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Mitral regurgitation

Shafaq Jawed, Ujala Zubair, Zarafshan Zubair
Mitral valve regurgitation (MVR) is the reverse passage of blood through the mitral valve when the valve fails to close during ventricle contraction. Transcatheter mitral valve repair and replacement (TMVR) is a recent technology that can benefit MVR patients as an alternative, minimally invasive, and safer solution than conventional open-heart surgical approaches. TMVR uses a catheter guided by ultrasonography to replace or repair the defective valve and has provided better clinical outcomes, decreased hospital stay, and reduced mortality rates...
April 18, 2018: Curēus
Mohamad Jihad Mansour, Malek Rahal, Elie Chammas, Omar Hamoui, Wael Aljaroudi
A 9-year-old boy with hypereosinophilic syndrome (HES) was referred for cardiac magnetic resonance (CMR) imaging following an abnormal echocardiogram that showed a large mass layered on the inferolateral wall of the left ventricle, causing secondary severe mitral regurgitation. Cardiac involvement in HES usually affects the ventricular apex. In our case, CMR confirmed the presence of a large mural thrombus of 0.9 cm × 4.2 cm. This unusual cardiac involvement in HES was diagnosed in its intermediate thrombotic stage...
May 2018: Annals of Pediatric Cardiology
Seth Uretsky, Edgar Argulian, Azhar Supariwala, Leo Marcoff, Konstantinos Koulogiannis, Lillian Aldaia, Farooq A Chaudhry, Steven D Wolff, Linda D Gillam
BACKGROUND: The American Society of Echocardiography (ASE) guidelines suggest the use of several echocardiographic methods to assess mitral regurgitation severity using an integrated approach, without guidance as to the weighting of each parameter. The purpose of this multicenter prospective study was to evaluate the recommended echocardiographic parameters against a reference modality and develop and validate a weighting for each echocardiographic measure of mitral regurgitation severity...
June 16, 2018: Journal of the American Society of Echocardiography
Robert A Sorabella, Anna Olds, Halit Yerebakan, Dua Hassan, Michael A Borger, Michael Argenziano, Craig R Smith, Isaac George
BACKGROUND: A significant proportion of patients presenting for isolated aortic valve replacement (AVR) demonstrate some degree of functional mitral regurgitation (fMR). Guidelines addressing concomitant mitral valve intervention in those patients with moderate fMR lack strong evidence-based support. Our aim is to determine the effect of untreated moderate fMR at the time of AVR on long-term survival. METHODS: All patients undergoing isolated AVR from 2000 to 2013 at our institution were retrospectively reviewed...
June 19, 2018: Journal of Cardiothoracic Surgery
Mirian M Pardi, Pablo M A Pomerantzeff, Roney Orismar Sampaio, Maria C Abduch, Carlos M A Brandão, Wilson Mathias, Max Grinberg, Flavio Tarasoutchi, Marcelo L C Vieira
BACKGROUND: The identification of predictors of mitral valve (MV) repair results is important for quality improvement in cardiac surgery. The aim of this study was to evaluate the relationship between MV morphological quantification by three-dimensional (3D) transesophageal echocardiography and mitral repair results. METHODS: Fifty-four patients with MV prolapse who were submitted to surgical repair were divided into 2 groups according to their postoperative mitral regurgitation (MR) degree (group 1, grade 0-I MR; group 2, ≥grade II MR)...
June 19, 2018: Echocardiography
Yao Liu, Gai-Li Guo, Bin Wen, Shouzheng Wang, Wen-Bin Ou-Yang, Yongquan Xie, Xiang-Bin Pan
OBJECTIVE: Percutaneous balloon mitral valvuloplasty (PBMV) is the treatment of choice in patients with isolated mitral stenosis. This study aimed to assess the feasibility of PBMV under echocardiography guidance only of isolated mitral stenosis (MS). METHODS: From October 2016 to Dec 2017, 20 consecutive patients with severe MS underwent PBMV with echocardiography as the only imaging modality at a single center. Outpatient follow-up including chest radiography, electrocardiography, and transthoracic echocardiography was conducted at 1, 3,6, and 12 months after the procedure...
June 19, 2018: Echocardiography
Pairoj Chattranukulchai, Jule Namchaisiri, Monravee Tumkosit, Sarinya Puwanant, Yongkasem Vorasettakarnkij, Suphot Srimahachota, Smonporn Boonyaratavej
BACKGROUND: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly. The enlarged right coronary artery provides retrograde collaterals to supply the left ventricle then preferentially directs into the lower pressure pulmonary artery system causing coronary steal phenomenon. Few patients who survive through adulthood without surgery must have abundant, well-formed functioning collaterals with adequate perfusion of the left ventricle...
June 18, 2018: Journal of Cardiothoracic Surgery
Giuseppe Speziale, Marco Moscarelli
Mitral valve regurgitation may require complex repair techniques that are challenging in minimally invasive and may expose patients to prolonged cardiopulmonary bypass and cross-clamp times. Here, we present a stepwise operative approach that may facilitate the repair of the mitral valve in a minimally invasive fashion and may be carried out even when multiple posterior segments are involved. This how-to-do article presents a method that was performed in 148 patients that were referred to our institution for severe organic mitral regurgitation between 2008 and 2016...
June 15, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Donato Mele, Gabriele Pestelli, Andrea Luisi, Vittorio Smarrazzo, Filippo Trevisan, Roberto Ferrari
Echocardiography is the most commonly used technique for evaluating patients with mitral regurgitation (MR) and estimating MR severity. However, in clinical practice, echocardiographic assessment of MR severity remains challenging in many cases, particularly in patients with forms of intermediate or borderline severity. The main causes are the improper application of the echocardiographic methods for assessment of MR severity and the lack of a validated standardized approach for quantification of various types of MR, including organic and functional MR...
June 2018: Giornale Italiano di Cardiologia
Samuel Heuts, Jean H T Daemen, Sebastian A F Streukens, Jules R Olsthoorn, Jindrich Vainer, Emile C Cheriex, Jos G Maessen, Peyman Sardari Nia
OBJECTIVE: Transapical off-pump minimally invasive mitral valve repair (TOP-MINI) is a new technique for the surgical repair of degenerative mitral regurgitation based on mitral valve prolapse. The aim of this study is to demonstrate the preoperative planning tools available for starting this new procedure in a safe manner. METHODS: The first patients undergoing TOP-MINI by a single surgeon in 2016 were prospectively included. All patients underwent identical clinical pathways and underwent extensive preoperative planning for a safe start of the program...
June 14, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Sami Nimer Ghazal
Severe chronic mitral regurgitation (MR) is known to cause left ventricular volume overload and subsequently left ventricular dilatation. Here, we present a case of a 68-year-old man with severe chronic MR which happened to coexist with atrial septal defect of secundum type leading to the right ventricular dilatation.
April 2018: Journal of Cardiovascular Echography
María Elena Arnáiz-García, María José Dalmau-Sorlí, José María González-Santos, María Elena Pérez-Losada, José Alfonso Sastre-Rincón, Jesús Hernández-Hernández, Mª Carmen Vargas-Fajardo, Víctor Sagredo-Meneses, Javier López-Rodríguez, Ana María Arnáiz-García
A 52-year-old male patient, who underwent mitral replacement with a mechanical prosthesis as a child, sustained a cardiac arrest which was successfully resuscitated. Further investigation showed prosthesis malfunction with significant regurgitation in the context of multi-organ failure. In such a life-threatening condition, veno-arterial extracorporeal membrane oxygenation was considered as a rescue procedure to achieve optimisation of clinical status to allow definitive surgical treatment. An unusual complete fracture of the prosthesis was subsequently identified as the cause of acute dysfunction...
April 2018: Journal of the Saudi Heart Association
V Boilève, J Dreyfus, D Attias, A Scheuble, I Codogno, E Brochet, A Vahanian, D Messika-Zeitoun
BACKGROUND: Mitral annulus (MA) enlargement can be observed in various cardiac conditions but respective influence of left atrial (LA) and left ventricle (LV) size remained unclear. METHODS: In 120 patients who underwent a clinically indicated 3D-transesophageal-echocardiography, 30 atrial fibrillation (AF), 30 secondary mitral regurgitation (SMR), 30 primary myxomatous mitral regurgitation (PMR) and 30 mitral stenosis (MS), we evaluated the association between MA area (MA-area) and LA volume (LAvol) measured using the biplane area-length method, end-diastolic (LVEDV) and end-systolic (LVESV) volumes measured using the biplane Simpson method...
June 5, 2018: International Journal of Cardiology
Dana AlNuaimi, Reem AlKetbi, Usama AlBastaki, Claude Pierre-Jerome, Ebrahim Ahmad Ebrahim
Pulmonary vein varix is an unusual cause of a mediastinal mass on a chest radiograph. It may be found as an isolated malformation or as a sequela of pulmonary venous hypertension. We encountered a case presenting with left hemiparesis and a past medical history of rheumatic heart disease. The chest radiograph revealed a well-defined mediastinal mass that turned out to be a hugely dilated pulmonary vein on contrast enhanced computed tomography of the chest. The computed tomography of the brain and upper abdomen revealed bilateral cerebral infarction and splenic infarction...
April 2018: Radiology case reports
Fanwei Kong, Thuy Pham, Caitlin Martin, John Elefteriades, Raymond McKay, Charles Primiano, Wei Sun
OBJECTIVES: Functional mitral regurgitation (FMR) is a significant complication of left ventricle (LV) dysfunction associated with poor prognosis and commonly treated by undersized ring annuloplasty. This study aimed to quantitatively simulate the treatment outcomes and mitral valve (MV) biomechanics following ring annulopalsty and papillary muscle relocation (PMR) procedures for a FMR patient. METHODS: We utilized a validated finite element model of the left heart for a patient with severe FMR and LV dilation from our previous study and simulated virtual ring annuloplasty procedures with various sizes of Edwards Classic and GeoForm annuloplasty rings...
2018: PloS One
Leona Wall, Annika Mohr, Florenza Lüder Ripoli, Nayeli Schulze, Camila Duarte Penter, StephanOscar Hungerbuehler, Jan-Peter Bach, Karin Lucas, Ingo Nolte
Exercise intolerance is the first symptom of heart disease. Yet an objective and standardised method in canine cardiology to assess exercise capacity in a clinical setting is lacking. In contrast, exercise testing is a powerful diagnostic tool in humans, providing valuable information on prognosis and impact of therapeutic intervention. To investigate whether an exercise test reveals differences between dogs with early stage mitral regurgitation (MR) and dogs without cardiac disease, 12 healthy beagles (healthy group, HG) and 12 dogs with presymptomatic MR (CHIEF B1 / B2, patient group, PG) underwent a six-stage submaximal exercise test (ET) on a motorised treadmill...
2018: PloS One
Giacomo Murana, Jacopo Alfonsi, Carlo Savini, Carlo Mariani, Giuditta Coppola, Valeria Lo Coco, Emanuele Pilato, Davide Pacini, Roberto Di Bartolomeo
OBJECTIVES: If mitral valve repair is not feasible, mitral valve replacement remains the only option. Based on our overall experience with the On-X mitral valve, the aim of this study was to investigate early and late outcomes after mitral valve replacement using this latest generation prosthesis. METHODS: From 1998 to 2016, 600 patients received an On-X prosthesis in the mitral position. Of them, we excluded all patients who had combined aortic procedures and retrospectively analysed 318 consecutive patients who had a mitral valve replacement...
June 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Alfonso Agnino, Alberto Maria Lanzone, Andrea Albertini, Amedeo Anselmi
The free margin running suture (FMRS) is a novel technique for nonresection correction of degenerative mitral regurgitation. It was employed in 37 minimally invasive mitral repair cases. We performed a retrospective collection of in-hospital data and a clinical/echocardiographic follow-up. All patients were discharged with none or mild mitral regurgitation, except one who had mild-to-moderate (2+) regurgitation. At follow-up (average: 2.1 years), all patients were alive; there were no instances of recurrent regurgitation, one case of 2+ regurgitation, and no valve-related complications...
June 13, 2018: Thoracic and Cardiovascular Surgeon
Marcell J Tjørnild, Søren N Skov, Karen B Poulsen, Mona Sharghbin, Leila L Benhassen, Lisa Carlson Hanse, Farhad Waziri, Diana M Røpcke, Sten L Nielsen, J Michael Hasenkam
OBJECTIVES: To investigate mitral valve posterior leaflet and subvalvular reconstruction using a 2-ply small intestinal submucosal extracellular matrix sheet. METHODS: Mitral valve posterior leaflet and subvalvular reconstruction was characterized in an acute 80-kg porcine model with 7 pigs acting as their own controls. The characterization was based on pressure catheter measurements of pressure differences to identify mitral regurgitation, stenosis and systolic anterior motion...
April 19, 2018: European Journal of Cardio-thoracic Surgery
Kelly Kohorst, Mias Pretorius
Mitral regurgitation is the most common valvular disease and significant (moderate/severe) mitral regurgitation is found in 2.3% of the population older than 65 years. New transcatheter minimally invasive technologies are being developed to address mitral valve disease in patients deemed too high a risk for conventional open-heart surgery. There are several features of the mitral valve (saddle-shaped noncalcified annulus with irregular leaflet geometry) that make a transcatheter approach to repair or replacing the valve more challenging compared with the aortic valve...
June 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
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