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Pulmonary hypertension mitral replacement

Ana Redondo Palacios, José López Menéndez, Javier Miguelena Hycka, Miren Martín García, Laura Varela Barca, Andrea Ferreiro Marzal, Rafael Muñoz Pérez, Enrique Oliva De Anquín, Ignacio García Andrade, Tomasa Centella Hernández, Daniel Celemín Canorea, Jorge Rodríguez-Roda Stuart
BACKGROUND: Nowadays, Tricuspid valve replacement (TVR) is much less common than aortic or mitral valve replacement, since repair is almost always preferable. Prosthetic tricuspid valves are associated with high mortality and morbidity, mostly due to thrombotic or hemorrhagic events. Nevertheless, there is lack of evidence of which is the optimal type of valve (biological versus mechanical) in tricuspid position. METHODS: We analysed all the patients who underwent TVR in our Institution, from 2005 to 2015...
September 16, 2016: Journal of Cardiovascular Surgery
O Milleron, C Bouleti, S Mazouz, E Brochet, F Rouzet, P Nataf, W Ghodbane, D Messika-Zeitoun, M P Dilly, S Cattan, A Vahanian, B Iung, G Jondeau
AIMS: So far, a total of five patients with eclipsed mitral regurgitation (MR) have been reported in the literature by three different teams. The aim of this article was to detail clinical and echocardiographic characteristics, and outcome of patients presenting eclipsed MR. METHODS AND RESULTS: We defined eclipsed MR as spontaneous appearance, at rest, from 1 min to the next of an acute restriction in the motion of mitral leaflets preventing coaptation and leading to massive MR in patients with normal left ventricular end-diastolic diameter, left ventricular ejection fraction >45%, and baseline MR ≤2...
September 13, 2016: European Heart Journal Cardiovascular Imaging
George T Nicholson, Michael S Kelleman, Caridad M De la Uz, Ricardo H Pignatelli, Nancy A Ayres, Christopher J Petit
OBJECTIVE: Shone's syndrome is a complex consisting of mitral valve stenosis in addition to left ventricle outflow obstruction. There are a few studies evaluating the long-term outcomes in this population. We sought to determine the long-term outcomes in our paediatric population with Shone's syndrome and the factors associated with left heart growth. METHODS: All patients diagnosed with Shone's syndrome with biventricular circulation treated between 1978 and 2010 were reviewed...
July 26, 2016: Cardiology in the Young
Adam R Kowalówka, Magdalena Onyszczuk, Wojciech Wańha, Marek A Deja
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Do we have to operate on moderate functional mitral regurgitation (FMR) during aortic valve replacement (AVR) for aortic stenosis (AS)?' Altogether 325 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
November 2016: Interactive Cardiovascular and Thoracic Surgery
Ricardo A Sarmiento, Rodrigo Blanco, Gerardo Gigena, Jorge Lax, Alejandro Garcia Escudero, Federico Blanco, Jorge Szarfer, Raul Solerno, Carlos D Tajer, Juan A Gagliardi
BACKGROUND: Percutaneous balloon mitral valvuloplasty (PMV) is an attractive therapeutic approach in patients with mitral stenosis. The aim of this study was to assess the immediate and long-term clinical, echocardiographic and haemodynamic outcomes of PMV in patients with severe pulmonary hypertension (PAH). METHODS: Percutaneous balloon mitral valvuloplasty was performed in 157 consecutive patients; 60 patients (38,2%) had significant PAH defined as baseline pulmonary artery mean pressure (PAMP) ≥ 30mm Hg (Group 1) and 97 patients (61,8%) had PAMP ≤ 30mmHg (Group 2)...
June 4, 2016: Heart, Lung & Circulation
Vincenzo Pestrichella, Antonio Pignatelli, Rossella Alemanni, Rosamaria Montesanti, Maurizio Braccio, Francesco Greco, Pierpaolo D'Ambruoso, Cataldo Davide Memmola, Mauro Cassese, Gaetano Contegiacomo, Rodrigo Bagur
A 67-year-old patient with rheumatic heart valve disease had undergone two cardiac surgeries at the age of 30 years, then re-do with mitral valve replacement at 50 years. She presented with congestive heart failure and hemolytic anemia. Doppler echocardiography showed moderate-severe mitral regurgitation due to paravalvular mitral valve leak (PVML) and severe pulmonary hypertension. Transesophageal echocardiography demonstrated severe PVML secondary to a large 20 mm-long PVML defect. Due to comorbidities, the heart team deemed a third reoperation at very high surgical risk; therefore, the patient was considered most suitable for a transcatheter approach to PVML closure...
July 2016: Journal of Invasive Cardiology
Laura Brown, Lowell Tilzer, Fred Plapp
A 33-year-old male was admitted to the hospital for a repeat mitral valve replacement. The original surgery, performed in India in 2008 due to rheumatic heart disease, required massive amounts of plasma replacement during and after the surgery. The patient was admitted to our hospital with extremely low Factor V and Factor VIII activities due to a rare combined Factor V and Factor VIII deficiency. His clinical condition on admission was grave due to severe pulmonary hypertension. It was decided to replace the patient's Factor V using therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) just prior to surgery, and his Factor VIII with Factor VIII concentrate...
June 16, 2016: Journal of Clinical Apheresis
Mostafa M Mokhles, Sabrina Siregar, Michel I M Versteegh, Luc Noyez, Bart van Putte, Alexander B A Vonk, Jolien W Roos-Hesselink, Ad J J C Bogers, Johanna J M Takkenberg
OBJECTIVES: The objective of this study was to compare male-female differences with respect to baseline characteristics and short-term outcome in a contemporary nationwide cohort of patients who underwent isolated mitral valve (MV) surgery. METHODS: All patients [N = 3411; 58% males (N = 1977)] who underwent isolated MV surgery (replacement: N = 1048, 31%; reconstruction: N = 2364, 69%) in the Netherlands between January 2007 and December 2011 were included in this study...
September 2016: European Journal of Cardio-thoracic Surgery
Alberto Roghi, Erika Poggiali, Elena Cassinerio, Patrizia Pedrotti, Marianna Giuditta, Angela Milazzo, Giuseppina Quattrocchi, Maria Domenica Cappellini
BACKGROUND: Type 1 Gaucher disease (GD1) is the most common lysosomal disorder, characterized by the accumulation of beta-glucocerebroside into the macrophages of several organs. Cardiac involvement is rare and referred to as restrictive cardiomyopathy, pulmonary hypertension, and calcifications of the valves and the aortic arch. AIM: To assess the cardiovascular status by cardiac magnetic resonance, including evaluation of tissue characterization, in GD1 patients...
June 30, 2016: Journal of Cardiovascular Medicine
Y I Zeng, Rongrong Sun, Xianchi Li, Min Liu, Shuang Chen, Peiying Zhang
Valvular heart disease (VHD) is caused by either damage or defect in one of the four heart valves, aortic, mitral, tricuspid or pulmonary. Defects in these valves can be congenital or acquired. Age, gender, tobacco use, hypercholesterolemia, hypertension, and type II diabetes contribute to the risk of disease. VHD is an escalating health issue with a prevalence of 2.5% in the United States alone. Considering the likely increase of the aging population worldwide, the incidence of acquired VHD is expected to increase...
April 2016: Experimental and Therapeutic Medicine
Bo Yang, Christina DeBenedictus, Tessa Watt, Sean Farley, Alona Salita, Whitney Hornsby, Xiaoting Wu, Morley Herbert, Donald Likosky, Steven F Bolling
OBJECTIVES: To provide initial evidence on the management of mitral stenosis and pulmonary hypertension (PH) based on short-term and long-term outcomes following mitral valve surgery. METHODS: Consecutive patients with mitral stenosis (n = 317) who had undergone mitral valve surgery between 1992 and 2014 with recorded pulmonary artery pressure (PAP) data were reviewed. PH severity, based on systolic PAP, was categorized as mild (35 to 44 mm Hg), moderate (45 to 59 mm Hg), or severe (>60 mm Hg)...
August 2016: Journal of Thoracic and Cardiovascular Surgery
Samuel Kingué, Serigne Abdou Ba, Dhadi Balde, Mamadou Bocary Diarra, Jean-Baptiste Anzouan-Kacou, Benedict Anisubia, Jean-Marie Damorou, Pierre Ndobo, Alain Menanga, Abdoul Kane, Maurice Kakou-Guikahué, Monique Kenfack, Bernard Metogo, David Chelo, Euloge Yangnigni, Cabral Tantchou, Edmond Bertrand, Jean-Jacques Monsuez
BACKGROUND: There are few African data available on rheumatic heart disease (RHD). AIM: To provide data on the clinical characteristics and treatment of patients with RHD hospitalized in sub-Saharan Africa. METHODS: The VALVAFRIC study is a multicentre hospital-based retrospective registry of patients with RHD hospitalized in African cardiology departments from 2004 to 2008. RESULTS: Among 3441 patients with at least one mild RHD lesion seen on echocardiography in 5 years in 12 cardiology departments from seven countries, 1385 had severe lesions (502 men; 803 women; mean age 29...
May 2016: Archives of Cardiovascular Diseases
N Ali-Tatar Chentir, M Korabi, M T Chentir
OBJECTIFS: Irradiation of the heart in patients with breast cancer increases the risk of the so-called "radiation-induced heart disease" (RIHD). Among risk factors of RIHD, overweight, hypertension and diabetes mellitus take a major place. To describe a clinical case of an obese hypertensive diabetes mellitus woman with breast cancer since the begining of her radiotherapy until heart failure on the basis of the report from the European Association of Cardiovascular Imaging consensus for evaluation of cardiovascular complications of radiotherapy in adults...
December 2015: Annales de Cardiologie et D'angéiologie
Raul A Borracci, Miguel Rubio, Maria L Sestito, Carlos A Ingino, Carlos Barrero, Carlos A Rapallo
BACKGROUND: The aim was to assess the incidence of prosthesis-patient mismatch (PPM) after mitral valve replacement (MVR) in patients receiving Biocor® porcine or mechanical valves, and to evaluate the effect of PPM on long-term survival. METHODS: All patients undergoing MVR between 2009 and 2013 received either mechanical or bioprosthetic valves (Biocor® porcine). PPM was defined as severe when the indexed effective ori-fice area was < 0.9 cm2/m2, moderate between 0...
2016: Cardiology Journal
Hakan Ozkan, Tahsin Bozat, Selma Kenar Tiryakioglu, Hasan Ari
BACKGROUND: The primary goal of this study is to evaluate the immediate and long-term ef-fects of percutaneous mitral balloon valvuloplasty (PBMV) on patients with rheumatic mitral stenosis (MS) complicated with severe pulmonary hypertension (PH). METHODS: The study population consisted of 85 patients with MS complicated with severe PH (systolic pulmonary pressure > 75 mm Hg). PBMV was performed with Inoue balloon technique. Clinical and echocardiographic follow-up was scheduled at 6 months and 1 year and yearly thereafter...
2016: Cardiology Journal
Gonçalo F Coutinho, Pedro M Correia, Carlos Branco, Manuel J Antunes
OBJECTIVES: To evaluate the feasibility of mitral valve repair in patients with anterior leaflet (ALP) or bileaflet prolapse (BLP) and identify factors predisposing patients to replacement. To compare long-term survival of patients submitted to repair (Group Repair) against those submitted to replacement (Group Replacement), and investigate causes of early and late failures of repair. METHODS: From January 1992 through December 2012, 768 patients with ALP or BLP were submitted to mitral valve surgery, of whom 501 had degenerative involvement [Myxomatous (Myx)-336 (67...
July 2016: European Journal of Cardio-thoracic Surgery
Javier Reque, Borja Quiroga, Caridad Ruiz, Maria Teresa Villaverde, Almudena Vega, Soraya Abad, Nayara Panizo, J Manuel López-Gómez
BACKGROUND AND OBJECTIVE: Pulmonary hypertension (PH) is a progressive disorder that can be caused by several underlying conditions or an intrinsic alteration of the pulmonary vasculature. Chronic increased pressure in the pulmonary vasculature leads to changes in the architecture of the vessels that can perpetuate PH and produce right ventricular dysfunction. These structural and functional alterations can decrease survival and quality of life of patients on hemodialysis; however, there is a lack of evidence about this problem in this population...
February 19, 2016: Medicina Clínica
Stephan Geidel, Peter Wohlmuth, Michael Schmoeckel
BACKGROUND: The objective of this study was to analyze the results of open heart mitral valve operations for survival prediction in patients with previously unsuccessful MitraClip procedures. METHODS: Thirty-three consecutive patients who underwent mitral valve surgery in our institution were studied. At a median of 41 days, they had previously undergone one to five futile MitraClip implantations. At the time of their operations, patients were 72.6 ± 10.3 years old, and the calculated risk, using the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, was a median of 26...
March 2016: Annals of Thoracic Surgery
Anita Saxena
Lesions of the heart valves are the commonest acquired cardiac abnormalities seen in pediatric age group. In India, the underlying cause for most valvular diseases is chronic rheumatic heart disease (RHD). The aim of evaluation of patients with valvular heart disease is not only to make a diagnosis, but also to decide the management plan. The pediatrician or physician is usually the first health care provider to whom such patients (or their parents) report. It is therefore imperative that the general physician and pediatricians are well versed with valvular heart diseases...
November 2015: Indian Journal of Pediatrics
Livia Williams, Fiona Kermeen, Daniel Mullany, Bruce Thomson
As a salvage strategy, extracorporeal membrane oxygenation (ECMO) permits the recovery of end-organ perfusion, whilst allowing the surgeon time for patient reassessment and surgical planning. We report upon the first known case in which VA ECMO was instituted as peri-operative supportive therapy for a young patient, in-extremis, with surgically correctable Chronic Thromboembolic Pulmonary Hypertension (CTEPH) and Hypertrophic Cardiomyopathy (HOCM).
October 2015: Heart, Lung & Circulation
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