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functional mitral regurgitation

Hidehiro Kaneko, Michael Neuss, Jens Weissenborn, Christian Butter
Functional mitral regurgitation (MR) is common in patients with heart failure and left ventricular (LV) dysfunction. MitraClip (MC) is a novel therapeutic option for patients with high-risk MR. Similar to LV dysfunction, right ventricular dysfunction (RVD) is an important predictor of patients with heart failure. We aimed to clarify the effect of RVD on outcomes of functional MR and LV dysfunction after MC implantation. We examined 117 patients with severe functional MR and reduced LV ejection fraction (≤40%) treated with MC...
August 30, 2016: American Journal of Cardiology
Richard Cheng, Emily Tat, Robert J Siegel, Reza Arsanjani, Asma Hussaini, Moody Makar, Yukiko Mizutani, Alfredo Trento, Saibal Kar
AIMS: Mitral annular calcification (MAC) negatively influences outcomes in surgical mitral valve (MV) repair for mitral regurgitation (MR). However, there are no data on whether MAC impacts on outcomes of MitraClip percutaneous MV edge-to-edge repair. This study sought to investigate whether the presence of MAC impacts on the procedural success and durability of percutaneous transcatheter repair of MR using the MitraClip. METHODS AND RESULTS: One hundred and seventy-three patients undergoing MitraClip repair for significant MR were studied...
October 20, 2016: EuroIntervention
Carsten Schwencke, Klaudija Bijuklic, Taoufik Ouarrak, Edith Lubos, Wolfgang Schillinger, Björn Plicht, Holger Eggebrecht, Stephan Baldus, Gerhard Schymik, Peter Boekstegers, Rainer Hoffmann, Jochen Senges, Joachim Schofer
AIMS: The use of the MitraClip system has gained widespread acceptance for the treatment of patients with mitral regurgitation (MR) who are not suitable for the conventional surgery. This study sought to investigate the early and 1-year outcome after MitraClip therapy of patients with MR and cardiac comorbidities. METHODS AND RESULTS: Outcomes through 12-month follow-up of patients (n = 528) who underwent MitraClip implantation were obtained from the German transcatheter mitral valve interventions (TRAMI) registry...
October 17, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Joyce Bischoff, Guillem Casanovas, Jill Wylie-Sears, Dae-Hee Kim, Philipp Bartko, J Guerrero, Jacob Dal-Bianco, Jonathan Beaudoin, Michael Garcia, Suzanne Sullivan, Margo Seybolt, Brittan Morris, Joshua Keegan, Whitney Irvin, Elena Aikawa, Robert Levine
RATIONALE: Ischemic mitral regurgitation (IMR), a complication after myocardial infarction (MI), induces adaptive mitral valve (MV) responses that may be initially beneficial, but eventually lead to leaflet fibrosis and MV dysfunction. We sought to examine the MV endothelial response and its potential contribution to IMR. OBJECTIVE: Endothelial, interstitial and hematopoietic cells in MVs from post-MI sheep were quantified. MV endothelial CD45, found post-MI, was analyzed in vitro...
October 6, 2016: Circulation Research
C Bening, K Hamouda, R Leyh
BACKGROUND: The impact of sex on cardiac morphology and function in chronic volume overload has been described in detail. However, the relation between sex and contractile properties at the actin-myosin level has not been well defined. Therefore, we evaluated the influence of sex on the contractile capacities of patients with chronic volume overload. METHODS: In 36 patients (18 males, 65 ± 9 years; 18 females, 65 ± 13 years) scheduled for elective mitral valve surgery due to severe mitral regurgitation (MR) with preserved left ventricular function, right auricle samples were obtained prior to extracorporal circulation...
October 14, 2016: BMC Cardiovascular Disorders
Anca D Mateescu, Ioan M Coman, Carmen C Beladan, Bogdan Radulescu, Carmen Ginghina, Bogdan A Popescu
We report the case of a rare association of a congenital Gerbode defect with severe mitral regurgitation due to abnormal linear structure of mitral valve, diagnosed in an adult patient. The case highlights the importance of a thorough examination interpreting the echocardiographic findings on a pathophysiological basis. It also underlines the complementary role of different imaging techniques with transesophageal echocardiography, allowing the precise assessment of both structural and functional abnormalities in such a complex case...
September 2016: Korean Circulation Journal
Denise C Joffe, Thomas K Jones, Mark Reisman, Elizabeth Perpetua, Yuk Law, Andreas Schuler, G Burkhard Mackensen
We present the primary report of a paediatric patient who had placement of the MitraClip device for severe functional mitral regurgitation. The patient was a 14-year-old boy with symptomatic end-stage non-compaction type cardiomyopathy secondary to a mitochondrial cytopathy. He had severe mitral regurgitation, tricuspid valve regurgitation, a severely dilated LV with apical non-compaction, severe LV dysfunction and severe pulmonary hypertension. Despite optimal medical therapy he developed progressive symptoms of congestive heart failure and he was not a candidate for an assist device or cardiac transplantation...
October 10, 2016: EuroIntervention
Steven F Bolling
No abstract text is available yet for this article.
October 10, 2016: JACC. Cardiovascular Interventions
Georg Nickenig, Christoph Hammerstingl, Robert Schueler, Yan Topilsky, Paul A Grayburn, Alec Vahanian, David Messika-Zeitoun, Marina Urena Alcazar, Stephan Baldus, Rudolph Volker, Michael Huntgeburth, Ottavio Alfieri, Azeem Latib, Giovanni La Canna, Eustachio Agricola, Antonio Colombo, Karl-Heinz Kuck, Felix Kreidel, Christian Frerker, Felix C Tanner, Ori Ben-Yehuda, Francesco Maisano
OBJECTIVES: This study sought to show safety and efficacy of the Cardioband system during 6 months after treatment. BACKGROUND: Current surgical and medical treatment options for functional mitral regurgitation (FMR) are limited. The Cardioband system (Valtech Cardio, OrYehuda, Israel) is a novel transvenous, transseptal direct annuloplasty device. METHODS: Thirty-one patients (71.8 ± 6.9 years of age; 83.9% male; EuroSCORE II: 8.6 ± 5.9) with moderate to severe FMR, symptomatic heart failure, and depressed left ventricular function (left ventricular ejection fraction 34 ± 11%) were prospectively enrolled...
October 10, 2016: JACC. Cardiovascular Interventions
Salvatore Scandura, Piera Capranzano, Anna Caggegi, Carmelo Grasso, Giuseppe Ronsivalle, Sarah Mangiafico, Yohei Ohno, Guilherme F Attizzani, Stefano Cannata, Sandra Giaquinta, Silvia Farruggio, Margherita Ministeri, Fabio Dipasqua, Anna M Pistritto, Sebastiano Immè, Davide Capodanno, Maria Elena Di Salvo, Corrado Tamburino
BACKGROUND: Although mitral regurgitation (MR) affects a relevant and increasing number of elderly, an optimal management of this high-risk population is challenging. METHODS AND RESULTS: The aim of this prospective, observational study was to compare one-year outcomes of MitraClip therapy in high surgical risk patients with moderate-to-severe or severe MR between patients aged <75 versus ≥75years. A total of 180 patients were included: 92 were <75years and 88 were ≥75years old...
September 24, 2016: International Journal of Cardiology
Charles H Bloodworth, Eric L Pierce, Thomas F Easley, Andrew Drach, Amir H Khalighi, Milan Toma, Morten O Jensen, Michael S Sacks, Ajit P Yoganathan
Computational modeling of the mitral valve (MV) has potential applications for determining optimal MV repair techniques and risk of recurrent mitral regurgitation. Two key concerns for informing these models are (1) sensitivity of model performance to the accuracy of the input geometry, and, (2) acquisition of comprehensive data sets against which the simulation can be validated across clinically relevant geometries. Addressing the first concern, ex vivo micro-computed tomography (microCT) was used to image MVs at high resolution (~40 micron voxel size)...
October 3, 2016: Annals of Biomedical Engineering
Mackram F Eleid, Guy S Reeder, Joseph F Malouf, Ryan J Lennon, Sorin V Pislaru, Vuyisille T Nkomo, Charanjit S Rihal
OBJECTIVES: This study sought to assess the learning curve for TMVR for treatment of primary mitral regurgitation (MR). BACKGROUND: Data are lacking regarding the technical experience required to achieve optimal clinical outcomes with transcatheter mitral valve repair (TMVR) using the edge-to-edge MitraClip technique. METHODS: We examined the sequential experience of the first 75 patients (age 80 ± 9 years; 77% male) who underwent TMVR at our institution...
October 2016: Journal of Interventional Cardiology
Sitaram M Emani, Breanna L Piekarski, David Zurakowski, Christopher A Baird, Audrey C Marshall, James E Lock, Pedro J Del Nido
BACKGROUND: Options for cardiac valve replacement in children are limited to fixed-diameter prostheses that do not accommodate for somatic growth. An externally stented bovine jugular vein graft has been modified for surgical valve replacement in pediatric patients, with the intention of subsequent valve expansion in the catheterization laboratory as the child grows. METHODS: Pediatric patients at a single institution who underwent surgical implantation of an expandable bovine jugular vein valve between 2010 and 2014 were reviewed retrospectively...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
Alqasem F Al Mosa, Aamir Omair, Ahmed A Arifi, Hani K Najm
OBJECTIVES: Mitral valve replacement with either a bioprosthetic or a mechanical valve is the treatment of choice for severe mitral stenosis. However, choosing a valve implant type is still a subject of debate. This study aimed to evaluate and compare the early and late outcomes of mitral valve replacement [mechanical (MMV) vs. bioprosthetic (BMV)] for severe mitral stenosis. METHODS: A retrospective cohort study was performed on data involving mitral stenosis patients who have undergone mitral valve replacement with either BMV (n = 50) or MMV (n = 145) valves from 1999 to 2012...
October 2016: Journal of the Saudi Heart Association
Liselotte C R Hensen, Victoria Delgado, Suzanne E van Wijngaarden, Melissa Leung, Mihaly K de Bie, Maurits S Buiten, Martin J Schalij, Jos J Van de Kerkhof, Ton J Rabelink, Joris I Rotmans, J Wouter Jukema, Jeroen J Bax
BACKGROUND: The prevalence of atrial fibrillation (AF) in end-stage renal disease (ESRD) patients is relatively high. The present study evaluated the association between left atrial (LA) remodelling, including an increased size and myocardial fibrosis, and slow LA conduction and the occurrence of AF. METHODS: In 171 ESRD patients enrolled in the Implantable Cardioverter Defibrillators in Dialysis patients (ICD2) trial, the LA dimensions, LA conduction delay [as reflected by the time difference between P-wave onset on surface electrocardiogram and A'-wave on tissue Doppler imaging (PA-TDI)] and LA function were compared between patients who exhibited AF versus patients without AF...
September 29, 2016: Nephrology, Dialysis, Transplantation
William H Gaasch, Sachin P Shah, Sherif B Labib, Theo E Meyer
OBJECTIVE: Mitral regurgitation (MR) is generally characterised as exhibiting a 'low impedance leak into the left atrium'. This notion is widely accepted without measured impedance data. The aim of this study was to define the impedance to retrograde and forward blood flow and to examine hydraulic (pressure-volume) and mechanical (stress-shortening) function in chronic severe MR. METHODS: A mathematical model of a double outlet ventricle was developed and the ratio of retrograde to forward impedance was plotted over a wide range of regurgitant fraction (RF)...
September 28, 2016: Heart: Official Journal of the British Cardiac Society
Alain J Poncelet, Gébrine El Khoury, Laurent De Kerchove, Thierry Sluysmans, Stéphane Moniotte, Mona Momeni, Thierry Detaille, Jean E Rubay
OBJECTIVES: To analyse our institutional results in the setting of paediatric aortic valve (AV) repair. Primary end-points were overall survival, freedom from AV reoperation and freedom from AV replacement. METHODS: A retrospective analysis of all patients under 18 years of age operated on from 1977 to 2015 in a single tertiary care level institution. Patients were included if they benefited from any type of AV repair procedure, including commissurotomy, leaflet shaving or plication, or leaflet augmentation...
September 28, 2016: European Journal of Cardio-thoracic Surgery
Busheng Zhang, Yue Zheng, Liang Fang, Huangdong Dai, Dan Zhu, Ye Kong
BACKGROUND: Morbidity and mortality risks in patients with end-stage renal disease (ESRD) undergoing mitral valve surgery are high; however, little is known regarding the risks and results of mitral valve repair in these patients. METHODS: We retrospectively reviewed the clinical data of dialysis-dependent patients who underwent mitral valve repair with the "respect" approach between April 2012 and April 2015 in our institution. RESULTS: All five identified patients survived and their data were included in the analysis...
August 2016: Annals of Translational Medicine
Leandro Slipczuk, Asim M Rafique, Carlos D Davila, Roy Beigel, Gregg S Pressman, Robert J Siegel
Mitral regurgitation (MR) is a common valvular disorder that has important health and economic consequences. Standardized guidelines exist regarding when and in whom to perform mitral valve surgery, but little information is available regarding medical treatment of MR. Many patients with moderate or severe MR do not meet criteria for surgery or are deemed to be at high risk for surgical therapy. We reviewed the available published data on medical therapy in the treatment of patients with primary MR. b-blockers and renin-angiotensin-aldosterone system inhibitors had the strongest supporting evidence for providing beneficial effects...
2016: Reviews in Cardiovascular Medicine
Merrill H Stewart, J Stephen Jenkins
BACKGROUND: Mitral regurgitation (MR) is the second leading cause of valvular heart disease in the United States behind aortic stenosis. The percutaneous repair of the mitral valve (MitraClip, Abbott, Inc.) has been approved in the United States since 2013 as an alternative to traditional mitral valve surgery. However, many questions are left unanswered about when to perform this procedure and whom to perform it on. METHODS: We reviewed major published literature on the MitraClip from 2003-2016 to help guide clinical decision-making...
2016: Ochsner Journal
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