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mitral valve gradients

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https://www.readbyqxmd.com/read/29149268/mitral-valve-replacement-with-the-novel-tribio-and-an-established-stented-bioprosthesis-in-a-sheep-model
#1
Sina Stock, Hans-Hinrich Sievers, Doreen Richardt, Michael Scharfschwerdt
OBJECTIVES: Heart valve replacement with a bioprosthesis is one of the most frequently performed procedures in cardiac surgery and represents a highly effective therapy to relieve diseased heart valves. Nevertheless, as postoperatively elevated transvalvular gradients and prosthesis-patient mismatch are reported as shortcomings of the procedure or of the currently used devices, there is a need for novel bioprostheses with improved haemodynamics. This study presents preclinical haemodynamic results after mitral valve replacement with the novel TRIBIO bioprosthesis (TRIBIO) compared with an established bioprosthesis in a sheep model...
November 15, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29149258/edge-to-edge-repair-for-mitral-regurgitation-associated-with-isolated-double-orifice-mitral-valve
#2
Takeshi Oda, Takanori Kono, Keiichi Akaiwa, Katsuhiko Nakamura
We report the case of a patient with severe mitral regurgitation who was diagnosed with double-orifice mitral valve by preoperative transthoracic and transoesophageal echocardiography. During surgery, it was revealed that the mitral valve was divided into 2 orifices, anterolateral and posteromedial, by a fibrous bridging tissue that was supported by the chordae tendineae originating from an accessory middle papillary muscle. The posterior scallop of the anterolateral orifice was prolapsed due to chordal elongation...
November 15, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29148156/long-term-outcomes-for-different-surgical-strategies-to-treat-left-ventricular-outflow-tract-obstruction-in-hypertrophic-cardiomyopathy
#3
Richard Collis, Oliver Watkinson, Constantinos O'Mahony, Oliver P Guttmann, Antonis Pantazis, Maria Tome-Esteban, Victor Tsang, Venkatachalam Chandrasekaran, Christopher G A McGregor, Perry M Elliott
AIMS: Surgical intervention is used to treat dynamic left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy. This study assesses the effect of different surgical strategies on long-term mortality and morbidity. METHODS AND RESULTS: In total, 347 patients underwent surgical intervention for LVOTO (1988-2015). Group A (n = 272) underwent septal myectomy; Group B (n = 33), septal myectomy and mitral valve (MV) repair; Group C (n = 22), myectomy and MV replacement; and Group D (n = 20), MV replacement alone...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29135480/mechanical-surface-area-of-prosthetic-heart-valve-adverse-clinical-impact-of-large-mechanical-valve-in-mitral-position
#4
Yang Hyun Cho, Kiick Sung, Wook Sung Kim, Jae-Hun Kim, Sung Mok Kim, Pyo Won Park
Although thromboembolic accidents are serious adverse events associated with mechanical mitral valves, there have been no studies on the clinical impact of the large mechanical surface areas (MSAs) of mechanical mitral prostheses. Between 1995 and 2010, 488 consecutive adult patients underwent isolated mechanical mitral valve replacement. We measured the MSA via three-dimensional computed tomography for each prosthesis. Mean patient age was 50.6 ± 11.1 years. The mean body surface area (BSA) and MSA index (MSAI, MSA/BSA) were 1...
November 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29134238/a-comparison-of-anterograde-versus-retrograde-approaches-for-neonatal-balloon-aortic-valvuloplasty
#5
Namrita Mozumdar, Edmund Burke, Melissa Schweizer, Matthew J Gillespie, Yoav Dori, Hari K Narayan, Jonathan J Rome, Andrew C Glatz
In neonates requiring balloon aortic valvuloplasty, both anterograde and retrograde approaches are feasible. A recent comparison of these two approaches is lacking. A retrospective cohort study of neonates at a single center undergoing BAV from 9/00 to 7/14 was performed. Records were reviewed including pre- and post-intervention echocardiograms and catheterization data. Comparisons of acute efficacy and procedural safety were made based on type of approach utilized. Forty-two neonates underwent BAV. Eleven cases utilized exclusively an anterograde approach, while 31 included a retrograde approach (including 4 with both approaches used)...
November 13, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29118891/systolic-anterior-motion-of-mitral-valve-subchordal-apparatus-a-rare-echocardiographic-pattern-in-non-obstructive-hypertrophic-cardiomyopathy
#6
Jezreel L Taquiso, Stephanie Martha O Obillos, Joerelle V Mojica, Lauro L Abrahan, Elleen C Cunanan, Jaime Alfonso M Aherrera, Jose Donato A Magno
Systolic anterior motion (SAM) of the mitral valve or chordate is one characteristic seen in hypertrophic cardiomyopathy (HCM) either in obstructive or non-obstructive phenotypes. More often than not, the obstruction is caused by valvular rather than chordal SAM. We describe the role of echocardiography in identifying the actual anatomical location of the mitral valve apparatus involved in SAM and in assessing consequent left ventricular outflow tract (LVOT) obstruction in an otherwise asymptomatic patient...
October 2017: Cardiology Research
https://www.readbyqxmd.com/read/29114917/pulmonary-arterial-pressure-detects-functional-mitral-stenosis-after-annuloplasty-for-primary-mitral-regurgitation-an-exercise-stress-echocardiographic-study
#7
Niloufar Samiei, Marzieh Tajmirriahi, Ali Rafati, Yeganeh Pasebani, Yousef Rezaei, Saeid Hosseini
INTRODUCTION: The restrictive mitral valve annuloplasty (RMA) is the treatment of choice for degenerative mitral regurgitation (MR), but postoperative functional mitral stenosis remains a matter of debate. In this study, we sought to determine the impact of mitral stenosis on the functional capacity of patients. METHODS: In a cross-sectional study, 32 patients with degenerative MR who underwent RMA using a complete ring were evaluated. All participants performed treadmill exercise test and underwent echocardiographic examinations before and after exercise...
November 8, 2017: Echocardiography
https://www.readbyqxmd.com/read/29106557/surgical-results-of-mitral-valve-repair-for-congenital-mitral-valve-stenosis-in-paediatric-patients
#8
Sungkyu Cho, Woong-Han Kim, Jae Gun Kwak, Jeong Ryul Lee, Yong Jin Kim
OBJECTIVES: Mitral valve (MV) repairs have been performed in paediatric patients with congenital MV stenosis. However, congenital MV stenosis lesions are a heterogeneous group of lesions, and their repair remains challenging. METHODS: From March 1999 to September 2014, MV repair was performed in 22 patients with congenital MV stenosis. The median age was 10.3 months (ranging from 22 days to 9.1 years), and the mean body weight was 7.9 ± 4.0 kg at the time of the operation...
July 4, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29092748/development-of-mitral-stenosis-after-mitral-valve-repair-importance-of-mitral-valve-area
#9
Kwan Leung Chan, Shin-Yee Chen, Thierry Mesana, Buu Khanh Lam
BACKGROUND: The development of mitral stenosis (MS) is not uncommon after mitral valve (MV) repair for degenerative mitral regurgitation (MR), but the significance of MS in this setting has not been defined. METHODS: We prospectively studied 110 such patients who underwent supine bicycle exercise testing to assess intracardiac hemodynamics at rest and at peak exercise. B-type natriuretic peptide (BNP) levels were measured at rest and after the exercise test. The patients also performed the 6-minute walk test and completed the 36-Item Short Form Survey (SF-36)...
September 11, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29062742/long-term-outcomes-and-prosthesis-performance-after-transcatheter-aortic-valve-replacement-results-of-self-expandable-and-balloon-expandable-transcatheter-heart-valves
#10
Giuseppe Tarantini, Paola A M Purita, Augusto D'Onofrio, Chiara Fraccaro, Anna Chiara Frigo, Gianpiero D'Amico, Luca Nai Fovino, Marta Martin, Francesco Cardaioli, Mostafa R A Badawy, Massimo Napodano, Gino Gerosa, Sabino Iliceto
BACKGROUND: Data on transcatheter aortic valve replacement (TAVR) long-term clinical outcomes and hemodynamic performance of the self-expandable CoreValve (CV) and the balloon-expandable Edwards SAPIEN XT (ES) (Edwards Lifesciences, Irvine, California, USA) transcatheter heart valves (THV) are limited. Therefore, this study aimed to compare long-term clinical outcome data and hemodynamic performance of TAVR with either CV or ES. METHODS: We reviewed prospectively collected data of 171 patients treated with TAVR for severe aortic stenosis (AS) at our center between June 2007 and December 2010, with last follow-up contact in 2016...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29060829/image-based-fluid-dynamics-analysis-of-left-ventricle-outflow-tract-pressure-gradient-after-deployment-transcatheter-mitral-valve
#11
Yousef Alharbi, Nigel H Lovell, James Otton, David Muller, Amr Al Abed, Socrates Dokos
The goal of this study was to develop an image-based model to computational investigate blood flow and pressure gradients resulting from left ventricular (LV) wall motion after the implantation of a mitral valve (MV) prosthesis. Two image-based 3D models were reconstructed from multi-slice computed tomography images obtained from patients undergoing transcatheter MV replacement. Navier-Stokes equations were then used to compute the fluid motion. Outflow tract obstruction of the models with MV prosthesis were identified by calculating the difference between LV systolic and aortic pressures...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29055629/early-prosthetic-valve-dysfunction-due%C3%A2-to%C3%A2-bioprosthetic-valve-thrombosis-the-role-of-echocardiography
#12
Alexander Egbe, Sorin V Pislaru, Mahmoud A Ali, Arooj R Khan, Amber N Boler, Hartzell V Schaff, Emmanuel Akintoye, Heidi M Connolly, Vuyisile T Nkomo, Patricia A Pellikka
OBJECTIVES: The purpose of this study was to review the institutional practice of surveillance transthoracic echocardiography (TTE) for diagnosing early prosthetic valve dysfunction (PVD). BACKGROUND: Bioprosthetic valve thrombosis (BPVT) is an important cause of PVD, and guidelines do not recommend routine TTE during the first 5 years after valve implantation. METHODS: The authors performed a retrospective case-control study of all suspected (imaging diagnosis) or confirmed (histopathological diagnosis) cases of BPVT from January 1997 through December 2016...
October 14, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29049749/transvalvular-pressure-gradients-for-different-methods-of-mitral-valve-repair-only-neochordoplasty-achieves-native-valve-gradients
#13
Silje Ekroll Jahren, Samuel Hurni, Paul Philipp Heinisch, Bernhard Winkler, Dominik Obrist, Thierry Carrel, Alberto Weber
OBJECTIVES: Many surgical and interventional methods are available to restore patency for patients with degenerative severe mitral valve regurgitation. Leaflet resection and neochordoplasty, which both include ring annuloplasty, are the most frequently performed techniques for the repair of posterior mitral leaflet flail. It is unclear which technique results in the best haemodynamics. In this study, we investigated the effect of different mitral valve reconstruction techniques on mitral valve haemodynamics and diastolic transvalvular pressure gradient in an ex vivo porcine model...
October 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29025679/relation-of-residual-mitral-regurgitation-despite-elevated-mitral-gradients-to-risk-of-heart-failure-hospitalization-after-mitraclip-repair
#14
Richard Cheng, Sam Dawkins, Emily Tat, Moody Makar, Asma Hussaini, Raj R Makkar, Alfredo Trento, Robert J Siegel, Saibal Kar
Achieving minimal residual mitral regurgitation (MR) after percutaneous MitraClip repair is limited by iatrogenic mitral stenosis. It is unknown whether allowing moderately elevated postprocedural mean mitral gradients (MMGs) to achieve < moderate residual MR is preferable to moderate residual regurgitation. Patients with less-than-moderate residual MR but a MMG of ≥5 mm Hg (Group 1) were compared with patients with moderate residual MR (Group 2). The primary end point was heart failure hospitalization...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29019612/unveiling-transthyretin-cardiac-amyloidosis-and-its-predictors-among-elderly-patients-with-severe-aortic-stenosis-undergoing-transcatheter-aortic-valve-replacement
#15
Adam Castaño, David L Narotsky, Nadira Hamid, Omar K Khalique, Rachelle Morgenstern, Albert DeLuca, Jonah Rubin, Codruta Chiuzan, Tamim Nazif, Torsten Vahl, Isaac George, Susheel Kodali, Martin B Leon, Rebecca Hahn, Sabahat Bokhari, Mathew S Maurer
Aims: Transthyretin cardiac amyloidosis (ATTR-CA) has been reported in patients with aortic stenosis (AS) but its prevalence and phenotype are not known. We examine elderly patients with severe symptomatic AS undergoing transcatheter aortic valve replacement (TAVR) and determine the prevalence and phenotype of ATTR-CA non-invasively. Methods and results: We performed technetium-99m pyrophosphate (99mTc-PYP) cardiac scintigraphy prospectively on patients who underwent TAVR, to screen for ATTR-CA...
October 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29017586/impact-of-prosthesis-patient-mismatch-after-mitral-valve-replacement-in-rheumatic-population-does-mitral-position-prosthesis-patient-mismatch-really-exist
#16
Seung Hyun Lee, Byung Chul Chang, Young-Nam Youn, Hyun Chel Joo, Kyung-Jong Yoo, Sak Lee
BACKGROUND: Prosthesis-patient mismatch (PPM) is characterised by the effects of inadequate prosthesis size relative to body surface area (BSA).The purpose of this study was to determine the impact of PPM on late clinical outcomes after mitral valve replacement (MVR) in rheumatic population. METHODS: From 2000 to 2013, a total of 445 patients (mean age 54.2 ± 11.7 years) underwent isolated MVR (±tricuspid annuloplasty) for rheumatic disease were investigated...
October 10, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28994654/impact-of-concomitant-mitral-regurgitation-on-transvalvular-gradient-and-flow-in-severe-aortic-stenosis-a-systematic-ex-vivo-analysis-of-a-subentity-of-low-flow-low-gradient-aortic-stenosis
#17
Felix Katte, Marcus Franz, Christian Jung, Hans R Figulla, David M Leistner, Philipp Jakob, Barbara E Stähli, Daniel Kretzschmar, Alexander Lauten
AIMS: Evaluation of aortic stenosis(AS) is based on measurement of mean transvalvular gradient(MPG), flow velocity(vmax) and aortic valve area(AVA). Objective of the present study was to analyse the impact of systemic hemodynamic variables and concomitant mitral regurgitation(MR) on aortic MPG, vmax and AVA in severe AS. METHODS AND RESULTS: A pulsatile circulatory model was designed to study function and interdependence of stenotic aortic and insufficient mitral prosthetic valves (n=8; effective regurgitation orifice (EROA)<0...
October 10, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28985849/treating-a-20-mm-hg-gradient-alleviates-myocardial-hypertrophy-in-experimental-aortic-coarctation
#18
David C Wendell, Ingeborg Friehs, Margaret M Samyn, Leanne M Harmann, John F LaDisa
BACKGROUND: Children with coarctation of the aorta (CoA) can have a hyperdynamic and remodeled left ventricle (LV) from increased afterload. Literature from an experimental model suggests the putative 20 mm Hg blood pressure gradient (BPG) treatment guideline frequently implemented in CoA studies may permit irreversible vascular changes. LV remodeling from pressure overload has been studied, but data are limited following correction and using a clinically representative BPG. MATERIALS AND METHODS: Rabbits underwent CoA at 10 weeks to induce a 20 mm Hg BPG using permanent or dissolvable suture thereby replicating untreated and corrected CoA, respectively...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28982556/early-outcomes-of-percutaneous-transvenous-transseptal-transcatheter-valve-implantation-in-failed-bioprosthetic-mitral-valves-ring-annuloplasty-and%C3%A2-severe-mitral-annular-calcification
#19
Mackram F Eleid, Brian K Whisenant, Allison K Cabalka, Mathew R Williams, Mohammed Nejjari, David Attias, Neil Fam, Nicholas Amoroso, Thomas A Foley, Peter M Pollak, Oluseun O Alli, Sorin V Pislaru, Sameh M Said, Joseph A Dearani, Charanjit S Rihal
OBJECTIVES: The aim of this study was to examine 1-year outcomes of transseptal balloon-expandable transcatheter heart valve implantation in failed mitral bioprosthesis, ring annuloplasty, and mitral annular calcification (MAC). BACKGROUND: Immediate outcomes following transseptal mitral valve implantation in failed bioprostheses are favorable, but data on subsequent outcomes are lacking. METHODS: Percutaneous transseptal implantation of balloon-expandable transcatheter heart valves was performed in 87 patients with degenerated mitral bioprostheses (valve in valve [VIV]) (n = 60), previous ring annuloplasty (valve in ring) (n = 15), and severe MAC (valve in MAC) (n = 12)...
October 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28964415/aortic-valve-replacement-with-perceval-bioprosthesis-single-center-experience-with-617%C3%A2-implants
#20
Giovanni Concistrè, Francesca Chiaramonti, Giacomo Bianchi, Alfredo Cerillo, Michele Murzi, Rafik Margaryan, Pierandrea Farneti, Marco Solinas
BACKGROUND: This study describes the clinical and echocardiographic outcomes in a large single-center cohort of patients who underwent aortic valve replacement (AVR) with a sutureless Perceval (LivaNova, Milan, Italy) aortic bioprosthesis. METHODS: Between March 2011 and December 2015, 617 patients underwent AVR with a Perceval bioprosthesis. The mean age was 76 ± 7 years, 388 patients were female (63%), and the mean European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was 6...
September 27, 2017: Annals of Thoracic Surgery
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