\n \n Methods<\/jats:italic>\n \u2014Transcranial Doppler monitoring for MES was performed over the middle cerebral arteries for 30 to 60 minutes per patient. Prevalence of neurological complications was evaluated with a standard neurological questionnaire in patients carrying the valve implant longer than 3 months (n=369).\n <\/jats:p>\n \n Results<\/jats:italic>\n \u2014Significant differences in MES prevalence and counts were noted among the 580 patients depending on valve type (presented with medians and [95% confidence intervals]): St Jude Medical, n=200, 72%, 4 [3 to 6]; Bjo\u0308rk Shiley Monostrut, n=99, 92%, 133 [93 to 181]; Medtronic Hall, n=80, 47%, 1 [2 to 5]; ATS, n=61, 52%, 3 [2 to 5]; Tecna, n=38, 71%, 2 [1 to 4]; Carbomedics, n=37, 81%, 8 [5 to 13]; Carpentier-Edwards supraannular, n=54, 39%, 1 [0 to 3]; Sorin biological, n=11, 9%, 0 [0 to 0]. No relation between MES counts and valve size, international normalized ratio, patients\u2019 age, cardiac rhythm, or implant duration was noted. No significant differences in MES counts or prevalence (22 [3 to 68] versus 5 [3 to 6] and 63% versus 69%, both\n P<\/jats:italic>\n >.05), in valve duration, valve position, valve type, patients\u2019 age, sex, cardiac rhythm, or international normalized ratio were evident between neurologically symptomatic (n=42) and asymptomatic patients.\n <\/jats:p>\n \n Conclusions<\/jats:italic>\n \u2014MES in patients with prosthetic cardiac valves depend on the type and, in certain valve types, the position of the valve implant and possess no direct clinical significance.\n <\/jats:p>","DOI":"10.1161\/01.str.29.1.140","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"140-143","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Clinical Correlations of Doppler Microembolic Signals in Patients With Prosthetic Cardiac Valves"],"prefix":"10.1161","volume":"29","author":[{"given":"Ulrich","family":"Sliwka","sequence":"first","affiliation":[{"name":"From the Departments of Neurology, Universities of Halle and Jena, Halle and Jena, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Georgiadis","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology, Universities of Halle and Jena, Halle and Jena, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"282","volume":"9","year":"1990","unstructured":"Berger M, Davis D, Lolley D, Rams J, Spencer MP. Detection of subclinical microemboli in patients with prosthetic heart valves) J Cardiovasc Tech. 1990;9:282\u2013283. Abstract.","journal-title":"J Cardiovasc Tech"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.7.1225"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1052-3057(10)80165-X"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(96)80148-5"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.6.1123"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.3.439"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.24.12.7902622"},{"key":"e_1_3_2_8_2","first-page":"128","volume":"3","year":"1994","unstructured":"Grosset DG, Coburn P, Georgiadis D, Dargie HJ, Faichney A, Lees KR. Ultrasound detection of cerebral emboli in patients with prosthetic heart valves. J Heart Valve Dis. 1994;3:128\u2013132.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.6.1203"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.1.63"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.3.8128512"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.6.8202982"},{"key":"e_1_3_2_13_2","first-page":"414","volume":"4","year":"1995","unstructured":"Mackay TG, Georgiadis D, Grosset DG, Kelman AW, Lees KR, Wheatley DJ. Transcranial Doppler ultrasound signals associated with prosthetic heart valves: an in vitro study. J Heart Valve Dis. 1995;4:414\u2013419.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_2_14_2","unstructured":"Spencer MP. Hyperbaric compression and Doppler-detected microemboli in prosthetic valve patients. Cerebrovasc Dis. 1996;6(suppl 3):69."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.11.2189"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon19977s1230"},{"key":"e_1_3_2_17_2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1177\/039139889101400309","volume":"14","year":"1991","unstructured":"Graf T, Fischer H, Reul H, Rau G. Cavitation potential of mechanical heart valve prostheses. Int J Artif Organs. 1991;14:169\u2013174.","journal-title":"Int J Artif Organs"},{"key":"e_1_3_2_18_2","first-page":"M","volume":"37","year":"1991","unstructured":"Lamson TC, Stinebring DR, Deutsch S, Rosenberg G, Tarbell JM. Real-time in vitro observation of cavitation in a prosthetic heart valve. ASAIO Transactions. 1991;37:M-351-M-353.","journal-title":"ASAIO Transactions"},{"key":"e_1_3_2_19_2","unstructured":"Wu ZJ Wang Y Hwang NH. Occluder closing behavior: a key factor in mechanical heart valve cavitation. J Heart Valve Dis. 1994;3(suppl I):25\u201334."},{"key":"e_1_3_2_20_2","first-page":"64","volume":"15","year":"1994","unstructured":"Georgiadis D, Grosset DG, Mackay TG, Brodie E, Mallinson A, Kelman AW, Faichney A, Lees KR. Cerebral microemboli in patients with prosthetic valves: Haematological and neuropsychological correlates. Eur Heart J. 1994;15:64. Abstract.","journal-title":"Eur Heart J"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.29.1.140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:41:15Z","timestamp":1715553675000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.29.1.140"}},"subtitle":["Analysis of 580 Cases"],"short-title":[],"issued":{"date-parts":[[1998,1]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1998,1]]}},"alternative-id":["10.1161\/01.STR.29.1.140"],"URL":"https:\/\/doi.org\/10.1161\/01.str.29.1.140","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,1]]},"assertion":[{"value":"1997-05-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-10-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-01-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}