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degenerative mitral valve insufficiency

Wenrui Ma, Wei Shi, Wei Zhang, Weihua Wu, Wei Ye, Ye Kong
We sought to present our institutional protocol to manage incomplete initial repair of degenerative mitral regurgitation and to evaluate its mid-term outcomes. Eight hundred and fifteen patients with degenerative mitral insufficiency undergoing mitral valve repair were investigated in this study. The initial repair attempt was incomplete in 48 patients, leaving a degree of residual regurgitation > mild, and an elevated transmitral gradient or systolic anterior motion (SAM). These patients were further treated with medication or mitral valve re-repair or replacement under reinstituted cardiopulmonary bypass...
May 9, 2018: International Heart Journal
Sigurdur Ragnarsson, Johan Sjögren, Martin Stagmo, Per Wierup, Shahab Nozohoor
OBJECTIVES: The aim of the study was to evaluate the right ventricular (RV) performance during exercise in patients who underwent mitral valve repair for chronic mitral valve insufficiency relative to healthy individuals and to assess exercise capacity using a semisupine ergometer. METHODS: We studied 56 patients who underwent mitral valve repair for degenerative posterior mitral leaflet prolapse between 2005 and 2014 and a control group of 13 healthy individuals...
April 5, 2018: General Thoracic and Cardiovascular Surgery
Anatol Prinzing, Sabine Bleiziffer, Markus Krane, Ruediger Lange
BACKGROUND: Artificial chord implantation has become one of the most applied techniques for mitral valve repair (MVR). Many techniques have been described with the goal of optimizing neochord implantation. A new annuloplasty device designed to simplify the determination of appropriate neochord length has been recently introduced. We will describe our initial experience with this new device. METHODS: The semirigid device is equipped with removable loops on the posterior aspect of the ring...
February 3, 2018: Annals of Thoracic Surgery
Naonori Kawamoto, Tomoyuki Fujita, Satsuki Fukushima, Yusuke Shimahara, Yuta Kume, Yorihiko Matsumoto, Kizuku Yamashita, Junjiro Kobayashi
BACKGROUND: There are few reports regarding factors related to late-onset of atrial fibrillation (Af) after mitral valve repair, which can compromise long-term outcome. We analyzed the risk factors for late Af after mitral valve repair. METHODS AND RESULTS: Between 2001 and 2015, 318 patients (214 males; median, 57.7 years) underwent mitral valve repair for degenerative mitral insufficiency (MI) without concomitant aortic valve disease in our institute. Patients with a history of paroxysmal or chronic Af preoperatively were excluded...
April 2018: Journal of Cardiology
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
Masaaki Ryomoto, Masataka Mitsuno, Mitsuhiro Yamamura, Hiroe Tanaka, Naosumi Sekiya, Hisashi Uemura, Ayaka Sato, Daisuke Ueda, Yuji Miyamoto
OBJECTIVE: Mitral annular structure and dynamics after mitral ring annuloplasty using transesophageal echocardiography during the operation have been reported. We evaluated mitral annular structure and dynamics of three different rings in the mid-term period postoperatively. METHODS: Thirty-one patients underwent mitral valve repair for degenerative mitral insufficiency. The MEMO 3D ring (semi-flexible), Carpentier-Edwards Physio II ring (semi-rigid), and St. Jude Medical Rigid Saddle Ring (rigid) were implanted in 15, 12, and eight patients, respectively, from September 2009 to February 2015...
November 2017: General Thoracic and Cardiovascular Surgery
Paul S Pagel, Brent T Boettcher, Derek J De Vry, Julie K Freed, Zafar Iqbal
OBJECTIVE: Transmitral blood flow produces a vortex ring (quantified using vortex formation time [VFT]) that enhances the efficiency of left ventricular (LV) filling. VFT is attenuated in LV hypertrophy resulting from aortic valve stenosis (AS) versus normal LV geometry. Many patients with AS also have aortic insufficiency (AI). The authors tested the hypothesis that moderate AI falsely elevates VFT by partially inhibiting mitral leaflet opening in patients with AS. DESIGN: Observational study...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Panagiotis Antiochos, Olivier Muller, Matthias Kirsch, Melissa Agostini, Salah Qanadli, Eric Eeckhout, Pierre Vogt, René Prêtre, Alain Delabays, Xavier Jeanrenaud, Pierre Monney
Mitral regurgitation (MR) is the most frequent valvular disease in industrialised countries. MR is classified as primary (mostly degenerative with valve prolapse) or secondary (mainly due to underlying ischemic heart disease resulting in deformation of the valve structure). Surgical repair represents the optimal treatment for severe primary MR, whereas the benefits of surgical correction of secondary MR are controversial. Over the past few years, transcatheter techniques have been developed to treat MR, such as the percutaneous edge-to-edge procedure (MitraClip)...
May 25, 2016: Revue Médicale Suisse
V M Nazarov, A V Afanasyev, S I Zheleznev, A V Bogachev-Prokophiev, I I Demin, A M Karaskov
Degenerative mitral valve disease nowadays is the most common cause of mitral insufficiency in developed countries and is associated with high morbidity and mortality. In the last decades repairing the mitral valve has become the operation of choice for treatment of the mitral valve prolapse, enabling to improve the geometry and function of the left ventricle and long-term survival. Nevertheless, the problem of choice of method of management of severe mitral regurgitation in asymptomatic patients with degenerative mitral valve disease remains unsolved...
2015: Kardiologiia
Rimantas Benetis, Paulius Orda, Jolanta Justina Vaškelytė, Vytenis Ivanauskas, Eglė Ereminienė, Povilas Jakuška, Loreta Jankauskienė
OBJECTIVE: To evaluate late outcomes after posterior mitral valve (MV) annulus double-suture annuloplasty for degenerative (non-ischaemic) MV insufficiency. DESIGN: Between 2005 and 2011, 138 patients underwent MV repair using posterior MV double-suture annuloplasty and an additional 105 patients underwent tricuspid valve repair. The study protocol included operative mortality, reoperation rate and reasons, as well as echocardiographic parameters at pre- and postoperative and follow-up periods (2-9 years)...
October 2016: Perfusion
Ferdinand Leya, J Michael Tuchek, Walter Coats
We present a patient with critical degenerative aortic stenosis, mitral annular and aortomitral continuity calcification, and senile sigmoid septal hypertrophy who underwent transcatheter aortic valve replacement using the CoreValve bioprosthesis. Immediately after predilation of the aortic valve (18-mm balloon), the patient developed severe hypotension and dynamic left ventricular outflow tract (LVOT) obstruction with systolic anterior motion of the anterior mitral leaflet, causing severe mitral regurgitation...
December 2016: Catheterization and Cardiovascular Interventions
Ioana Pasca, Patricia Dang, Gaurav Tyagi, Ramdas G Pai
BACKGROUND: Severe mitral annular calcification causing degenerative mitral stenosis (DMS) is increasingly encountered in patients undergoing mitral and aortic valve interventions. However, its clinical profile and natural history and the factors affecting survival remain poorly characterized. The goal of this study was to characterize the factors affecting survival in patients with DMS. METHODS: An institutional echocardiographic database was searched for patients with DMS, defined as severe mitral annular calcification without commissural fusion and a mean transmitral diastolic gradient of ≥2 mm Hg...
May 2016: Journal of the American Society of Echocardiography
Mehmet Bilge, Sina Ali, Yakup Alsancak, Ayse Saatci Yasar
Percutaneous valve repair with the MitraClip represents a new and promising therapeutic option for patients with severe mitral regurgitation (MR). Mitral valve prolapse and flail leaflet are two major causes of degenerative MR in patients who underwent the MitraClip procedure. Mitral annular calcification (MAC) is also a less-frequent cause of degenerative MR. Among patients with MAC, open surgical treatment or valvular replacement is the treatment of choice for severe MR. Herein we present a case with severe MR secondary to MAC in whom successful percutaneous valve repair was accomplished with the MitraClip system due to the high risk of open-heart surgery...
May 2015: Journal of Heart Valve Disease
Jianmin Li, Wenzhi Pan, Yigang Yin, Leilei Cheng, Xianhong Shu
OBJECTIVE: Little is known about the prevalence of mitral regurgitation (MR) in China until now. The objective of the study was to survey the prevalence, correlates and causes of MR in a large Chinese patient population in the current era. METHODS: This study retrospectively analysed the echocardiographic database of the subjects visiting our heart centre from 2010 to 2012. RESULTS: A total of 134,874 cases were included into the analysis...
February 2016: Acta Cardiologica
Amine Mazine, Mitesh Badiwala, Gideon Cohen
PURPOSE OF REVIEW: In recent years, great emphasis has been placed on reconstructive techniques for the surgical management of heart valve disease. In this review, we discuss recent data and current practice as it pertains to the subject of reconstructive valve surgery. RECENT FINDINGS: New techniques and an improved understanding of the mechanisms of aortic insufficiency have led to marked improvement in the early and late outcomes of aortic valve repair. While mitral valve repair is the established approach for the management of degenerative mitral valve disease, surgical technique continues to be refined, with valve reconstruction principles applied to increasingly challenging anatomy...
March 2016: Current Opinion in Cardiology
José M Bernal, Carlos A Mestres
No abstract text is available yet for this article.
January 2016: Journal of Thoracic and Cardiovascular Surgery
Gonzalo Latorre S, Josefina Almeida Z, Santiago Besa B, Samuel Córdova A, Ricardo Zalaquett S
BACKGROUND: The 2014 Guidelines for the Management of Patients with Valvular Heart Disease require to know the probability of success and operative mortality of Mitral Valve Repair (MVR) for Degenerative Mitral Insufficiency (DMI) at a given institution. AIM: To assess the probability of success, operative mortality and long-term results of MVR for DMI. PATIENTS AND METHODS: The database of the Cardiovascular Surgery Service was reviewed for the period December 1991 to December 2013...
October 2015: Revista Médica de Chile
Károly Vörös, Viktória Szilvási, Ferenc Manczur, Ákos Máthé, Jenő Reiczigel, Ingo Nolte, Stephan Hungerbühler
Chronic degenerative valve disease (CDVD) is the most common cardiac disease in dogs, usually resulting in mitral valve insufficiency (MVI). The goal of this study was to investigate the occurrence of MVI in clinically healthy Beagle populations. A total of 79 adult healthy Beagles (41 females and 38 males; age: 5.6 ± 2.7 years, range 1.4 to 11.7 years) were examined. The diagnosis of MVI was based on the detection of a systolic murmur heard above the mitral valve, and was confirmed by colour flow Doppler (CFD) echocardiography...
December 2015: Acta Veterinaria Hungarica
Frederick C Cobey, Elena Ashihkmina, Thomas Edrich, John Fox, Douglas Shook, Bruce Bollen, Janis L Breeze, Wannakuwatte Waduge Sanouri Ursprung, Stanton K Shernan
BACKGROUND: In patients with mitral regurgitation (MR), the effective regurgitant orifice area can be estimated by measuring the vena contracta area (VCA). We hypothesize that the VCA has characteristic temporal dynamics related to the underlying mechanism of functional mitral regurgitation (FMR) versus degenerative mitral valve disease (DMVD). METHODS: VCA measurements obtained by planimetry of the proximal jet from 3D transesophageal echocardiographic (TEE) color flow Doppler data sets were acquired in 42 cardiac surgical patients, including 22 with FMR and 20 with DMVD...
February 2016: Anesthesia and Analgesia
Eiki Tayama, Tomohiro Ueda, Ryusuke Mori, Ken-ichi Imasaka, Yukihiro Tomita
BACKGROUND: In rare cases, echo findings of degenerative valve disease is similar to valvular mass. CASE PRESENTATION: A 56-year-old woman was evaluated for palpitation. Echocardiography revealed an 8- mm mass on the anterior mitral leaflet with minimal mitral insufficiency. Resection of the valve tumor was attempted to prevent a possible embolism. However, the lesion was not a tumor, but an aneurysm-like bulge on the anterior leaflet without chorda elongation. Triangular resection and ring annuloplasty were performed...
November 2, 2015: Journal of Cardiothoracic Surgery
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