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Severe mitral regurgitation

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https://www.readbyqxmd.com/read/28645469/transcatheter-mitral-valve-repair-with-mitraclip-for-symptomatic-functional-mitral-valve-regurgitation
#1
REVIEW
Rodrigo Mendirichaga, Vikas Singh, Vanessa Blumer, Manuel Rivera, Alex P Rodriguez, Mauricio G Cohen, William W O'Neill, Sammy Elmariah
Transcatheter edge-to-edge mitral valve repair (TMVr) with MitraClip has proved to be safe and effective for high-risk surgical patients with severe symptomatic degenerative mitral regurgitation. There is paucity of data regarding its use in functional mitral regurgitation (FMR). The objective of this study was to evaluate the use of MitraClip in patients with symptomatic moderate or severe FMR and a high surgical risk. Medical libraries were systematically searched for studies assessing the use of MitraClip for patients with symptomatic moderate or severe FMR and a high surgical risk...
May 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28642994/cardiovascular-magnetic-resonance-imaging-to-assess-myocardial-fibrosis-in-valvular-heart-disease
#2
Tomaz Podlesnikar, Victoria Delgado, Jeroen J Bax
The left ventricular (LV) remodeling process associated with significant valvular heart disease (VHD) is characterized by an increase of myocardial interstitial space with deposition of collagen and loss of myofibers. These changes occur before LV systolic function deteriorates or the patient develops symptoms. Cardiovascular magnetic resonance (CMR) permits assessment of reactive fibrosis, with the use of T1 mapping techniques, and replacement fibrosis, with the use of late gadolinium contrast enhancement...
June 22, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28637305/left-atrial-structure-and-function-in-cardiac-amyloidosis
#3
Kotaro Nochioka, Candida Cristina Quarta, Brian Claggett, Gabriela Querejeta Roca, Claudio Rapezzi, Rodney H Falk, Scott D Solomon
Aims: Although cardiac amyloidosis (CA) is characterized by significant left atrial (LA) dilatation, the characteristics of LA function remain to be fully investigated. Methods and results: We assessed LA function by speckle-tracking echocardiography in 124 patients with CA and sinus rhythm: 68 with light chain (AL), 29 with mutant (ATTRm), 27 with wild-type (ATTRwt) transthyretin amyloidosis. Conventional and strain-derived parameters, including LA peak longitudinal strain (LS) and strain rate (peak LSR: reservoir function; early LSR: conduit function; late LSR: active function), were assessed compared between CA patients and 20 healthy controls of similar age and gender...
June 16, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28636718/trends-and-outcomes-of-off-label-use-of-transcatheter-aortic-valve-replacement-insights-from-the-ncdr-sts-acc-tvt-registry
#4
Ravi S Hira, Sreekanth Vemulapalli, Zhuokai Li, James M McCabe, John S Rumsfeld, Samir R Kapadia, Mahboob Alam, Hani Jneid, Creighton Don, Mark Reisman, Salim S Virani, Neal S Kleiman
Importance: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for severe aortic stenosis in patients who cannot undergo surgery and for patients at high operative risk. Use of TAVR for off-label indications has not been previously reported. Objective: To evaluate patterns and adverse outcomes of off-label use of TAVR in US clinical practice. Design, Setting and Participants: Patients receiving commercially funded TAVR in the United States are included in the Transcatheter Valve Therapy Registry...
June 21, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28636512/isolated-mitral-valve-p3-prolapse-with-severe-regurgitation-transoesophageal-2d-3d-echo-guidance-in-transapical-artificial-neochordae-implantation-in-challenging-patient
#5
Katarzyna Kurnicka, Krzysztof Wrobel, Diana Zakarkaite, Andrzej Biederman, Piotr Pruszczyk
No abstract text is available yet for this article.
March 21, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28624411/incremental-prognostic-utility-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-patients-with-significant-chronic-aortic-regurgitation-and-preserved-left-ventricular-ejection-fraction
#6
Alaa Alashi, Amgad Mentias, Amjad Abdallah, Ke Feng, A Marc Gillinov, L Leonardo Rodriguez, Douglas R Johnston, Lars G Svensson, Zoran B Popovic, Brian P Griffin, Milind Y Desai
OBJECTIVES: We sought to examine the prognostic utility of left ventricular (LV) global longitudinal strain (GLS) in asymptomatic patients with ≥III+ aortic regurgitation (AR), an indexed LV end-systolic dimension of <2.5 cm/m(2), and preserved left ventricular ejection fraction (LVEF). BACKGROUND: Management of asymptomatic patients with severe chronic AR and preserved LVEF is challenging and is typically based on LV dimensions. METHODS: We studied 1,063 such patients (53 ± 16 years; 77% men) seen between 2003 and 2010 (excluding those with symptoms, obstructive coronary artery disease, acute AR/dissection, aortic/mitral stenosis, more than moderate mitral regurgitation, and previous cardiac surgery)...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28619195/association-of-triglyceride-related-genetic-variants-with-mitral%C3%A2-annular%C3%A2-calcification
#7
Mehdi Afshar, Kevin Luk, Ron Do, Line Dufresne, David S Owens, Tamara B Harris, Gina M Peloso, Kathleen F Kerr, Quenna Wong, Albert V Smith, Mathew J Budoff, Jerome I Rotter, L Adrienne Cupples, Stephen S Rich, James C Engert, Vilmundur Gudnason, Christopher J O'Donnell, Wendy S Post, George Thanassoulis
BACKGROUND: Mitral annular calcium (MAC), commonly identified by cardiac imaging, is associated with cardiovascular events and predisposes to the development of clinically important mitral valve regurgitation and mitral valve stenosis. However, its biological determinants remain largely unknown. OBJECTIVES: The authors sought to evaluate whether a genetic predisposition to elevations in plasma lipids is associated with the presence of MAC. METHODS: The authors used 3 separate Mendelian randomization techniques to evaluate the associations of lipid genetic risk scores (GRS) with MAC in 3 large patient cohorts: the Framingham Health Study, MESA (Multiethnic European Study of Atherosclerosis), and the AGE-RS (Age, Gene/Environment Susceptibility-Reykjavik Study)...
June 20, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28614263/misdiagnosed-anomalous-left-coronary-artery-from-the-pulmonary-artery-as-endocardial-fibroelastosis-in-infancy-a-case-series
#8
Fan Ma, Kaiyu Zhou, Xiaoqing Shi, Xiaoqing Wang, Yi Zhang, Yifei Li, Yimin Hua, Chuan Wang
INTRODUCTION: Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare but severe congenital cardiac malformation. The prognosis mainly depends on the early and accurate diagnosis and treatment. However, without a typical and specific clinical manifestation in early stage, ALCAPA has a higher rate of false initial diagnosis. DIAGNOSTIC AND THERAPEUTIC PROCEDURE: Three infants with impaired left ventricle (LV) function, LV enlargement, mitral valve regurgitation (MR), and LV endocardium thickness were initially diagnosed as endocardial fibroelastosis (EFE)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28612452/unusual-interatrial-membrane-in-the-left-atrium-a-newer-obstacle-for-transseptal-based-percutaneous-mitral-valve-repair-techniques
#9
Antonio Popolo Rubbio, Sarah Mangiafico, Salvatore Scandura, Sergio Buccheri, Marco Barbanti, Giuseppe Ronsivalle, Maria Elena Di Salvo, Marta Chiarandà, Tatiana Salerno, Anna Caggegi, Sandra Giaquinta, Davide Capodanno, Carmelo Grasso, Corrado Tamburino
We present a case of a patient with severe mitral regurgitation referred to our Institution for an echocardiographic examination as part of the routine workup to assess the eligibility for mitral valve percutaneous repair with either the MitraClip or Cardioband systems. Echocardiography showed the presence of an unusual interatrial membrane in the left atrium that represented a contraindication for the puncture of the interatrial septum. The patient was finally deferred to percutaneous mitral valve replacement using transapical access...
June 13, 2017: Echocardiography
https://www.readbyqxmd.com/read/28611348/early-detection-of-subclinical-aortic-valve-endocarditis-with-the-cardiomems-heart-failure-system
#10
Sinan Sarsam, Georgy Kaspar, Shukri David, Marcel Zughaib
BACKGROUND The CardioMEMS Heart Failure System is a well validated tool to optimize management of systolic and diastolic heart failure and has been shown to reduce the risk of hospitalization by 37%. We are reporting a unique case of acute aortic valve insufficiency as a first sign of endocarditis, detected early in a patient with the CardioMEMS device. CASE REPORT A 79-year-old man with dual bioprosthetic mitral and aortic valve replacement and non-ischemic cardiomyopathy had a CardioMEMS Heart Failure System implanted 2 months following valve replacement surgery...
June 14, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28606278/-efficacy-of-mitral-valve-repair-versus-replacement-in-severe-ischemic-mitral-regurgitation
#11
Z B Qiu, X Chen, M Xu, Y S Jiang, L M Wang, F H Huang, P S Liu, R Wang, F Xiang, J J Shao, W Qin
Objective: To compare the mortality, survival rate and the therapeutic efficacy between mitral valve repair and replacement as treatment for severe ischemic mitral regurgitation (IMR), and explore the middle- and long-term outcomes. Methods: Between January 2000 and January 2016, 378 patients with severe IMR underwent coronary artery bypass grafting (CABG) combined with mitral valve repair (n=162) or mitral valve replacement (n=216) in the Department of Cardiovascular Surgery of Nanjing First Hospital. Clinical data, in-hospital morbidity and mortality of patients were retrospectively reviewed...
June 13, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28604463/complete-neurologic-recovery-from-extreme-hypoglycemia-secondary-to-cardiogenic-liver-failure-a-case-report
#12
Yafen Liang, Jeremy M Bennett, Douglas B Coursin, Mark J Rice
Cardiogenic shock from acute severe mitral valve regurgitation can cause acute liver failure due to hypoperfusion. Impaired liver glycogenesis can then lead to profound hypoglycemia. The time frame for restoring normoglycemia without neurologic sequelae is not clearly established in humans. Thus, the clinical decision to provide further resuscitation in the setting of extreme hypoglycemia mainly depends on the patient's overall clinical condition, provider opinion, and/or institutional practice. Here, we report a case where the patient made complete neurologic recovery from extreme hypoglycemia (<5 mg/dL by central laboratory testing) secondary to acute cardiogenic shock and liver failure...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28600094/cardiac-resynchronization-therapy-for-heart-failure
#13
REVIEW
Amole Ojo, Sohaib Tariq, Prakash Harikrishnan, Sei Iwai, Jason T Jacobson
Cardiac resynchronization therapy (CRT) has emerged as a valued nonpharmacologic therapy in patients with heart failure, reduced ejection fraction (EF), and ventricular dyssynchrony manifest as left bundle branch block. The mechanisms of benefit include remodeling of the left ventricle leading to decreased dimensions and increased EF, as well as a decrease in the severity of mitral regurgitation. This article reviews the rationale, effects, and indications for CRT, and discusses the patient characteristics that predict response and considerations for nonresponders...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600091/transcatheter-aortic-valve-replacement-and-mitraclip-to-reverse-heart-failure
#14
REVIEW
Sukhdeep Basra, Molly Szerlip
Valvular heart diseases such as aortic stenosis and mitral regurgitation are often associated with heart failure, which in turn increases patients' Surgical Thoracic Society (STS) score. A high STS score means the patient is high risk for surgical aortic valve replacement and mitral valve repair/replacement. Transcatheter aortic valve replacement and percutaneous mitral valve repair offer a minimally invasive alternative for the treatment of valvular heart disease in patients with severe heart failure. We aim to review the current evidence on the safety, efficacy, and outcomes of these devices in patients with severe heart failure...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28597998/a-novel-mechanical-mitral-valve-replacement-using-sapien-xt
#15
Megan Koehle, Justin A Strote, Mark Guadagnoli, J Bradley Oldemeyer
PATIENT PRESENTATION: We report the case of a 66 year old female who presented to our institution fourteen years after receiving a St. Jude Mechanical Mitral Valve Replacement. She presented in refractory NYHA class IV congestive heart failure with comorbidities of acute renal failure, liver failure, and mental status changes. She was found to have immobility of one of the mitral valve disks with resultant severe mitral stenosis with a mean pressure gradient of 12 mmHg. EVALUATION AND MANAGEMENT: The patient was found to have an STS predicted mortality of 39% with redo surgical MVR, and evaluation by the valve team led to a recommendation of a hybrid surgical and transcatheter procedure...
June 9, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28595229/-relapse-of-mitral-regurgitation-due-to-tethering-after-valve-plasty-with-edge-to-edge-repair-report-of-a-case
#16
Keita Sasaki, Takafumi Inoue, Akihiro Yoshimoto, Masayuki Fujisaki, Sei Morizumi, Yoshihiro Suematsu
A 75-year-old woman with severe mitral regurgitation (MR) successfully underwent mitral valve plasty with edge-to-edge plasty and commissural annuloplasty. Three days after the operation, she was found to have moderate MR caused by tethering of the valve. Functional MR occurring as a complication of mitral edge-to-edge plasty could be treated conservatively.
June 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28595227/-aortic-valve-replacement-and-mitral-valve-plasty-in-a-patient-with-left-ventricular-noncompaction-associated-with-aortic-regurgitation-and-mitral-regurgitation-report-of-a-case
#17
Bun Nakamura, Toshiya Tokui, Yasumi Maze, Koji Hirano, Taro Fujii, Masahiro Inagaki, Ryosai Inoue
Left ventricular noncompaction (LVNC) is believed to represent an arrest in the normal process of myocardial compaction, resulting in persistence of both hyper-trabeculation and intra-trabecular recess within the left ventricle. The clinical features of this disease are left ventricular dilatation and systolic dysfunction, which carry a high mortality. Most patients die in infancy, but some cases of LVNC in adults have been reported. To the best of our knowledge, only 4 cases of LVNC with valvular heart disease in adults have recently been operated...
June 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28589570/transapical-transcatheter-valve-in-ring-implantation-following-mitral-annuloplasty
#18
Steffen Pfeiffer, Laszlo Gazdag, Jürgen Jessl, Giuseppe Santarpino
Despite advances in surgical techniques for mitral valve repair, more than 20% of patients require reoperation within 10 years due to recurrence of severe mitral regurgitation. However, reoperations on the mitral valve are often associated with increased morbidity and mortality. We report a transapical mitral valve-in-ring implantation in a patient who had undergone mitral valve repair for ischemic mitral regurgitation using a complete semi-rigid Memo 3D mitral ring (LivaNova Group, Milan, Italy).
June 6, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28589566/prevalence-of-optimal-valve-morphology-for-mitraclip-in-patients-with-mitral-regurgitation
#19
Juan Manuel Monteagudo Ruiz, Covadonga Fernández-Golfín, Dolores Mesa, Teresa González-Alujas, Marta Sitges, Fernando Carrasco-Chinchilla, Chi-Hion Li, Antonio Grande-Trillo, Amparo Martínez, Javier Matabuena, David Alonso-Rodríguez, Iolanda Aquila, José Luis Zamorano
AIMS: To evaluate how often patients with moderate-to-severe or severe mitral regurgitation (MR) meet the anatomical criteria for MitraClip implant and to examine the role of transthoracic echocardiography (TTE) for this task. METHODS AND RESULTS: From February to June 2015, all patients undergoing a TTE in nine Spanish hospitals were prospectively included. Patients with moderate-to-severe and severe mitral regurgitation were selected for analysis. Anatomical eligibility criteria for MitraClip were defined according to the EVEREST trial...
June 7, 2017: Echocardiography
https://www.readbyqxmd.com/read/28589141/postoperative-echocardiographic-reduction-of-right-ventricular-function-is-pericardial-opening-modality-the-main-culprit
#20
Marco Zanobini, Matteo Saccocci, Gloria Tamborini, Fabrizio Veglia, Alessandro Di Minno, Paolo Poggio, Mauro Pepi, Francesco Alamanni, Claudia Loardi
Echocardiographic reduction of RV function, measured using TAPSE, is a well described phenomenon after cardiac surgery. The aim of the present study was to investigate the relation between the modality of pericardial opening (lateral versus anterior) and the postoperative right ventricular systolic function by comparing echocardiographic parameters in patients undergoing minimally invasive or traditional mitral valve repair. 34 patients with severe mitral regurgitation due to mitral valve prolapse underwent traditional (sternotomy) operation (Group A) or minimally invasive surgery with right anterolateral thoracotomy (Group B)...
2017: BioMed Research International
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