Aortic stenosis and Crash Bandicoot: Difference between pages

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{{Original research|date=January 2008}}
{{DiseaseDisorder infobox |
{{otheruse |this=the Crash Bandicoot video game series |use1=the first game of the series |page1=Crash Bandicoot}}
Name = Aortic valve stenosis |
[[Image:CrashBandicootLogo.png|thumb|The ''Crash Bandicoot'' series logo]]
ICD10 = {{ICD10|I|35|0|i|30}}, {{ICD10|I|06|0|i|05}}, {{ICD10|Q|23|0|q|20}} |
'''''Crash Bandicoot''''' is a series of [[platform game|platform]] [[video game]]s currently developed by [[Radical Entertainment]] and published by [[Sierra Entertainment]]. Initially created by [[Andy Gavin]] and [[Jason Rubin]], the series was developed for its first four years by the video game company [[Naughty Dog]]. Since then, the series has been given to numerous developers before finally settling at Radical Entertainment. The series has 15 games as of 2008.
ICD9 = {{ICD9|395.0}}, {{ICD9|396.0}}, {{ICD9|746.3}} |
ICDO = |
Image = |
Caption = |
OMIM = |
OMIM_mult = |
MedlinePlus = 000178 |
eMedicineSubj = med |
eMedicineTopic = 157 |
DiseasesDB = 844 |
}}
'''Aortic valve stenosis''' ('''AS''') is a [[valvular heart disease]] caused by the incomplete opening of the [[aortic valve]].


The games are mostly set in the fictitious Wumpa Islands, an archipelago situated on the south of [[Australia]], although other locations are common. The main games of the series are largely platform games, but the majority of the games are spin-offs in different [[computer and video game genres|genres]]. The protagonist of the games is an [[Eastern Barred Bandicoot]] named [[Crash Bandicoot (character)|Crash]], whose quiet life on the Wumpa Islands is often interrupted by the main [[antagonist]] in the series, [[Doctor Neo Cortex]], who created Crash and now wants nothing more than his demise. It's usually up to Crash to defeat Cortex and foil any world domination plans he might have.
The [[aortic valve]] controls the direction of blood flow from the [[left ventricle]] to the [[aorta]]. When in good working order, the aortic valve does not impede the flow of blood between these two spaces. Under some circumstances, the aortic valve becomes narrower than normal, impeding the flow of blood. This is known as aortic valve stenosis, or aortic stenosis, often abbreviated as '''AS'''.


The ''Crash Bandicoot'' series has been a commercial success, selling 40 million copies.<ref name="vivendi">{{cite web |url=http://news.teamxbox.com/xbox/14894/Sierra-Ships-Crash-of-the-Titans/ |title=Sierra Ships ''Crash of the Titans'' |date=2007-10-23 |publisher=[[Vivendi]] |accessdate=2006-11-15 |format=[[PDF]]}}</ref>
==Pathophysiology==
[[Image:Aortic stenosis rheumatic, gross pathology 20G0014 lores.jpg|thumb|300px|An [[aortic valve]] that, due to [[rheumatic heart disease]], has a severe stenosis (centre of image). The [[pulmonary trunk]] is seen at the lower right (of the image). The proximal portion of [[right coronary artery]] and its [[ostium]] can be seen at the lower left (of the image). The proximal [[left main coronary artery]] and its ostium are seen on the right (of the image). [[Autopsy]] specimen.]]
[[Image:Aortic Stenosis - Hemodynamic Pressure Tracing.png|thumb|right|300px|Simultaneous left ventricular and aortic pressure tracings demonstrate a pressure gradient between the left ventricle and aorta, suggesting aortic stenosis. The left ventricle generates higher pressures than what is transmitted to the aorta. The pressure gradient, caused by aortic stenosis, is represented by the green shaded area. (AO = ascending aorta; LV = left ventricle; ECG = electrocardiogram.)]]


==Common gameplay elements==
When the aortic valve becomes [[stenosis|stenotic]], it causes a pressure gradient between the left ventricle (LV) and the aorta.<ref name=Lilly>{{cite book | author = Lilly LS (editor) | title = Pathophysiology of Heart Disease | edition = 3rd ed. | publisher = Lippincott Williams & Wilkins | year = 2003 | id = ISBN 0-7817-4027-4 }}</ref> The more constricted the valve, the higher the gradient between the LV and the aorta. For instance, with a mild AS, the gradient may be 20 [[mmHg]]. This means that, at peak systole, while the LV may generate a pressure of 140 mmHg, the pressure that is transmitted to the aorta will only be 120 mmHg. So, while a [[Sphygmomanometer|blood pressure cuff]] may measure a normal [[systole|systolic]] [[blood pressure]], the actual pressure generated by the LV would be considerably [[hypertension|higher]].
The first three ''Crash'' games, as well as several subsequent ''Crash'' games, were platform games. There are [[Aku Aku]] copy masks sparsely scattered throughout the levels. Collecting an Aku Aku mask while Crash already has one turns the one he has gold. Collecting another mask while Crash has a gold one grants Crash limited-time invincibility, after which the mask reverts to being gold. Getting hit will reduce the mask from gold to normal or from normal to nothing. If Crash gets hit when he does not have a mask, he will meet his end in a sometimes comical animation. In effect, therefore, masks serve as [[hit points]].


Main collectables include 'Wumpa Fruit' , healthy forest fruit (based on apples), grown from Wumpa Trees, which gives an additional life to Crash when 100 are obtained. Other, more valuable goodies include Gems (rare jewels awarded for completing tasks such as smashing every crate on a level, or finding and completing an alternate path) and Crystals (jewels located somewhere in the main path of the level), which often play a key role in the plot. The only other collectables to note are Time Relics, featured from ''Crash Bandicoot: Warped'' and most other Crash games afterwards (collected by racing a level's time trial; in ''Warped'', the player can win a sapphire relic by beating the established time, and a gold one by finishing even faster; this generally requires that the player pick up a move that allows them to sprint through the level) and trophies, which are featured in ''Crash Team Racing'', ''Crash Nitro Kart'' and ''Crash Bash''. In the Crash games of recent years, 'Wumpa Fruit' are still present, although they serve as a means of health, with a substance called 'Mojo' effectively replacing them as collectible items.
In individuals with AS, the left ventricle (LV) has to generate an increased pressure in order to overcome the increased [[afterload]] caused by the stenotic aortic valve and eject blood out of the LV. The more severe the aortic stenosis, the higher the gradient is between the left ventricular systolic pressures and the aortic systolic pressures. Due to the increased pressures generated by the left ventricle, the [[myocardium]] (muscle) of the LV undergoes [[left ventricular hypertrophy|hypertrophy]] (increase in muscle mass). This is seen as thickening of the walls of the LV. The type of hypertrophy most commonly seen in AS is concentric hypertrophy, meaning that all the walls of the LV are (approximately) equally thickened.


Obstacles in Crash's path include animal-like creatures and other badguys, Doctor Neo Cortex's lab assistants, various machinery, and physical barriers. To surmount these, Crash can use his jump move and his spin attack. In Crash platformers after the first, he can also do a body slam, slide, duck, crawl, and perform an extra-high jump by sliding or ducking and then jumping. Starting with ''Crash Bandicoot 3: Warped'', Crash can also collect a special move after defeating each boss.
==Etiology==
Major causes and predisposing conditions of aortic stenosis include [[acute rheumatic fever]] and [[bicuspid aortic valve]]. As individuals age, calcification of the [[aortic valve]] may occur and result in stenosis. This is especially likely to occur in people with a bicuspid aortic valve, but also occurs in the setting of perfectly normal valves as a result of age-induced 'wear and tear'. Typically, aortic stenosis due to calcification of a bicuspid valve occurs in the 4th of 5th decade of life, whereas that due to calcification of a normal valve tends to occur later - around the 7th or 8th decade.


In some of the ''Crash'' platformers, not including the original, some levels have a skull platform which transports Crash to a hidden part of the level. To be able to use the platform, Crash must not have died before reaching it in the current playthrough of the level. The hidden path will usually contain a hidden gem.
Of the various forms of aortic stenosis, the calcific type is predominant. Since calcific aortic stenosis shares many pathological features and risk factors with [[atherosclerosis]], and since atherosclerosis may be prevented and/or reversed by cholesterol lowering, there has been interest in attempting to modify the course of calcific aortic stenosis by cholesterol lowering with [[statin]] drugs. Although a number of small, [[observational studies]] demonstrated an association between lowered cholesterol and decreased progression, and even regression, of calcific aortic stenosis, a recent, large [[randomized clinical trial]], published in 2005, failed to find any predictable effect of cholesterol lowering on calcific aortic stenosis. However, a 2007 study did demonstrate a slowing of aortic stenosis with the statin [[rosuvastatin]].<ref>{{cite journal |author=Moura LM, Ramos SF, Zamorano JL, ''et al'' |title=Rosuvastatin affecting aortic valve endothelium to slow the progression of aortic stenosis |journal=J. Am. Coll. Cardiol. |volume=49 |issue=5 |pages=554–61 |year=2007 |pmid=17276178 |doi=10.1016/j.jacc.2006.07.072}}</ref>


Most of the ''Crash Bandicoot'' series each contain around 25 levels of gameplay. In the later games, higher levels will require special moves obtained from defeating bosses. There will also be hidden levels, where bonus items can be obtained.
==Prevalence==
Aortic stenosis is a common problem. Approximately 2% of people over the age of 65, 3% of people over age 75, and 4% percent of people over age 85 have the disorder. In North America and Europe, at least, the population is aging. Hence, the prevalence of aortic stenosis is increasing. Since the disease carries with it considerable morbidity and mortality, both with large personal and economic impact, aortic stenosis is a major health problem.


===Crates===
==Symptoms of aortic stenosis==
There are crates scattered throughout the levels. Most crates contain some form of bonus. Some have Wumpa fruits in them, and collecting 100 of the game's "Wumpa Fruit" gives the player an extra life. Others have Aku Aku masks or extra lives.


The player can get one Gem per level by breaking all of the crates in one level. The remaining gems must be collected by finding and touching them. They are invariably positioned in an area that is difficult to reach. Most gems are white, but some are colored. In the original ''Crash Bandicoot'', but in none of its sequels, some gems acquired by breaking all of a level's boxes are colored. The colored Gems in the later ''Crash'' games, except for ''Twinsanity'', are often obtained via completing the Skull paths (mentioned earlier) or other harder, secret routes. These colored gems activate additional secret routes, which may also be needed to acquire either Gem on a level.
When [[symptomatic]], aortic stenosis can cause dizziness, [[fainting|syncope]], [[Angina pectoris|angina]] and [[congestive heart failure]]. More symptoms indicate a worse prognosis. Treatment requires [[aortic valve replacement|replacement]] of the diseased valve with an [[artificial heart valve]].


In addition to crates that provide bonuses, there are also [[Trinitrotoluene|TNT]] crates. If Crash attacks one, he loses a mask, or, failing that, a life. If he jumps on one, a three second countdown is started, after which the TNT crate explodes. Some TNT crates are useful to clear obstacles. Some crates have on them an arrow pointing upwards. Landing on one will spring Crash into the air, much like a [[trampoline]] does. With the exception of the original, there are [[Nitroglycerin|Nitro]] crates in all ''Crash'' platformers. If Crash touches one, he loses a mask or a life. A notable exception is in ''Crash Bandicoot: The Wrath of Cortex'', where the special ability 'creep' allows the player to walk along the top of Nitro Crates, but not fall on them, or touch them in any other way. Attacking a metal green crate with an exclamation mark on it destroys all of a level's Nitro crates.
===Congestive heart failure===


Also present in all ''Crash'' platformers except for the original are normal crates that are protected by a metal gridlock surrounding their edges normally destroyed by using the body slam move. Beginning with the third ''Crash'' game, ''Crash Bandicoot: Warped'', some crates are shifting crates, also known as 'slot crates'. They shift among different kinds of crates. The rate at which a shifting crate changes gradually increases, until finally the crate becomes metallic and indestructible. For destroying these crates, an aku aku, a life or nothing can be obtained. Also present in the newer ''Crash Bandicoot'' games, there are Time Trial crates, which can only be found on levels when in Time Trial mode. Breaking any of these crates will stop the watch that counts your time to complete the level for a limited amount of time. Depending on the number on the crate (1, 2 or 3), the watch will stop for that number of seconds until continuing counting.
[[Congestive heart failure]] (CHF) carries a grave prognosis in patients with AS. Patients with CHF that is attributed to AS have a 2 year mortality rate of 50%, if the aortic valve is not replaced.


==Games==
CHF in the setting of AS is due to a combination of systolic dysfunction (a decrease in the [[ejection fraction]]) and [[diastolic dysfunction]] (elevated filling pressure of the LV).
{{Unreferencedsection|date=April 2008}}
{| border="2" cellpadding="4" cellspacing="0" style="margin: 1em 1em 1em 0; background: #f9f9f9; border: 1px #aaa solid; border-collapse: collapse; font-size: 95%;"
|'''Title'''
|'''Release date'''
|'''Released for'''
|'''Information'''
|-
|''[[Crash Bandicoot]]''
|1996
|[[PlayStation]], [[PlayStation Network]]
|''[[Crash Bandicoot (video game)|Crash Bandicoot]]'', was released in the [[United States]] in 1996. The game was looked upon in a positive light due to its innovations such as a large number of level themes, the three different types of bonus levels rather than just one, and a number of gameplay elements that do not appear to belong to an integrated whole, such as the awkward face icons.{{Fact|date=April 2008}} This experimental appearance may have been because the game was a pioneer of a new series, and the developers may have been testing several ideas to see if they would work well in future Crash games.{{Or|date=April 2008}}
|-
|''[[Crash Bandicoot 2: Cortex Strikes Back]]''
|1997
|[[PlayStation]], [[PlayStation Network]]
|''[[Crash Bandicoot 2: Cortex Strikes Back]]'', was released in the [[Halloween]] of 1997, and departed from some of the concepts of the first game, the most notable being the exchange of the ''[[Super Mario Bros. 3]]''-esque map screen for a group of hub rooms called "warp rooms" with each containing five levels, which follow the same straightforward layout of the first game, and one boss. It has overall been better received than its predecessor,<ref name="CSBRankings">{{cite web |publisher=Game Rankings |title=''Crash Bandicoot 2: Cortex Strikes Back'' reviews |url=http://www.gamerankings.com/htmlpages2/196987.asp |accessdate=2008-05-09}}</ref> in part because it allowed the user to save game progress any time while in the central area ("warp room"). In the first game, this was only possible after successful completion of a bonus level.
|-
|''[[Crash Bandicoot 3: Warped]]''
|1998
|[[PlayStation]], [[PlayStation Network]]
|Exactly one year later, ''[[Crash Bandicoot 3: Warped]]'' introduced more new concepts, including a time trial mode and new moves that can be obtained after a boss is defeated. The game was also the first in the series to use the then-new [[DualShock]] controller, with the rumble effect being used frequently in the game. The game is still considered the pinnacle of the series today, being named one of the best platformers of all time.[http://www.angelfire.com/co4/colin_gaea/gi100.htm]
|-
|''[[Crash Team Racing]]''
|1999
|[[PlayStation]], [[PlayStation Network]]
|''[[Crash Team Racing]]'', was the first racing game of the series and the last made by Naughty Dog. After the game's release in 1999, Naughty Dog left Universal Interactive Studios to become an in-house developer for Sony Computer Entertainment America and create their other trademark series, ''[[Jak and Daxter]]''.
|-
|''[[Crash Bash]]''
|2000
|[[PlayStation]]
|After another year, the U.K.-based video game developer [[Eurocom]] released the party game ''[[Crash Bash]]'', which retained the warp room concept of ''Crash Bandicoot 2'', but was met with mixed reviews. It was the last game in the series for the PlayStation.
|-
|''[[Crash Bandicoot: The Wrath of Cortex]]''
|2002
|[[PlayStation 2]], [[Xbox]], [[Gamecube]]
|''[[Crash Bandicoot: The Wrath of Cortex]]'' was released in 2002 for the [[PlayStation 2]], [[Xbox]] and [[Nintendo GameCube]], making it Crash's first multi-platform release. The most common criticism of the game was that it brought almost nothing new to the series.
|-
|''[[Crash Bandicoot: The Huge Adventure]]''
|2002
|[[Game Boy Advance]]
|Crash Bandicoot: The Huge Adventure uses a [[Side-scrolling video game|side-scrolling]] concept instead of the straightforward view of the console games, also used in the follow-up game ''[[Crash Bandicoot 2: N-Tranced]]''. Fans criticised both two side-scrolling games for creating a large plot hole in the series as a whole, due to ''N-Tranced'''s inclusion of the Crunch Bandicoot character from ''The Wrath of Cortex''. Thus, the games are mostly considered in an alternate universe from the main series.
|-
|''[[Crash Bandicoot 2: N-Tranced]]''
|2003
|[[Game Boy Advance]]
|''N-Tranced'' also used a side-scrolling concept, as did its predecessor. It too is considered in an alternate universe due to its inclusion of Crunch.
|-
|''[[Crash Nitro Kart]]''
|2003
|[[PlayStation 2]], [[GameCube]], [[Xbox]], [[Game Boy Advance]], [[N-Gage]]
|''[[Crash Nitro Kart]]'' was also released on multiple platforms in 2003 as an indirect sequel to ''[[Crash Team Racing]]''. It became the first ''Crash'' game released on the [[N-Gage]].
|-
|''[[Crash Bandicoot Purple: Ripto's Rampage]]''
|2004
|[[Game Boy Advance]]
|''[[Crash Bandicoot Purple: Ripto's Rampage]]'' was a crossover game featuring [[Spyro the Dragon (character)|Spyro]] of ''Spyro the Dragon'' game. The game received mixed reviews by critics. However, this game is considered non-canon, due to the Spyro series' reboot with ''[[The Legend of Spyro: A New Beginning]]'' and Nina Cortex's appearance (as well as her mannerisms).
|-
|''[[Crash Twinsanity]]''
|2004
|[[PlayStation 2]], [[Xbox]]
|On September 2004, [[Traveller's Tales]] released ''[[Crash Twinsanity]]'' just months after ''Ripto's Rampage''. ''Twinsanity'' was a major deviation from the previous ''Crash'' gameplay, focusing on a new free-roaming environment instead of the straightforward gameplay of the past. It also marked the first time Cortex was a playable character in a platformer game.
|-
|''[[Crash Tag Team Racing]]''
|2005
|[[PlayStation 2]], [[GameCube]], [[Xbox]], [[PlayStation Portable]]
|''[[Crash Tag Team Racing]]'' arrived as the third racing game of the series. The game once again incorporated the free-roaming element of ''Twinsanity'', along with including an option to clash with another driver to form one larger car. However, the boss races from the previous two racing titles are absent from this game. The game was released for the first time in Crash's history on the [[PlayStation Portable]].
|-
|''[[Crash Boom Bang!]]''
|2006
|[[Nintendo DS]]
|To celebrate Crash's tenth anniversary, ''[[Crash Boom Bang!]]'' was released on October 2006. The title was Crash's second party game, and followed a more ''[[Mario Party]]''-esque format than its predecessor. However, many feel the ''Crash'' license was largely cosmetic, and the minigames were dull. The game was met with poor reviews. The game was the first ''Crash'' title released for the [[Nintendo DS]].
|-
|''[[Crash of the Titans]]''
|2007
|[[PlayStation 2]], [[PlayStation Portable]], [[Wii]], [[Nintendo DS]], [[Game Boy Advance]], [[Xbox 360]]
|''[[Crash of the Titans]]'' mainly focused on the concept of stunning opponents and "jacking", or taking control of them. The characters underwent major appearance changes which caused different reactions from Crash Bandicoot fans. The game was the first in the series to be released for the [[Wii]] and [[Xbox 360]].
|-
|''[[Crash: Mind over Mutant]]''
| 2008
|[[Nintendo DS]], [[PlayStation 2]], [[PlayStation Portable]], [[Wii]], [[Xbox 360]]
|Realesed October 2008, ''[[Crash: Mind over Mutant]]'' is on the [[PlayStation 2]], [[Nintendo DS]], [[PlayStation Portable]], [[Wii]] and [[Xbox 360]], and deals with Cortex trying take over the world using mind-controlling PDA's.
|-
|}


==Nature of the protagonist==
===Syncope===
{{main|Crash Bandicoot (character)}}
Naughty Dog once referenced the development of Crash as a character both "goofy yet heroic", and being able to portray it well. Originally however, he took the role of a silent protagonist and thus expressed little of his personality or opinions (a trait developer Jason Rubin later claimed to regret), though in more recent games he has played a larger role.


Crash's personality is hard to pinpoint, sometimes varying from game to game. Overall, he has a rather wacky, comical, cartoonish personality akin to a tornado. His behavior was in fact extended to actual hostility in ''Crash Tag Team Racing'', in which he took pleasure in acts of hurting Park Drones and even himself (it should be noted that ''CTTR'' is criticised for its over-caricaturisation or even complete change in character personalities). Despite this however, Crash is usually kind-hearted and laid back, rarely showing true sorrow or anger (though he detests evil, such as Cortex), though he is also rather simple, to some fans almost to the point of [[Mental retardation|retardedness]] and lack of awareness. Indeed, Cortex in ''Crash Twinsanity'' remarks, "With my mighty intellect and your vacuous stupidity, we'll be unbeatable!"
[[fainting|Syncope]] (fainting spells) in the setting of heart failure increases the risk of death. In patients with syncope, the 3 year mortality rate is 50%, if the aortic valve is not replaced.


Crash's most common ability is his tornado spin, upon which he twirls insanely to hit a nearby opponent, similar to the tornado spin of the ''Looney Tunes'' 's [[Tasmanian Devil (Looney Tunes)|Taz]]. The power of this attack varies in different games, to the point he can spin constantly or even float on air when using it. He can also spin objects, living or not, to gain a better hit radius. Like other platformers, he can also jump on opponents as well as slide and body slam. A large amount of special abilities can be obtained in various titles. Crash can also ride a whole range of vehicles, such as motorcycles, bi-planes, wave-boards, 4X4 jeeps, karts and a whole range of other cars. In a common tradition to the platform genre, he can also be seen riding a minecart at times.
It is unclear why aortic stenosis causes syncope. One popular theory is that severe AS produces a nearly fixed [[cardiac output]]. When the patient exercises, their [[peripheral vascular resistance]] will decrease as the blood vesels of the [[skeletal muscles]] dilate to allow the muscles to receive more blood to allow them to do more work. This decrease in peripheral vascular resistance is normally compensated for by an increase in the cardiac output. Since patients with severe AS cannot increase their cardiac output, the blood pressure falls and the patient will syncopize due to decreased blood perfusion to the [[brain]].


===Mascot===
A second theory as to why syncope may occur in AS is that during exercise, the high pressures generated in the hypertrophied LV cause a vasodepressor response, which causes a secondary peripheral [[vasodilation]] which in turn causes decreased blood flow to the [[brain]]. Indeed, in aortic stenosis, because of the fixed obstruction to bloodflow out from the heart, it may be impossible for the heart to increase its output to offset peripheral vasodilation.
The original ''[[Crash Bandicoot (video game)|Crash Bandicoot]]'' was one of the earliest [[3D computer graphics|3D]] platformers and was a major seller. [[Sony Computer Entertainment|Sony]] unofficially made Crash the [[List of video game mascots|mascot]] for the PlayStation.


Crash was often compared to [[Mario]] and [[Sonic the Hedgehog (character)|Sonic the Hedgehog]], as the three of them were mascots of their respective consoles. Both the original ''Crash Bandicoot'' and ''[[Super Mario 64]]'' were early 3D platformers, with the cancelled ''[[Sonic X-treme]]'' intended to be Sonic's answer to these games in that time. After the first three ''Crash'' games, much like Mario and Sonic before him, Crash branched out, starring in a [[Crash Team Racing|racing game]], analogous to ''[[Mario Kart 64]]'' and ''[[Sonic R]]'', and a [[Crash Bash|party game]], analogous to ''[[Mario Party]]'' and ''[[Sonic Shuffle]]'' (although this was on the [[Dreamcast]] rather than on the [[Sega Saturn]]). All of this contributed to the perception that Crash was Sony's equivalent of Mario and Sonic.
A third mechanism may sometimes be operative. Due to the hypertrophy of the [[left ventricle]] in aortic stenosis, including the consequent inability of the [[coronary arteries]] to adequately supply blood to the [[myocardium]] (see "Angina" below), [[arrhythmias]] may develop. These can lead to [[syncope]].


However, with the release of ''Crash'' games on other platforms, this is no longer the case. Despite now being a third-party franchise, some still believe Crash to be a Sierra equivalent of Mario. Sonic suffered a similar multi-platform fate, although he is still associated to the [[Sega]] brand being the official mascot of the company, something which is not the case of Crash. However, despite the recent decline in the platforming genre, Mario, Sonic and Crash remain popular.
Finally, in calcific aortic stenosis at least, the calcification in and around the aortic valve can progress and extend to involve the [[electrical conduction system of the heart]]. If that occurs, the result may be [[heart block]] - a potentially lethal condition of which syncope may be a symptom.


===Angina===
==Developers==
The first four ''Crash Bandicoot'' games were developed by [[Naughty Dog]]. ''[[Crash Bash]]'' was developed by [[Eurocom]]. ''[[Crash Bandicoot: The Wrath of Cortex]]'' and ''[[Crash Twinsanity]]'' were developed by [[Traveller's Tales]] and its division Traveller's Tales Oxford. ''[[Crash Bandicoot: The Huge Adventure]]'' (''Crash Bandicoot XS'' in Europe), ''[[Crash Bandicoot 2: N-Tranced]]'', ''[[Crash Nitro Kart]]'' and ''[[Crash Bandicoot Purple: Ripto's Rampage]]'' (''Crash Bandicoot Fusion'' in Europe) have all been developed by [[Vicarious Visions]]. ''[[Crash Tag Team Racing]]'' and ''[[Crash of the Titans]]'' were developed by [[Radical Entertainment]] and ''[[Crash Boom Bang!]]'' was developed by [[Dimps]]. The first four ''Crash'' titles were published by Sony as well as the games being produced by Universal Interactive Studios. All of the other ''Crash'' titles were published by Universal Interactive Studios (now known as [[Vivendi|Vivendi Games]]).


The first five ''Crash'' games were exclusives to the Sony PlayStation. Since then, multiple developers have worked with the property and games have been released for [[Nintendo]] and [[Microsoft]] [[video game console|consoles]], in addition to Sony.
[[Angina pectoris|Angina]] in the setting of heart failure also increases the risk of death. In patients with angina, the 5 year mortality rate is 50%, if the aortic valve is not replaced.


Though some of the Vicarious Visions titles have not fared critically as well as the Naughty Dog games, they have still received gratitude for keeping the series true to its original platforming roots. In an almost opposite twist, there are also fans who praise the work of Traveller's Tales Oxford for their work in ''[[Crash Twinsanity]]'', which was the first platformer in the series to drive away from the "warp room" interface of the original series and simultaneously reimagine certain story details.
Angina in the setting of AS is secondary to the [[left ventricular hypertrophy]] (LVH) that is caused by the constant production of increased pressure required to overcome the pressure gradient caused by the AS. While the [[myocardium]] (i.e. heart muscle) of the LV gets thicker, the arteries that supply the muscle do not get significantly longer or bigger, so the muscle may become ischemic (i.e. doesn't receive an adequate blood supply). The [[ischemia]] may first be evident during exercise, when the heart muscle requires increased blood supply to compensate for the increased workload. The individual may complain of exertional angina. At this stage, a [[stress test]] with imaging may be suggestive of ischemia.
''Crash of the Titans'' was the first to drive away from the platformer into the action genre.


==Reception and legacy==
Eventually, however, the muscle will require more blood supply at rest than can be supplied by the coronary artery branches. At this point there may be signs of ''ventricular strain pattern'' (ST segment depression and T wave inversion) on the [[EKG]], suggesting subendocardial ischemia. The subendocardium is the region that becomes ischemic because it is the most distant from the epicardial coronary arteries.
<div style="font-size: 90%;float:right;border-left:1em solid white">
{| class="wikitable"
|+'''Aggregate review scores'''
!Game
![[Game Rankings]]
![[Metacritic]]
|-
|''[[Crash Bandicoot]]''
|<center>80.4%<ref>{{cite web |publisher=Game Rankings |title=''Crash Bandicoot'' reviews |url=http://www.gamerankings.com/htmlpages2/196986.asp |accessdate=2008-05-09}}</ref>
|<center>-
|-
|''[[Crash Bandicoot 2: Cortex Strikes Back]]''
|<center>88.5%<ref name="CSBRankings"/>
|<center>-
|-
|''[[Crash Bandicoot 3: Warped]]''
|<center>89.1%<ref>{{cite web |publisher=Game Rankings |title=''Crash Bandicoot 3: Warped'' reviews |url=http://www.gamerankings.com/htmlpages2/196988.asp |accessdate=2008-05-09}}</ref>
|<center>91%<ref>{{cite web |publisher=Metacritic |title=''Crash Bandicoot 3: Warped'' (psx: 1998) |url=http://www.metacritic.com/games/platforms/psx/crashbandicoot3warped |accessdate=2008-05-09}}</ref>
|-
|''[[Crash Team Racing]]''
|<center>91.7%<ref>{{cite web |publisher=Game Rankings |title=''Crash Team Racing'' reviews |url=http://www.gamerankings.com/htmlpages2/196989.asp |accessdate=2008-05-09}}</ref>
|<center>88%<ref>{{cite web |publisher=Metacritic |title=''Crash Team Racing'' (psx: 1999) |url=http://www.metacritic.com/games/platforms/psx/crashteamracing |accessdate=2008-05-09}}</ref>
|-
|''[[Crash Bash]]''
|<center>71.3%<ref>{{cite web |publisher=Game Rankings |title=''Crash Bash'' reviews |url=http://www.gamerankings.com/htmlpages2/914119.asp |accessdate=2008-05-09}}</ref>
|<center>68%<ref>{{cite web |publisher=Metacritic |title=''Crash Bash'' (psx: 2000) |url=http://www.metacritic.com/games/platforms/psx/crashbash |accessdate=2008-05-09}}</ref>
|-
|''[[Crash Bandicoot: The Wrath of Cortex]]''
|<center>(Xbox) 70.2%<ref>{{cite web |publisher=Game Rankings |title=''Crash Bandicoot: The Wrath of Cortex'' (Xbox) reviews |url=http://www.gamerankings.com/htmlpages2/552471.asp |accessdate=2008-05-09}}</ref><br>(PS2) 70.1%<ref>{{cite web |publisher=Game Rankings |title=''Crash Bandicoot: The Wrath of Cortex'' (PS2) reviews |url=http://www.gamerankings.com/htmlpages2/472571.asp |accessdate=2008-05-09}}</ref><br>(GC) 62.3%<ref>{{cite web |publisher=Game Rankings |title=''Crash Bandicoot: The Wrath of Cortex'' (GC) reviews |url=http://www.gamerankings.com/htmlpages2/478250.asp |accessdate=2008-05-09}}</ref>
|<center>(Xbox) 70%<ref>{{cite web |publisher=Metacritic |title=''Crash Bandicoot: The Wrath of Cortex'' (xbx: 2002) |url=http://www.metacritic.com/games/platforms/xbx/crashbandicootwrath |accessdate=2008-05-09}}</ref><br>(PS2) 66%<ref>{{cite web |publisher=Metacritic |title=''Crash Bandicoot: The Wrath of Cortex'' (ps2: 2001) |url=http://www.metacritic.com/games/platforms/ps2/crashbandicootwrath |accessdate=2008-05-09}}</ref><br>(GC) 62%<ref>{{cite web |publisher=Metacritic |title=''Crash Bandicoot: The Wrath of Cortex'' (cube: 2002) |url=http://www.metacritic.com/games/platforms/cube/crashbandicootwrath |accessdate=2008-05-09}}</ref>
|-
|''[[Crash Bandicoot: The Huge Adventure]]''
|<center>78.8%<ref>{{cite web |publisher=Game Rankings |title=''Crash Bandicoot: The Huge Adventure'' reviews |url=http://www.gamerankings.com/htmlpages2/528154.asp |accessdate=2008-05-09}}</ref>
|<center>78%<ref>{{cite web |publisher=Metacritic |title=''Crash Bandicoot: The Huge Adventure'' (gba: 2002) |url=http://www.metacritic.com/games/platforms/gba/crashbandicootthehuge |accessdate=2008-05-09}}</ref>
|-
|''[[Crash Bandicoot 2: N-Tranced]]''
|<center>75.1%<ref>{{cite web |publisher=Game Rankings |title=''Crash Bandicoot 2: N-Tranced'' reviews |url=http://www.gamerankings.com/htmlpages2/562580.asp |accessdate=2008-05-09}}</ref>
|<center>75%<ref>{{cite web |publisher=Metacritic |title=''Crash Bandicoot 2: N-Tranced'' (gba: 2003) |url=http://www.metacritic.com/games/platforms/gba/crashbandicoot2ntranced |accessdate=2008-05-09}}</ref>
|-
|''[[Crash Nitro Kart]]''
|<center>(GBA) 69.7%<ref>{{cite web |publisher=Game Rankings |title=''Crash Nitro Kart'' (GBA) reviews |url=http://www.gamerankings.com/htmlpages2/915605.asp |accessdate=2008-05-09}}</ref><br>(PS2) 65.9%<ref>{{cite web |publisher=Game Rankings |title=''Crash Nitro Kart'' (PS2) reviews |url=http://www.gamerankings.com/htmlpages2/914685.asp |accessdate=2008-05-09}}</ref><br>(Xbox) 65.7%<ref>{{cite web |publisher=Game Rankings |title=''Crash Nitro Kart'' (Xbox) reviews |url=http://www.gamerankings.com/htmlpages2/914686.asp |accessdate=2008-05-09}}</ref><br>(GC) 63.2%<ref>{{cite web |publisher=Game Rankings |title=''Crash Nitro Kart'' (GC) reviews |url=http://www.gamerankings.com/htmlpages2/914687.asp |accessdate=2008-05-09}}</ref><br>(Mobile) 61.3%<ref>{{cite web |publisher=Game Rankings |title=''Crash Nitro Kart'' (Mobile) reviews |url=http://www.gamerankings.com/htmlpages2/924848.asp |accessdate=2008-05-09}}</ref><br>(N-Gage) 57.1%<ref>{{cite web |publisher=Game Rankings |title=''Crash Nitro Kart'' (N-Gage) reviews |url=http://www.gamerankings.com/htmlpages2/919845.asp |accessdate=2008-05-09}}</ref>
|<center>(GBA) 78%<ref>{{cite web |publisher=Metacritic |title=''Crash Nitro Kart'' (gba: 2003) |url=http://www.metacritic.com/games/platforms/gba/crashnitrokart |accessdate=2008-05-09}}</ref><br>(Xbox) 70%<ref>{{cite web |publisher=Metacritic |title=''Crash Nitro Kart'' (xbx: 2003) |url=http://www.metacritic.com/games/platforms/xbx/crashnitrokart |accessdate=2008-05-09}}</ref><br>(PS2) 69%<ref>{{cite web |publisher=Metacritic |title=''Crash Nitro Kart'' (ps2: 2003) |url=http://www.metacritic.com/games/platforms/ps2/crashnitrokart |accessdate=2008-05-09}}</ref><br>(GC) 66%<ref>{{cite web |publisher=Metacritic |title=''Crash Nitro Kart'' (cube: 2003) |url=http://www.metacritic.com/games/platforms/cube/crashnitrokart |accessdate=2008-05-09}}</ref><br>(N-Gage) 64%<ref>{{cite web |publisher=Metacritic |title=''Crash Nitro Kart'' (ngage: 2004) |url=http://www.metacritic.com/games/platforms/ngage/crashnitrokart |accessdate=2008-05-09}}</ref><br>(Mobile) -
|-
|''[[Crash Bandicoot Purple: Ripto's Rampage]]''
|<center>64.8%<ref>{{cite web |publisher=Game Rankings |title=''Crash Bandicoot Purple: Ripto's Rampage |url=http://www.gamerankings.com/htmlpages2/919868.asp |accessdate=2008-05-09}}</ref>
|<center>67%<ref>{{cite web |publisher=Metacritic |title=''Crash Bandicoot Purple: Ripto's Rampage'' (gba: 2004) |url=http://www.metacritic.com/games/platforms/gba/crashbandicootpurpleriptosrampage |accessdate=2008-05-09}}</ref>
|-
|''[[Crash Twinsanity]]''
|<center>(Mobile) 74.3%<ref>{{cite web |publisher=Game Rankings |title=''Crash Twinsanity'' (Mobile) reviews |url=http://www.gamerankings.com/htmlpages2/925347.asp |accessdate=2008-05-09}}</ref><br>(Xbox) 68.1%<ref>{{cite web |publisher=Game Rankings |title=''Crash Twinsanity'' (Xbox) reviews |url=http://www.gamerankings.com/htmlpages2/920120.asp |accessdate=2008-05-09}}</ref><br>(PS2) 65.3%<ref>{{cite web |publisher=Game Rankings |title=''Crash Twinsanity'' (PS2) reviews |url=http://www.gamerankings.com/htmlpages2/920119.asp |accessdate=2008-05-09}}</ref>
|<center>(Xbox) 66%<ref>{{cite web |publisher=Metacritic |title=''Crash Twinsanity'' (xbx: 2004) |url=http://www.metacritic.com/games/platforms/xbx/crashtwinsanity |accessdate=2008-05-09}}</ref><br>(PS2) 64%<ref>{{cite web |publisher=Metacritic |title=''Crash Twinsanity'' (ps2: 2004) |url=http://www.metacritic.com/games/platforms/ps2/crashtwinsanity |accessdate=2008-05-09}}</ref><br>(Mobile)-
|-
|''[[Crash Tag Team Racing]]''
|<center>(Xbox) 68.6%<ref>{{cite web |publisher=Game Rankings |title=''Crash Tag Team Racing'' (Xbox) reviews |url=http://www.gamerankings.com/htmlpages2/927301.asp |accessdate=2008-05-09}}</ref><br>(PS2) 68.3%<ref>{{cite web |publisher=Game Rankings |title=''Crash Tag Team Racing'' (PS2) reviews |url=http://www.gamerankings.com/htmlpages2/927300.asp |accessdate=2008-05-09}}</ref><br>(PSP) 68.1%<ref>{{cite web |publisher=Game Rankings |title=''Crash Tag Team Racing'' (PSP) reviews |url=http://www.gamerankings.com/htmlpages2/929190.asp |accessdate=2008-05-09}}</ref><br>(GC) 66.6%<ref>{{cite web |publisher=Game Rankings |title=''Crash Tag Team Racing'' (GC) reviews |url=http://www.gamerankings.com/htmlpages2/927302.asp |accessdate=2008-05-09}}</ref>
|<center>(Xbox) 69%<ref>{{cite web |publisher=Metacritic |title=''Crash Tag Team Racing'' (xbx: 2005) |url=http://www.metacritic.com/games/platforms/xbx/crashtagteamracing |accessdate=2008-05-09}}</ref><br>(PSP) 68%<ref>{{cite web |publisher=Metacritic |title=''Crash Tag Team Racing'' (psp: 2005) |url=http://www.metacritic.com/games/platforms/psp/crashtagteamracing |accessdate=2008-05-09}}</ref><br>(PS2) 66%<ref>{{cite web |publisher=Metacritic |title=''Crash Tag Team Racing'' (ps2: 2005) |url=http://www.metacritic.com/games/platforms/ps2/crashtagteamracing |accessdate=2008-05-09}}</ref><br>(GC) 66%<ref>{{cite web |publisher=Metacritic |title=''Crash Tag Team Racing'' (cube: 2005) |url=http://www.metacritic.com/games/platforms/cube/crashtagteamracing |accessdate=2008-05-09}}</ref>
|-
|''[[Crash Boom Bang!]]''
|<center>41%<ref>{{cite web |publisher=Game Rankings |title=''Crash Boom Bang!'' reviews |url=http://www.gamerankings.com/htmlpages2/932603.asp |accessdate=2008-05-09}}</ref>
|<center>37%<ref>{{cite web |publisher=Metacritic |title=''Crash Boom Bang!'' (ds: 2006) |url=http://www.metacritic.com/games/platforms/ds/crashboombang |accessdate=2008-05-09}}</ref>
|-
|''[[Crash of the Titans]]''
|<center>(DS) 72%<ref>{{cite web |publisher=Game Rankings |title=''Crash of the Titans'' (DS) reviews |url=http://www.gamerankings.com/htmlpages2/939008.asp |accessdate=2008-05-09}}</ref><br>(PS2) 71.9%<ref>{{cite web |publisher=Game Rankings |title=''Crash of the Titans'' (PS2) reviews |url=http://www.gamerankings.com/htmlpages2/939006.asp |accessdate=2008-05-09}}</ref><br>(Wii) 70.9%<ref>{{cite web |publisher=Game Rankings |title=''Crash of the Titans'' (Wii) reviews |url=http://www.gamerankings.com/htmlpages2/939005.asp |accessdate=2008-05-09}}</ref><br>(PSP) 70%<ref>{{cite web |publisher=Game Rankings |title=''Crash of the Titans'' (PSP) reviews |url=http://www.gamerankings.com/htmlpages2/939010.asp |accessdate=2008-05-09}}</ref><br>(X360) 64.7%<ref>{{cite web |publisher=Game Rankings |title=''Crash of the Titans'' (X360) reviews |url=http://www.gamerankings.com/htmlpages2/939007.asp |accessdate=2008-05-09}}</ref><br>(GBA) -
|<center>(DS) 73%<ref>{{cite web |publisher=Metacritic |title=''Crash of the Titans'' (ds: 2007) |url=http://www.metacritic.com/games/platforms/ds/crashofthetitans |accessdate=2008-05-09}}</ref><br>(PS2) 70%<ref>{{cite web |publisher=Metacritic |title=''Crash of the Titans'' (ps2: 2007) |url=http://www.metacritic.com/games/platforms/ps2/crashofthetitans |accessdate=2008-05-09}}</ref><br>(Wii) 69%<ref>{{cite web |publisher=Metacritic |title=''Crash of the Titans'' (wii: 2007) |url=http://www.metacritic.com/games/platforms/wii/crashofthetitans |accessdate=2008-05-09}}</ref><br>(X360) 65%<ref>{{cite web |publisher=Metacritic |title=''Crash of the Titans'' (xbox360: 2007) |url=http://www.metacritic.com/games/platforms/xbox360/crashofthetitans |accessdate=2008-05-09}}</ref><br>(PSP) -<br>(GBA) -
|-
|''[[Crash: Mind over Mutant]]''
|<center>(Wii) 77.0%<ref name="Wii MOM at Gamerankings">{{cite web |url=http://www.gamerankings.com/htmlpages2/945945.asp |title=''Crash: Mind over Mutant'' (Wii) at Game Rankings |accessdate=2008-10-07 |accessmonthday=October 7 |accessdaymonth=7 October |accessyear=2008 |author= |last= |first= |authorlink= |coauthors= |date= |year= |month= |format= |work= |publisher=[[Game Rankings]] |location= |pages= |language=English |doi= |archiveurl= |archivedate= |quote= }}</ref>
|<center>TBA
|}
</div>
The ''Crash Bandicoot'' series has been a commercial success. As of 2008, the series altogether has sold more than 40 million copies.<ref name="vivendi"/> According to [[Gamasutra]], the first ''Crash Bandicoot'' game has sold 6.8 million copies as of November 2003,<ref>{{cite web |url=http://gamasutra.com/features/20060804/boutros_06.shtml |title=Crash Bandicoot |work=A Detailed Cross-Examination of Yesterday and Today's Best-Selling Platform Games |pages=6 |author=Daniel Boutros |date=2006-08-04 |accessdate=2008-05-10}}</ref> making it the seventh best-selling PlayStation game of all time. ''Cortex Strikes Back'' sold 3.87 million copies in the U.S.,<ref name="magicbox">{{cite web |date=2007-12-27 |publisher=The Magic Box |title=US Platinum Videogame Chart |url=http://www.the-magicbox.com/Chart-USPlatinum.shtml |accessdate=2008-05-10}}</ref> while ''Warped'' sold 3.76 million.<ref name="magicbox"/> The last two games on the PlayStation console, ''Crash Team Racing'' and ''Crash Bash'', sold 1.9 million and 1.1 million copies in the U.S. respectively.<ref name="magicbox"/> The only individual non-PlayStation ''Crash'' game to break the one-million mark in sales is the PlayStation 2 version of ''Crash Bandicoot: The Wrath of Cortex'', which sold 1.95 million copies in the U.S.<ref name="magicbox"/>


The ''Crash Bandicoot'' series is one of the few Western video game series to find blockbuster success in [[Japan]]. ''Cortex Strikes Back'' and ''Warped'' sold 1.3 and 1.4 million copies in the country respectively,<ref name="magicboxjapan">{{cite web |publisher=The Magic Box |title=Japan Platinum Game Chart |url=http://www.the-magicbox.com/topten2.htm |accessdate=2008-05-10}}</ref> while the PlayStation 2 version of ''Wrath of Cortex'' sold 203,000 copies.<ref>{{cite web |publisher=Japan Game Charts |title=Sony PS2 Japanese Ranking |url=http://www.japan-gamecharts.com/ps2.php |accessdate=2008-05-10}}</ref>
===Associated symptoms===
In [[Heyde's syndrome]], aortic stenosis is associated with [[angiodysplasia]] of the [[colon (anatomy)|colon]]. Recent research has shown that the stenosis causes a form of [[von Willebrand disease]] by breaking down its associated [[coagulation]] factor ([[factor VIII]]-associated antigen, also called [[von Willebrand factor]]), due to increased turbulence around the stenosed valve.

==Physical examination==

Aortic stenosis is most often diagnosed when it is [[asymptomatic]] and can sometimes be detected during routine examination of the heart and circulatory system. Good evidence exists to demonstrate that certain characteristics of the peripheral pulse can rule in the diagnosis.<ref>[http://jama.ama-assn.org/cgi/content/abstract/277/7/564 JAMA - Abstract: Does this patient have an abnormal systolic murmur?, February 19, 1997, Etchells et al. 277 (7): 564<!-- Bot generated title -->]</ref> In particular, there may be a slow and/or sustained upstroke of the arterial pulse, and the pulse may be of low volume. This is sometimes referred to as ''[[pulsus tardus et parvus]]''. There may also be a noticeable delay between the [[heart sounds|first heart sound]] (on [[auscultation]]) and the corresponding pulse in the [[carotid]] artery (so-called 'apical-carotid delay'). Similarly, there may be a delay between the appearance of each pulse in the brachial artery (in the arm) and the radial artery (in the wrist).

An easily heard [[systole|systolic]], crescendo-decrescendo (i.e. 'ejection') [[heart murmur|murmur]] is heard loudest at the upper right sternal border, and radiates to the [[carotid artery|carotid arteries]] bilaterally. The murmur increases with squatting, decreases with standing and isometric muscular contraction, which helps distinguish it from [[hypertrophic obstructive cardiomyopathy]] (HOCM). The murmur is louder during expiration, but is also easily heard during inspiration. The more severe the degree of the stenosis, the later the peak occurs in the crescendo-decrescendo of the murmur.

The 2nd heart sound tends to become softer as the aortic stenosis becomes more severe. This is a result of the increasing calcification of the valve preventing it from "snapping" shut and producing a sharp, loud sound. Due to increases in [[left ventricular pressure]] from the stenotic aortic valve, over time the ventricle may hypertrophy, resulting in a diastolic dysfunction. As a result, one may hear a 4th heart sound due to the stiff ventricle. With continued increases in ventricular pressure, dilatation of the ventricle will occur, and a 3rd heart sound may be manifest.

Finally, aortic stenosis often co-exists with some degree of [[aortic insufficiency]]. Hence, the physical exam in aortic stenosis may also reveal signs of the latter, for example an early diastolic decrescendo murmur. Indeed, when both valve abnormalities are present, the expected findings of either may be modified or may not even be present. Rather, new signs emerge which reflect the presence of simultaneous aortic stenosis and insufficiency, e.g. [[pulsus bisferiens]].

According to a [[meta analysis]], the most useful findings for ruling in aortic stenosis in the clinical setting were slow rate of rise of the carotid pulse(positive [[likelihood ratio]] ranged 2.8-130 across studies), mid to late peak intensity of the murmur(positive likelihood ratio, 8.0-101), and decreased intensity of the second heart sound(positive likelihood ratio, 3.1-50).<ref>{{cite journal |author=Etchells E, Bell C, Robb K |title=Does this patient have an abnormal systolic murmur? |journal=JAMA |volume=277 |issue=7 |pages=564–71 |year=1997 |pmid=9032164|doi=10.1001/jama.277.7.564}}</ref>

Peripheral signs include:
* a slow-rising, small volume carotid pulse
* narrowed pulse pressure
* sustained, thrusting apex beat which is usually not displaced unless the stenosis is severe

==Diagnostic tests==
===The [[electrocardiogram]] (ECG)===
Although aortic stenosis does not lead to any ''specific'' findings on the [[ECG]], it still often leads to a number of electrocardiographic abnormalities. ECG manifestations of [[left ventricular hypertrophy]] (LVH) are common in aortic stenosis and arise as a result of the stenosis having placed a chronically high pressure load on the [[left ventricle]] (with LVH being the expected response to chronic pressure loads on the left ventricle no matter how caused).

As noted below, the calcification process which occurs in aortic stenosis can progress to extend beyond the aortic valve and into the [[electrical conduction system of the heart]]. Evidence of this phenomenon may include [[heart block]] that is apparent on the ECG but otherwise undetectable.

===Heart catheterization===
The heart may be [[cardiac catheterization|catheterized]] to directly measure the pressure on both sides of the aortic valve. The pressure gradient may be used as a decision point for treatment. Catheterization is accurate for moderate velocity stenosis, while Doppler echo is more accurate at faster velocities.{{Fact|date=June 2007}}

===Echocardiogram===
[[Echocardiogram]] (heart ultrasound) is the best non-invasive test to evaluate the aortic valve anatomy and function.

The aortic valve area can be [[Aortic valve area calculation|calculated]] non-invasively using echocardiographic flow velocities. Using the velocity of the blood through the valve, the pressure gradient across can be calculated by the modified [[Bernoulli's equation]]: <blockquote>Gradient = 4(velocity)² mmHg</blockquote> A normal aortic valve has no gradient. If the mean gradient is <25 mm Hg, the stenosis is mild; if the mean gradient is between 25 mm Hg and 50 mm Hg, the stenosis is moderate; if the mean gradient is >50 mm Hg the stenosis is severe; and when the gradient is greater than 70 mm Hg, the stenosis is critical. A normal aortic valve area is >2 cm<sup>2</sup>. If the valve area is between 1.3 and 2.0 cm<sup>2</sup>, the stenosis is mild; if the valve area is between 1.0 and 1.3 cm<sup>2</sup>, the stenosis is moderate; if the valve area is between 0.7 and 1.0 cm<sup>2</sup>, the stenosis is moderate-severe; areas of less than 0.7 cm<sup>2</sup> constitute severe aortic stenosis.

==Cautions==
People with aortic stenosis of any aetiology are at risk for the development of infection of their stenosed valve, i.e. [[infective endocarditis]]. To lessen the chance of developing that serious complication, people with AS are usually advised to take antibiotic prophylaxis around the time of certain dental/medical/surgical procedures. Such procedures may include dental extraction, deep scaling of the teeth, gum surgery, dental implants, treatment of [[esophageal varices]], dilation of [[esophageal strictures]], gastrointestinal ''surgery'' where the intestinal [[mucosa]] will be disrupted, [[prostate]] surgery, [[urethral stricture]] dilation, and [[cystoscopy]]. Note that routine upper and lower GI [[endoscopy]] (i.e. [[gastroscopy]] and [[colonoscopy]]), with or without [[biopsy]], are not usually considered indications for antibiotic prophylaxis.

Notwithstanding the foregoing, the American Heart Association has recently changed its recommendations regarding antibiotic prophylaxis for endocarditis. Specifically, as of 2007, it is recommended that such prophylaxis be limited only to 1. those with prosthetic heart valves, 2. those with previous episode(s) of endocarditis, and 3. those with certain types of congenital heart disease.<ref>[http://www.americanheart.org/presenter.jhtml?identifier=4436 Infective Endocarditis (previously referred to as bacterial endocarditis)<!-- Bot generated title -->]</ref>

Since the stenosed aortic valve may limit the heart's output, people with aortic stenosis are at risk of [[syncope]] and dangerously low blood pressure should they use any of a number of common medications. Ironically, these same medicines are used to treat a variety of cardiovascular diseases, many of which may co-exist with aortic stenosis. Examples include [[nitroglycerin]], [[nitrates]], [[ACE inhibitor]]s, [[terazosin]] (Hytrin), and [[hydralazine]]. Note that all of these substances lead to peripheral [[vasodilation]]. Normally, however, in the absence of aortic stenosis, the heart is able to increase its output and thereby offset the effect of the dilated blood vessels. In some cases of aortic stenosis, however, due to the obstruction of blood flow out of the heart caused by the stenosed aortic valve, [[cardiac output]] cannot be increased. Low blood pressure or [[syncope]] may ensue.

==Treatment==
===Medical===
Aortic stenosis may be medically treated to control symptoms, although survival is poor with medical treatment alone.

===Surgical===
In adults, aortic stenosis usually requires [[aortic valve replacement]] if medical management does not successfully control symptoms.
According to a prospective, single-center, nonrandomized study of 25 patients, percutaneous implantation of an aortic valve prosthesis in high risk patients with aortic stenosis results in marked hemodynamic and clinical improvement when successfully completed.<ref>{{cite journal |author=Grube E, Laborde JC, Gerckens U, ''et al'' |title=Percutaneous implantation of the CoreValve self-expanding valve prosthesis in high-risk patients with aortic valve disease: the Siegburg first-in-man study |journal=Circulation |volume=114 |issue=15 |pages=1616–24 |year=2006 |pmid=17015786 |doi=10.1161/CIRCULATIONAHA.106.639450}}</ref>

For infants and children, [[balloon valvuloplasty]], where a balloon is inflated to stretch the valve and allow greater flow, may also be effective[http://www.mayoclinic.com/health/aortic-valve-stenosis/DS00418/DSECTION=8].


==See also==
*[[List of Crash Bandicoot characters]]
*''[[Jak & Daxter]]''
*''[[Sly Cooper series|Sly Cooper]]''
*''[[Ratchet & Clank series|Ratchet & Clank]]''
*[[Naughty Dog]]
*[[Sony Computer Entertainment]]
*[[Vivendi Games]]
*[[Traveller's Tales]]
*[[Sierra Entertainment]]
*[[Radical Entertainment]]
*[[Spyro the Dragon]]
==References==
==References==
{{reflist|2}}
<references />

== See also ==
[[Aortic valve area calculation]]


==External links==
==External links==
;Official websites (in gaming order)
* [http://heartcenter.seattlechildrens.org/conditions_treated/aortic_stenosis.asp Aortic stenosis information] from Seattle Children's Hospital Heart Center
* [http://www.mitralvalverepair.org Mitral Valve Repair at The Mount Sinai Hospital]
*[http://www.naughtydog.com/crash/ Naughty Dog's Official Crash Bandicoot Site]
*[http://www.crashbandicoot.com/ Vivendi Universal's Official Crash Bandicoot Site]

*[http://www.us.playstation.com/Content/OGS/SCUS-94900/Site/ Playstation One's Official Crash Bandicoot Site]
{{Circulatory system pathology}}
*[http://www.us.playstation.com/Content/OGS/SCUS-94154/Site/ Playstation One's Official Crash Bandicoot 2: Cortex Strikes Back Site]
{{Congenital malformations and deformations of circulatory system}}
*[http://www.us.playstation.com/Content/OGS/SCUS-94244/Site/ Playstation One's Official Crash Bandicoot 3: Warped Site]
[[Category:Valvular heart disease]]
*[http://www.us.playstation.com/Content/OGS/SCUS-94426/Site/ Playstation One's Official Crash Team Racing Site]
*[http://www.us.playstation.com/Content/OGS/SCUS-94570/Site/ Playstation One's Official Crash Bash Site]
*[http://twinsanity.crashbandicoot.com/us/ Vivendi Universal's Official Crash Twinsanity Site]
*[http://ttr.crashbandicoot.com/us/ Sierra's Official Crash Tag Team Racing Site]
*[http://village.crashbandicoot.com/splash/ Sierra's Offical Crash of the Titans Site]
;General resources
*{{moby game|id=-group/crash-bandicoot-series|name=''Crash Bandicoot'' series}}
*[http://crashban.wikia.com/wiki/Main_Page Wikia's Crash Bandicoot Wiki]
*[http://crashbandicoot.wikia.com/wiki/Crash_Bandicoot_Wiki:Toplist A Toplist about the Crash Bandicoot Sites]
*[http://crashmania.net/home.php Crash Mania, thinking outside the Crate]
{{Crash Bandicoot series}}
[[Category:Crash Bandicoot|*]]
[[Category:Video game franchises]]


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Revision as of 01:49, 10 October 2008

For other uses, see Crash Bandicoot (disambiguation).
File:CrashBandicootLogo.png
The Crash Bandicoot series logo

Crash Bandicoot is a series of platform video games currently developed by Radical Entertainment and published by Sierra Entertainment. Initially created by Andy Gavin and Jason Rubin, the series was developed for its first four years by the video game company Naughty Dog. Since then, the series has been given to numerous developers before finally settling at Radical Entertainment. The series has 15 games as of 2008.

The games are mostly set in the fictitious Wumpa Islands, an archipelago situated on the south of Australia, although other locations are common. The main games of the series are largely platform games, but the majority of the games are spin-offs in different genres. The protagonist of the games is an Eastern Barred Bandicoot named Crash, whose quiet life on the Wumpa Islands is often interrupted by the main antagonist in the series, Doctor Neo Cortex, who created Crash and now wants nothing more than his demise. It's usually up to Crash to defeat Cortex and foil any world domination plans he might have.

The Crash Bandicoot series has been a commercial success, selling 40 million copies.[1]

Common gameplay elements

The first three Crash games, as well as several subsequent Crash games, were platform games. There are Aku Aku copy masks sparsely scattered throughout the levels. Collecting an Aku Aku mask while Crash already has one turns the one he has gold. Collecting another mask while Crash has a gold one grants Crash limited-time invincibility, after which the mask reverts to being gold. Getting hit will reduce the mask from gold to normal or from normal to nothing. If Crash gets hit when he does not have a mask, he will meet his end in a sometimes comical animation. In effect, therefore, masks serve as hit points.

Main collectables include 'Wumpa Fruit' , healthy forest fruit (based on apples), grown from Wumpa Trees, which gives an additional life to Crash when 100 are obtained. Other, more valuable goodies include Gems (rare jewels awarded for completing tasks such as smashing every crate on a level, or finding and completing an alternate path) and Crystals (jewels located somewhere in the main path of the level), which often play a key role in the plot. The only other collectables to note are Time Relics, featured from Crash Bandicoot: Warped and most other Crash games afterwards (collected by racing a level's time trial; in Warped, the player can win a sapphire relic by beating the established time, and a gold one by finishing even faster; this generally requires that the player pick up a move that allows them to sprint through the level) and trophies, which are featured in Crash Team Racing, Crash Nitro Kart and Crash Bash. In the Crash games of recent years, 'Wumpa Fruit' are still present, although they serve as a means of health, with a substance called 'Mojo' effectively replacing them as collectible items.

Obstacles in Crash's path include animal-like creatures and other badguys, Doctor Neo Cortex's lab assistants, various machinery, and physical barriers. To surmount these, Crash can use his jump move and his spin attack. In Crash platformers after the first, he can also do a body slam, slide, duck, crawl, and perform an extra-high jump by sliding or ducking and then jumping. Starting with Crash Bandicoot 3: Warped, Crash can also collect a special move after defeating each boss.

In some of the Crash platformers, not including the original, some levels have a skull platform which transports Crash to a hidden part of the level. To be able to use the platform, Crash must not have died before reaching it in the current playthrough of the level. The hidden path will usually contain a hidden gem.

Most of the Crash Bandicoot series each contain around 25 levels of gameplay. In the later games, higher levels will require special moves obtained from defeating bosses. There will also be hidden levels, where bonus items can be obtained.

Crates

There are crates scattered throughout the levels. Most crates contain some form of bonus. Some have Wumpa fruits in them, and collecting 100 of the game's "Wumpa Fruit" gives the player an extra life. Others have Aku Aku masks or extra lives.

The player can get one Gem per level by breaking all of the crates in one level. The remaining gems must be collected by finding and touching them. They are invariably positioned in an area that is difficult to reach. Most gems are white, but some are colored. In the original Crash Bandicoot, but in none of its sequels, some gems acquired by breaking all of a level's boxes are colored. The colored Gems in the later Crash games, except for Twinsanity, are often obtained via completing the Skull paths (mentioned earlier) or other harder, secret routes. These colored gems activate additional secret routes, which may also be needed to acquire either Gem on a level.

In addition to crates that provide bonuses, there are also TNT crates. If Crash attacks one, he loses a mask, or, failing that, a life. If he jumps on one, a three second countdown is started, after which the TNT crate explodes. Some TNT crates are useful to clear obstacles. Some crates have on them an arrow pointing upwards. Landing on one will spring Crash into the air, much like a trampoline does. With the exception of the original, there are Nitro crates in all Crash platformers. If Crash touches one, he loses a mask or a life. A notable exception is in Crash Bandicoot: The Wrath of Cortex, where the special ability 'creep' allows the player to walk along the top of Nitro Crates, but not fall on them, or touch them in any other way. Attacking a metal green crate with an exclamation mark on it destroys all of a level's Nitro crates.

Also present in all Crash platformers except for the original are normal crates that are protected by a metal gridlock surrounding their edges normally destroyed by using the body slam move. Beginning with the third Crash game, Crash Bandicoot: Warped, some crates are shifting crates, also known as 'slot crates'. They shift among different kinds of crates. The rate at which a shifting crate changes gradually increases, until finally the crate becomes metallic and indestructible. For destroying these crates, an aku aku, a life or nothing can be obtained. Also present in the newer Crash Bandicoot games, there are Time Trial crates, which can only be found on levels when in Time Trial mode. Breaking any of these crates will stop the watch that counts your time to complete the level for a limited amount of time. Depending on the number on the crate (1, 2 or 3), the watch will stop for that number of seconds until continuing counting.

Games

Title Release date Released for Information
Crash Bandicoot 1996 PlayStation, PlayStation Network Crash Bandicoot, was released in the United States in 1996. The game was looked upon in a positive light due to its innovations such as a large number of level themes, the three different types of bonus levels rather than just one, and a number of gameplay elements that do not appear to belong to an integrated whole, such as the awkward face icons.[citation needed] This experimental appearance may have been because the game was a pioneer of a new series, and the developers may have been testing several ideas to see if they would work well in future Crash games.[original research?]
Crash Bandicoot 2: Cortex Strikes Back 1997 PlayStation, PlayStation Network Crash Bandicoot 2: Cortex Strikes Back, was released in the Halloween of 1997, and departed from some of the concepts of the first game, the most notable being the exchange of the Super Mario Bros. 3-esque map screen for a group of hub rooms called "warp rooms" with each containing five levels, which follow the same straightforward layout of the first game, and one boss. It has overall been better received than its predecessor,[2] in part because it allowed the user to save game progress any time while in the central area ("warp room"). In the first game, this was only possible after successful completion of a bonus level.
Crash Bandicoot 3: Warped 1998 PlayStation, PlayStation Network Exactly one year later, Crash Bandicoot 3: Warped introduced more new concepts, including a time trial mode and new moves that can be obtained after a boss is defeated. The game was also the first in the series to use the then-new DualShock controller, with the rumble effect being used frequently in the game. The game is still considered the pinnacle of the series today, being named one of the best platformers of all time.[1]
Crash Team Racing 1999 PlayStation, PlayStation Network Crash Team Racing, was the first racing game of the series and the last made by Naughty Dog. After the game's release in 1999, Naughty Dog left Universal Interactive Studios to become an in-house developer for Sony Computer Entertainment America and create their other trademark series, Jak and Daxter.
Crash Bash 2000 PlayStation After another year, the U.K.-based video game developer Eurocom released the party game Crash Bash, which retained the warp room concept of Crash Bandicoot 2, but was met with mixed reviews. It was the last game in the series for the PlayStation.
Crash Bandicoot: The Wrath of Cortex 2002 PlayStation 2, Xbox, Gamecube Crash Bandicoot: The Wrath of Cortex was released in 2002 for the PlayStation 2, Xbox and Nintendo GameCube, making it Crash's first multi-platform release. The most common criticism of the game was that it brought almost nothing new to the series.
Crash Bandicoot: The Huge Adventure 2002 Game Boy Advance Crash Bandicoot: The Huge Adventure uses a side-scrolling concept instead of the straightforward view of the console games, also used in the follow-up game Crash Bandicoot 2: N-Tranced. Fans criticised both two side-scrolling games for creating a large plot hole in the series as a whole, due to N-Tranced's inclusion of the Crunch Bandicoot character from The Wrath of Cortex. Thus, the games are mostly considered in an alternate universe from the main series.
Crash Bandicoot 2: N-Tranced 2003 Game Boy Advance N-Tranced also used a side-scrolling concept, as did its predecessor. It too is considered in an alternate universe due to its inclusion of Crunch.
Crash Nitro Kart 2003 PlayStation 2, GameCube, Xbox, Game Boy Advance, N-Gage Crash Nitro Kart was also released on multiple platforms in 2003 as an indirect sequel to Crash Team Racing. It became the first Crash game released on the N-Gage.
Crash Bandicoot Purple: Ripto's Rampage 2004 Game Boy Advance Crash Bandicoot Purple: Ripto's Rampage was a crossover game featuring Spyro of Spyro the Dragon game. The game received mixed reviews by critics. However, this game is considered non-canon, due to the Spyro series' reboot with The Legend of Spyro: A New Beginning and Nina Cortex's appearance (as well as her mannerisms).
Crash Twinsanity 2004 PlayStation 2, Xbox On September 2004, Traveller's Tales released Crash Twinsanity just months after Ripto's Rampage. Twinsanity was a major deviation from the previous Crash gameplay, focusing on a new free-roaming environment instead of the straightforward gameplay of the past. It also marked the first time Cortex was a playable character in a platformer game.
Crash Tag Team Racing 2005 PlayStation 2, GameCube, Xbox, PlayStation Portable Crash Tag Team Racing arrived as the third racing game of the series. The game once again incorporated the free-roaming element of Twinsanity, along with including an option to clash with another driver to form one larger car. However, the boss races from the previous two racing titles are absent from this game. The game was released for the first time in Crash's history on the PlayStation Portable.
Crash Boom Bang! 2006 Nintendo DS To celebrate Crash's tenth anniversary, Crash Boom Bang! was released on October 2006. The title was Crash's second party game, and followed a more Mario Party-esque format than its predecessor. However, many feel the Crash license was largely cosmetic, and the minigames were dull. The game was met with poor reviews. The game was the first Crash title released for the Nintendo DS.
Crash of the Titans 2007 PlayStation 2, PlayStation Portable, Wii, Nintendo DS, Game Boy Advance, Xbox 360 Crash of the Titans mainly focused on the concept of stunning opponents and "jacking", or taking control of them. The characters underwent major appearance changes which caused different reactions from Crash Bandicoot fans. The game was the first in the series to be released for the Wii and Xbox 360.
Crash: Mind over Mutant 2008 Nintendo DS, PlayStation 2, PlayStation Portable, Wii, Xbox 360 Realesed October 2008, Crash: Mind over Mutant is on the PlayStation 2, Nintendo DS, PlayStation Portable, Wii and Xbox 360, and deals with Cortex trying take over the world using mind-controlling PDA's.

Nature of the protagonist

Main article: Crash Bandicoot (character)

Naughty Dog once referenced the development of Crash as a character both "goofy yet heroic", and being able to portray it well. Originally however, he took the role of a silent protagonist and thus expressed little of his personality or opinions (a trait developer Jason Rubin later claimed to regret), though in more recent games he has played a larger role.

Crash's personality is hard to pinpoint, sometimes varying from game to game. Overall, he has a rather wacky, comical, cartoonish personality akin to a tornado. His behavior was in fact extended to actual hostility in Crash Tag Team Racing, in which he took pleasure in acts of hurting Park Drones and even himself (it should be noted that CTTR is criticised for its over-caricaturisation or even complete change in character personalities). Despite this however, Crash is usually kind-hearted and laid back, rarely showing true sorrow or anger (though he detests evil, such as Cortex), though he is also rather simple, to some fans almost to the point of retardedness and lack of awareness. Indeed, Cortex in Crash Twinsanity remarks, "With my mighty intellect and your vacuous stupidity, we'll be unbeatable!"

Crash's most common ability is his tornado spin, upon which he twirls insanely to hit a nearby opponent, similar to the tornado spin of the Looney Tunes 's Taz. The power of this attack varies in different games, to the point he can spin constantly or even float on air when using it. He can also spin objects, living or not, to gain a better hit radius. Like other platformers, he can also jump on opponents as well as slide and body slam. A large amount of special abilities can be obtained in various titles. Crash can also ride a whole range of vehicles, such as motorcycles, bi-planes, wave-boards, 4X4 jeeps, karts and a whole range of other cars. In a common tradition to the platform genre, he can also be seen riding a minecart at times.

Mascot

The original Crash Bandicoot was one of the earliest 3D platformers and was a major seller. Sony unofficially made Crash the mascot for the PlayStation.

Crash was often compared to Mario and Sonic the Hedgehog, as the three of them were mascots of their respective consoles. Both the original Crash Bandicoot and Super Mario 64 were early 3D platformers, with the cancelled Sonic X-treme intended to be Sonic's answer to these games in that time. After the first three Crash games, much like Mario and Sonic before him, Crash branched out, starring in a racing game, analogous to Mario Kart 64 and Sonic R, and a party game, analogous to Mario Party and Sonic Shuffle (although this was on the Dreamcast rather than on the Sega Saturn). All of this contributed to the perception that Crash was Sony's equivalent of Mario and Sonic.

However, with the release of Crash games on other platforms, this is no longer the case. Despite now being a third-party franchise, some still believe Crash to be a Sierra equivalent of Mario. Sonic suffered a similar multi-platform fate, although he is still associated to the Sega brand being the official mascot of the company, something which is not the case of Crash. However, despite the recent decline in the platforming genre, Mario, Sonic and Crash remain popular.

Developers

The first four Crash Bandicoot games were developed by Naughty Dog. Crash Bash was developed by Eurocom. Crash Bandicoot: The Wrath of Cortex and Crash Twinsanity were developed by Traveller's Tales and its division Traveller's Tales Oxford. Crash Bandicoot: The Huge Adventure (Crash Bandicoot XS in Europe), Crash Bandicoot 2: N-Tranced, Crash Nitro Kart and Crash Bandicoot Purple: Ripto's Rampage (Crash Bandicoot Fusion in Europe) have all been developed by Vicarious Visions. Crash Tag Team Racing and Crash of the Titans were developed by Radical Entertainment and Crash Boom Bang! was developed by Dimps. The first four Crash titles were published by Sony as well as the games being produced by Universal Interactive Studios. All of the other Crash titles were published by Universal Interactive Studios (now known as Vivendi Games).

The first five Crash games were exclusives to the Sony PlayStation. Since then, multiple developers have worked with the property and games have been released for Nintendo and Microsoft consoles, in addition to Sony.

Though some of the Vicarious Visions titles have not fared critically as well as the Naughty Dog games, they have still received gratitude for keeping the series true to its original platforming roots. In an almost opposite twist, there are also fans who praise the work of Traveller's Tales Oxford for their work in Crash Twinsanity, which was the first platformer in the series to drive away from the "warp room" interface of the original series and simultaneously reimagine certain story details. Crash of the Titans was the first to drive away from the platformer into the action genre.

Reception and legacy

Aggregate review scores
Game Game Rankings Metacritic
Crash Bandicoot
80.4%[3]
-
Crash Bandicoot 2: Cortex Strikes Back
88.5%[2]
-
Crash Bandicoot 3: Warped
89.1%[4]
91%[5]
Crash Team Racing
91.7%[6]
88%[7]
Crash Bash
71.3%[8]
68%[9]
Crash Bandicoot: The Wrath of Cortex
(Xbox) 70.2%[10]
(PS2) 70.1%[11]
(GC) 62.3%[12]
(Xbox) 70%[13]
(PS2) 66%[14]
(GC) 62%[15]
Crash Bandicoot: The Huge Adventure
78.8%[16]
78%[17]
Crash Bandicoot 2: N-Tranced
75.1%[18]
75%[19]
Crash Nitro Kart
(GBA) 69.7%[20]
(PS2) 65.9%[21]
(Xbox) 65.7%[22]
(GC) 63.2%[23]
(Mobile) 61.3%[24]
(N-Gage) 57.1%[25]
(GBA) 78%[26]
(Xbox) 70%[27]
(PS2) 69%[28]
(GC) 66%[29]
(N-Gage) 64%[30]
(Mobile) -
Crash Bandicoot Purple: Ripto's Rampage
64.8%[31]
67%[32]
Crash Twinsanity
(Mobile) 74.3%[33]
(Xbox) 68.1%[34]
(PS2) 65.3%[35]
(Xbox) 66%[36]
(PS2) 64%[37]
(Mobile)-
Crash Tag Team Racing
(Xbox) 68.6%[38]
(PS2) 68.3%[39]
(PSP) 68.1%[40]
(GC) 66.6%[41]
(Xbox) 69%[42]
(PSP) 68%[43]
(PS2) 66%[44]
(GC) 66%[45]
Crash Boom Bang!
41%[46]
37%[47]
Crash of the Titans
(DS) 72%[48]
(PS2) 71.9%[49]
(Wii) 70.9%[50]
(PSP) 70%[51]
(X360) 64.7%[52]
(GBA) -
(DS) 73%[53]
(PS2) 70%[54]
(Wii) 69%[55]
(X360) 65%[56]
(PSP) -
(GBA) -
Crash: Mind over Mutant
(Wii) 77.0%[57]
TBA

The Crash Bandicoot series has been a commercial success. As of 2008, the series altogether has sold more than 40 million copies.[1] According to Gamasutra, the first Crash Bandicoot game has sold 6.8 million copies as of November 2003,[58] making it the seventh best-selling PlayStation game of all time. Cortex Strikes Back sold 3.87 million copies in the U.S.,[59] while Warped sold 3.76 million.[59] The last two games on the PlayStation console, Crash Team Racing and Crash Bash, sold 1.9 million and 1.1 million copies in the U.S. respectively.[59] The only individual non-PlayStation Crash game to break the one-million mark in sales is the PlayStation 2 version of Crash Bandicoot: The Wrath of Cortex, which sold 1.95 million copies in the U.S.[59]

The Crash Bandicoot series is one of the few Western video game series to find blockbuster success in Japan. Cortex Strikes Back and Warped sold 1.3 and 1.4 million copies in the country respectively,[60] while the PlayStation 2 version of Wrath of Cortex sold 203,000 copies.[61]

See also

References

  1. ^ a b "Sierra Ships Crash of the Titans" (PDF). Vivendi. 2007-10-23. Retrieved 2006-11-15.
  2. ^ a b "Crash Bandicoot 2: Cortex Strikes Back reviews". Game Rankings. Retrieved 2008-05-09.
  3. ^ "Crash Bandicoot reviews". Game Rankings. Retrieved 2008-05-09.
  4. ^ "Crash Bandicoot 3: Warped reviews". Game Rankings. Retrieved 2008-05-09.
  5. ^ "Crash Bandicoot 3: Warped (psx: 1998)". Metacritic. Retrieved 2008-05-09.
  6. ^ "Crash Team Racing reviews". Game Rankings. Retrieved 2008-05-09.
  7. ^ "Crash Team Racing (psx: 1999)". Metacritic. Retrieved 2008-05-09.
  8. ^ "Crash Bash reviews". Game Rankings. Retrieved 2008-05-09.
  9. ^ "Crash Bash (psx: 2000)". Metacritic. Retrieved 2008-05-09.
  10. ^ "Crash Bandicoot: The Wrath of Cortex (Xbox) reviews". Game Rankings. Retrieved 2008-05-09.
  11. ^ "Crash Bandicoot: The Wrath of Cortex (PS2) reviews". Game Rankings. Retrieved 2008-05-09.
  12. ^ "Crash Bandicoot: The Wrath of Cortex (GC) reviews". Game Rankings. Retrieved 2008-05-09.
  13. ^ "Crash Bandicoot: The Wrath of Cortex (xbx: 2002)". Metacritic. Retrieved 2008-05-09.
  14. ^ "Crash Bandicoot: The Wrath of Cortex (ps2: 2001)". Metacritic. Retrieved 2008-05-09.
  15. ^ "Crash Bandicoot: The Wrath of Cortex (cube: 2002)". Metacritic. Retrieved 2008-05-09.
  16. ^ "Crash Bandicoot: The Huge Adventure reviews". Game Rankings. Retrieved 2008-05-09.
  17. ^ "Crash Bandicoot: The Huge Adventure (gba: 2002)". Metacritic. Retrieved 2008-05-09.
  18. ^ "Crash Bandicoot 2: N-Tranced reviews". Game Rankings. Retrieved 2008-05-09.
  19. ^ "Crash Bandicoot 2: N-Tranced (gba: 2003)". Metacritic. Retrieved 2008-05-09.
  20. ^ "Crash Nitro Kart (GBA) reviews". Game Rankings. Retrieved 2008-05-09.
  21. ^ "Crash Nitro Kart (PS2) reviews". Game Rankings. Retrieved 2008-05-09.
  22. ^ "Crash Nitro Kart (Xbox) reviews". Game Rankings. Retrieved 2008-05-09.
  23. ^ "Crash Nitro Kart (GC) reviews". Game Rankings. Retrieved 2008-05-09.
  24. ^ "Crash Nitro Kart (Mobile) reviews". Game Rankings. Retrieved 2008-05-09.
  25. ^ "Crash Nitro Kart (N-Gage) reviews". Game Rankings. Retrieved 2008-05-09.
  26. ^ "Crash Nitro Kart (gba: 2003)". Metacritic. Retrieved 2008-05-09.
  27. ^ "Crash Nitro Kart (xbx: 2003)". Metacritic. Retrieved 2008-05-09.
  28. ^ "Crash Nitro Kart (ps2: 2003)". Metacritic. Retrieved 2008-05-09.
  29. ^ "Crash Nitro Kart (cube: 2003)". Metacritic. Retrieved 2008-05-09.
  30. ^ "Crash Nitro Kart (ngage: 2004)". Metacritic. Retrieved 2008-05-09.
  31. ^ "Crash Bandicoot Purple: Ripto's Rampage". Game Rankings. Retrieved 2008-05-09.
  32. ^ "Crash Bandicoot Purple: Ripto's Rampage (gba: 2004)". Metacritic. Retrieved 2008-05-09.
  33. ^ "Crash Twinsanity (Mobile) reviews". Game Rankings. Retrieved 2008-05-09.
  34. ^ "Crash Twinsanity (Xbox) reviews". Game Rankings. Retrieved 2008-05-09.
  35. ^ "Crash Twinsanity (PS2) reviews". Game Rankings. Retrieved 2008-05-09.
  36. ^ "Crash Twinsanity (xbx: 2004)". Metacritic. Retrieved 2008-05-09.
  37. ^ "Crash Twinsanity (ps2: 2004)". Metacritic. Retrieved 2008-05-09.
  38. ^ "Crash Tag Team Racing (Xbox) reviews". Game Rankings. Retrieved 2008-05-09.
  39. ^ "Crash Tag Team Racing (PS2) reviews". Game Rankings. Retrieved 2008-05-09.
  40. ^ "Crash Tag Team Racing (PSP) reviews". Game Rankings. Retrieved 2008-05-09.
  41. ^ "Crash Tag Team Racing (GC) reviews". Game Rankings. Retrieved 2008-05-09.
  42. ^ "Crash Tag Team Racing (xbx: 2005)". Metacritic. Retrieved 2008-05-09.
  43. ^ "Crash Tag Team Racing (psp: 2005)". Metacritic. Retrieved 2008-05-09.
  44. ^ "Crash Tag Team Racing (ps2: 2005)". Metacritic. Retrieved 2008-05-09.
  45. ^ "Crash Tag Team Racing (cube: 2005)". Metacritic. Retrieved 2008-05-09.
  46. ^ "Crash Boom Bang! reviews". Game Rankings. Retrieved 2008-05-09.
  47. ^ "Crash Boom Bang! (ds: 2006)". Metacritic. Retrieved 2008-05-09.
  48. ^ "Crash of the Titans (DS) reviews". Game Rankings. Retrieved 2008-05-09.
  49. ^ "Crash of the Titans (PS2) reviews". Game Rankings. Retrieved 2008-05-09.
  50. ^ "Crash of the Titans (Wii) reviews". Game Rankings. Retrieved 2008-05-09.
  51. ^ "Crash of the Titans (PSP) reviews". Game Rankings. Retrieved 2008-05-09.
  52. ^ "Crash of the Titans (X360) reviews". Game Rankings. Retrieved 2008-05-09.
  53. ^ "Crash of the Titans (ds: 2007)". Metacritic. Retrieved 2008-05-09.
  54. ^ "Crash of the Titans (ps2: 2007)". Metacritic. Retrieved 2008-05-09.
  55. ^ "Crash of the Titans (wii: 2007)". Metacritic. Retrieved 2008-05-09.
  56. ^ "Crash of the Titans (xbox360: 2007)". Metacritic. Retrieved 2008-05-09.
  57. ^ "Crash: Mind over Mutant (Wii) at Game Rankings". Game Rankings. Retrieved 2008-10-07. {{cite web}}: Cite has empty unknown parameters: |month= and |coauthors= (help); Unknown parameter |accessdaymonth= ignored (help); Unknown parameter |accessmonthday= ignored (help); Unknown parameter |accessyear= ignored (|access-date= suggested) (help)
  58. ^ Daniel Boutros (2006-08-04). "Crash Bandicoot". A Detailed Cross-Examination of Yesterday and Today's Best-Selling Platform Games. p. 6. Retrieved 2008-05-10.
  59. ^ a b c d "US Platinum Videogame Chart". The Magic Box. 2007-12-27. Retrieved 2008-05-10.
  60. ^ "Japan Platinum Game Chart". The Magic Box. Retrieved 2008-05-10.
  61. ^ "Sony PS2 Japanese Ranking". Japan Game Charts. Retrieved 2008-05-10.

External links

Official websites (in gaming order)
General resources
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