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Mitral insufficiency

Gian Manuel Jiménez-Rodríguez, Sergio Criales-Vera, Mario Adrian Juárez-Peñaloza, Luis Alonso González-Tapia, Mariana Chaire-Hernández
We present the case of a 72-year-old woman diagnosed with rheumatic fever at the age of 6. In 1972, she was diagnosed with mitral valve insufficiency and mitral valve stenosis, then in 1974, a decision was made to perform mitral valve replacement surgery with a 32-mm Braunwald-Cutter ball cage prosthesis. An echocardiogram performed in 2014 revealed normal biventricular systolic function, mechanical prosthesis in mitral position with maximum speed of 1.9 m/s, maximum gradient of 15 mmHg, mean gradient of 6 mmHg, severe tricuspid valve insufficiency, inferior vena cava measuring 15 mm with more than 50% collapse and pulmonary artery systolic pressure of 40 mmHg...
February 2018: Oxford Medical Case Reports
Olivia K Ginty, John M Moore, Yuanwei Xu, Wenyao Xia, Satoru Fujii, Daniel Bainbridge, Terry M Peters, Bob B Kiaii, Michael W A Chu
OBJECTIVE: Planned mitral repair strategies are generally established from preoperative echocardiography; however, specific details of the repair are often determined intraoperatively. We propose that three-dimensional printed, patient-specific, dynamic mitral valve models may help surgeons plan and trial all the details of a specific patient's mitral repair preoperatively. METHODS: Using preoperative echocardiography, segmentation, modeling software, and three-dimensional printing, we created dynamic, high-fidelity, patient-specific mitral valve models including the subvalvular apparatus...
February 22, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
V A Sandrikov, T Y Kulagina, V A Ivanov, A S Krylov, A M Yatchenko, D R Кhadzhieva, A V Tsyganov, A V Gavrilov, I V Arkhipov
OBJECTIVE: to examine relationship between anatomical changes of the left ventricle (LV), dynamics of velocity of its volume modification, and blood flows in the LV in patients with mitral regurgitation (MR) before and after surgical treatment. MATERIALS AND METHODS: We included into this study 58 patients with severe 3-4 degree MR (38 men, 20 women aged 24-69 [mean age 51±9] years) in sinus rhythm (96 %) or atrial fibrillation (4 %). The control group included 86 healthy volunteers, mean age 39±7 years...
January 2018: Kardiologiia
Zehra Nihal Dolgun, Cihan Inan, N Cenk Sayin
OBJECTIVE: Pregnancies complicated with PHT are serious debates for obstetricians due to high maternal and fetal complication potentials. The aim of the study was to present our maternofetal outcomes in pregnant women with pulmonary hypertension. MATERIALS AND METHODS: This study was performed using data extracted from the medical files of 23 pregnancies of 18 patients with PHT who were followed-up in the obstetrics and gynecology department. RESULTS: The average age was 27...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
Vladimiro L Vida, Lorenza Zanotto, Massimiliano Carrozzini, Massimo A Padalino, Giovanni Stellin
Congenital mitral valve (MV) dysplasia is a relatively rare and highly complex cardiac disease. We sought to provide a comprehensive analysis of the current surgical techniques for treating mitral valve insufficiency and the results of mitral valve repair at our institution. Between 1972 and 2017, 104 consecutive patients underwent surgical repair of congenital MV dysplasia-insufficiency at our institution. Among these, 59 patients presented with MV insufficiency (or prevalent MV insufficiency) and were part of the study...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Enisa Hodzic, Nermir Granov
Introduction: Excess dilatation of the left atrium >65 mm is known in the literature as gigantic atrium. This dilation is most commonly encountered in the mitral insufficiency of rheumatic etiology, but also in severe prolapses of the mitral valve, permanent atrial fibrillation, and at the left right shunt with cardiac insufficiency. Case report: In this paper is presented a case study of echocardiographically verified giant thrombus in left atrium in a 50 years old female patient aged 50 hospitalized because of tiredness, choking, heartburn and urinary tract symptoms...
December 2017: Medical Archives
Anatol Prinzing, Sabine Bleiziffer, Markus Krane, Ruediger Lange
BACKGROUND: Artificial chord implantation has become one of the most applied techniques for mitral valve repair (MVR). Many techniques have been described with the goal of optimizing neochord implantation. A new annuloplasty device designed to simplify the determination of appropriate neochord length has been recently introduced. We will describe our initial experience with this new device. METHODS: The semirigid device is equipped with removable loops on the posterior aspect of the ring...
February 3, 2018: Annals of Thoracic Surgery
Joseph L Blackshear
Gastrointestinal bleeding with severe aortic stenosis was originally described in the 1950s by Heyde, although for years, the association was debated. Further discovery of mechanisms and the ubiquity and severity of acquired von Willebrand syndrome in the left ventricular assist device therapy have removed any doubts. At this time, gastrointestinal bleeding from intestinal angiodysplasia in patients with turbulence-related proteolysis of the highest molecular weight multimers of von Willebrand factor is now known to occur in patients with aortic stenosis, and also subaortic obstruction and associated mitral insufficiency in hypertrophic cardiomyopathy, isolated mitral and aortic insufficiency, endocarditis, and in patients with prosthetic valve dysfunction, either from stenosis or insufficiency...
February 3, 2018: Current Treatment Options in Cardiovascular Medicine
Z H Ni, W H Huang, Y Liu, Z J Chen, J Li, J Q Yang, P C He, Y L Zhou, J Y Chen, J F Luo
Objective: To evaluate the safety and feasibility of treating de novo coronary lesions with paclitaxel-eluting balloon. Methods: This is a retrospective study, which enrolled 76 patients with 80 de novo coronary lesions treated with paclitaxel-eluting balloons(<30% residual stenosis and there was no blood flow limited dissection after pretreatment) from April 2015 to November 2016 in Guangdong general hospital. The data of basic characteristics,procedures,devices and follow-up information were retrieved and analyzed...
January 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
David P Cork, Robert Adamson, Raghava Gollapudi, Walter Dembitsky, Brian Jaski
Mitral regurgitation commonly improves after implantation of a left ventricular assist device without concomitant valvular repair owing to the mechanical unloading of the left ventricle. However, the development (or persistence) of significant mitral regurgitation after implantation of a left ventricular assist device is associated with adverse clinical events. We present a case of a left ventricular assist device patient who successfully underwent a percutaneous MitraClip procedure for repair of persistent late postoperative mitral insufficiency with demonstrable clinical and hemodynamic improvement...
February 2018: Annals of Thoracic Surgery
Mitesh Badiwala, Terrence Yau
PURPOSE OF REVIEW: As ventricular assist device (VAD) therapy in patients with advanced heart failure continues to grow, experience with concomitant valvular diseases present either before or after VAD implantation continues to accrue. In this review, we discuss recent data and current practice as it pertains to the subject of concomitant valvular disease in patients requiring VADs. RECENT FINDINGS: Persistent aortic valve closure has been identified as a potential contributor to aortic valve 'disuse atrophy' resulting in valve degeneration...
January 13, 2018: Current Opinion in Cardiology
Francesco Onorati, Giovanni Mariscalco, Daniel Reichart, Andrea Perrotti, Giuseppe Gatti, Marisa De Feo, Antonio Rubino, Giuseppe Santarpino, Fausto Biancari, Christian Detter, Francesco Santini, Giuseppe Faggian
OBJECTIVE: Transcatheter mitral valve-in-valve/valve-in-ring procedures (TM-VIVoR) are increasing. The authors aimed to identify independent predictors for hospital mortality in redo mitral valve surgery as possible future selection criteria for TM-VIVoR. DESIGN: Retrospective multicenter registry. SETTING: Tertiary university and community hospitals. PARTICIPANTS: Two-hundred and sixty patients (out of 920 enrolled) who are potentially candidates for TM-VIVoR undergoing redo-surgery...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Tomoki Kokubun, Masayoshi Oikawa, Yasuhiro Ichijo, Yoshiyuki Matsumoto, Tetsuro Yokokawa, Kazuhiko Nakazato, Yoshiyuki Sato, Shinya Takase, Hiroharu Shinjo, Hitoshi Yokoyama, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
A 40-year-old man was transferred to our hospital following an isolated horse kick injury to the anterior chest wall. The case showed bi-fascicular block, severe tricuspid valve regurgitation due to ruptured chordae tendineae of the anterior leaflet, moderate mitral valve regurgitation due to prolapse of mitral anterior leaflet, and hypokinetic motion of the inferior septal wall. Both tricuspid and mitral insufficiency were completely repaired by a surgical operation. Fortunately, these injuries were not fatal in this case, but the comprehensive assessment of cardiac damage and careful observation are important for managing patients with cardiac injury...
January 11, 2018: Internal Medicine
You Zhong, Qays Almodares, JieFu Yang, Fang Wang, Michael Fu, Magnus C Johansson
PURPOSE: Reduced blood circulation is an important feature of heart failure, and Doppler stroke distance of the left ventricular outflow tract is a measure of forward stroke volume. Several echocardiographic parameters have known prognostic implications in heart failure, but the prognostic implications of stroke distance in relation to other parameters are insufficiently known. The aim was therefore to test the hypothesis that stroke distance is associated with five-year all-cause mortality, independently of other echocardiography variables, and that stroke distance has added long-term prognostic value...
January 9, 2018: Clinical Physiology and Functional Imaging
Roya Sattarzadeh, Anahita Tavoosi, Mohammad Saadat, Leila Derakhshan, Bakhtyar Khosravi, Babak Geraiely
Accurate measurement of Mitral Valve Area (MVA) is essential to determining the Mitral Stenosis (MS) severity and to achieving the best management strategies for this disease. The goal of the present study is to compare mitral valve area (MVA) measurement by Continuity Equation (CE) and Pressure Half-Time (PHT) methods with that of 2D-Planimetry (PL) in patients with moderate to severe mitral stenosis (MS). This comparison also was performed in subgroups of patients with significant Aortic Insufficiency (AI), Mitral Regurgitation (MR) and Atrial Fibrillation (AF)...
November 2017: Acta Medica Iranica
Naonori Kawamoto, Tomoyuki Fujita, Satsuki Fukushima, Yusuke Shimahara, Yuta Kume, Yorihiko Matsumoto, Kizuku Yamashita, Junjiro Kobayashi
BACKGROUND: There are few reports regarding factors related to late-onset of atrial fibrillation (Af) after mitral valve repair, which can compromise long-term outcome. We analyzed the risk factors for late Af after mitral valve repair. METHODS AND RESULTS: Between 2001 and 2015, 318 patients (214 males; median, 57.7 years) underwent mitral valve repair for degenerative mitral insufficiency (MI) without concomitant aortic valve disease in our institute. Patients with a history of paroxysmal or chronic Af preoperatively were excluded...
December 21, 2017: Journal of Cardiology
Dae-Hee Kim, Ran Heo, Mark D Handschumacher, Sahmin Lee, Yun-Sil Choi, Kyu-Ri Kim, Yewon Shin, Hong-Kyung Park, Joyce Bischoff, Elena Aikawa, Jong-Min Song, Duk-Hyun Kang, Robert A Levine, Jae-Kwan Song
OBJECTIVES: This study hypothesized that compensatory mitral leaflet area (MLA) adaptation occurs in patients with persistent atrial fibrillation (AF) without left ventricular (LV) dysfunction but has limitations that augment mitral regurgitation (MR). The study also explored whether asymmetrical annular dilation is matched by relative leaflet enlargement. BACKGROUND: Functional MR occurs in patients with AF and isolated annular dilation, but the relationship of MLA adaptation with annular area (AA) is unknown...
December 8, 2017: JACC. Cardiovascular Imaging
Alexandr V Bogachev-Prokophiev, Alexandr V Afanasyev, Sergei I Zheleznev, Vladimir M Nazarov, Ravil M Sharifulin, Alexandr M Karaskov
BACKGROUND: We aimed to compare the outcomes of mitral valve repair with flexible band (FB) versus complete semirigid ring (SR) in degenerative mitral valve disease patients. METHODS: From September 2011 to 2014, 171 patients were randomized and underwent successful mitral valve repair using a SR (n = 85) or FB (n = 86). There were no significant between-group differences at baseline. RESULTS: There were no early mortalities. The mean follow up was 24...
December 13, 2017: Journal of Cardiothoracic Surgery
Guilherme Ferreira Gazzoni, Matheus Bom Fraga, Andres Di Leoni Ferrari, Pablo da Costa Soliz, Anibal Pires Borges, Eduardo Bartholomay, Carlos Antonio Abunader Kalil, Vanessa Giaretta, Luis Eduardo Paim Rohde
BACKGROUND: Clinical studies demonstrate that up to 40% of patients do not respond to cardiac resynchronization therapy (CRT), thus, appropriate patient selection is critical to the success of CRT in heart failure. OBJECTIVE: Evaluation of mortality predictors and response to CRT in the Brazilian scenario. METHODS: Retrospective cohort study including patients submitted to CRT in a tertiary hospital in southern Brazil from 2008 to 2014. Survival was assessed through a database of the State Department of Health (RS)...
December 2017: Arquivos Brasileiros de Cardiologia
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
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