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Ischemic mitral

Pieter van der Bijl, Mand Khidir, Nina Ajmone Marsan, Victoria Delgado, Martin B Leon, Gregg W Stone, Jeroen J Bax
Functional mitral regurgitation (FMR) is common in heart failure (HF), and negatively impacts prognosis. Cardiac resynchronization therapy (CRT) can improve FMR, but the long-term changes in and impact of FMR after CRT are still unclear. The present study investigated the prevalence, evolution and impact on mortality of FMR before and after CRT in patients with HF. A total of 1,313 patients (66 ± 11 years, 77% male, 59% ischemic heart disease) treated with CRT were evaluated. Patients were divided into 4 groups of FMR according to the evolution at 6 months after CRT: no or mild FMR at baseline which remained unchanged at 6 months (grade 0-1 FMR unchanged, n = 609 [51%]), no or mild FMR which worsened to moderate to severe (grade 0-1 FMR worsened, n = 66 [6%)]), moderate to severe FMR which improved to no or mild (grade 2-4 improved, n = 209 [18%]), and moderate to severe FMR which remained unchanged (grade 2-4 unchanged, n = 309 [26%])...
January 1, 2019: American Journal of Cardiology
Edme Roxana Mustafa, Diana Rodica Tudoraşcu, Alina Giucă, Despina Manuela Toader, Maria Camelia Foarfă, Ileana Puiu, Anca Maria Istrate-Ofiţeru
A 46-year-old female diagnosed several years ago with arterial hypertension and an ischemic stroke with significant recovery was admitted for dyspnea on usual physical activity and fatigue. Physical examination revealed signs of heart failure with crackles on both lung bases, distented jugular veins, accentuated pulmonic valve closure (P2) and tricuspid regurgitation murmur. Echocardiography identified a large tumor in the left atrium, suggestive of atrial myxoma, which caused a severe functional mitral stenosis and produced severe pulmonary hypertension...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Xiaotian Sun, Yuwen Jiang, Guoqian Huang, Jiechun Huang, Meng Shi, Liewen Pang, Yiqing Wang
OBJECTIVE: Focusing on 3-dimensional mitral valve structure, this study investigated predictors for moderate ischemic mitral regurgitation (IMR) improvement after off-pump coronary artery bypass grafting (OPCAB). METHODS: This study included 143 patients (age 67.6 ± 7.6 years, 32.9% female) with previous myocardial infarction and moderate IMR undergoing OPCAB. Preoperative 3-dimensional echocardiographic data were analyzed, focusing on mitral annular geometry and leaflet tethering model...
September 29, 2018: Journal of Thoracic and Cardiovascular Surgery
Kendra J Grubb, Vasa Jevremovic, Edgar G Chedrawy
BACKGROUND: Myxomas account for approximately half of all primary cardiac neoplasms. Most occur in the left atrium and only rarely are attached to the mitral valve, with just over 30 such cases reported in the literature. These neoplasms can manifest with a combination of obstruction of blood flow, systemic embolization, and constitutional symptoms. CASE DESCRIPTION: We present a case of a 32-year-old African American man presenting at an emergency department with symptoms of a transient ischemic attack...
December 8, 2018: Journal of Medical Case Reports
César Caro Martínez, Ginés Elvira Ruiz, Pedro J Flores Blanco, Juan José Cerezo Manchado, Helena Albendín Iglesias, Alejandro Lova Navarro, Francisco Arregui Montoya, Arcadio García Alberola, Domingo Andrés Pascual Figal, José Luis Bailén Lorenzo, Sergio Manzano Fernández
INTRODUCTION AND OBJECTIVES: Valvular heart disease in patients with atrial fibrillation included in clinical trials with direct oral anticoagulants (DOAC) is common and is associated with worse prognosis. The aim of this study was to evaluate the prevalence of valvular heart disease and its influence on clinical events in real-world clinical practice. METHODS: We conducted a retrospective multicenter registry including 2297 consecutive patients with nonvalvular atrial fibrillation initiating DOAC between January 2013 and December 2016...
November 26, 2018: Revista Española de Cardiología
Gui-Fang Cao, Wei Liu, Qi Bi
OBJECTIVE: To explore the relationship between infective endocarditis (IE) and stroke. METHODS: The clinical data of patients diagnosed with IE from January 2003 to December 2017 in Beijing Anzhen Hospital Affiliated to Capital Medical University were retrospectively analyzed. RESULTS: A total of 861 patients (mean age: 40.79 ± 16.27 [SD]) with IE was recruited. Vegetations were confirmed in 97.32% of all the patients, among whom 296 were diagnosed with congenital heart disease and another 53 with rheumatic valvular disease...
November 28, 2018: European Neurology
Jiwon Kim, Javid Alakbarli, Brian Yum, Nathan H Tehrani, Meridith P Pollie, Christiane Abouzeid, Antonino Di Franco, Mark B Ratcliffe, Athena Poppas, Robert A Levine, Richard B Devereux, Jonathan W Weinsaft
Ischemic mitral regurgitation (iMR) augments risk for right ventricular dysfunction (RVDYS ). Right and left ventricular (LV) function are linked via common coronary perfusion, but data is lacking regarding impact of LV ischemia and infarct transmurality-as well as altered preload and afterload-on RV performance. In this prospective multimodality imaging study, stress CMR and 3-dimensional echo (3D-echo) were performed concomitantly in patients with iMR. CMR provided a reference for RVDYS (RVEF < 50%), as well as LV function/remodeling, ischemia and infarction...
November 20, 2018: International Journal of Cardiovascular Imaging
Chtioui Mamoun, Fagouri Houda
The diagnosis of splenic infarction is rarely reported in pregnant women. Current incidence of splenic infarction, especially during infectious endocardites as well as diagnostic methods used are poorly specified in the literature. We here report the case of a 26-year old woman with no particular previous history or cardiovascular risk factor who, at the end 14 weeks of amenorrhea, presented to the Emergency Department with febrile syndrome evolving over 10 days and abdominal pain of recent onset at the level of the left hypochondre...
2018: Pan African Medical Journal
Paolo Calabrò, Giampaolo Niccoli, Felice Gragnano, Erik Lerkevang Grove, Rocco Vergallo, Dimitri P Mikhailidis, Giuseppe Patti, Carmen Spaccarotella, Niki Katsiki, Giulia Masiero, Daisuke Ueshima, Eduardo Pinar, Alaide Chieffo, Gian Paolo Ussia, Ingo Eitel, Giuseppe Tarantini
Gender differences in the pathophysiology of atherosclerosis, cardiovascular risk factors, and diagnosis of coronary artery disease and valvular heart disease are well known. Such differences have also been outlined in the management and outcomes after acute coronary syndromes and valvular repair. Regarding the atherosclerotic process, pathological experimental studies suggest that plaque composition and burden may differ by gender. Female gender is associated with worse outcomes in the case of ischemic heart disease and, compared with men, women are less likely to undergo interventional cardiac procedures and sustain worse outcomes...
November 9, 2018: International Journal of Cardiology
Wolfgang Bothe, Tomasz A Timek, Frederick A Tibayan, Mario Walther, George T Daughters, Neil B Ingels, D Craig Miller
OBJECTIVE: Papillary muscle (PM) displacement contributes to ischemic/functional mitral regurgitation (IMR/FMR). The displaced PMs pull the mitral leaflets into the left ventricle (ie, toward the apex) thus hampering leaflet coaptation. Intuitively apical leaflet tethering results from apical PM displacement. The 3-dimensional directions of PM displacement are, however, incompletely characterized. METHODS: Data from in vivo ovine models of IMR (6-8 weeks of posterolateral infarction, n = 12) and FMR (9-21 days of rapid left ventricular pacing, n = 11) were analyzed...
October 10, 2018: Journal of Thoracic and Cardiovascular Surgery
Seán Fitzgerald, Asim Rizvi, Daying Dai, Eric E Williamson, Giuseppe Lanzino, Karen M Doyle, David F Kallmes, Waleed Brinjikji
Cardiac surgery has been shown to be associated with increased risk of acute ischemic stroke. This report presents a case of a successful mechanical embolectomy procedure to treat a patient for an acute ischemic stroke, which was caused by the cardiac embolization of a 'foreign body' containing debris following a redo sternotomy procedure for mitral valve replacement and tricuspid valve annuloplasty.
November 14, 2018: Interventional Neuroradiology
Daniel J P Burns
No abstract text is available yet for this article.
October 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Mehrnoush Toufan, Sakineh Hadi, Afshin Habibzadeh
Introduction: Ischemic mitral regurgitation (IMR) is common after acute myocardial infarction (AMI) which is associated with long-term cardiovascular mortality. Size, transmurality and location of the myocardial infarction (MI) has role on the development of IMR. In this study we evaluated the severity of IMR after different types of MI. Methods: One-hundred patients with the first AMI were recruited and according to echocardiographic findings were categorized to have moderate to severe IMR (case group, n=50) or trivial or no IMR (control group, n=50)...
2018: Journal of Cardiovascular and Thoracic Research
Salah Eldien Altarabsheh, Salil V Deo, Abeer Rababa'h, Yagthan M Obeidat, Osama Haddad
Chronic ischemic mitral valve regurgitation is a result of disturbed left ventricular geometry secondary to myocardial ischemia in the absence of intrinsic mitral valve pathology. It is a common complication after myocardial infarction, and patients who have ischemic mitral regurgitation (IMR) have a worse prognosis compared to patients who have ischemic heart disease alone, and this is directly related to the severity of IMR. Medical therapy has limited efficacy, and surgical options including various repair techniques and valve replacement had been tried with variable success...
October 26, 2018: World Journal of Cardiology
Serguei Melnitchouk, Gus J Vlahakes
No abstract text is available yet for this article.
October 10, 2018: Journal of Thoracic and Cardiovascular Surgery
Daisuke Kaneyuki, Hiroki Kohno, Kaoru Matsuura, Hideki Ueda, Goro Matsumiya
The surgical indication and optimal approach for ischemic mitral regurgitation with ventricular septal defect remain uncertain. Very few studies have reported the occurrence of left ventricular aneurysms after repair of ischemic ventricular septal defects. We report a case of a left posterior ventricular aneurysm that developed after an urgent operation to repair an acute ischemic posterior ventricular septal defect using the double-patch sandwich technique via a right ventriculotomy.
October 22, 2018: Annals of Thoracic Surgery
Patrizia Aruta, Denisa Muraru, Andrada Camelia Guta, Sorina Mihaila, Niccolò Ruozi, Chiara Palermo, Basma Elnagar, Sabino Iliceto, Luigi P Badano
BACKGROUND: Transcatheter mitral valve replacement (TMVR) is a new therapeutic option for high surgical risk patients with mitral regurgitation (MR). Mitral valve (MV) geometry quantification is of paramount importance for success of the procedure and transthoracic 3D echocardiography represents a useful screening tool. Accordingly, we sought to asses MV geometry in patients with functional MR (FMR) that would potentially benefit of TMVR, focusing on the comparison of mitral annulus (MA) geometry between patients with ischemic (IMR) and non ischemic mitral regurgitation (nIMR)...
October 12, 2018: Cardiovascular Ultrasound
Mehmet Adnan Celkan, Ismail Kork, Abdullah Ulucay
BACKGROUND: In this study, we present the outcomes of 53 patients with concomitant coronary artery disease and ischemic mitral regurgitation (IMR)who underwent coronary bypass grafting (CABG) plus mitral repair (flexible posterior band annuloplasty). MATERIALS AND METHODS: A total of 53 patients with concomitant ischemic mitral regurgitation  and coronary artery disease underwent CABG plus posterior mitral band annuloplasty between June 2008 and June 2015. Flexible Duran AnCore® annuloplasty band (Medtronic) was used in all patients...
August 14, 2018: Heart Surgery Forum
Sina Stock, Michael Scharfschwerdt, Rebecca Janina Warnecke, Doreen Richardt, Stanislav Tsvelodub, Hans-Hinrich Sievers
BACKGROUND:  Optimal surgical treatment of functional ischemic mitral regurgitation (FIMR) is still controversy. Due to the underlying pathophysiology, stand-alone ring annuloplasty is assumed with a high recurrence rate of mitral regurgitation, thus additional subvalvular repair techniques might improve the results. This in vitro study introduces a new device for subvalvular mitral valve repair. METHODS:  We developed a new device for subvalvular mitral valve repair, consisting of two frames for papillary muscle (PM) attachment, which are connected with two holding bars serving for fixation of the device on an annuloplasty ring...
October 8, 2018: Thoracic and Cardiovascular Surgeon
Simone Calcagno, Sara Cimino, Bruna Cerbelli, Gennaro Sardella
Cerebral ischemic lesions occurring during transcatheter valve interventions are common feared complications and the use of filter device seems to reduce their incidence. We report the case of an 84-year old female patient with severe mitral regurgitation undergoing MitraClip. During the trans-esophageal echocardiography (TEE)-guided procedure was detected the presence of a little fibrin strand adherent to the steerable guide catheter for which we decided to implant the Claret CE Pro (Claret Medical, Inc. Santa Rosa, CA, USA) cerebral protection device and to continue the procedure during which the thrombus disappeared...
October 4, 2018: Catheterization and Cardiovascular Interventions
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