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Ischemic mitral

Xinxin Wang, Bo Zhang, Jian Zhang, Yongquan Ying, Chengchu Zhu, Baofu Chen
BACKGROUND: The best surgical option for severe ischemic mitral regurgitation (IMR) is still controversial. The aim of this study was to perform a meta-analysis to compare the clinical outcomes of mitral valve repair (MVP) with replacement (MVR). METHODS: A literature search was conducted in PubMed, Embase, and Medline using the terms "ischemic mitral regurgitation" and "repair or annuloplasty or reconstruction" and "replacement" in the title/abstract field...
August 2018: Medicine (Baltimore)
Katsuhiko Kasahara
We applied cardiac resynchronization therapy with an implantable cardioverter-defibrillator( CRT-D) and with concomitant cardiac surgery to 2 patients with left ventricular (LV) systolic dysfunction and dyssynchronous ventricular activation. A patient had severe ischemic dilated cardiomyopathy with coronary artery aneurysms (LV ejection fraction 12%, LV diastolic dimension 81 mm, LV systolic dimension 75 mm and atrial fibrillation, with complete left bundle branch block). Another patient had severe dilated cardiomyopathy with mitral valve regurgitation (LV ejection fraction 25%, LV diastolic dimension 75 mm, LV systolic dimension 61 mm atrial fibrillation, and complete left bundle branch block)...
July 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Yasushige Shingu, Tomonori Ooka, Tsuyoshi Tachibana, Suguru Kubota, Yoshiro Matsui
Surgical strategy for non-ischemic dilated cardiomyopathy (NIDCM) is currently controversial. Subjects were 20 patients who underwent left ventriculoplasty(LVP) from 2006 to 2013 and 6 patients who underwent papillary muscle tugging approximation (PMTA) after 2015. PMTA is a new trans-mitral approach combined with valve replacement without left ventriculotomy. Another group of patients( n=14)who were registered for heart transplantation( HTx) after 2013 was also analyzed for left ventricular assist device(LVAD) free survival...
July 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Boqing Xu, Takayuki Kawata, Masao Daimon, Koichi Kimura, Tomoko Nakao, Seitetz C Lee, Megumi Hirokawa, Aya Yoshinaga, Masafumi Watanabe, Yutaka Yatomi, Issei Komuro
The prognostic value of the right ventricular (RV) systolic to diastolic duration ratio (S/D ratio) in patients with advanced heart failure is not clear.We enrolled 45 patients with DCM (40 ± 13 years, 33 male) who were admitted to our hospital for evaluation or treatment of heart failure. The RV systolic and diastolic durations were measured using continuous Doppler imaging of tricuspid regurgitation, and the RV S/D ratio was calculated. Cardiac events were defined as cardiac death or left ventricular assist device implantation within the first year...
July 18, 2018: International Heart Journal
Zainab Samad, Linda K Shaw, Matthew Phelan, Donald D Glower, Mads Ersboll, John H Toptine, John H Alexander, Joseph A Kisslo, Andrew Wang, Daniel B Mark, Eric J Velazquez
BACKGROUND: We aimed to determine the association of MR severity and type with all-cause death in a large, real-world, clinical setting. METHODS: We reviewed full echocardiography studies at Duke Echocardiography Laboratory (01/01/1995-12/31/2010), classifying MR based on valve morphology, presence of coronary artery disease, and left ventricular size and function. Survival was compared among patients stratified by MR type and baseline severity. RESULTS: Of 93,007 qualifying patients, 32,137 (34...
May 18, 2018: American Heart Journal
Meng-Lin Lee, Thay-Hsiung Chen, Hsien-Da Huang, Shaw-Min Hou
Background: The optimal management of ischemic mitral regurgitation (IMR) is controversial. The aim of this study was to examine our eight years' experience of surgical treatment in patients with IMR, and to compare outcomes of mitral valve repair versus replacement with concomitant coronary artery bypass grafting (CABG). Methods: A retrospective, observational, cohort study was undertaken to collect data on consecutive patients with IMR and coronary artery disease who received CABG and mitral valve surgery in our hospital between January 2008 and December 2015...
May 2018: Journal of Thoracic Disease
Shin Watanabe, Olympia Bikou, Roger J Hajjar, Kiyotake Ishikawa
Mitral regurgitation (MR) is among the most common valvular heart diseases in clinics. MR induces volume overload of the heart and leads to heart failure (HF). Because physiological and molecular mechanisms in nonischemic HF are distinct from that of ischemic HF, a clinically relevant animal model of nonischemic HF is important for understanding the pathophysiology and developing new therapeutics targeting this HF phenotype. Additionally, the large animal model of MR provides opportunities to test new surgical and percutaneous approaches for correcting mitral valve insufficiency...
2018: Methods in Molecular Biology
Dae-Hee Kim, Brittan Morris, J Luis Guerrero, Suzanne M Sullivan, Judy Hung, Robert A Levine
Ischemic mitral regurgitation (IMR) is a common complication of ischemic heart disease that doubles mortality after myocardial infarction and is a major driving factor increasing heart failure. IMR is caused by left ventricular (LV) remodeling which displaces the papillary muscles that tether the mitral valve leaflets and restrict their closure. IMR frequently recurs even after surgical treatment. Failed repair associates with lack of reduction or increase in LV remodeling, and increased heart failure and related readmissions...
2018: Methods in Molecular Biology
Gehan Magdy, Ebtihag Hamdy, Tarek Elzawawy, Maher Ragab
BACKGROUND: Mitral annular plane systolic excursion (MAPSE) is an M-mode derived echocardiographic marker of left ventricular longitudinal function, the aim of this study is to evaluate the value of MAPSE in assessment of contractile reserve in patients with ischemic cardiomyopathy before cardiac revascularization. METHODS: The study included 50 patients with ischemic cardiomyopathy with ejection fraction (EF) ≤35%, the patients presented to echocardiography laboratory for dobutamine stress echocardiography (DSE) to assess viability and contractile reserve before revascularization, patients with primary valvular disease, and those with significant mitral annular calcifications were excluded from the study...
May 2018: Indian Heart Journal
Robert E Michler
No abstract text is available yet for this article.
June 4, 2018: Journal of Thoracic and Cardiovascular Surgery
Fereshteh Ghaderi, Farveh Vakilian, Pouya Nezafati, Omid Reza Amini, Mohammad Sobhan Sheikh-Andalibi
BACKGROUND: Differentiating ischemic from non-ischemic functional mitral regurgitationý (FMR) in patients with cardiomyopathy is important in terms of the therapeutic decision-making and prognosis, but might be clinically challenging. In this study, the deformation of mitral valve (MV) indices in the prediction of the etiology of FMR was assessed using 2D transthoracic and tissue Doppler echocardiography. METHODS: This case-control study was conducted from April 2015 to January 2016 in Imam Reza Hospital in Mashhad, Iran...
January 2018: ARYA Atherosclerosis
Lowie M R Van Assche, Mark J Ricciardi
Functional mitral regurgitation (FMR) is common in patients with heart failure and portends a poor prognosis. The etiology is secondary to non-ischemic or ischemic (post myocardial infarction) adverse remodeling. Treatment includes guideline-directed medical therapy, cardiac resynchronization therapy, and in some cases, surgical repair or replacement. Transcatheter mitral valve repair with the MitraClip device is approved in patients with degenerative MR and is currently under investigation for use in FMR; as are several transcatheter mitral valve repair devices...
June 22, 2018: Cardiology in Review
Cosmo Godino, Andrea Scotti, Maurizio Taramasso, Marianna Adamo, Marco Russo, Mauro Chiarito, Francesco Melillo, Alessandro Beneduce, Carlo Andrea Pivato, Luca Arrigoni, Evelina Toscano, Anna Salerno, Alberto Cappelletti, Valeria Magni, Stefano Stella, Gabriele Fragasso, Matteo Montorfano, Eustachio Agricola, Federica Ettori, Alberto Margonato, Francesco Maisano, Antonio Colombo
BACKGROUND: MitraClip implantation has evolved as a new tool for treatment of inoperable or high-risk patients with severe functional mitral regurgitation (FMR) due to dilated cardiomyopathy (DCM). Limited data are available regarding MitraClip outcomes comparing patients with ischemic and non-ischemic DCM. METHODS: From 2008 to 2016, 314 patients received MitraClip for FMR at four institutions: Brescia, Zurich and Milan. Patients were stratified according to MR aetiology in non-ischemic FMR (n = 99) and ischemic FMR (n = 215)...
June 12, 2018: International Journal of Cardiology
L A Nikolenko, E S Shopova, E S Golovneva, E S Nikolenko
Due to current options of cardiac surgery, operations on the heart of elderly patients have become routine in specialized cardiosurgical centers. The issue of pre- and postoperative anemia of different nature is essential in surgical correction of heart valves and coronary bypass. AIM: To study indexes of red blood in elderly patients with ischemic heart disease (IHD) and pathology of heart valves before and after surgical correction, including the relationship with position and type of the prosthesis...
2018: Kardiologiia
Mohammad Y Salmasi, Amer Harky, Mohammed F Chowdhury, Ali Abdelnour, Anastasia Benjafield, Farah Suker, Stephanie Hubbard, Hunaid A Vohra
BACKGROUND: Ischemic mitral regurgitation (IMR) is associated with increased mortality and recurrent congestive heart failure following coronary artery bypass graft (CABG) surgery. While mitral surgery should be undertaken for severe MR during CABG, the treatment of moderate IMR remains controversial. We conducted a meta-analysis to determine the outcomes of CABG alone and combine with mitral valve repair (MVr) in moderate IMR. METHODS: A literature search was conducted by Pubmed, Ovid, and Embase, which included 643 articles...
July 2018: Journal of Cardiac Surgery
Tariq A Ahmad, Matthew Nudy, Dirk Pabst, Mark Kozak
Mitral valve repair is becoming an increasingly frequent surgery for patients with mitral valve regurgitation. Iatrogenic coronary artery injury and ischemic myocardial compromise have been previously reported in the literature as a rare but serious complication of surgical mitral valve repair. This potentially life-threatening complication should be considered and quickly recognized during perioperative mitral valve repair or replacement to prevent morbidity and mortality. To increase awareness and to prevent this complication from being missed in the future, we present a case report of iatrogenic left circumflex artery dynamic occlusion and subsequent myocardial infarction from mitral valve annuloplasty resulting in severe peri-operative heart failure and death...
April 25, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
J Scott Rankin, Maria Grau-Sepulveda, David M Shahian, A Marc Gillinov, Rakesh Suri, James S Gammie, Steven F Bolling, Patrick M McCarthy, Vinod H Thourani, Niv Ad, Sean M O'Brien, Jeffrey P Jacobs, Vinay Badhwar
BACKGROUND: The patho-etiology of mitral regurgitation (MR) has been suggested as a mediator of outcomes following mitral valve (MV) operations, particularly in ischemic functional mitral regurgitation (IMR). This study examined the independent association of MV etiology with mortality. METHODS: Using the Society of Thoracic Surgeons Database, all patients undergoing mitral valve replacement or repair from 2011-2014 were assessed. Patients who underwent concomitant surgical ablation, septal defect closure, tricuspid valve repair, or coronary artery bypass grafting were included...
May 16, 2018: Annals of Thoracic Surgery
S A Sunny, S Moinuddin, A B Adhikary, M A Hossain
Functional ischemic mitral regurgitation is strongly associated with poor outcomes in patient with coronary artery disease. The best management for mitral regurgitation at the time of coronary revascularization remains controversial. We report, a case of 58 years-old men admitted to GKNM hospital, Coimbatore, Tamil Nadu, India with chest pain and respiratory distress for last 6 hours during my fellowship training in that hospital. ECG showed acute antero-septal MI. The transthoracic echocardiogram revealed severe left ventricular dysfunction with moderate mitral regurgitation...
April 2018: Mymensingh Medical Journal: MMJ
Miguel Rodríguez-Santamarta, Rodrigo Estévez-Loureiro, Tomás Benito-González, Javier Gualis, Carmen Garrote, Armando Pérez de Prado, Felipe Fernández-Vázquez
A 79-year-old woman with a history of ischemic dilated cardiomyopathy, severely depressed left ventricular ejection fraction and significant mitral regurgitation (MR) was admitted to the authors´ institution for percutaneous mitral valve repair. Transesophageal echocardiography (TEE) revealed the presence of a posterior mitral cleft at the P2 level, causing a trileaflet mitral valve that contributed significantly to the regurgitant jet. The procedure was performed under general anesthesia and guided by real-time three-dimensional TEE...
September 2017: Journal of Heart Valve Disease
Evangelos Oikonomou, Georgia Vogiatzi, Dimitrios Karlis, Gerasimos Siasos, Christina Chrysohoou, Theodoros Zografos, George Lazaros, Sotirios Tsalamandris, Konstantinos Mourouzis, Georgios Georgiopoulos, Marina Toutouza, Dimitris Tousoulis
BACKGROUND & AIMS: Polyunsaturated fatty acids (PUFAs) may affect the cardiovascular system with a multiplicity of mechanisms. We assessed the effects of omega-3 PUFAs supplements on inflammation, fibrosis, left ventricle performance and endothelial function of ischemic heart failure (HF) patients. METHODS: In this double-blind, placebo controlled, cross-over trial we enrolled 31 patients with ischemic HF, followed by a 6-week wash-out period. Omega-3 PUFAs (2 g daily, 8 weeks) were administered PO in the intervention arm...
May 3, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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