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Severe mitral regurgitation

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https://www.readbyqxmd.com/read/29346710/an-extensive-caseous-calcification-of-the-mitral-annulus-complicated-with-severe-mitral-regurgitation
#1
Alper Karakus, Hakan Tibilli, Ibrahim H Inanc, Hakan Tasolar, Serdar Turkmen, Erdal Akturk
Caseous calcification of the mitral annulus (CCMA) is considered a rare variant of mitral annular calcification (MAC) due to caseous transformation of the inner material and prevalence of CCMA, about 0.63% of all MAC cases and 0.06%-0.07% of the population. The precise pathophysiology of CCMA is still unknown. It is a chronic degenerative disorder common in the elderly, particularly in women. Caseous calcification of the mitral annulus (CCMA) is a soft peri-annular extensive calcification, resembling cardiac tumors, abscesses, vegetation, or calcified thrombus, which is composed of an admixture of calcium, fatty acids, and cholesterol with a toothpaste-like texture...
January 18, 2018: Echocardiography
https://www.readbyqxmd.com/read/29346535/tricuspid-regurgitation-in-acute-heart-failure-is-there-any-incremental-risk
#2
Diab Mutlak, Jonathan Lessick, Shehrban Khalil, Sergey Yalonetsky, Yoram Agmon, Doron Aronson
Aim: Significant tricuspid regurgitation (TR) is common in heart failure (HF) and portends poor prognosis. We sought to determine whether the poor outcome results from the TR itself, or whether the TR is a surrogate marker of advanced left-sided myocardial or valvular heart disease. Methods and results: We studied 639 patients admitted for acute HF. The relationship between TR severity and the endpoint of readmission for HF or mortality was assessed after adjustment for multiple clinical and echocardiographic parameters...
January 15, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29345417/catheter-based-edge-to-edge-mitral-valve-repair-for-pulmonary-pressure-reduction-and-to-postpone-heart-transplantation-in-a-teenaged-patient
#3
Moritz Messner, Florian Hintringer, Silvana Müller, Marc Michael Zaruba, Nikolaos Bonaros, Herwig Antretter, Daniel Basic, Gerhard Pölzl
We report a case of catheter-based edge-to-edge mitral valve repair in a teenage male patient with non-ischaemic cardiomyopathy to improve pulmonary hypertension secondary to severe functional mitral regurgitation (FMR) to defer anticipated heart transplantation. A 19-year-old patient with previous history of fulminant myocarditis followed by markedly left ventricular dysfunction presented with severe mitral regurgitation 3 years after initial recovery. Slightly over time, deterioration of FMR was associated with gradual increase in pulmonary artery pressures despite optimal medical therapy...
January 18, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29344383/prognosis-of-patients-with-secondary-mitral-regurgitation-and-reduced-ejection-fraction
#4
Samer Mowakeaa, Aeshita Dwivedi, Jason R Grossman, Gaurav Parikh, Zelmira Curillova, Krishna G Aragam, Sammy Elmariah, Scott Kinlay, Jayashri Aragam
Objective: The impact of the severity of secondary mitral regurgitation (MR) on the risk of death and heart failure (HF) hospitalisations in patients with reduced left ventricular (LV) systolic function is poorly defined. The study sought to identify the incremental risk of secondary MR in patients with reduced LV systolic function. Methods: We studied 615 consecutive patients with LV ejection fraction ≤35% by transthoracic echocardiography at a single medical centre...
2018: Open Heart
https://www.readbyqxmd.com/read/29342024/clinical-profile-of-patients-with-heart-failure-can-predict-rehospitalization-and-quality-of-life
#5
Michele Di Mauro, Renata Petroni, Daniela Clemente, Massimiliano Foschi, Fabrizio Tancredi, Virginia Camponetti, Sabina Gallina, Antonio M Calafiore, Maria Penco, Silvio Romano
BACKGROUND: The aim of this retrospective study was to identify clinical, humoral and echocardiographic variables predicting rehospitalization and poor quality of life (QOL) in patients with reduced or mid-range ejection fraction heart failure. METHODS: From 2009 to 2012, 310 patients were admitted having signs and symptoms of heart failure with reduced ejection fraction. All the patients were followed by phone, calling the patients or the referring general practitioner...
January 15, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29338299/mitral-valve-replacement-via-a-left-thoracotomy-in-dextrocardia-and-situs-solitus
#6
María García Vieites, María Jose Martinez-Sapiña Llanas, Marcos Gómez Zincke, Beatriz Bouzas Zubeldía, Victor Bautista-Hernandez
Dextrocardia with situs solitus and severe mitral regurgitation is a rare clinical presentation which posse a surgical challenge and requires specific preoperative planning. A 54-year-old women with this anatomy, multiple thoracic procedures, and severe mitral valve regurgitation underwent successful mitral valve replacement with a 27-mm mechanical prosthesis through a left thoracotomy under ventricular fibrillation, on the basis of computed tomography findings. We emphasize the importance of preoperative planning and a surgical approach through a left thoracotomy and under ventricular fibrillation...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29334829/rare-combination-of-pathologies-causing-mitral-stenosis-and-mitral-regurgitation-a-case-report
#7
Anupama K Nair, Kuntal Roy Chowdhuri, Sitaraman Radhakrishnan, Krishna S Iyer, Manish Saxena
A supramitral ring is a rare cause of mitral stenosis, while an isolated mitral valve cleft is a rare cause of congenital mitral regurgitation. Fortunately, both the lesions are known to have good outcomes after surgical correction. Although each is known to be associated with a variety of other structural heart defects, their coexistence has not been reported previously. We report a case of a three- and half-year-old boy detected to have a rare combination of supramitral ring producing severe mitral stenosis with a coexisting cleft in the anterior leaflet of mitral valve causing severe mitral regurgitation...
January 1, 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29334508/practical-valvular-issues-in-patients-requiring-ventricular-assist-devices
#8
Mitesh Badiwala, Terrence Yau
PURPOSE OF REVIEW: As ventricular assist device (VAD) therapy in patients with advanced heart failure continues to grow, experience with concomitant valvular diseases present either before or after VAD implantation continues to accrue. In this review, we discuss recent data and current practice as it pertains to the subject of concomitant valvular disease in patients requiring VADs. RECENT FINDINGS: Persistent aortic valve closure has been identified as a potential contributor to aortic valve 'disuse atrophy' resulting in valve degeneration...
January 13, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29331957/mitral-valve-anatomic-predictors-of-hemodynamic-success-with-transcatheter-mitral-valve-repair
#9
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/29321434/tricuspid-and-mitral-valve-regurgitation-with-bi-fascicular-block-following-a-horse-kick
#10
Tomoki Kokubun, Masayoshi Oikawa, Yasuhiro Ichijo, Yoshiyuki Matsumoto, Tetsuro Yokokawa, Kazuhiko Nakazato, Yoshiyuki Sato, Shinya Takase, Hiroharu Shinjo, Hitoshi Yokoyama, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
A 40-year-old man was transferred to our hospital following an isolated horse kick injury to the anterior chest wall. The case showed bi-fascicular block, severe tricuspid valve regurgitation due to ruptured chordae tendineae of the anterior leaflet, moderate mitral valve regurgitation due to prolapse of mitral anterior leaflet, and hypokinetic motion of the inferior septal wall. Both tricuspid and mitral insufficiency were completely repaired by a surgical operation. Fortunately, these injuries were not fatal in this case, but the comprehensive assessment of cardiac damage and careful observation are important for managing patients with cardiac injury...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321212/prognostic-value-of-right-ventricular-dysfunction-in-heart-failure-with-reduced-ejection-fraction-superiority-of-longitudinal-strain-over-tricuspid-annular-plane-systolic-excursion
#11
Erberto Carluccio, Paolo Biagioli, Gianfranco Alunni, Adriano Murrone, Cinzia Zuchi, Stefano Coiro, Clara Riccini, Anna Mengoni, Antonella D'Antonio, Giuseppe Ambrosio
BACKGROUND: In heart failure (HF) with reduced ejection fraction, right ventricular (RV) impairment, as defined by reduced tricuspid annular plane systolic excursion, is a predictor of poor outcome. However, peak longitudinal strain of RV free wall (RVFWS) has been recently proposed as a more accurate and sensitive tool to evaluate RV function. Accordingly, we investigated whether RVFWS could help refine prognosis of patients with HF with reduced ejection fraction in whom tricuspid annular plane systolic excursion is still preserved...
January 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29313818/long-term-mortality-in-patients-with-severe-secondary-mitral-regurgitation-and-normal-left-ventricular-ejection-fraction-interventional-perspective
#12
Amr F Barakat, Mohammad Q Raza, Kinjal Banerjee, Rayji S Tsutsui, Amgad Mentias, Karim Abdur Rehman, Badal Thakkar, Sajjad Gul, Raquib Faruqui, Amar Krishnaswamy, Leonardo L Rodriguez, Richard Grimm, Brian Griffin, Emin Murat Tuzcu, Samir R Kapadia
AIMS: Patients with severe secondary mitral regurgitation (MR) and normal ejection fraction are being excluded from clinical trials evaluating transcatheter mitral devices. We sought to evaluate the long-term mortality with medical management alone in this patient population. METHODS AND RESULTS: We retrospectively evaluated patients diagnosed with ≥3+ mitral MR at our institution over 15 years. Only patients with ejection fraction ≥ 60% were included in the study...
January 9, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29313150/alfieri-stitch-for-temporary-severe-functional-mitral-regurgitation-after-aortic-valve-replacement
#13
Yoshihisa Morimoto, Takaki Sugimoto
The outcome in functional mitral regurgitation after aortic valve replacement is unclear. A frail 82-year-old woman with severe aortic valve regurgitation and mild to moderate functional mitral valve regurgitation (NYHA functional class III) was referred to our clinic. In consideration of her frail condition, aortic valve replacement without mitral surgery was performed. She had hemodynamic instability and difficulty to wean off cardiopulmonary bypass caused by severe functional mitral valve regurgitation with left ventricular dilatation...
January 8, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29310672/3d-vena-contracta-area-after-mitraclip%C3%A2-procedure-precise-quantification-of-residual-mitral-regurgitation-and-identification-of-prognostic-information
#14
Alexander Dietl, Christine Prieschenk, Franziska Eckert, Christoph Birner, Andreas Luchner, Lars S Maier, Stefan Buchner
BACKGROUND: Percutaneous mitral valve repair (PMVR) is increasingly performed in patients with severe mitral regurgitation (MR). Post-procedural MR grading is challenging and an unsettled issue. We hypothesised that the direct planimetry of vena contracta area (VCA) by 3D-transoesophageal echocardiography allows quantifying post-procedural MR and implies further prognostic relevance missed by the usual ordinal scale (grade I-IV). METHODS: Based on a single-centre PMVR registry containing 102 patients, the association of VCA reduction and patients' functional capacity measured as six-minute walk distance (6 MW) was evaluated...
January 9, 2018: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29306705/adverse-impact-of-diabetes-mellitus-on-left-ventricular-remodelling-in-patients-with-chronic-primary-mitral-regurgitation
#15
Laura Ernande, Jonathan Beaudoin, Victoria Piro, Souhila Meziani, Marielle Scherrer-Crosbie
BACKGROUND: Diabetes mellitus (DM) has an impact on left ventricular (LV) geometry and function, and is associated with worsening of pressure-overload LV remodelling; however, its impact on volume-overload LV remodelling is unknown. AIM: The objective of the study was to examine the association between DM and LV remodelling in patients with chronic mitral regurgitation (MR) caused by mitral valve prolapse. METHODS: During a median follow-up of 3...
January 3, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#16
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29302945/a-new-method-to-evaluate-atrial-hemodynamic-and-quantify-mitral-regurgitation-using-cardiovascular-magnetic-resonance-the-pulmonary-venous-flow-approach
#17
Giovanni Benfari, Giulia Vinco, Karl Sayegh, Matthias Friedrich, Andrea Rossi
Pulmonary venous flow (PVF) provides incremental information on left ventricular (LV) diastolic function, and can support the diagnosis of severe mitral regurgitation (MR). The suggestion has been made to combine the left atrial filling volume (LA Fill) and PVF for estimating the mitral regurgitant volume, but echocardiographic PVF evaluation is known to have many limitations. The present case report includes an example of how to assess PVF using cardiovascular magnetic resonance, and a new method is proposed for quantification of the mitral regurgitant volume...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302944/restrictive-mitral-annuloplasty-with-or-without-papillary-muscle-approximation-for-functional-mitral-regurgitation
#18
Yusuke Misumi, Takafumi Masai, Koichi Toda, Teruya Nakamura, Shigeru Miyagawa, Yasushi Yoshikawa, Satsuki Fukushima, Shunsuke Saito, Keitaro Domae, Satoshi Kainuma, Takayoshi Ueno, Toru Kuratani, Takashi Daimon, Yoshiki Sawa
BACKGROUND: The impact of adding papillary muscle approximation (PMA) to restrictive mitral annuloplasty (RMA) on postoperative left ventricular (LV) function is unknown. Changes in LV function parameters and clinical outcome were evaluated following RMA with and without PMA in patients with clinically relevant functional mitral regurgitation (FMR). METHODS: A total of 176 patients with advanced cardiomyopathy underwent RMA either with (n = 59) or without (n = 117) PMA...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302943/left-heart-ejection-fraction-as-a-load-independent-parameter-for-patients-with-mitral-regurgitation
#19
Hai-Yan Chen, Jun Li, Chun-Sheng Wang, Cui-Zhen Pan, Xian-Hong Shu
BACKGROUND: The functions of the left ventricle and left atrium are closely associated with the outcomes of surgically treated patients with severe mitral regurgitation (MR). However, both parameters were overestimated in the presence of MR. The present study integrated the left atrium and left ventricle as the left heart (LH) to eliminate the influence of MR within the integrated structure. The study aim was to explore whether the emptying fraction of the LH is a load-independent parameter for patients with MR...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302936/impact-of-tricuspid-valve-regurgitation-on-early-outcomes-after-transcatheter-aortic-valve-replacement
#20
Mihir Barvalia, Rajiv Tayal, Marc Cohen, Martin Miguel Amor, Lilia Tcharnaia, Chunguang Chen, Mark Russo, Bruce Haik
BACKGROUND: Tricuspid valve regurgitation (TR) is often not taken into consideration in the prognostication of patients undergoing transcatheter aortic valve replacement (TAVR). Accordingly, its impact on such patients remains relatively poorly defined. The study aim was to explore the effect of TR and parameters of right ventricular (RV) function on outcomes in patients undergoing TAVR. METHODS: Baseline demographic and echocardiographic data were collected for 460 consecutive patients undergoing TAVR at the authors' institution between 2012 and 2015...
July 2017: Journal of Heart Valve Disease
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