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Severe mitral regurgitation

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https://www.readbyqxmd.com/read/27911009/echocardiographic-predictors-of-outcome-in-patients-with-chronic-obstructive-pulmonary-disease
#1
Ivan Stankovic, Robert Marcun, Aleksandra Janicijevic, Jerneja Farkas, Sasa Kadivec, Ivan Ilic, Aleksandar N Neskovic, Mitja Lainscak
BACKGROUND: We aimed to assess the relationship between echocardiographic characteristics and mortality in patients with chronic obstructive pulmonary disease (COPD). METHODS: We prospectively studied 154 patients (mean age 71 ± 10 years, 71% male) with COPD. All patients underwent transthoracic Doppler echocardiography within 48 hours of hospital admission. Primary endpoint was all-cause mortality during a median period of 22 months. RESULTS: Mildly elevated tricuspid regurgitation pressure and mitral E/e' ratio were the most commonly encountered echocardiographic abnormalities, observed in 60% and 56% of patients, respectively...
December 2, 2016: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/27899396/twenty-year-outcome-after-mitral-repair-versus-replacement-for-severe-degenerative-mitral-regurgitation-analysis-of-a-large-prospective-multicenter-international-registry
#2
Siham Lazam, Jean-Louis Vanoverschelde, Christophe Tribouilloy, Francesco Grigioni, Rakesh M Suri, Jean-Francois Avierinos, Christophe de Meester, Andrea Barbieri, Dan Rusinaru, Antonio Russo, Agnès A Pasquet, Hector I Michelena, Marianne Huebner, Joseph Maalouf, Marie-Annick Clavel, Catherine Szymanski, Maurice E Enriquez-Sarano
BACKGROUND: -Mitral valve (MV) repair is preferred over replacement in clinical guidelines and is an important determinant of the indication for surgery in degenerative mitral regurgitation (MR). Yet, the level of evidence supporting current recommendations is low, and recent data cast doubts on its validity in the current era. Accordingly, the aim of the present study was to analyze very long-term outcome after MV repair and replacement for degenerative MR with a flail leaflet. METHODS: -MIDA is a multicenter registry enrolling patients with degenerative MR with a flail leaflet in 6 tertiary European and US centers...
November 29, 2016: Circulation
https://www.readbyqxmd.com/read/27896596/haemodynamic-and-functional-consequences-of-the-iatrogenic-atrial-septal-defect-following-mitraclip-therapy
#3
REVIEW
E A Hart, K Zwart, A J Teske, M Voskuil, P R Stella, S A J Chamuleau, A O Kraaijeveld
Percutaneous MitraClip placement for treatment of severe mitral regurgitation in high surgical risk patients is a commonly performed procedure and requires a transseptal puncture to reach the left atrium. The resulting iatrogenic atrial septal defect (iASD) is not routinely closed, yet the haemodynamic and functional consequences of a persisting defect are not fully understood. Despite positive effects such as acute left atrial pressure relief, persisting iASDs are associated with negative consequences, namely significant bidirectional shunting and subsequent worse clinical outcome...
November 28, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27892889/the-impact-of-functional-vs-degenerative-mitral-regurgitation-on-clinical-outcomes-among-patients-undergoing-transcatheter-aortic-valve-implantation
#4
René Vollenbroich, Stefan Stortecky, Fabien Praz, Jonas Lanz, Anna Franzone, Katarzyna Zuk, Dik Heg, Marco Valgimigli, Crochan John O'Sullivan, Corinna Heinisch, Eva Roost, Peter Wenaweser, Stephan Windecker, Thomas Pilgrim
BACKGROUND: Among patients undergoing transcatheter aortic valve implantation (TAVI), concomitant mitral regurgitation (MR) has been associated with adverse prognosis. We aimed to assess long-term clinical outcomes according to MR etiology. METHODS: In a single-center registry of consecutive patients undergoing TAVI, we investigated the impact of functional (FMR) vs degenerative (DMR) MR on cardiovascular (CV) mortality throughout 2years of follow-up. RESULTS: Among 603 patients (mean age 82...
October 28, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27879530/transaortic-edge-to-edge-repair-for-functional-mitral-regurgitation-during-aortic-valve-replacement-a-13-year-experience
#5
Christos G Mihos, Maiteder Larrauri-Reyes, Judy Hung, Orlando Santana
OBJECTIVE: The study evaluated the feasibility of a transaortic edge-to-edge mitral valve repair (Alfieri stitch) for moderate or greater (≥2+) functional mitral regurgitation (MR) in high-risk patients undergoing aortic valve replacement. METHODS: We retrospectively evaluated 40 consecutive patients who underwent aortic valve replacement combined with a transaortic edge-to-edge mitral valve repair for 2+ or greater functional MR, between February 2002 and April 2015...
November 22, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27876001/severe-mitral-regurgitation-due-to-mitral-leaflet-aneurysm-diagnosed-by-three-dimensional-transesophageal-echocardiography-a-case-report
#6
Takao Konishi, Naohiro Funayama, Tadashi Yamamoto, Daisuke Hotta, Kenjiro Kikuchi, Katsumi Ohori, Hiroshi Nishihara, Shinya Tanaka
BACKGROUND: A small mitral valve aneurysm (MVA) presenting as severe mitral regurgitation (MR) is uncommon. CASE PRESENTATION: A 47-year-old man with a history of hypertension complained of exertional chest discomfort. A transthoracic echocardiogram (TTE) revealed the presence of MR and prolapse of the posterior leaflet. A 6-mm in diameter MVA, not clearly visualized by TTE, was detected on the posterior leaflet on a three-dimensional (3D) transesophageal echocardiography (TEE)...
November 22, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27875721/percutaneous-mitral-valve-repair-the-last-chance-for-symptoms-improvement-in-advanced-refractory-chronic-heart-failure
#7
Alessandra Berardini, Elena Biagini, Francesco Saia, Davide Stolfo, Mario Previtali, Francesco Grigioni, Bruno Pinamonti, Gabriele Crimi, Alessandro Salvi, Maurizio Ferrario, Antonio De Luca, Fabrizio Gazzoli, Maria Letizia Bacchi Reggiani, Claudia Raineri, Gianfranco Sinagra, Claudio Rapezzi
BACKGROUND: The role of percutaneous mitral valve repair (PMVR) in patients with end-stage heart failure (HF) and functional mitral regurgitation (FMR) is unclear. METHODS: Seventy-five consecutive patients with FMR grade≥3+ and severe HF symptoms despite optimal medical therapy and resynchronization therapy underwent PMVR with the MitraClip system (Abbott, Abbott Park, IL, USA) at 3 centers. Clinical evaluation, echocardiography and pro-BNP measurement were performed at baseline and at 6-month...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27873344/impact-of-residual-mitral-regurgitation-on-right-ventricular-systolic-function-after-left-ventricular-assist-device-implantation
#8
Serkan Ertugay, Hatice S Kemal, Umit Kahraman, Catagay Engin, Sanem Nalbantgil, Tahir Yagdi, Mustafa Ozbaran
Significant mitral regurgitation (MR) is thought to decrease after left ventricular assist device (LVAD) implantation, and therefore repair of mitral valve is not indicated in current practice. However, residual moderate and severe MR leads to pulmonary artery pressure increase, thereby resulting in right ventricular (RV) dysfunction during follow-up. We examined the impact of residual MR on systolic function of the right ventricle by echocardiography after LVAD implantation. This study included 90 patients (mean age: 51...
November 22, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27869900/-transient-left-ventricular-apical-ballooning-with-dynamic-outflow-tract-obstruction-complicated-by-persistent-hypotension
#9
Rodolfo Pino, Faro Manzella, Danilo Puccio, Giuseppa Sciortino, Giovanni Polizzi
The pathogenesis of tako-tsubo syndrome remains, nowadays, unclear: it is likely that the relevance of the different proposed mechanisms differs among specific clinical contexts. In this paper, we describe the case of a 61-year-old woman admitted to the intensive cardiac care unit for pre-syncope and persistent hypotension. Clinical and echocardiographic data were suggestive of tako-tsubo syndrome with severe dynamic left ventricular outflow tract (LVOT) obstruction and severe mitral regurgitation. Coronary angiography was normal...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27867305/pulmonary-hypertension-in-heart-failure-patients-presenting-at-oauthc-ile-ife-nigeria
#10
Valentine N Amadi, Olufemi E Ajayi, Anthony O Akintomide, Olugbenga O Abiodun, Olaniyi J Bamikole, Michael O Balogun
BACKGROUND: Pulmonary hypertension (PH) is common in heart failure patients. Literature on PH in heart failure is sparse in Nigeria. This study was carried out to determine the prevalence of PH in heart failure patients and ascertain the relationship between left ventricular systolic and diastolic function and the degree of PH. METHODS: A total of 125 heart failure patients had echocardiography done. PH was diagnosed using tricuspid regurgitation jet and pulmonary ejection jet profile...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27863908/role-of-echocardiography-for-catheter-based-management-of-valvular-heart-disease
#11
REVIEW
Takahiro Shiota
Catheter-based treatment of valvular heart disease, such as transvalvular aortic valve replacement (TAVR) or mitral clip procedure, has been increasingly accepted as a treatment choice for the past several years. Such new treatment options have been changing the management of patients with valvular heart disease drastically while socio-economic factors regarding their application need to be taken into consideration. The use of echocardiography, including transesophageal echocardiography (TEE), for such catheter-based treatments is essential for the success of the procedures...
November 15, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27863743/in-vitro-and-in-silico-approaches-to-quantify-the-effects-of-the-mitraclip-%C3%A2-system-on-mitral-valve-function
#12
Francesco Sturla, Riccardo Vismara, Michal Jaworek, Emiliano Votta, Paolo Romitelli, Omar A Pappalardo, Federico Lucherini, Carlo Antona, Gianfranco B Fiore, Alberto Redaelli
Mitraclip(®) implantation is widely used as a valid alternative to conventional open-chest surgery in high-risk patients with severe mitral valve (MV) regurgitation. Although effective in reducing mitral regurgitation (MR) in the majority of cases, the clip implantation produces a double-orifice area that can result in altered MV biomechanics, particularly in term of hemodynamics and mechanical stress distribution on the leaflets. In this scenario, we combined the consistency of in vitro experimental platforms with the versatility of numerical simulations to investigate clip impact on MV functioning...
November 10, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27862027/surgical-transapical-approach-for-prosthetic-mitral-paravalvular-leak-closure-early-results
#13
Unal Aydin, Onur Sen, Ersin Kadirogullari, Burak Onan, Aydin Yildirim, Ihsan Bakir
The objective is to demonstrate safety and early clinical results of surgical transapical closure of paravalvular leaks (PVLs) following mitral valve replacement in significant regurgitation. Between March 2014 and February 2015, 12 patients (mean age 52.1 ± 6.0 years, 66.6% male) with severe symptomatic mitral PVLs (n = 13) underwent surgical transapical closure procedure through left mini-thoracotomy. All patients were in NYHA functional class III-IV and median logistic EuroSCORE was 24.2 ± 6...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27861188/controversies-in-quantification-of-mitral-valve-regurgitation-role-of-cardiac-magnetic-resonance-imaging
#14
Kim A Connelly, Edwin C Ho, Howard Leong-Poi
PURPOSE OF REVIEW: Mitral regurgitation remains a common problem, and when severe, is associated with significant morbidity and mortality. At present, echocardiography remains the primary modality for assessing both mechanism and severity of mitral regurgitation. However, recent studies demonstrate that the echocardiographic assessment of mitral regurgitation severity may be subject to variability as a result of semiquantitative parameters, dependence upon loading conditions and significant interobserver variability...
November 18, 2016: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27860182/from-tricuspid-to-double-orifice-morphology-percutaneous-tricuspid-regurgitation-repair-with-the-mitraclip-device-in-congenitally-corrected-transposition-of-great-arteries
#15
Fabien Picard, Victor-Xavier Tadros, Anita W Asgar
Edge to edge transcatheter mitral valve repair with MitraClip (Abbott Vascular, Menlo Park, CA) is increasing for high-risk surgical patients with significant mitral regurgitation. Patients with congenitally corrected transposition of the great arteries (CCTGA) presenting with tricuspid valve regurgitation of a systemic right ventricle may represent particularly challenging candidates for MitraClip given their anatomy. We report the case of a 67-year-old gentleman with CCTGA and severe tricuspid regurgitation who was referred for MitraClip implantation after heart team consensus...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27855288/should-pre-operative-left-atrial-volume-receive-more-consideration-in-patients-with-degenerative-mitral-valve-disease-undergoing-mitral-valve-surgery
#16
Giuseppe Di Gioia, Simona Mega, Antonio Nenna, Cosimo Marco Campanale, Iginio Colaiori, Domenico Scordino, Laura Ragni, Marco Miglionico, Germano Di Sciascio
BACKGROUND: Severe primary mitral regurgitation (MR) carries a significant incidence of mortality and morbidity. Though a number of prognostic factors have been identified, the best timing for mitral valve repair is still debated. We assessed the role of Left Atrial Volume Indexed (LAVI) as predictor of adverse events after mitral valve surgery. METHODS: 134 patients with severe MR were studied with a follow-up of 42±16months. Endpoints were Post-Operative Atrial Fibrillation (POAF), atrial and ventricular remodeling (LARR/LVRR) and correlation with outcome...
November 8, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27852485/coronary-sinus-based-approach-to-mitral-regurgitation
#17
REVIEW
Steven L Goldberg, Christoph Hammerstingl
Functional, or secondary, mitral regurgitation (FMR) is clinically important because patient with congestive heart failure with FMR have worse clinical outcomes and associated higher risks than patients without FMR. There is interest in finding repair techniques which may modify the mitral valve dysfunction and reduce the clinical impact. Although several devices have taken advantage of the close anatomical relationship between the coronary sinus and the posterior annulus of the mitral valve, in order to provide a cinching force on the mitral annulus, only the Carillon device is currently in use in humans...
January 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27847075/combined-nuss-procedure-and-cardiac-procedure-through-a-left-anterolateral-thoracotomy
#18
François Roubertie, Sowmya Ramanan, Frederic Lavrand, Jean-Benoit Thambo
Aortic root aneurysms associated with severe pectus excavatum caused by Marfan's syndrome can be challenging to correct in children. Recent reports suggest single-stage correction of both cardiac and chest wall deformities through a median sternotomy. We report a 9-year-old girl with Marfan's syndrome, an ascending aorta aneurysm, mitral regurgitation, and pectus excavatum, who underwent David's procedure with mitral valve repair and the Nuss procedure to correct the thoracic deformity. This single-stage combined procedure was performed through a left anterolateral thoracotomy...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27847071/evolut-r-implantation-to-treat-severe-pure-aortic-regurgitation-in-a-patient-with-mitral-bioprosthesis
#19
Giuseppe Bruschi, Paola Colombo, Stefano Nava, Francesco Musca, Bruno Merlanti, Oriana Belli, Francesco Soriano, Luca Botta, Danile De Caria, Cristina Giannattasio, Claudio F Russo
Transcatheter aortic valves have been designed to treat high-risk surgical candidates affected by severe aortic stenosis, but little is known about the use of transcatheter valves in patients with severe pure aortic regurgitation. We describe the implantation of Medtronic CoreValve Evolut R (Medtronic, Minneapolis, MN) to treat an 82-year-old patient affected by severe pure aortic regurgitation who underwent prior mitral valve replacement with a biological valve protruding into the left ventricular outflow tract...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27847070/mitraclip-implantation-for-the-treatment-of-new-onset-systolic-anterior-motion-of-the-mitral-valve-after-transcatheter-aortic-valve-replacement
#20
Carmelo Grasso, Salvatore Scandura, Sergio Buccheri, Marco Barbanti, Maria Elena Di Salvo, Sarah Mangiafico, Giuseppe Ronsivalle, Sebastiano Immé, Claudia Tamburino, Martina Patané, Carmelo Sgroi, Davide Capodanno, Piera Capranzano, Corrado Tamburino
New-onset systolic anterior motion of the anterior mitral valve leaflet in patients undergoing transcatheter aortic valve replacement is a rare pathophysiologic mechanism leading to postprocedural development of mitral regurgitation and, eventually, left ventricular outflow obstruction. We report the first human case of successful MitraClip implantation to treat new-onset systolic anterior motion of the mitral valve after transcatheter aortic valve replacement causing severe obstruction to left ventricular outflow that was unresponsive to standard medical therapy...
December 2016: Annals of Thoracic Surgery
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