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mitral valve gradients

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https://www.readbyqxmd.com/read/29331957/mitral-valve-anatomic-predictors-of-hemodynamic-success-with-transcatheter-mitral-valve-repair
#1
Jeremy J Thaden, Joseph F Malouf, Vuyisile T Nkomo, Sorin V Pislaru, David R Holmes, Guy S Reeder, Charanjit S Rihal, Mackram F Eleid
BACKGROUND: Mitral regurgitation is a heterogeneous disease. Determining which patients derive optimal outcomes from transcatheter edge-to-edge mitral valve repair (TMVR) remains challenging. We sought to determine whether baseline mitral valve anatomic characteristics are predictive of left atrial pressure (LAP) changes during TMVR with MitraClip. METHODS AND RESULTS: Consecutive patients with severe mitral regurgitation undergoing TMVR (n=112) underwent continuous intraprocedural LAP monitoring and retrospective echocardiographic analysis for specific mitral anatomic characteristics...
January 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29317120/preoperative-invasive-hemodynamic-determinants-of-survival-among-patients-undergoing-aortic-or-mitral-valve-surgery
#2
David X Zhuo, Kenneth C Bilchick, Sula Mazimba
OBJECTIVES: To evaluate the association of preoperative invasive hemodynamic parameters with mortality in valvular heart surgery. DESIGN: Retrospective cohort study. SETTING: Single tertiary academic medical center. PARTICIPANTS: A total of 382 patients who underwent preoperative right and/or left heart catheterization before open aortic valve replacement (AVR), open mitral valve repair/replacement (MVR), or combined AVR and MVR, from July 2009 to December 2014...
September 29, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29275594/-comparison-of-early-clinical-effects-of-ablation-with-surgery-treatment-in-patients-with-hypertrophic-cardiomyopathy
#3
Y P Ruan, X W Liu, Y Zhang, J C Han, Y Q Lai, J Lü, Y H He
Objective: To compare the early clinical effect of septal myectomy and percutaneous transluminal septal myocardial ablation (PTMSA) on the left ventricular outflow obstruction and the rate of complication in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: A total of 204 patients with HOCM who received septal reduction treatment were recruited. These patients were divided into two groups, surgery group (n=135) (65 patients with modified Morrow procedure, 70 patients with non-Morrow myomectomy) and PTMSA group (n=69)...
December 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29258732/using-a-regent-aortic-valve-in-a-small-annulus-mitral-position-is-a-viable-option
#4
Yaron D Barac, Brittany Zwischenberger, Jacob N Schroder, Mani A Daneshmand, Jack Haney, Jeff Gaca, Andrew Wang, Carmelo A Milano, Donald D Glower
BACKGROUND: Outcome of mitral valve replacement in extreme scenarios of small mitral annulus using the Regent mechanical aortic valve is not well documented. METHODS: Records were examined in 31 consecutive patients undergoing mitral valve replacement using the aortic Regent valve due to a small mitral annulus. RESULTS: Mean age was 60±14 years. Mitral stenosis or mitral annulus calcification was present in 30/31(97%) patients. Concurrent procedures were performed in 17/31(55%) patients...
December 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29244156/percutaneous-increase-of-mitral-leaflet-coaptation-length-after-mitral-valve-repair-results-from-a-preclinical-study
#5
Piergiorgio Tozzi, Giuseppe Siniscalchi, Enrico Ferrari, Matthias Kirsch, Daniel Hayoz
OBJECTIVES: The failure of mitral repairs can be the result of inadequate leaflet coaptation length (CL< 8 mm at the A2-P2 level). A new annuloplasty ring conceived by the authors enables post-surgical CL increase using percutaneous balloon catheter technology. We conducted preclinical studies to assess the in vivo feasibility of the procedure and the safety of the postimplant deformable mitral ring. METHODS: The new annuloplasty ring allows the percutaneous and progressive displacement of each of the 3 anatomical regions of the posterior mitral annulus towards the anterior...
December 13, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29237465/mid-term-results-of-mitral-valve-repair-using-flexible-bands-versus-complete-rings-in-patients-with-degenerative-mitral-valve-disease-a-prospective-randomized-study
#6
Alexandr V Bogachev-Prokophiev, Alexandr V Afanasyev, Sergei I Zheleznev, Vladimir M Nazarov, Ravil M Sharifulin, Alexandr M Karaskov
BACKGROUND: We aimed to compare the outcomes of mitral valve repair with flexible band (FB) versus complete semirigid ring (SR) in degenerative mitral valve disease patients. METHODS: From September 2011 to 2014, 171 patients were randomized and underwent successful mitral valve repair using a SR (n = 85) or FB (n = 86). There were no significant between-group differences at baseline. RESULTS: There were no early mortalities. The mean follow up was 24...
December 13, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29226591/validating-a-prediction-modeling-tool-for-left-ventricular-outflow-tract-lvot-obstruction-after-transcatheter-mitral-valve-replacement-tmvr
#7
Dee Dee Wang, Marvin H Eng, Adam B Greenbaum, Eric Myers, Michael Forbes, Patrick Karabon, Milan Pantelic, Thomas Song, Jeff Nadig, Mayra Guerrero, William W O'Neill
OBJECTIVE: Demonstrate proof-of-concept validation of a computed tomography (CT) computer-aided design prediction modeling tool to identify patients at risk for left ventricular outflow tract (LVOT) obstruction in transcatheter mitral valve replacement (TMVR). BACKGROUND: LVOT obstruction is a significant and even fatal consequence of TMVR. METHODS: From August 2013 to August 2017, 38 patients in 5 centers underwent TMVR with compassionate use of balloon-expandable valves for severe mitral valve dysfunction because of degenerative surgical mitral ring, bioprosthesis, or severe native mitral stenosis from to severe mitral annular calcification...
December 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29226357/atrial-deformation-correlated-with-functional-capacity-in-mitral-stenosis-patients
#8
Chen-Yu Chien, Chih-Wei Chen, Tin-Kwang Lin, Yu Lin, Jnnu-Wen Lin, Yi-Da Li, Chi-Hsien Chen, Wei-Chuan Tsai
BACKGROUND: Left atrial (LA) dysfunction, expressed as impaired LA deformation using two-dimensional (2D) strain imaging, has been observed in association with rheumatic mitral stenosis (MS). However, the clinical role of speckle tracking echocardiography (STE)-derived LA strain has rarely been studied in MS. AIM: This study aimed to identify the determinants of New York Heart Association (NYHA) functional class in patients with mitral stenosis and to investigate the relationship between left atrial deformation as measured by two-dimensional STE-derived LA strain and heart failure symptoms...
December 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/29217633/stress-echocardiography-in-patients-with-native-valvular-heart-disease
#9
REVIEW
Patrizio Lancellotti, Raluca Dulgheru, Yun Yun Go, Tadafumi Sugimoto, Stella Marchetta, Cécile Oury, Madalina Garbi
Valve stress echocardiography (VSE) can be performed as exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE) depending on the patient's clinical status, severity and type of valve disease. ESE combines exercise testing with two-dimensional grey scale and Doppler echocardiography during exercise. Thus, it provides objective assessment of symptomatic status (exercise test), as well as exercise-induced changes of a series of echocardiographic parameters (different depending on the valve disease type), which yield prognostic information in individual patients and help in a better treatment planning...
December 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29208340/different-indicators-for-postprocedural-mitral-stenosis-caused-by-single-or-multiple-clip-implantation-after-percutaneous-mitral-valve-repair
#10
Yuji Itabashi, Hiroto Utsunomiya, Shunsuke Kubo, Yukiko Mizutani, Hirotsugu Mihara, Mitsushige Murata, Robert J Siegel, Saibal Kar, Keiichi Fukuda, Takahiro Shiota
BACKGROUND: Postprocedural mitral stenosis (MS) is a main limitation for MitraClip™ (Abbot Vascular, Inc., Santa Clara, CA, USA) procedure. The purpose of this study was to detect the preprocedural predictors of high transmitral pressure gradient (TMPG) after MitraClip™ implantation, which indicated postprocedural mitral stenosis (MS). METHODS: We studied 79 patients who were implanted with MitraClip™ in our institute. Before the procedure, mitral valve orifice area (MVOA), and anterior-posterior (AP) and medial-lateral (ML) mitral annular diameters were measured at diastole using three-dimensional (3D) transesophageal echocardiography (TEE) data set...
December 2, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29198984/relation-of-an-echocardiographic-based-cardiac-calcium-score-to-mitral-stenosis-severity-and-coronary-artery-disease-in-patients-with-severe-aortic-stenosis
#11
Siyuan P Sheng, Lucius A Howell, Melissa C Caughey, Michael Yeung, John P Vavalle
Patients with calcific aortic stenosis (AS) often have diffuse cardiac calcification involving the mitral valve apparatus and coronary arteries. We examined the association between global cardiac calcification quantified by a previously validated echocardiographic calcium score (eCS) with the severity of mitral stenosis (MS) and coronary artery disease (CAD) in patients with a clinical diagnosis of severe calcific AS. In this sample of 147 patients (mean age 81 ± 9 years, 50% male), 81 patients (55%) were determined by echocardiography to have some degree of MS...
October 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29193333/repeated-mitraclip-procedure-in-patients-with-recurrent-mr-after-a-successful-first-procedure-limitations-and-outcome
#12
Jonathan Curio, Markus Reinthaler, Mario Kasner, Haitham Saleh Ali Al-Hindwan, Johan Baeckemo-Johansson, Tim Neumann, Stephan Jacobs, Alexander Lauten, Ulf Landmesser
OBJECTIVES: The present study aimed to evaluate the outcome and potential limitations of a repeated MitraClip procedure (ReClip). BACKGROUND: The MitraClip procedure has emerged as a treatment option in high surgical risk patients suffering from severe mitral regurgitation (MR). However, despite successful initial repair a significant number of patients develops severe recurrent MR. METHODS: Patients undergoing a ReClip procedure in our institution were retrospectively identified...
November 29, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29182736/does-septal-thickness-influence-outcome-of-myectomy-for-hypertrophic-obstructive-cardiomyopathy
#13
Anita Nguyen, Hartzell V Schaff, Rick A Nishimura, Joseph A Dearani, Jeffrey B Geske, Brian D Lahr, Steve R Ommen
OBJECTIVES: Patients with hypertrophic obstructive cardiomyopathy and basal septal thickness <18 mm are often considered unsuitable candidates for myectomy. Mitral valve (MV) replacement is frequently performed instead. We aimed to determine whether septal thickness affects outcomes and adequacy of myectomy. METHODS: Clinical and echocardiographic data were reviewed for 1486 consecutive adult patients with hypertrophic obstructive cardiomyopathy who underwent transaortic septal myectomy from January 2005 through December 2014...
November 22, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29168622/mitral-valve-pressure-gradient-after-percutaneous-mitral-valve-repair-every-beat-counts
#14
Daniel Lavall, Bruno Scheller, Christian Werner, Axel Buob, Felix Mahfoud
A patient presented with symptoms of decompensated heart failure 2 months after percutaneous mitral valve (MV) repair. Echocardiography demonstrated impaired left ventricular function with elevated MV pressure gradients and pulmonary pressures during rapid atrial fibrillation. Heart rate control was achieved by implantation of a biventricular pacemaker with subsequent His-bundle ablation because atrial fibrillation was refractory to medical treatment. During biventricular pacing at different rates (50-110 b...
November 23, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29168204/early-and-medium-term-outcomes-of-alfieri-mitral-valve-repair-in-the-management-of-systolic-anterior-motion-during-septal-myectomy
#15
Richard Collis, Oliver Watkinson, Antonis Pantazis, Maria Tome-Esteban, Perry M Elliott, Christopher G A McGregor
BACKGROUND: This report studies the early and medium-term clinical and echocardiographic outcomes of the Alfieri edge-to-edge mitral valve repair, as adjunctive therapy, to prevent and treat systolic anterior motion (SAM) at the time of septal myectomy (SM) for left ventricular outflow tract obstruction in hypertrophic cardiomyopathy. METHODS: From 2009-2015, 11 consecutive patients had a trans-atrial Alfieri repair, to prevent (n = 7) or treat (n = 4) SAM at the time of SM...
November 23, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29168199/experimental-investigation-of-left-ventricular-flow-patterns-after-percutaneous-edge-to-edge-mitral-valve-repair
#16
Morteza Jeyhani, Shahrokh Shahriari, Michel Labrosse
Mitral valve percutaneous edge-to-edge repair (PEtER) is a viable solution in high-risk patients with severe symptomatic mitral regurgitation. However, the generated double-orifice configuration poses challenges for the evaluation of the hemodynamic performance of the mitral valve and may alter flow patterns in the left ventricle (LV) during diastole. This in vitro study aims to evaluate the hemodynamic modifications following a simulated PEtER. A custom-made mitral valve was developed, and two configurations were tested: (i) a single-orifice valve with mitral regurgitation and (ii) a double-orifice mitral valve configuration following PEtER...
November 23, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29158019/impact-of-significant-mitral-regurgitation-on-assessing-the-severity-of-aortic-stenosis
#17
Pil Hyung Lee, Jung Ae Hong, Byung Joo Sun, Seungbong Han, Sangwoo Park, Jeong Yoon Jang, Dae-Hee Kim, Duk-Hyun Kang, Jae-Kwan Song, Jong-Min Song
BACKGROUND: Significant mitral regurgitation (MR) may reduce a pressure gradient of aortic stenosis (AS) by decreasing forward stroke volume. The study objective was to evaluate whether significant MR can cause inconsistency when assessing the severity of AS. METHODS: Among 5,355 patients diagnosed with AS from 2000 to 2015, 68 were retrospectively found to have concomitant significant (moderate or greater) MR and normal left ventricular ejection fractions in normal sinus rhythm (AS with MR)...
November 17, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29149268/mitral-valve-replacement-with-the-novel-tribio-and-an-established-stented-bioprosthesis-in-a-sheep-model
#18
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
#19
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
#20
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
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