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Eccentric severe mitral regurgitation

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https://www.readbyqxmd.com/read/27279924/myxomatous-mitral-valve-with-prolapse-and-flail-scallop
#1
Jerry Fan, Alexa Timbrook, Sarmad Said, Kamran Babar, Mohamed Teleb, Debabrata Mukherjee, Aamer Abbas
BACKGROUND: Myxomatous mitral valve with prolapse are classically seen with abnormal leaflet apposition during contraction of the heart. Hemodynamic disorders can result from eccentric mitral regurgitation usually caused by chordae tendinae rupture or papillary muscle dysfunction. Echocardiography is the gold standard for evaluation of leaflet flail and prolapse due to high sensitivity and specificity. Though most mitral valve prolapse are asymptomatic those that cause severe regurgitation need emergent surgical intervention to prevent disease progression...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27115534/robotic-septal-myectomy-and-mitral-valve-repair-for-idiopathic-hypertrophic-subaortic-stenosis-with-systolic-anterior-motion
#2
Selin Bayburt, Sahin Senay, Ahmet Umit Gullu, Muharrem Kocyigit, Gultekin Karakus, Mustafa Kemal Batur, Cem Alhan
Combined therapeutic approach with performing mitral valve repair may be necessitated for the treatment of idiopathic hypertrophic subaortic stenosis (IHSS) with systolic anterior motion. This report includes operative technique for combined robotic septal myectomy and mitral valve repair. A 45-year-old man with IHSS was admitted to our center for surgical intervention. The transthoracic echocardiography showed typical asymmetric ventricular hypertrophy. Left ventricle posterior wall thickness was 11 mm, and interventricular septum thickness was 21 mm...
March 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27069567/isolated-parachute-mitral-valve-in-a-29-years-old-female-a-case-report
#3
Mehrnoush Toufan, Seyed Sajjad Mahmoudi
A 29-year old female patient was referred to our hospital for evaluation of dyspnea NYHA class I which begun from several months ago. The only abnormal sign found on physical examination was a grade 2/6 systolic murmur at the apex position without radiation. Echocardiography revealed normal left and right ventricular sizes and systolic function, and only one papillary muscle in left ventricular (LV) cavity which all chordae tendineae inserted into that muscle. The mitral valve orifice was eccentrically located at the lateral side with mild to moderate mitral regurgitation but without significant mitral stenosis...
2016: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/26309843/quantitation-of-mitral-regurgitation-after-percutaneous-mitraclip-repair-comparison-of-doppler-echocardiography-and-cardiac-magnetic-resonance-imaging
#4
Christian Hamilton-Craig, Wendy Strugnell, Niranjan Gaikwad, Matthew Ischenko, Vicki Speranza, Jonathan Chan, Johanne Neill, David Platts, Gregory M Scalia, Darryl J Burstow, Darren L Walters
OBJECTIVE: Percutaneous valve intervention for severe mitral regurgitation (MR) using the MitraClip is a novel technology. Quantitative assessment of residual MR by transthoracic echocardiography (TTE) is challenging, with multiple eccentric jets and artifact from the clips. Cardiovascular magnetic resonance (CMR) is the reference standard for left and right ventricular volumetric assessment. CMR phase-contrast flow imaging has superior reproducibility for quantitation of MR compared to echocardiography...
July 2015: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/26306297/blockade-of-the-acute-activation-of-mtor-complex-1-decreases-hypertrophy-development-in-rats-with-severe-aortic-valve-regurgitation
#5
Marie-Claude Drolet, Vincent Desbiens-Brassard, Elise Roussel, Veronique Tu, Jacques Couet, Marie Arsenault
BACKGROUND: Hypertrophy (H) is an adaptive response of the heart to a hemodynamic overload. Severe left ventricular (LV) volume overload (VO) from valve regurgitations (aortic (AR) or mitral regurgitation) leads to eccentric LVH. Increased protein turnover is a major event during development of LVH and the mechanistic target of rapamycin (mTOR) is a key molecule for its control. The role of mTOR inhibition in the development of LVH using rapamycin for relatively short periods of time (days to a few weeks) has been studied in the past in pressure overload models but not in VO models...
2015: SpringerPlus
https://www.readbyqxmd.com/read/26184641/resonant-cardiac-chamber-with-diastolic-thrill
#6
Hirofumi Kurokawa, Ikuo Misumi, Tsuyoshi Honda, Hiroki Usuku, Hisayo Yasuda, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa, Daisuke Nakatsuka, Minoru Tabata
A 70-year-old man with a diastolic Levine V/VI musical murmur came to our department. Doppler color-flow imaging showed eccentric severe aortic regurgitation. M-mode echocardiography demonstrated fluttering of the anterior mitral leaflet and fine tremors at the aortic root. The curved M-mode representation of the myocardial strain rate showed that the basal septum was encoded in a mixture of blue and red spots during diastole, showing massive basal septal vibration. In the present case, the force of the regurgitant flow might have caused vibration of the basal septum, thereby possibly leading to distinct thrill...
June 2015: Journal of Echocardiography
https://www.readbyqxmd.com/read/26164059/automatic-quantification-of-aortic-regurgitation-using-3d-full-volume-color-doppler-echocardiography-a-validation-study-with-cardiac-magnetic-resonance-imaging
#7
COMPARATIVE STUDY
Jaehuk Choi, Geu-Ru Hong, Minji Kim, In Jeong Cho, Chi Young Shim, Hyuk-Jae Chang, Joel Mancina, Jong-Won Ha, Namsik Chung
Recent advances in real-time three-dimensional (3D) echocardiography provide the automated measurement of mitral inflow and aortic stroke volume without the need to assume the geometry of the heart. The aim of this study is to explore the ability of 3D full volume color Doppler echocardiography (FVCDE) to quantify aortic regurgitation (AR). Thirty-two patients with more than a moderate degree of AR were enrolled. AR volume was measured by (1) two-dimensional-CDE, using the proximal isovelocity surface area (PISA) and (2) real-time 3D-FVCDE with (3) phase-contrast cardiac magnetic resonance imaging (PC-CMR) as the reference method...
October 2015: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/26003146/echocardiographic-evaluation-of-prosthetic-heart-valves
#8
REVIEW
Haïfa Mahjoub, Philippe Pibarot, Jean-Gaston Dumesnil
The specific flow pattern and imaging features of prosthetic heart valves poses major challenges for the Doppler echocardiographic assessment of prosthetic valve structure and function. A comprehensive approach that integrates several semi-quantitative and quantitative parameters obtained from multiple views is key to appropriately detect and quantitate prosthetic valve dysfunction and complications. In patients with prosthetic valves, and particularly in those with mitral prostheses, transesophageal echocardiography is often required to confirm and/or complement information obtained by transthoracic echocardiography...
June 2015: Current Cardiology Reports
https://www.readbyqxmd.com/read/25972285/left-ventricular-remodeling-and-function-in-children-with-biventricular-circulation-after-fetal-aortic-valvuloplasty
#9
Kevin G Friedman, Lindsay Freud, Maria Escobar-Diaz, Puja Banka, Sitaram Emani, Wayne Tworetzky
Fetal aortic valvuloplasty (FAV) has shown promise in averting the progression of fetal aortic stenosis to hypoplastic left-heart syndrome. Altered loading conditions due to valvar disease, intrinsic endomyocardial abnormalities, and procedures that alter endomyocardial mechanics may place patients with biventricular circulation (BiV) after FAV at risk of abnormal LV remodeling and function. Using the most recent echo data on BiV patients after technically successful FAV (n = 34), we evaluated LV remodeling pattern, risk factors for pathologic LV remodeling, and the association between LV remodeling pattern and LV function...
October 2015: Pediatric Cardiology
https://www.readbyqxmd.com/read/25662003/repeat-mitral-valve-repair-for-haemolysis-in-children
#10
Olivia Weill, Marianne Peyre, Mathieu Vergnat, Alexandre Cazavet, Bertrand Stos, Emre Belli, Sébastien Hascoet, Philippe Acar
BACKGROUND: Severe haemolysis is a rare complication after mitral valve repair in congenital heart disease. AIM: We describe four children with severe mitral regurgitation who underwent valve repair and subsequently developed profound haemolytic anaemia. METHODS: Clinical, echocardiographic and surgical data were collected retrospectively from a surgical centre in France during a 5-year period. RESULTS: Two patients had atrioventricular septal defects, one patient had congenital mitral dysplasia and one had anomalous left coronary artery from the pulmonary artery with mitral regurgitation...
February 2015: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/25478486/partially-unroofed-coronary-sinus-with-intact-atrial-septum-in-an-elderly-patient
#11
Maryam Esmaeilzadeh, Mohammadtaghi Salehi-Omran, Saeid Hosseini, Mohammadali Sadr-Ameli
We present a very rare case of partially unroofed coronary sinus without persistent left superior vena cava in a 74 years old female with a history of hypertension, severe myxomatous bileaflet mitral valve prolapse with severe eccentric mitral regurgitation which was diagnosed during cardiac surgery.
November 2012: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/25136886/severe-infective-endocarditis-after-mitraclip-implantation-treated-by-cardiac-surgery
#12
Christian Frerker, Karl-Heinz Kuck, Tobias Schmidt, Felix Kreidel, Ralf Bader, Michael Schmoeckel, Stephan Geidel
AIMS: To report the first described case of a mitral valve infective endocarditis (IE) post MitraClip®. METHODS AND RESULTS: An 88-year-old patient at high surgical risk (log. EuroSCORE 30.4%) underwent a MitraClip procedure for severe eccentric organic mitral regurgitation (MR) due to prolapse with a flail leaflet of the P2 segment (flail gap 6 mm). After one month, the patient was readmitted to our department for fever and recurrence of shortness of breath. An echocardiogram demonstrated severe MR recurrence due to ulceration in the region of the posterior leaflet despite good insertion of both clips, and a large vegetation of 1513 mm within the clip region...
July 2015: EuroIntervention
https://www.readbyqxmd.com/read/24749164/ruptured-anterior-mitral-leaflet-aneurysm-in-aortic-valve-infective-endocarditis-evaluation-by-three-dimensional-echocardiography
#13
Rajiv Bharat Kharwar, Abhisekh Mohanty, Akhil Sharma, Varun Shankar Narain, Rishi Sethi
Ruptured aneurysm of the anterior mitral leaflet is a rare but a devastating complication secondary to aortic valve infective endocarditis. We report a case of 30-year-old male with native aortic valve endocarditis who was referred to us for evaluation of worsening of heart failure after an initial period of responsiveness to antibiotics. Detailed evaluation with two-dimensional and three-dimensional transthoracic echocardiography revealed ruptured anterior mitral leaflet aneurysm with severe eccentric mitral regurgitation along with a large vegetation on the aortic valve...
March 2014: Echocardiography
https://www.readbyqxmd.com/read/24700692/differential-effect-of-3-dimensional-color-doppler-echocardiography-for-the-quantification-of-mitral-regurgitation-according-to-the-severity-and-characteristics
#14
Jaehuk Choi, Ran Heo, Geu-Ru Hong, Hyuk-Jae Chang, Ji Min Sung, Sang Hoon Shin, In Jeong Cho, Chi-Young Shim, Namsik Chung
BACKGROUND: The aim of this study is to explore the differential effect of 3-dimensional color Doppler echocardiography for the quantification of mitral regurgitation (MR). Two-dimensional color Doppler echocardiography-based MR quantification has well-documented limitations. METHODS AND RESULTS: We consecutively enrolled 221 patients with MR. Adequate image quality was obtained by 2D- and 3D-color Doppler echocardiography in 211 (95.5%) patients. The quantitative differences between the MR volumes obtained by 2D- and 3D-proximal isovelocity surface area (PISA) were analyzed in various MR subgroups...
May 2014: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/24548173/development-of-left-ventricular-hypertrophy-in-a-novel-porcine-model-of-mitral-regurgitation
#15
Nathja Ravn, Nora E Zois, Sophia G Moesgaard, Jesper L Honge, Morten H Smerup, J Michael Hasenkam, Erik Sloth, Signe E Cremer, Lisbeth H Olsen
OBJECTIVES: We aimed to develop a porcine model for chronic nonischemic mitral regurgitation (MR) to investigate left ventricular (LV) enlargement and eccentric hypertrophy. DESIGN: Nonischemic MR was induced in 30 pigs by open-chest immobilization of the posterior mitral leaflet by transannular traction sutures that where applied in transmyocardial fashion. A sham operated control group (n = 13) was included. Echocardiographic LV size and heart weight assessed at euthanasia were used to evaluate the development of LV enlargement and eccentric hypertrophy after 8 weeks follow-up...
June 2014: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/24438748/quantification-of-mitral-regurgitation-by-general-imaging-three-dimensional-quantification-feasibility-and-accuracy
#16
RANDOMIZED CONTROLLED TRIAL
Wugang Wang, Qiongwen Lin, Weichun Wu, Yong Jiang, Tingyu Lan, Hao Wang
BACKGROUND: Mitral regurgitant volume (MRvol) is an important index of the severity of mitral regurgitation (MR), but MRvol measurement remains challenging. With the development of probe technology and software, General Imaging 3D Quantification (GI 3DQ) allows the direct measurement of MR jet volume. The aim of this study was to evaluate the feasibility and accuracy of MRvol by quantification of MR jet volume using GI 3DQ. METHODS: Ninety-three patients were included, 61 with functional MR and 32 with mitral valve prolapse...
March 2014: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/23860094/proximal-isovelocity-surface-area-by-single-beat-three-dimensional-color-doppler-echocardiography-applied-for-tricuspid-regurgitation-quantification
#17
Jose Alberto de Agustin, Dafne Viliani, Catarina Vieira, Fabian Islas, Pedro Marcos-Alberca, Jose Juan Gomez de Diego, Ivan Javier Nuñez-Gil, Carlos Almeria, Jose Luis Rodrigo, Maria Luaces, Miguel Angel Garcia-Fernandez, Carlos Macaya, Leopoldo Perez de Isla
BACKGROUND: The two-dimensional (2D) proximal isovelocity surface area (PISA) method has known technical limitations, mainly the geometric assumptions of PISA shape required to calculate effective regurgitant orifice area (EROA). Recently developed single-beat real-time three-dimensional (3D) color Doppler imaging allows the direct measurement of PISA without geometric assumptions and has already been validated for mitral regurgitation assessment. The aim of this study was to apply this novel method in patients with chronic tricuspid regurgitation (TR)...
September 2013: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/23742271/altered-mitral-inflow-orifice-in-severe-aortic-regurgitation-real-time-three-dimensional-echocardiographic-findings
#18
Philippe B Bertrand, David Verhaert, Pieter Vandervoort
We present the case of a young man with severe eccentric aortic regurgitation, obstructing mitral inflow and provoking an audible Austin Flint murmur at clinical examination. Two-dimensional color Doppler echocardiography depicts the remarkable mechanical interaction between aortic regurgitant jet and anterior mitral leaflet opening. Three-dimensional transesophageal echocardiography aids in understanding the geometric and hemodynamic consequences of the regurgitant jet and in the genesis of the Austin Flint murmur...
2014: Echocardiography
https://www.readbyqxmd.com/read/23664737/the-additional-value-of-live-real-time-three-dimensional-transesophageal-echocardiography-over-two-dimensional-transesophageal-echocardiography-for-assessing-mitral-regurgitation-with-eccentric-jets
#19
Shen-Kou Tsai, Jeng Wei, Ming C Hsiung, Ching-Huei Ou, Chung-Yi Chang, Yi-Cheng Chuang, Kuo-Chen Lee, Yi-Pen Chou
BACKGROUND: Two-dimensional transesophageal echocardiography (2D TEE) Doppler color flow imaging is the gold standard for assessing the severity of mitral regurgitation (MR). Severe MR with very eccentric jet may involve more than one mitral leaflet lesion and can be missed by 2D TEE. The purpose of this study was to assess the usefulness and the incremental value of real-time three-dimensional (RT 3D) TEE over 2D TEE findings in the evaluation of patients suffering eccentric MR with more than one mitral leaflet lesion...
July 2013: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/23216843/postresuscitation-myocardial-dysfunction-in-a-dog
#20
Reid K Nakamura, Ilana C Zuckerman, Danielle L Yuhas, Renee K Fenty, Domenico Bianco
OBJECTIVE: To describe a clinical case of postresuscitation myocardial dysfunction in a dog. CASE SUMMARY: An 11-month-old, 2.37 kg female spayed Chihuahua was referred for management post CPR after suffering cardiopulmonary arrest. Postresuscitation a gallop rhythm was identified and an echocardiogram revealed severe left ventricular dilation and severely impaired myocardial contractility with a mild eccentric jet of mitral regurgitation on color Doppler interrogation...
December 2012: Journal of Veterinary Emergency and Critical Care
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