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Severe mitral regurgitation

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https://www.readbyqxmd.com/read/28336789/percutaneous-therapy-for-tricuspid-regurgitation-a-new-frontier-for-interventional-cardiology
#1
Samir R Kapadia, Amar Krishnaswamy, E Murat Tuzcu
Functional tricuspid regurgitation (FTR) is common, whether in association with mitral or aortic valve disease or presenting as an isolated valvular disease. Several studies have shown that TR is associated with poor patient outcomes, though a cause-and-effect relationship of TR to mortality has not been proven. Similarly the impact of surgical treatment of TR on outcomes needs well-controlled randomized trials that are under planning. The current professional society guidelines for treatment of TR are based on expert opinions with a level of evidence C for all indications...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28336788/transcatheter-treatment-of-severe-tricuspid-regurgitation-with-the-edge-to-edge-mitraclip-technique
#2
Georg Nickenig, Marek Kowalski, Jörg Hausleiter, Daniel Braun, Joachim Schofer, Ermela Yzeiraj, Volker Rudolph, Kai Friedrichs, Francesco Maisano, Maurizio Taramasso, Neil P Fam, Giovanni Bianchi, Francesco Bedogni, Paolo Denti, Ottavio Alfieri, Azeem Latib, Antonio Colombo, Christoph Hammerstingl, Robert Schueler
Background -Current surgical and medical treatment options for severe tricuspid regurgitation (TR) are limited and additional interventional approaches are required. In the present observational study, the safety and feasibility of transcatheter repair of chronic severe TR with the MitraClip system were evaluated. In addition, the effects on clinical symptoms were assessed. Methods -Patients with heart failure symptoms and severe TR on optimal medical treatment were treated with the MitraClip system. Safety, defined as periprocedural adverse events such as death, myocardial infarction, stroke, or cardiac tamponade, and feasibility, defined as successful implantation of one or more MitraClip devices and reduction of TR by at least one grade, were evaluated before discharge and after 30 days...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28336204/n-terminal-pro-brain-natriuretic-peptide-is-related-with-coronary-flow-velocity-reserve-and-diastolic-dysfunction-in-patients-with-asymmetric-hypertrophic-cardiomyopathy
#3
Milorad Tesic, Jelena Seferovic, Danijela Trifunovic, Ana Djordjevic-Dikic, Vojislav Giga, Ivana Jovanovic, Olga Petrovic, Jelena Marinkovic, Sanja Stankovic, Jelena Stepanovic, Arsen Ristic, Milan Petrovic, Nebojsa Mujovic, Bosiljka Vujisic-Tesic, Branko Beleslin, Vladan Vukcevic, Goran Stankovic, Petar Seferovic
BACKGROUND: The relations of elevated N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and cardiac ischemia in hypertrophic cardiomyopathy (HCM) patients is uncertain. Therefore we designed the study with the following aims: (1) to analyze plasma concentrations of NT-pro-BNP in various subsets of HCM patients; (2) to reveal the correlations of NT-pro-BNP, myocardial ischemia, and diastolic dysfunction; (3) to assess predictors of the elevated plasma levels of NT-pro-BNP. METHODS AND RESULTS: In 61 patients (mean age 48...
March 20, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28335897/mitral-loop-cerclage-annuloplasty-for-secondary-mitral-regurgitation-first-human-results
#4
Yong-Hyun Park, Min-Ku Chon, Robert J Lederman, Si-Chan Sung, Hyung-Gon Je, Ki-Seok Choo, Sang-Hyun Lee, Eun-Seok Shin, Jeong-Su Kim, Ki-Won Hwang, Soo-Yong Lee, Kook-Jin Chun, Cheol-Min Kim, June-Hong Kim
OBJECTIVES: This is an early feasibility clinical test of mitral loop cerclage annuloplasty to treat secondary mitral valve regurgitation. BACKGROUND: Secondary mitral regurgitation is characterized by cardiomyopathy, mitral annular enlargement, and leaflet traction contributing to malcoaptation. Transcatheter mitral loop cerclage applies circumferential compression to the mitral annulus by creating a loop through the coronary sinus across the interventricular septum, protecting entrapped coronary arteries from compression, and interactive annular reduction under echocardiographic guidance...
March 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28332088/simple-technique-of-repair-for-barlow-syndrome-with-posterior-resection-and-chordal-transfer-via-minimally-invasive-approach-primary-experience-in-a-consecutive-series-of-22-patients
#5
H Kamiya, Payam Akhyari, J-P Minol, A C Ites, T Weinreich, S Sixt, P Rellecke, U Boeken, A Albert, A Lichtenberg
OBJECTIVE: Current techniques for mitral valve repair (MVR) in Barlow's disease require high level of surgical expertise due to a complex anatomy. A novel and simple standardized technique that particularly considers the pathological changes of the mitral valve in Barlow's disease has been developed. METHODS: Between 2009 and 2013, 22 patients underwent minimally invasive MVR for Barlow's disease and severe mitral regurgitation (MR). A simple, standardized technique was applied, including resection of P2 segment of posterior mitral leaflet (PML) with preservation of the shortest chordae, transfer of the preserved chordae to A2, and implantation of a semi-rigid open ring...
March 22, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28329369/long-term-results-up-to-14-years-of-the-clover-technique-for-the-treatment-of-complex-tricuspid-valve-regurgitation%C3%A2
#6
Michele De Bonis, Elisabetta Lapenna, Stefania Di Sanzo, Benedetto Del Forno, Federico Pappalardo, Alessandro Castiglioni, Luca Vicentini, Alberto Pozzoli, Ilaria Giambuzzi, Azeem Latib, Davide Schiavi, Giovanni La Canna, Ottavio Alfieri
OBJECTIVES: To report the long-term results of the clover technique for the treatment of complex forms of tricuspid regurgitation (TR). METHODS: Ninety-six consecutive patients (mean age 60 ± 16.4, left ventricular ejection fraction 58 ± 8.8%) with severe or moderately-severe TR due to important leaflets prolapse/flail (81 patients), tethering (13 patients) or mixed (2 patients) lesions underwent clover repair combined with annuloplasty. The aetiology of TR was degenerative in 74 cases (77...
February 23, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329271/short-and-long-term-results-after-prosthetic-mitral-valve-implantation-in-patients-with-severe-mitral-annulus-calcification%C3%A2
#7
Ronny Ben-Avi, Boris Orlov, Leonid Sternik, Alexander Kogan, Rafael Kuperstien, Amjad Shalabi, Eilon Ram, Alexander Lipey, Ehud Raanani
OBJECTIVES: To investigate short- and long-term outcomes of a conservative decalcification approach in mitral valve replacement (MVR) surgery in the presence of mitral annulus calcification (MAC). METHODS: Of the 1038 patients who underwent MVR, 133 (13%) had significant MAC with at least 30% of the annular circumference heavily calcified. In most patients, the surgical approach to MAC included conservative decalcification, supra-annular prosthesis implantation and insertion of a pericardial patch between the MV annulus and the prosthesis...
March 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329173/mitral-valve-repair-for-secondary-mitral-regurgitation-in-non-ischaemic-dilated-cardiomyopathy-is-associated-with-left-ventricular-reverse-remodelling-and-increase-of-forward-flow
#8
Vasileios Kamperidis, Suzanne E van Wijngaarden, Philippe J van Rosendael, William Kok Fai Kong, Madelien V Regeer, Frank van der Kley, Georgios Sianos, Nina Ajmone Marsan, Jeroen J Bax, Victoria Delgado
Aims: It remains unclear whether surgical or transcatheter mitral valve repair for secondary mitral regurgitation (MR) in patients with non-ischaemic cardiomyopathy reverse the underlying left ventricular (LV) pathophysiology. We hypothesized that mitral valve repair improves LV systolic function and forward flow and induces LV reverse remodelling in this group of patients. Methods and results: Seventy-six patients (65 ± 14 years old, 43% male) with non-ischaemic cardiomyopathy and moderate to severe chronic secondary MR treated successfully with transcatheter or surgical mitral valve repair were evaluated...
February 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28324874/strategies-and-outcomes-of-repeat-mitral-valve-interventions-after-failed-mitraclip-therapy
#9
Carmelo Grasso, Sergio Buccheri, Davide Capodanno, Antonio Popolo Rubbio, Maria Elena Di Salvo, Salvatore Scandura, Sarah Mangiafico, Tatiana Salerno, Stefano Cannata, Veronica Dezio, Giuseppe Castania, Marco Barbanti, Piera Capranzano, Corrado Tamburino
Percutaneous mitral valve repair (PMVR) with the MitraClip system (Abbott Vascular, Santa Clara, CA, USA) is a valid therapeutic option for patients with severe mitral regurgitation (MR) deemed to be at high or prohibitive surgical risk. Despite the reassuring data on efficacy and long-term durability of the procedure, the proportion of patients with residual or relapsing severe MR after MitraClip therapy is not negligible. In light of the detrimental prognostic impact of severe MR, repeat interventions are increasingly performed in clinical practice using different techniques...
March 22, 2017: Cardiology
https://www.readbyqxmd.com/read/28321004/avj-514-trial%C3%A3-baseline-characteristics-and-30-day-outcomes-following-mitraclip-%C3%A2-treatment-in-a-japanese-cohort
#10
Kentaro Hayashida, Satoshi Yasuda, Takashi Matsumoto, Makoto Amaki, Shingo Mizuno, Tetsuya Tobaru, Kentaro Jujo, Tatsushi Ootomo, Junichi Yamaguchi, Keiichi Fukuda, Shigeru Saito, Elyse Foster, Atif Qasim, Ryohei Yozu, Morimasa Takayama
BACKGROUND: The MitraClip(®)system is a transcatheter-based therapeutic option for patients with chronic mitral regurgitation (MR) who are at high risk for surgery. A prospective, multicenter, single-arm study was initiated to confirm the transferability of this system to Japan.Methods and Results:Patients with symptomatic chronic moderate-to-severe (3+) or severe (4+) functional or degenerative MR with a Society of Thoracic Surgery (STS) score ≥8%, or the presence of 1 predefined risk factor were enrolled...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28320990/comorbidities-and-complications-in-nonagenarians-undergoing-coronary-angiography-and-intervention
#11
Mohamed Gayed, Nour Yadak, Waad Qamhia, Yunis Daralammouri, Marc-Alexander Ohlow
Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28320316/clinical-outcomes-of-conventional-surgery-versus-mitraclip%C3%A2-therapy-for-moderate-to-severe-symptomatic-mitral-valve-regurgitation-in-the-elderly-population-an-institutional-experience
#12
Anthony Alozie, Liliya Paranskaya, Bernd Westphal, Alexander Kaminski, Mohammad Sherif, Magnus Sindt, Stephan Kische, Jochen Schubert, Doreen Diedrich, Hüseyin Ince, Gustav Steinhoff, Alper Öner
BACKGROUND: The aim of this study was to compare treatment of moderate to severe symptomatic mitral regurgitation (MR) with either conventional surgery or the mitral valve edge-to-edge device (MitraClip®) in very elderly patients. The newly introduced MitraClip device has demonstrated promising acute results in treating this patient cohort. Also noteworthy is the fact that patients who otherwise would have been denied surgery are increasingly referred for treatment with the MitraClip device...
March 20, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28303686/afterload-mismatch-after-transcatheter-mitral-valve-repair-with-mitraclip-for-degenerative-mitral-regurgitation-in-acute-cardiogenic-shock
#13
Gilbert H L Tang, Martin Cohen, Tanya Dutta, Cenap Undemir
Acute afterload mismatch after surgery for mitral regurgitation (MR) with transient left ventricular dysfunction is well known, but not described after transcatheter mitral valve repair with MitraClip, except in functional MR and cardiomyopathy. MitraClip to manage acute severe MR and cardiogenic shock has also been rarely reported. We report here a 77-year-old female who presented with acute severe degenerative MR from a flail posterior leaflet, with cardiogenic shock requiring intra-aortic balloon pump support...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28302288/valvular-heart-disease-patients-on-edoxaban-or-warfarin-in-the-engage%C3%A2-af-timi-48-trial
#14
Raffaele De Caterina, Giulia Renda, Anthony P Carnicelli, Francesco Nordio, Marco Trevisan, Michele F Mercuri, Christian T Ruff, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The use of non-vitamin K antagonist oral anticoagulants (NOACs) instead of vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) and coexisting valvular heart disease (VHD) is of substantial interest. OBJECTIVES: This study explored outcomes in patients with AF with and without VHD in the ENGAGE AF-TIMI 48 (Effective Anticoagulation with factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction 48) trial, comparing edoxaban with warfarin...
March 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28295158/first-trimester-ultrasound-tests-alone-or-in-combination-with-first-trimester-serum-tests-for-down-s-syndrome-screening
#15
REVIEW
S Kate Alldred, Yemisi Takwoingi, Boliang Guo, Mary Pennant, Jonathan J Deeks, James P Neilson, Zarko Alfirevic
BACKGROUND: Down's syndrome occurs when a person has three, rather than two copies of chromosome 21; or the specific area of chromosome 21 implicated in causing Down's syndrome. It is the commonest congenital cause of mental disability and also leads to numerous metabolic and structural problems. It can be life-threatening, or lead to considerable ill health, although some individuals have only mild problems and can lead relatively normal lives. Having a baby with Down's syndrome is likely to have a significant impact on family life...
March 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28293311/aortic-annulus-enlargement-early-and-long-terms-results
#16
Selman Dumani, Ermal Likaj, Laureta Dibra, Vera Beca, Saimir Kuci, Ali Refatllari
AIM: Patient-prosthesis mismatch (PPM) is a common occurrence in aortic valve surgery. Even the discussions about the impact of this phenomenon on the results of aortic valve surgery, the management of this problem remain one of the main topics in this kind of surgery. One of the ways of a solution is aortic annulus enlargement. The main topic of this study is to evaluate the early and longterm results of this technique in our country. METHODS: During the period January 2010 -January 2015, 641 patients performed aortic valve surgery...
March 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28292860/cardiac-computed-tomography-and-magnetic-resonance-imaging-in-the-evaluation-of-mitral-and-tricuspid-valve-disease-implications-for-transcatheter-interventions
#17
Christopher Naoum, Philipp Blanke, João L Cavalcante, Jonathon Leipsic
Transcatheter interventions to treat mitral and tricuspid valve disease are becoming increasingly available because of the growing number of elderly patients with significant comorbidities or high operative risk. Thorough clinical and imaging evaluation in these patients is essential. The latter involves both characterization of the mechanism and severity of valvular disease as well as determining the hemodynamic consequences and extent of ventricular remodeling, which is an important predictor of future outcomes...
March 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28290178/multiple-valvular-complications-of-hypereosinophilic-syndrome
#18
Zoltán Pozsonyi, Szabolcs Benedek, Pál Sármán, Lívia Jánoskuti, Tivadar Hüttl, Astrid Apor
Endomyocardial fibrosis (EMF) is the most common cardiac abnormality in hyeperosinophilic syndrome (HES), sometimes complicated with mitral valve disease. Mitral valve disease without ventricular manifestation is very rare, however. Case reports link HES to prosthetic valve thrombosis (PVT), but the optimal type of prosthetic valve in HES is not known. Herein is reported the case of a young female HES patient with secondary mitral valve degeneration and severe regurgitation. A mechanical prosthetic valve was implanted six months after she was diagnosed with HES, but despite anticoagulation and antiplatelet therapy she developed PVT three months later...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28290172/frequency-mechanism-and-severity-of-mitral-regurgitation-are-there-any-differences-between-primary-and-secondary-mitral-regurgitation
#19
José L Zamorano, Juan Manuel Monteagudo, Dolores Mesa, Teresa Gonzalez-Alujas, Marta Sitges, Fernando Carrasco-Chinchilla, Chi-Hion Li, Antonio Grande-Trillo, Amparo Martinez, Javier Matabuena, David Alonso-Rodriguez, Covadonga Fernandez-Golfin
BACKGROUND: Although mitral regurgitation (MR) is a well-recognized prognosis factor, its true prevalence is probably underestimated and its etiology and mechanisms have not been sufficiently explored. The study aim was to evaluate the burden of MR, focusing attention on its frequency, severity, etiology, mechanism, and other associated conditions. METHODS: Between February and June 2015, a total of 39,855 consecutive echocardiographic studies was performed at nine tertiary hospitals, and were prospectively included in the study...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28290169/a-systematic-review-and-meta-analysis-of-outcomes-following-mitral-valve-surgery-in-patients-with-significant-functional-mitral-regurgitation-and-left-ventricular-dysfunction
#20
Ali Andalib, Michael Chetrit, Masha Eberg, Kristian B Filion, Pascal Thériault-Lauzier, Ruediger Lange, Jean Buithieu, Giuseppe Martucci, Mark Eisenberg, Steven F Bolling, Nicolo Piazza
BACKGROUND: The surgical correction of functional mitral regurgitation (MR) remains challenging and controversial. The study aim was to systematically review the outcomes of surgical mitral valve repair (MVRpr) and mitral valve replacement (MVR) in patients with significant functional MR and left ventricular (LV) dysfunction. METHODS: A meta-analysis was performed of published data acquired from patients with moderate to severe functional MR and LV ejection fraction (LVEF) <40% who underwent surgical MVRpr or MVR...
November 2016: Journal of Heart Valve Disease
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