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Severe mitral regurgitation

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https://www.readbyqxmd.com/read/29774187/multimodality-imaging-for-the-quantitative-assessment-of-mitral-regurgitation
#1
REVIEW
Pei G Chew, Katrina Bounford, Sven Plein, Dominik Schlosshan, John P Greenwood
The natural history of mitral regurgitation (MR) results in significant morbidity and mortality. Innovations in non-invasive imaging have provided new insights into the pathophysiology and quantification of MR, in addition to early detection of left ventricular (LV) dysfunction and prognostic assessment in asymptomatic patients. Transthoracic (TTE) and transesophageal (TOE) echocardiography are the mainstay for diagnosis, assessment and serial surveillance. However, the advance from 2D to 3D imaging leads to improved assessment and characterization of mitral valve (MV) disease...
April 2018: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29769510/surgical-management-of-a-critical-ischemic-mitral-regurgitation-patient
#2
S A Sunny, S Moinuddin, A B Adhikary, M A Hossain
Functional ischemic mitral regurgitation is strongly associated with poor outcomes in patient with coronary artery disease. The best management for mitral regurgitation at the time of coronary revascularization remains controversial. We report, a case of 58 years-old men admitted to GKNM hospital, Coimbatore, Tamil Nadu, India with chest pain and respiratory distress for last 6 hours during my fellowship training in that hospital. ECG showed acute antero-septal MI. The transthoracic echocardiogram revealed severe left ventricular dysfunction with moderate mitral regurgitation...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29762933/ross-procedure-following-a-dislodged-transcatheter-aortic-valve-replacement
#3
Samuel R Schnittman, Aaron J Weiss, Robin Varghese, Paul Stelzer
A 36-year-old pregnant woman with a history of rheumatic heart disease and prior aortic valve replacement and mitral valve repair presented to an outside hospital with severe aortic stenosis. The patient had a cardiac arrest upon labor induction and underwent a transcatheter aortic valve replacement (TAVR), which dislodged two days later. Five months later, the patient underwent removal of the dislodged TAVR and a Ross procedure at the authors' institution. The patient was stable upon discharge, with minimal aortic and pulmonary regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762931/mitraclip-technique-five-years-after-alfieri-stitch-mitral-valve-repair
#4
Ivaylo R Tonchev, Anna Turyan, Ronen Beeri, Mony Shuvy
The case is described of a successful MitraClip procedure performed on an 88-year-old patient with severe mitral regurgitation (MR), five years after she had undergone mitral valve repair using the Alfieri surgical procedure. It is suggested that the MitraClip procedure is an option in patients with severe MR persisting after the Alfieri procedure. Video 1: Transesophageal echocardiography before the MitraClip procedure. Severe mitral regurgitation with preserved left ventricular systolic function. The main regurgitant jet originates from the medial commissure...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762929/trileaflet-mitral-valve-treated-with-the-mitraclip%C3%A2-system
#5
Miguel Rodríguez-Santamarta, Rodrigo Estévez-Loureiro, Tomás Benito-González, Javier Gualis, Carmen Garrote, Armando Pérez de Prado, Felipe Fernández-Vázquez
A 79-year-old woman with a history of ischemic dilated cardiomyopathy, severely depressed left ventricular ejection fraction and significant mitral regurgitation (MR) was admitted to the authors´ institution for percutaneous mitral valve repair. Transesophageal echocardiography (TEE) revealed the presence of a posterior mitral cleft at the P2 level, causing a trileaflet mitral valve that contributed significantly to the regurgitant jet. The procedure was performed under general anesthesia and guided by real-time three-dimensional TEE...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762924/early-improvement-in-mitral-regurgitation-after-cardiac-resynchronization-therapy-in-cardiomyopathy-patients
#6
Hakimeh Sadeghian, Masoumeh Lotfi-Tokaldany, Mahdi Montazeri, Ali Kazemi Saeed, Mohammad Sahebjam, Akram Sardari, Gita Ejmalian
BACKGROUND: The study aim was to investigate factors affecting the improvement of mitral regurgitation (MR) severity within 48 hours after cardiac resynchronization therapy (CRT) in patients with cardiomyopathy. METHODS: Sixty-nine cardiomyopathy patients (48 males, 21 females; mean age 59.12 ± 9.66 years) in NYHA functional class ≥III, with left ventricular ejection fraction (LVEF) ≤35%, and QRS duration >120 ms, with MR ≥moderate, were included in the study...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762923/intraoperative-transesophageal-echocardiography-for-surgical-repair-of-degenerative-mitral-regurgitation
#7
Calogera Pisano, Claudia Calia, Alessandro Ricasoli, Oreste Fabio Triolo, Vincenzo Argano
BACKGROUND: Segmental analysis of diseased mitral valves is important to predict a successful surgical valve repair. An assessment was made of the comparative accuracy of intraoperative three-dimensional (3D) and two-dimensional (2D) transesophageal echocardiography (TEE) in the evaluation of mitral valve lesions when compared with intraoperative surgical segmental analysis. METHODS: A total of 42 consecutive patients (12 females, 30 males; mean age 70.5 ± 14 years) with severe mitral valve regurgitation due to degenerative disease and who underwent mitral valve repair was enrolled in the study...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29755630/echocardiographic-features-in-bartonella-endocarditis-a-case-series
#8
Orathai Pachirat, Sompop Prathanee, George Watt
Bartonella spp. are emerging pathogens that are reported as the cause of blood culture-negative endocarditis ( BCNE). However, echocardiographic features and assessment of this endocarditis remains unclear. Four patients with B. henselae endocarditis were identified. All patients had underlying cardiac conditions: rheumatic heart disease in three, congenital heart disease in one. Evidence of vegetations was found on the aortic valve in all patients with large, highly mobile vegetations and severely destroyed valves demonstrated by the transthoracic echocardiogram leading to severe aortic regurgitation and heart failure...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29755084/-further-surgery-for-mitral-stenosis-12-years-after-mitral-valve-repair-report-of-a-case
#9
Naohiro Shimada, Takashi Ueda, Noriyuki Hatanaka, Hiroyuki Yamada
A rare case of mitral stenosis after mitral valve repair for non-rheumatic mitral regurgitation is presented. An 81-year-old woman who had undergone mitral valve repair using an annuloplasty ring 12 years earlier, was referred to our hospital because of dyspnea during exertion. As echocardiography revealed severe mitral stenosis, and redo surgery was carried out. During the surgery, fibrous tissue covered the annuloplasty ring and extended onto both leaflets of the mitral valve, which narrowed its orifice, by rendering the leaflets stiff and immobile...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755073/-beating-mitral-valve-replacement-for-functional-mitral-regurgitation-after-cardiac-resynchronization-therapy-report-of-a-case
#10
Hiroshi Kumano, Keisuke Shuntoh, Akimitsu Yamaguchi
A 72-year-old man was admitted to our hospital because of dyspnea. He had a history of cardiac resynchronization therapy for congestive heart failure due to dilated cardiomyopathy 6 months previously. Echocardiography revealed severe functional mitral regurgitation which had been mild 6 months before. Because medical treatment was ineffective, on-pump beating mitral valve replacement using a bioprosthesis was performed to prevent reperfusion injury. The patient was easily weaned from cardiopulmonary bypass with low-dose inotropic support and scheduled intra-aortic balloon pump...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29753818/routine-papillary-muscle-realignment-and-septal-myectomy-for-obstructive-hypertrophic-cardiomyopathy
#11
Howard K Song, Jason Turner, Rebekah Macfie, Suwen Kumar, Meghan J Mannello, Danielle Smith, Castigliano Bhamidipati, Jaishankar Raman, Frederick Tibayan, Stephen B Heitner
BACKGROUND: Septal myectomy has been the mainstay of the surgical treatment of obstructive hypertrophic cardiomyopathy (HCM), however recently there is growing appreciation for associated mitral valve abnormalities that contribute to left ventricular outflow tract (LVOT) obstruction. In this study, we describe our experience with combined papillary muscle realignment (PMR) and septal myectomy for the treatment of obstructive HCM. METHODS: We identified 44 patients undergoing surgery for obstructive HCM whose anatomy was amenable to combined PMR and septal myectomy at our institution over a 20-month period...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29752195/prevalence-clinical-characteristics-and-outcome-of-atrial-functional-mitral-regurgitation-in-hospitalized-heart-failure-patients-with-atrial-fibrillation
#12
Chihiro Saito, Yuichiro Minami, Kotaro Arai, Shintaro Haruki, Yoshimi Yagishita, Kentaro Jujo, Kyomi Ashihara, Nobuhisa Hagiwara
BACKGROUND: Functional mitral regurgitation (MR) caused by reduced left ventricular ejection fraction (EF) and tethering, termed ventricular functional MR (VFMR), is associated with worse outcomes. Atrial functional MR (AFMR) caused by left atrial enlargement and annular dilatation was also recently described in patients with atrial fibrillation (AF). However, the clinical profiles of AFMR in hospitalized heart failure (HF) patients are unclear. We investigated the prevalence, clinical characteristics, and prognosis of AFMR in hospitalized HF patients with AF...
May 8, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29747569/systolic-characteristics-and-dynamic-changes-of-the-mitral-valve-in-different-grades-of-ischemic-mitral-regurgitation-insights-from-3d-transesophageal-echocardiography
#13
Caroline Morbach, Diego Bellavia, Stefan Störk, Lissa Sugeng
BACKGROUND: Mitral regurgitation in ischemic heart disease (IMR) is a strong predictor of outcome but until now, pathophysiology is not sufficiently understood and treatment is not satisfying. We aimed to systematically evaluate structural and functional mitral valve leaflet and annular characteristics in patients with IMR to determine the differences in geometric and dynamic changes of the MV between significant and mild IMR. METHODS: Thirty-seven patients with IMR (18 mild (m)MR, 19 significant (moderate+severe) (s)MR) and 33 controls underwent TEE...
May 10, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29745455/infective-endocarditis-following-transcatheter-edge-to-edge-mitral-valve-repair-a-systematic-review
#14
Lluis Asmarats, Tania Rodriguez-Gabella, Chekrallah Chamandi, Mathieu Bernier, Jonathan Beaudoin, Kim O'Connor, Eric Dumont, François Dagenais, Jean-Michel Paradis, Josep Rodés-Cabau
OBJECTIVES: To assess the clinical characteristics, management, and outcomes of patients diagnosed with infective endocarditis (IE) after edge-to-edge mitral valve repair with the MitraClip device. BACKGROUND: Transcatheter edge-to-edge mitral valve repair has emerged as an alternative to surgery in high-risk patients. However, few data exist on IE following transcatheter mitral procedures. METHODS: Four electronic databases (PubMed, Google Scholar, Embase, and Cochrane Library) were searched for original published studies on IE after edge-to-edge transcatheter mitral valve repair from 2003 to 2017...
May 10, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29743999/transcatheter-mitral-valve-replacement-for-native-and-failed-bioprosthetic-mitral-valves
#15
REVIEW
Kunal Sarkar, Michael J Reardon, Stephen H Little, Colin M Barker, Neal S Kleiman
Transcatheter mitral valve replacement (TMVR) is a novel approach for treatment of severe mitral regurgitation. A number of TMVR devices are currently undergoing feasibility trials using both transseptal and transapical routes for device delivery. Overall experience worldwide is limited to fewer than 200 cases. At present, the 30-day mortality exceeds 30% and is attributable to both patient- and device-related factors. TMVR has been successfully used to treat patients with degenerative mitral stenosis (DMS) as well as failed mitral bioprosthesis and mitral repair using transcatheter mitral valve-in-valve (TMViV)/valve-in-ring (ViR) repair...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29743996/emerging-transcatheter-options-for-tricuspid-regurgitation
#16
REVIEW
Ankur Kalra, Angad S Uberoi, Azeem Latib, Sahil Khera, Stephen H Little, Deepak L Bhatt, Michael J Reardon, Neal S Kleiman, Colin M Barker
Tricuspid regurgitation (TR) presents as either primary valve pathology or secondary to pulmonary or left-sided heart disease. Severe TR portends a worse prognosis independent of age, right ventricular size and function, severe left ventricular dysfunction, and increased pulmonary arterial pressures. Surgical treatment for TR has mostly been limited to patients undergoing mitral valve repair since those at high surgical risk are not candidates for traditional TR surgery. For these patients, minimally invasive techniques could be of great benefit, yet these techniques have been slow to develop because of the various anatomic and physiological aspects of the tricuspid valve apparatus...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29741485/one-year-results-of-transcatheter-treatment-of-severe-tricuspid-regurgitation-using-the-edge-to-edge-repair-technique
#17
Daniel Braun, Michael Nabauer, Mathias Orban, Andrea Englmaier, Diana Rösler, Christian Hagl, Steffen Massberg, Jörg Hausleiter
AIMS: The aim of this study was to evaluate one-year durability and clinical outcome of transcatheter tricuspid valve repair using the edge-to-edge repair technique in symptomatic patients with severe tricuspid regurgitation (TR). METHODS AND RESULTS: We evaluated twenty-four consecutive patients suffering from severe right sided heart failure (NYHA III-IV) primarily due to moderate to severe primary tricuspid regurgitation. Applying a modified steering technique for clip delivery, 8 patients were treated for isolated severe TR, while 16 patients were treated for moderate to severe TR and concomitant severe mitral regurgitation...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29738755/durability-at-19-years-of-quadrangular-resection-with-annular-plication-for-mitral-regurgitation
#18
Elisabetta Lapenna, Benedetto Del Forno, Ludovica Amore, Stefania Ruggeri, Giuseppe Iaci, Davide Schiavi, Igor Belluschi, Marta Bargagna, Ottavio Alfieri, Michele De Bonis
BACKGROUND: To report the long-term (19 years) clinical and echocardiographic results of the quadrangular resection with annular plication and annuloplasty. METHODS: A hundred forty-five consecutive patients (mean age 58±11.1years, LVEF 59±9.5%) with severe degenerative mitral regurgitation due to posterior leaflet prolapse/flail, underwent quadrangular resection of the posterior leaflet combined with ring (127 patients,87.5%) or pericardium (18 patients,12.5%) annuloplasty...
May 5, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29735498/diffuse-alveolar-haemorrhage-and-libman-sacks-endocarditis-a-rare-presentation-of-antiphospholipid-syndrome
#19
Brianna Bielski, Nikhil H Shah, Donevan Westerveld, Carolyn Stalvey
A 26-year-old woman with a history of idiopathic thrombocytopaenic purpura and a 1-year history of blood-streaked sputum presented after a severe episode of haemoptysis with dyspnoea. Chest imaging revealed diffuse ground glass and bronchovascular nodules. Bronchoscopy revealed bilateral diffuse alveolar haemorrhage (DAH). Sputum and bronchoalveolar lavage studies were negative for infectious aetiologies. A transthoracic echocardiogram revealed Libman-Sacks endocarditis with severe mitral regurgitation and physical examination revealed retinal artery occlusion and Osler's nodes...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29735373/natural-history-of-echocardiographic-abnormalities-in-mucopolysaccharidosis-iii
#20
Carolyn M Wilhelm, Kristen V Truxal, Kim L McBride, John P Kovalchin, Kevin M Flanigan
BACKGROUND: Mucopolysaccharidosis (MPS) type III, Sanfilippo Syndrome, is an autosomal recessive lysosomal storage disorder. MPS I and II patients often develop cardiac involvement leading to early mortality, however there are limited data in MPS III. The objective of this study is to describe cardiac abnormalities in a large group of MPS III patients followed in a longitudinal natural history study designed to determine outcome measures for gene transfer trials. METHODS: A single center study of MPS III patients who were enrolled in the Nationwide Children's Hospital natural history study in 2014...
April 27, 2018: Molecular Genetics and Metabolism
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