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Mitral valve percutaneous intervention

Shinji Kanemitsu
Papillary muscle rupture is a rare complication after myocardial infarction and almost all cases occur in the mitral valve papillary muscle. Tricuspid regurgitation development after right ventricular myocardial infarction caused by papillary muscle rupture is extremely rare.  In this video tutorial we present a 70-year-old man with massive tricuspid regurgitation caused by papillary muscle rupture after percutaneous stenting of the right coronary artery. We performed tricuspid valve repair with reimplanted papillary muscle in situ using neither artificial chordae nor a prosthetic valve...
December 6, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Kevin M Veen, Mostafa M Mokhles, Jerry Braun, Michel I M Versteegh, Ad J J C Bogers, Johanna J M Takkenberg
OBJECTIVES: This study aims to explore male-female differences in baseline and procedural characteristics, and outcomes of patients undergoing isolated or concomitant tricuspid valve (TV) surgery. METHODS: All TV procedures registered between 2007 and 2016 in the database of the Netherlands Association for Cardio-Thoracic Surgery were analysed. Logistic regression analyses with interaction terms were used to determine whether sex was associated with hospital mortality...
December 4, 2018: European Journal of Cardio-thoracic Surgery
Hüseyn Ince, Tobias Zeus
Surgical management of patients with aortic valve stenosis is declining and Transcatheter aortic valve implantation (TAVI) is becoming the treatment of choice in many patients. The ESC guideline integrated results of randomized controlled trials in patients with intermediate surgical risk for the first time. TAVI showed good and comparable results to the standard surgical approach.Mitral regurgitation (MR) is a complex disease with good surgical results in primary MR and mixed results in secondary MR. Secondary MR is mainly based on left ventricular disease with subsequent dilatation...
December 2018: Deutsche Medizinische Wochenschrift
Annunziata Nusca, Edoardo Bressi, Iginio Colaiori, Marco Miglionico, Germano Di Sciascio
Transcatheter interventions for valvular and structural heart diseases are rapidly expanding due to greater operators' experience and development of new generation devices associated with increased procedural safety. They represent the standard strategy for patients with prohibitive risk for open surgery. These procedures are associated with a significant occurrence of both thrombotic and bleeding complications, thus in this setting, even more than in other percutaneous procedures, the balance between thrombotic and bleeding risk is critical...
October 2018: Cardiovascular Diagnosis and Therapy
Timothy A Joseph, Mackram F Eleid, Allison K Cabalka, Joseph F Maalouf, Charanjit S Rihal
OBJECTIVES: This study reports long-term outcomes percutaneous Melody valve (Medtronic, Minneapolis, Minnesota) valve-in-valve therapy in patients with prosthetic valve dysfunction. BACKGROUND: Repeat valve surgery is associated with high morbidity and mortality. Transcatheter mitral valve-in-valve is a promising alternative in patients at high-risk for cardiac surgery. METHODS: We conducted a retrospective cohort analysis of 13 patients who underwent Melody valve-in-valve for bioprosthetic dysfunction from July 2011 to October 2013...
November 20, 2018: Catheterization and Cardiovascular Interventions
Shota Yamanaka, Tomoya Uchimuro, Suguru Amagaya, Ryogen Yun, Yohei Onga, Chihaya Itou, Daiki Saito, Masayuki Shimizu, Kenji Wada, Takahide Yoshio, Shuichiro Takanashi
A 70-year-old woman with back pain was diagnosed with adult anomalous origin of the left coronary artery from the pulmonary artery [Bland-White-Garland (BWG) syndrome]. Preoperative transthoracic echocardiography showed diffuse hypokinesia of the left ventricle and mild mitral valve regurgitation. Coronary angiography revealed dilatation of both coronary arteries, but no aneurysms. The left coronary ostium was removed as buttons of the pulmonary arterial wall, and a prosthetic graft (8 mm ePTFE graft) was interposed between the ascending aorta and coronary button...
November 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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
Charles B Nyman, Douglas C Shook, Stanton Shernan
The advent of percutaneous therapies has significantly altered therapeutic options for patients with valvular heart disease. Building on the success of transcatheter aortic valve replacement, both expanded indications and purpose-built devices are now being used to address percutaneous approaches for mitral valve pathology. While surgical mitral valve repair remains the gold standard for addressing significant mitral valve pathology, there has been a progressive increase in the utilization of bioprosthetic valves despite their limited lifespan...
November 8, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
P Guérin
Mitral regurgitation (MR) is the second most common form of valvular heart disease. It is classified as either primary (degenerative) or secondary (functional). Secondary MR is the consequence of myocardium disease. Primary MR from degenerative valve disease is due to a primary disruption of the mitral valve apparatus from either prolapsed or flail leaflets. It covers all aetiologies in which intrinsic lesions affect one or several components of the mitral valve apparatus. Gold-standard therapeutic management of severe primary MR is surgery usually to repair but sometime to replace the mitral valve...
December 2018: Annales de Cardiologie et D'angéiologie
Kevin Bryan Lo, Sandeep Dayanand, Pradhum Ram, Pradeep Dayanand, Leandro N Slipczuk Bustamante, Vincent M Figueredo, Janani Rangaswami
Percutaneous mitral valve repair is emerging as a reasonable alternative especially in those with an unfavorable surgical risk profile in the repair of mitral regurgitation. At this time, our understanding of the effects of underlying renal dysfunction on outcomes with percutaneous mitral valve repair and the effects of this procedure itself on renal function is evolving, as more data emerges in this field. The current evidence suggests that the correction of mitral regurgitation via percutaneous mitral valve repair is associated with some degree of improvement in cardiac function, hemodynamics and renal function...
October 24, 2018: Current Cardiology Reviews
Jamshid H Karimov, Tomislav Mihaljevic, Shengqiang Gao, Gengo Sunagawa, Patrick Grady, Martin Sinkewich, Kiyotaka Fukamachi
OBJECTIVE: With heart disease increasing worldwide, demand for new minimally invasive techniques and transcatheter technologies to treat structural heart disease is rising. Cardioscopy has long been considered desirable, as it allows direct tissue visualization and intervention to deliver therapy via a closed chest, with real-time fiber-optic imaging of intracardiac structures. Herein, the feasibility of the advanced cardioscopic platform, allowing both transapical and fully percutaneous access is reported...
October 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
Ana Belén Cid Álvarez, Oriol Rodríguez Leor, Raúl Moreno, Armando Pérez de Prado
INTRODUCTION AND OBJECTIVES: To present the annual report of the Working Group on Cardiac Catheterization and Interventional Cardiology on the activity data for 2017. METHODS: Data were voluntarily provided by Spanish centers with a catheterization laboratory. The information was introduced online and was analyzed by the Steering Committee of the Working Group on Cardiac Catheterization and Interventional Cardiology. RESULTS: In 2017, data were reported by 107 hospitals, of which 82 are public...
October 5, 2018: Revista Española de Cardiología
Deepak Thakur, Yerramareddy Vijaya Chandra, Chinnasamy Sivaprakasam Muthukumaran
Rheumatic heart disease (RHD) is a major health hazard in most developing countries as well as sporadically in developed economies with high prevalence rates. Mitral stenosis is among the important morbid valvular conditions accounting for 25% of RHD cases. Percutaneous transmitral commissurotomy (PTMC) using Inoue balloon is the standard treatment for severe mitral stenosis with favorable Wilkins score. In certain cases it is difficult to cross mitral valve (MV) either due to dilated left atrium (LA), low septal puncture, or severe mitral valvular and subvalvular stenosis leading to prolonged procedure time or failure of PTMC procedure...
April 2018: Journal of Cardiology Cases
Andreas Glatthaar, Peter Seizer, Johannes Patzelt, Harald Langer, Jürgen Schreieck, Meinrad Gawaz
Percutaneous mitral valve repair (PMVR) using the MitraClip system (Abbott, Abbott Park, IL, USA) is an innovative method allowing treatment of mitral regurgitation (MR) for patients that are not accessible by conventional operation. Thrombogenicity in the left atrium (LA) in general is increased in the presence of atrial fibrillation and mitral valve disease. We observed in a patient who underwent PMVR an acute change in thrombogenicity in the LA with thrombus formation in the left atrial appendix (LAA) immediately after clip placement...
January 2018: Journal of Cardiology Cases
Fahad Alqahtani, Khaled Ziada, Charanjit S Rihal, Mohamad Alkhouli
BACKGROUND: Coronary ischemia requiring early percutaneous coronary intervention (PCI) is a rare but serious complication of isolated valve surgery. We sought of assess the incidence, predictors and outcomes of early PCI after isolated valve surgery using the national inpatient sample. METHODS: Patients who underwent isolated aortic valve replacement (AVR), isolated mitral valve repair (MVr) or replacement (MVR) between 2003 and 2014 were identified. Patients who had early postoperative PCI were compared with patients who did not require PCI...
September 30, 2018: Catheterization and Cardiovascular Interventions
Mirjam Keßler, Julia Seeger, Jochen Wöhrle, Wolfgang Rottbauer, Sinisa Markovic
OBJECTIVES: To analyze 30-day and 6-month results after percutaneous mitral valve repair using an IABP as circulatory support. BACKGROUND: The use of intra-aortic balloon counterpulsation pump extended the spectrum of cardiovascular interventions. METHODS: Since 2014, 17 patients of 365 patients (4.7%) at our center received an IABP during MitraClip implantation procedure. We compare the periprocedural results to a control group of 17 patients treated with MitraClip without an IABP support...
September 30, 2018: Catheterization and Cardiovascular Interventions
Farshad Tahmasebi, Alice Hurrell, Amie Ford, Manish Gupta, Damien Geindreau, Dominic Pimenta, Constantinos O'Mahony
Spontaneous coronary artery dissection is a rare but important cause of acute coronary syndrome. Its relevance for women during the puerperium mandates awareness and understanding amongst obstetric healthcare professionals. The aetiology of the increased risk in pregnancy has not been fully elucidated, but include medial eosinophilic angitis, pregnancy-induced degeneration of collagen in conjunction with the stresses of parturition, and rupture of the vasa vasorum. The risk of mortality necessitates prompt diagnosis, usually by angiography...
September 2018: Obstetric Medicine
Konstantinos Koutsampasopoulos, Savvas Grigoriadis, Ioannis Vogiatzis
Introduction We herein present an unusual case of a pseudoaneurysm of the left ventricular myocardium, which is a rare and fatal complication of myocardial infarction. Case report A 64-year-old man with a history of bipolar disorder and arterial hypertension was hospitalized for delayed presentation ST-elevation myocardial infarction. He was admitted to our hospital 24 hours after symptom onset. Diagnostic coronary angiography revealed 95% stenosis at the distal third of the right coronary artery, and he underwent a primary percutaneous coronary intervention to the culprit lesion...
September 5, 2018: Journal of International Medical Research
Lorenzo Faggioni, Michela Gabelloni, Sandra Accogli, Marco Angelillis, Giulia Costa, Paolo Spontoni, Anna Sonia Petronio, Davide Caramella
Mitral regurgitation is the most common valve disorder in the Western world, and although surgery is the established therapeutic gold standard, percutaneous transcatheter mitral interventions are gaining acceptance in selected patients who are inoperable or at an exceedingly high surgical risk. For such patients, multidetector computed tomography (MDCT) can provide a wealth of valuable morphological and functional information in the preoperative setting. Our aim is to give an overview of the MDCT image acquisition protocols, post-processing techniques, and imaging findings with which radiologists should be familiar to convey all relevant information to the Heart Team for successful treatment planning...
2018: European Journal of Radiology Open
Deepakraj Gajanana, Toby Rogers, William S Weintraub, Micaela Iantorno, Kyle D Buchanan, Itsik Ben-Dor, Augusto D Pichard, Lowell F Satler, Vinod H Thourani, Rebecca Torguson, Petros G Okubagzi, Ron Waksman
There is scarcity of evidence regarding antiplatelet and anticoagulant therapy in patients with prosthetic valves undergoing percutaneous coronary intervention (PCI). Our goal was to compare clinical outcomes between patients with mechanical or bioprosthetic valves undergoing PCI. The study population comprised patients with either a bioprosthetic or mechanical heart valve in the aortic and/or mitral position undergoing PCI between January 2003 and July 2017. Demographics, admission, and discharge medications as well as procedural details were documented...
November 1, 2018: American Journal of Cardiology
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