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Severe mitral regurgitation

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https://www.readbyqxmd.com/read/28209176/infective-endocarditis-causing-mitral-valve-stenosis-a-rare-but-deadly-complication-a-case-report
#1
Michael A Hart, Gautam R Shroff
BACKGROUND: Infective endocarditis rarely causes mitral valve stenosis. When present, it has the potential to cause severe hemodynamic decompensation and death. There are only 15 reported cases in the literature of mitral prosthetic valve bacterial endocarditis causing stenosis by obstruction. This case is even more unusual due to the mechanism by which functional mitral stenosis occurred. CASE PRESENTATION: We report a case of a 23-year-old white woman with a history of intravenous drug abuse who presented with acute heart failure...
February 17, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28208930/precautionary-measures-for-successful-open-heart-surgery-in-g6pd-deficient-patient-a-case-report
#2
Rupesh Kumar
Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is among the most common enzymatic disorders of red blood cells. Cardiac surgeries on this group of individuals are associated with an additional risk in terms of impaired oxygenation, prolonged ventilation and increased risk of haemolysis. These patients have a very low threshold for haemolysis due to oxidative stress. Many commonly used drugs also predispose the individual for haemolysis when they are subjected to surgery. Here we present a known case of G6PD deficient patient with symptoms of breathlessness for the last nine years who was taken for surgery with pre-planned precautionary measures to avoid unnecessary haemolysis...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203542/robotic-trans-atrial-and-trans-mitral-ventricular-septal-resection
#3
REVIEW
W Randolph Chitwood
Localized ventricular septal hypertrophy, also known as idiopathic hypertrophic subaortic stenosis or idiopathic hypertrophic subaortic septal obstruction (IHSS), can create severe ventricular outflow obstruction. This often results in a high sub-aortic pressure gradient with potentially lethal symptoms. In 1960, Braunwald described the hemodynamic characteristics of IHSS, and thereafter, Morrow developed a trans-aortic approach to resect a large part of the ventricular septum, enlarging the outflow tract. The Morrow operation has remained the gold standard for surgically treating this pathology...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28203419/diagnosis-of-mitral-valve-cleft-using-real-time-3-dimensional-echocardiography
#4
Xinchun Yuan, Aiyun Zhou, Li Chen, Cheng Zhang, Yan Zhang, Pan Xu
BACKGROUND: Mitral valve cleft (MVC) is the most common cause of congenital mitral insufficiency, and MVC may occur alone or in association with other congenital heart lesions. Direct suture and valvuloplasty are the major and effective treatments for mitral regurgitation (MR) caused by MVC. Therefore, it is important to determine the location and magnitude of the pathological damage due to MVC when selecting a surgical procedure for treatment. This study explored the application value of transthoracic real-time 3-dimensional (3D) echocardiography (RT-3DE) in the diagnosis of MVC...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28185701/immediate-increase-of-cardiac-output-after-percutaneous-mitral-valve-repair-pmvr-determined-by-echocardiographic-and-invasive-parameters-patzelt-increase-of-cardiac-output-after-pmvr
#5
Johannes Patzelt, Yingying Zhang, Harry Magunia, Rezo Jorbenadze, Michal Droppa, Miriam Ulrich, Shanglang Cai, Henning Lausberg, Tobias Walker, Tobias Wengenmayer, Peter Rosenberger, Juergen Schreieck, Peter Seizer, Meinrad Gawaz, Harald F Langer
BACKGROUND: Successful percutaneous mitral valve repair (PMVR) in patients with severe mitral regurgitation (MR) causes changes in hemodynamics. Echocardiographic calculation of cardiac output (CO) has not been evaluated in the setting of PMVR, so far. Here we evaluated hemodynamics before and after PMVR with the MitraClip system using pulmonary artery catheterization, transthoracic (TTE) and transesophageal (TEE) echocardiography. METHODS: 101 patients with severe MR not eligible for conventional surgery underwent PMVR...
January 26, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28180206/multiple-cardiac-complications-after-adjuvant-therapy-for-breast-cancer-the-importance-of-echocardiography-a-case-report-and-review-of-the-literature
#6
Adriana Luminita Gurghean, Ilinca Savulescu-Fiedler, Anca Mihailescu
Cardiovascular complications induced by adjuvant cancer therapies may become symptomatic after many years, being responsible for increased morbidity and mortality in long-term survivors. We report a case of a 54-year old female admitted for severe heart failure induced by myocardial and valvular damage after postoperative adjuvant therapy for left breast cancer 6 years ago. Her recent history revealed nonST elevation myocardial infarction in the absence of significant cardiovascular risk factors. Transthoracic echocardiography, tissue Doppler imaging and speckle-tracking imaging revealed severe biventricular systolic dysfunction, severe mitral and tricuspid regurgitation and severe pulmonary hypertension...
January 31, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/28174408/-double-valve-replacement-and-tricuspid-annuloplasty-in-a-patient-with-situs-inversus-totalis-and-mirror-image-dextrocardia-report-of-a-case
#7
Hiroshi Kumano, Keisuke Shuntoh, Akimitsu Yamaguchi, Kazuhito Tatsu
Situs inversus totalis and mirror-image dextrocardia is a rare congenital anomaly. A 79-year-old man with a history of atrial fibrillation presented to our hospital with chest oppression. Chest X-ray and computed tomography showed mirror-image dextrocardia and situs inversus totalis. Echocardiography revealed severe mitral and aortic regurgitation and mild tricuspid regurgitation. Mitral and aortic valve replacement using bioprosthesises, tricuspid annuloplasty and closure of the left atrial appendage were successfully performed...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28169216/prognostic-implication-of-post-mitraclip-vena-contracta-area-in-heart-failure-patients-with-functional-mitral-regurgitation
#8
Hannes Alessandrini, Felix Kreidel, Michael Schlüter, Christian Frerker, Tobias Schmidt, Thomas Thielsen, Ulrich Schäfer, Karl-Heinz Kuck
AIMS: Significant functional mitral regurgitation (FMR) in elderly heart-failure patients is increasingly being treated by MitraClip implantation. We sought to assess the prognostic implications of the intraprocedural assessment of vena contracta area (VCA) after MitraClip therapy in such patients. METHODS AND RESULTS: MitraClip therapy with intraprocedural assessment of VCA was performed in 97 heart-failure patients (74±10 years; 66 men; left ventricular ejection fraction [LVEF] 31±12%; 93 patients in New York Heart Association [NYHA] functional class III [n=59] or IV [n=34]; 86 patients with FMR severity 3+ [n=65] or 4+ [n=21])...
February 8, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28168077/a-case-of-neonatal-marfan-syndrome-a-management-conundrum-and-the-role-of-a-multidisciplinary-team
#9
Elliott J Carande, Samuel J Bilton, Satish Adwani
Neonatal Marfan syndrome (nMFS) is a rare condition with a poor prognosis. It is genotypically and phenotypically distinct from the typical Marfan syndrome and carries a poorer prognosis. This case report describes the progression of a 14-month-old girl diagnosed with nMFS at 5 months of age. Her diagnosis followed the identification of a fibrillin-1 mutation (FBN1 gene, exon 26, chromosome 15), which is a common locus of nMFS. This patient developed severe cardiac complications resulting in congestive cardiac failure in early life and required major cardiac surgery...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28167462/a2-p3-oblique-clipping-for-the-treatment-of-severe-mitral-regurgitation-in-the-presence-of-mitral-valve-cleft-and-flail
#10
Giuseppe Tarantini, Giulia Masiero, Umberto Cucchini, Luca Nai Fovino
No abstract text is available yet for this article.
February 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28163835/one-year-outcome-of-percutaneous-mitral-valve-repair-in-patients-with-severe-symptomatic-mitral-valve-regurgitation
#11
Michael Gotzmann, Isabell Sprenger, Aydan Ewers, Andreas Mügge, Leif Bösche
AIM: To investigate one-year outcomes after percutaneous mitral valve repair with MitraClip(®) in patients with severe mitral regurgitation (MR). METHODS Our study investigated consecutive patients with symptomatic severe MR who underwent MitraClip(®) implantation at the University Hospital Bergmannsheil from 2012 to 2014. The primary study end-point was all-cause mortality. Secondary end-points were degree of MR and functional status after percutaneous mitral valve repair. RESULTS: The study population consisted of 46 consecutive patients (mean logistic EuroSCORE 32% ± 21%)...
January 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28154601/cardiac-resynchronization-therapy-device-implantation-in-a-patient-with-cardiogenic-shock-under-percutaneous-mechanical-circulatory-support
#12
Kyunghee Lim, Jin-Oh Choi, Jeong Hoon Yang, Seung-Jung Park, Sun Hwa Kim, Jiseok Kang, Hyun Sung Joh, Sun Hye Shin
65-year-old woman was admitted to our hospital with acute decompensated heart failure with reduced left ventricular ejection fraction and severe mitral regurgitation. Electrocardiography revealed a typical left bundle branch block and atrial fibrillation. Her condition deteriorated despite administering high-doses of inotropes and vasopressors. Pending a decision to therapy, venoarterial extracorporeal membrane oxygenation (ECMO) was performed when the patient underwent a cardiogenic shock. Although the hemodynamic status stabilized with ECMO support, weaning the patient from ECMO was not possible...
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28145876/novel-use-of-mitraclip-for-severe-mitral-regurgitation-due-to-infective-endocarditis
#13
Pranav Chandrashekar, Erin A Fender, Mohammed A Al-Hijji, Krishnaswamy Chandrasekaran, Charanjit S Rihal, Mackram F Eleid, Nandan S Anavekar
A 75-year-old man presented with infective endocarditis. Transesophageal echocardiogram (TEE) revealed mild-moderate mitral regurgitation (MR). After 4 weeks of antibiotics, he presented with New York Heart Association class III dyspnea. Repeat TEE demonstrated severe MR. After consultation with Infectious Diseases, it was determined the infection risk was low and transcatheter mitral valve repair (TMVR) was offered. Deployment of two MitraClip devices (Abbott Vascular) resulted in symptom relief. This case demonstrates a potential role of TMVR in treating acute severe MR due to endocarditis...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28145607/left-atrial-strain-at-different-stages-of-myxomatous-mitral-valve-disease-in-dogs
#14
K Nakamura, S Kawamoto, T Osuga, T Morita, N Sasaki, K Morishita, H Ohta, M Takiguchi
BACKGROUND: Decreased function of the left atrium (LA) is a useful prognostic indicator in dogs with myxomatous mitral valve disease (MMVD). In humans, LA strain is a novel severity indicator of mitral regurgitation, but its clinical utility in dogs has not been confirmed. OBJECTIVES: To examine whether LA strain as evaluated with speckle-tracking echocardiography is associated with MMVD stage in dogs. ANIMALS: Fifty-two client-owned dogs with MMVD...
February 1, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28131996/cohort-profile-prevalence-of-valvular-heart-disease-in-community-patients-with-suspected-heart-failure-in-uk
#15
Anna Marciniak, Keli Glover, Rajan Sharma
PURPOSE: The aim of this study was to evaluate the proportion of suspected heart failure patients with significant valvular heart disease. Early diagnosis of valve disease is essential as delay can limit treatment and negatively affect prognosis for undiagnosed patients. The prevalence of unsuspected valve disease in the community is uncertain. PARTICIPANTS: We prospectively evaluated 79 043 patients, between 2001 and 2011, who were referred to a community open access echocardiography service for suspected heart failure...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28130793/twist-deformation-for-predicting-postoperative-left-ventricular-function-in-patients-with-mitral-regurgitation-a-speckle-tracking-echocardiography-study
#16
Ozkan Candan, Suzan Hatipoglu Akpinar, Cem Dogan, Aykut Demirkıran, Barış Dindar, Zubeyde Bayram, Fatih Yılmaz, Cihangir Kaymaz, Nihal Ozdemir
PURPOSE: Postoperative LV dysfunction is associated with poor prognosis and increased mortality in patient with mitral regurgitation undergoing surgery. With this study, we aimed to investigate the predictive value of classic and speckle tracking echocardiographic (STE) LV deformational parameters for estimating postoperative LV dysfunction. METHODS: Fifty-nine asymptomatic patients with severe mitral regurgitation (MR) due to mitral valve prolapse, who had sinus rhythm and LV ejection fraction (EF) ≥50%, were included...
January 28, 2017: Echocardiography
https://www.readbyqxmd.com/read/28127033/advanced-imaging-in-valvular-heart-disease
#17
REVIEW
Jeroen J Bax, Victoria Delgado
Although echocardiography remains the mainstay imaging technique for the evaluation of patients with valvular heart disease (VHD), innovations in noninvasive imaging in the past few years have provided new insights into the pathophysiology and quantification of VHD, early detection of left ventricular (LV) dysfunction, and advanced prognostic assessment. The severity grading of valve dysfunction has been refined with the use of Doppler echocardiography, cardiac magnetic resonance (CMR), and CT imaging. LV ejection fraction remains an important criterion when deciding whether patients should be referred for surgery...
January 27, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28126445/a-complex-transcatheter-mitral-valve-replacement-and-repair-for-the-treatmemt-of-refractory-severe-mitral-regurgitation
#18
Jose F Condado, Vasilis C Babaliaros, Vinod H Thourani, Hanna K Jensen, Dennis W Kim, Brian W Kaebnick, Peter C Block, Stamatios Lerakis
Hybrid transcatheter Mitral Valve-in-Ring and Mitral Valve-in-Valve procedures can be an alternative to traditional surgical valve replacement in patients with high surgical risk. We present a case of a 65-year-old male with recurrent severe mitral regurgitation (MR) that failed two traditional surgical attempts due to severe chest fibrosis. We performed a mitral valve-in ring replacement with a Sapien valve followed by a mitral valve-in-valve replacement with a Melody valve. Patient had a residual paravalvular leak that was closed with a vascular plug...
January 23, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28118792/noteworthy-articles-in-2016-for-the-cardiothoracic-anesthesiologist
#19
Dirk J Varelmann, J Daniel Muehlschlegel
Clinical research and outcome studies dominated the publication spectrum for the cardiothoracic anesthesiologist in 2016. Echocardiography is an important tool in the armamentarium of the cardiothoracic anesthesiologist. Technology is advancing at a fast pace: A new method to quantify the regurgitant volume in mitral regurgitation has been described in an experimental model and been validated in humans. Interesting studies on key elements of our daily practice have been published: Does tranexamic acid decrease the transfusion requirements after cardiac surgery? Are patients with a postoperative cognitive deficit at risk for dementia 7...
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28117283/prognostic-impact-of-invasive-hemodynamic-measurements-in-combination-with-clinical-and-echocardiographic-characteristics-on-2-year-clinical-outcomes-of-patients-undergoing-transcatheter-aortic-valve-implantation
#20
Anna Franzone, Crochan J O'Sullivan, Stefan Stortecky, Dik Heg, Jonas Lanz, René Vollenbroich, Fabien Praz, Raffaele Piccolo, Masahiko Asami, Eva Roost, Lorenz Räber, Marco Valgimigli, Stephan Windecker, Thomas Pilgrim
AIMS: To evaluate the prognostic utility of right heart catheterization (RHC)-derived measures among patients undergoing transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: Data of 469 patients included in the Bern TAVI Registry between August 2007 and December 2012 and undergoing pre-operative RHC were analyzed. The relationship between hemodynamic parameters and survival was evaluated with Cox proportional hazard models. At 2-year follow-up, 118 patients had died (25...
January 25, 2017: EuroIntervention
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