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functional mitral regurgitation

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https://www.readbyqxmd.com/read/29232298/use-of-a-new-expanded-polytetrafluoroethylene-multichordal-mitral-apparatus-mitrapatch-to-repair-complex-mitral-valve-lesions
#1
Surendra K Chawla, Muralidhar Padala, W Randolph Chitwood, Robert W M Frater
OBJECTIVE: We report a new expanded polytetrafluoroethylene multichordal mitral apparatus (MitraPatch) to simplify mitral repairs involving multiple cusps and sought to describe the surgical technique and demonstrate the efficacy of the device. METHODS: MitraPatch was laser cut from a single sheet of expanded polytetrafluoroethylene and mounted on a custom-designed handle. Surgical technique to deploy the apparatus on the native mitral valve was developed in ex vivo porcine hearts...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29232249/clinical-trials-in-valvular-surgery-a-2018-update
#2
Bobby Yanagawa, Amine Mazine, Derrick Y Tam, Subodh Verma
PURPOSE OF REVIEW: There is a growing emphasis on the conduct of large-scale, multicenter randomized controlled trials (RCTs) to guide decision-making in cardiac surgery. Here we review recent landmark RCTs in cardiac valvular surgery. RECENT FINDINGS: RCTs are the gold-standard level of data in medicine. However, there are unique challenges of conducting large-scale surgical trials including funding, blinding, generalizability, nonstandardization of the surgical technique, crossover, among others...
December 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29224215/deleterious-variants-in-dchs1-are-prevalent-in-sporadic-cases-of-mitral-valve-prolapse
#3
Alisson Clemenceau, Jean-Christophe Bérubé, Paméla Bélanger, Nathalie Gaudreault, Maxime Lamontagne, Oumhani Toubal, Marie-Annick Clavel, Romain Capoulade, Patrick Mathieu, Philippe Pibarot, Yohan Bosse
BACKGROUND: A recent study identified DCHS1 as a causal gene for mitral valve prolapse. The goal of this study is to investigate the presence and frequency of known and novel variants in this gene in 100 asymptomatic patients with moderate to severe organic mitral regurgitation. METHODS: DNA sequencing assays were developed for two previously identified functional missense variants, namely p.R2330C and p.R2513H, and all 21 exons of DCHS1. Pathogenicity of variants was evaluated in silico...
December 10, 2017: Molecular Genetics & Genomic Medicine
https://www.readbyqxmd.com/read/29223748/is-tricuspid-annuloplasty-increasing-surgical-mortality-and-morbidity-during-mitral-valve-replacement-a-single-centre-experience
#4
Constance Verdonk, Arthur Darmon, Claire Cimadevilla, Laurent Lepage, Richard Raffoul, Patrick Nataf, Alec Vahanian, David Messika-Zeitoun
BACKGROUND: Performance of tricuspid annuloplasty (TA) in patients undergoing mitral valve surgery is recommended based on the degree of tricuspid regurgitation and tricuspid annulus size, but is often underused. AIM: To evaluate the impact of combined TA on in-hospital outcome in patients undergoing mitral valve replacement (MVR). METHODS: We selected all consecutive patients who underwent MVR for native valve disease. Clinical, echocardiographic and in-hospital complications were obtained from chart review...
December 6, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29222864/effects-of-cardiac-resynchronization-therapy-after-inferior-myocardial-infarction-on-secondary-mitral-regurgitation-and-mitral-valve-geometry
#5
Christos G Mihos, Evin Yucel, Romain Capoulade, Mary P Orencole, Gaurav A Upadhyay, Orlando Santana, Jagmeet P Singh, Michael H Picard
BACKGROUND: The effects of cardiac resynchronization therapy (CRT) on secondary mitral regurgitation (MR), and mitral valve (MV) and left ventricular (LV) geometry, in patients with prior inferior myocardial infarction is not clearly defined. We assessed these outcomes utilizing 2-dimensional echocardiography, and analyzed echocardiographic geometric variables that may correlate with follow-up MR severity. METHODS: Between 2009 and 2012, 229 CRT were implanted. Twenty-two had prior inferior myocardial infarction, ≥ mild MR at baseline, and serial echocardiography...
December 9, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29218014/acute-effects-of-positive-airway-pressure-on-functional-mitral-regurgitation-in-patients-with-systolic-heart-failure
#6
Takao Kato, Takatoshi Kasai, Shoichiro Yatsu, Azusa Murata, Hiroki Matsumoto, Shoko Suda, Masaru Hiki, Nanako Shiroshita, Mitsue Kato, Fusae Kawana, Sakiko Miyazaki, Hiroyuki Daida
Background: Acute effects of positive airway pressure (PAP) [including continuous PAP (CPAP) and adaptive servo-ventilation, an advanced form of bi-level PAP] on functional mitral regurgitation (fMR) in patients with heart failure (HF) with left ventricular (LV) systolic dysfunction remain unclear. Thus, whether PAP therapy reduces fMR in such patients with HF was investigated. Methods and Results: Twenty patients with HF and LV systolic dysfunction defined as LV ejection fraction (LVEF) <50% (14 men; mean LVEF, 35...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29216983/atrial-infarction-and-ischemic-mitral-regurgitation-contribute-to-post-mi-remodeling-of-the-left-atrium
#7
Jaume Aguero, Carlos Galan-Arriola, Rodrigo Fernandez-Jimenez, Javier Sanchez-Gonzalez, Nina Ajmone, Victoria Delgado, Jorge Solis, Gonzalo J Lopez, Antonio de Molina-Iracheta, Roger J Hajjar, Jeroen J Bax, Valentin Fuster, Borja Ibáñez
BACKGROUND: Left atrial (LA) remodeling after an acute myocardial infarction (MI) is poorly characterized regarding its determinants or its effect on ischemic mitral regurgitation (MR) development. OBJECTIVES: The purpose of this study was: 1) to compare LA structural remodeling in experimental MI swine models recapitulating the effects of left ventricular (LV) dysfunction, ischemic MR, and left atrial infarction (LAI); and 2) to analyze how LA remodeling influences ischemic MR development...
December 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29215470/invasive-assessment-of-microvascular-function-in-patients-with-valvular-heart-disease
#8
Takeshi Nishi, Hideki Kitahara, Saito Yuichi, Tomoko Nishi, Takashi Nakayama, Yoshihide Fujimoto, Goro Matsumiya, Yoshio Kobayashi
BACKGROUND: The aim of this study was to investigate microvascular function in patients with valvular heart disease (VHD), which causes chronic left ventricular volume and/or pressure overload, therefore change in coronary microvascular hemodynamics. PATIENTS AND METHODS: We prospectively enrolled 30 patients with VHD considered for surgery (10 aortic stenosis, 12 aortic regurgitation, and eight mitral regurgitation) and 30 controls. Intracoronary physiological assessments were performed in the unobstructed left anterior descending artery using a pressure-temperature sensor guidewire at rest and hyperemia...
December 5, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29209786/prognostic-value-of-preprocedural-6-min-walk-test-in-patients-undergoing-transcatheter-mitral-valve-repair-insights-from-the-german-transcatheter-mitral-valve-interventions-registry
#9
Jakob Ledwoch, Jennifer Franke, Edith Lubos, Peter Boekstegers, Miriam Puls, Taoufik Ouarrak, Stephan von Bardeleben, Christian Butter, Joachim Schofer, Ralf Zahn, Hüsseyin Ince, Jochen Senges, Horst Sievert
AIMS: The 6-min walk test (6 MWT) has been established as an important tool for functional assessment in heart failure patients. However, its prognostic impact on the outcome in subjects with mitral regurgitation undergoing transcatheter mitral valve repair is unknown. METHODS: This present work represents a sub-analysis of the German, prospective, multicenter, Transcatheter Mitral Valve Interventions (TRAMI) registry. Of the main study cohort (n = 828) 326 patients underwent 6 MWT prior to the procedure...
December 5, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29208632/right-ventricular-exercise-contractile-reserve-and-outcomes-after-early-surgery-for-primary-mitral-regurgitation
#10
Emilie Vitel, Elena Galli, Christophe Leclercq, Maxime Fournet, Christian Bosseau, Hervé Corbineau, Guillame Bouzille, Erwan Donal
OBJECTIVE: To assess if the lack of development of right ventricular (RV) contractile reserve during exercise echocardiography (ex-echo) might be a predictor of postoperative major adverse cardiovascular events (MACEs) in patients with primary mitral regurgitation (pMR) undergoing early surgery. METHODS: Comprehensive resting and ex-echo were performed in 142 asymptomatic patients (58±21 years, 68% men, New York Heart Association functional class ≤2) with isolated severe pMR and preserved left ventricular (LV) function (LV ejection >60%, LV end-systolic diameter <45 mm) undergoing mitral valve replacement (n=20) or repair...
December 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29208340/different-indicators-for-postprocedural-mitral-stenosis-caused-by-single-or-multiple-clip-implantation-after-percutaneous-mitral-valve-repair
#11
Yuji Itabashi, Hiroto Utsunomiya, Shunsuke Kubo, Yukiko Mizutani, Hirotsugu Mihara, Mitsushige Murata, Robert J Siegel, Saibal Kar, Keiichi Fukuda, Takahiro Shiota
BACKGROUND: Postprocedural mitral stenosis (MS) is a main limitation for MitraClip™ (Abbot Vascular, Inc., Santa Clara, CA, USA) procedure. The purpose of this study was to detect the preprocedural predictors of high transmitral pressure gradient (TMPG) after MitraClip™ implantation, which indicated postprocedural mitral stenosis (MS). METHODS: We studied 79 patients who were implanted with MitraClip™ in our institute. Before the procedure, mitral valve orifice area (MVOA), and anterior-posterior (AP) and medial-lateral (ML) mitral annular diameters were measured at diastole using three-dimensional (3D) transesophageal echocardiography (TEE) data set...
December 2, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29204737/initial-slovenian-experience-with-mitraclip-therapy-careful-selection-of-patients-is-crucial-for-optimal-outcome
#12
Jana Ambrožič, Marta Cvijič, Mojca Bervar, Špela Mušič, Matjaž Bunc
BACKGROUND: MitraClip is a percutaneous mitral repair technology increasingly used for high surgical risk patients with primary or secondary mitral regurgitation. We describe initial Slovenian experience with MitraClip and discuss the importance of identifying the suitable candidates for this procedure. METHODS: We retrospectively analyzed the first 10 patients (mean age 75.6 ± 6.9 years, logistic Euroscore 28.4 ± 10.9%) with severe and moderate to severe mitral regurgitation (8 secondary, 1 primary and 1 mixed etiology) who underwent a MitraClip procedure between January 2015 and February 2017...
December 4, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29196230/functional-anatomy-and-pathophysiologic-principles-in-mitral-regurgitation-non-invasive-assessment
#13
REVIEW
Sylvestre Maréchaux, Jeffery E Illman, James Huynh, Hector I Michelena, Vuyisile T Nkomo, Christophe Tribouilloy
Mitral regurgitation (MR) is the most prevalent cause of valvular heart disease (VHD) in western countries. In the Euro Heart Survey on VHD, MR was the second most common heart VHD requiring surgery. It is also the most common form of VHD in community and population-based studies from the United States. The categorization of MR based on causes and mechanisms is a major determinant of clinical outcome, of possible therapies for the MR and of the effectiveness of these therapies. Surgical mitral valve (MV) repair has been shown to improve survival in patients with severe primary MR compared with MV replacement...
November 28, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29186494/mitral-valve-repair-in-barlow-s-disease-with-bileaflet-prolapse-the-effect-of-annular-stabilization-on-functional-mitral-valve-leaflet-prolapse
#14
Anton Tomšic, Yasmine L Hiemstra, Daniella D Bissessar, Thomas J van Brakel, Michel I M Versteegh, Nina Ajmone Marsan, Robert J M Klautz, Meindert Palmen
OBJECTIVES: Barlow's disease is the most severe form of degenerative mitral valve disease, commonly characterized by bileaflet prolapse. Abnormal mitral annular dynamics is typically present and results in functional prolapse of the mitral leaflets that may be addressed with annular stabilization alone. METHODS: Between January 2001 and December 2015, 128 patients with Barlow's disease and bileaflet prolapse underwent valve repair. This included anterior mitral valve leaflet (AMVL) repair in 70 patients, whereas 58 patients were identified as having functional prolapse and underwent no specific AMVL repair...
November 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29186415/atrioventricular-dromotropathy-evidence-for-a-distinctive-entity-in-heart-failure-with-prolonged-pr-interval
#15
Floor C W M Salden, Valentina Kutyifa, Martin Stockburger, Frits W Prinzen, Kevin Vernooy
Heart failure (HF) is often accompanied by atrioventricular (AV) conduction disturbance, represented by prolongation of the PR interval on the electrocardiogram. Studies suggest that PR prolongation exists in at least 10% of HF patients, and it seems more prevalent in the presence of prolonged QRS duration. A prolonged PR interval may result in elevated left ventricular (LV) end-diastolic pressure, diastolic mitral regurgitation, and reduced LV pump function. This seems especially the case in patients with heart disease, in whom it is associated with an increased risk for atrial fibrillation, advanced AV heart block, HF, and death...
November 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29182759/long-term-outcome-after-anomalous-left-coronary-artery-from-the-pulmonary-artery-repair-a-40-year-single-centre-experience
#16
Rüdiger Lange, Julie Cleuziou, Markus Krane, Peter Ewert, Jelena Pabst von Ohain, Elisabeth Beran, Keti Vitanova
OBJECTIVES: An anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly, often associated with severely impaired left ventricular (LV) contractility and functional mitral valve (MV) regurgitation. Current data suggest that earlier correction of ALCAPA may result in a more complete recovery of LV function. By analysing the results of a large single-centre ALCAPA cohort, we sought to investigate whether these treatment paradigms remain valid. METHODS: A retrospective study was performed evaluating all patients undergoing repair of ALCAPA over a period of almost 40 years...
November 22, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29177448/long-term-results-of-annuloplasty-in-trivial-to-mild-functional-tricuspid-regurgitation-during-mitral-valve-replacement-should-we-perform-annuloplasty-on-the-tricuspid-valve-or-leave-it-alone
#17
Jae Woong Choi, Kyung Hwan Kim, Hyoung Woo Chang, Myoung-Jin Jang, Sue Hyun Kim, Sang Yoon Yeom, Ho Young Hwang
OBJECTIVES: The benefits of concomitant tricuspid annuloplasty (TAP) for non-significant functional tricuspid regurgitation (TR) during mitral valve replacement (MVR) are controversial. We evaluated the long-term outcomes-particularly the long-term tricuspid valve (TV) functional outcomes-of MVR with or without tricuspid ring annuloplasty. METHODS: From 2004 to 2014, 256 patients (56.4 ± 12.1 years) with trivial or mild functional TR who underwent MVR were enrolled...
November 21, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29176139/preoperative-evaluation-and-midterm-outcomes-after-the-surgical-correction-of-anomalous-origin-of-the-left-coronary-artery-from-the-pulmonary-artery-in-50-infants-and-children
#18
Hui-Li Zhang, Shou-Jun Li, Xu Wang, Jun Yan, Zhong-Dong Hua
BACKGROUND: Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) is a rather rare congenital anomaly that has a profound effect on heart function. This study aimed to retrospectively illustrate the perioperative clinical features, therapy experience, and midterm outcomes after surgical correction, and to determine the value of left ventricular ejection fraction (LVEF) and myocardial viability in differentiating critically ill patients among infants and children with ALCAPA...
December 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29174559/assessment-of-the-severity-of-native-mitral-valve-regurgitation
#19
REVIEW
Kinan Carlos El-Tallawi, David Messika Zeitoun, William A Zoghbi
Mitral regurgitation (MR) is a major cause of cardiovascular morbidity and mortality. MR is classified as primary (organic) if it is due to an intrinsic valve abnormality, or secondary (functional) if the etiology is because of remodeling of left ventricular geometry and/or valve annulus. Transthoracic echocardiography (TTE) is the initial modality for MR evaluation. Parameters used for the assessment of MR include valve structure, cardiac remodeling, and color and spectral Doppler. Quantitative measurements include effective regurgitant orifice area, regurgitant volume, and regurgitant fraction...
November 21, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29166721/-a-preliminary-study-on-the-relationship-between-idiopathic-arrhythmia-and-cardiac-magnetic-resonance-imaging-defined-cardiac-features-in-patients-with-straight-back-syndrome
#20
L Chen, X H Ma, L Zhao, R Bai, S N Li, L Wang, H Chen, Z M Fan, M W Lou, Y D Niu
Objective: To retrospectively analyze the potential correlation between cardiac magnetic resonance (CMR) imaging and clinical features and idiopathic arrhythmia in patients with straight back syndrome (SBS). Methods: Patients receiving CMR imaging examination from April 2015 to March 2016 at our department (n=1 432) were screened, 76 patients met the diagnosis criteria of flat chest (anteroposterior diameter/transthoracic diameter (APD/TTD) ratio<0.37 at the T8 vertebra). After excluding 33 patients with structural heart disease, 43 SBS patients were divided into two groups: SBS without obvious morphological change in the heart (group A, n=19) and SBS with morphological change of the heart (group B, n=24)...
November 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
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