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Mitral valve regurgitation

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https://www.readbyqxmd.com/read/28106962/the-adjustable-slipknot-technique-for-implanting-neochordae-in-the-repair-of-mitral-valve-prolapse
#1
Mitsuhiro Yano, Masakazu Matsuyama, Masanori Nishimura, Katsuya Kawagoe
The adjustable slipknot technique is a novel procedure for implanting neochordae. The neochorda acts like a lasso. The procedure facilitates accurate assessment of the length of the neochordae. We performed repairs for 30 of 31 (97.7%) patients using this technique. Less than mild residual regurgitation was observed in all patients at hospital discharge.
December 6, 2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/28105998/simultaneous-transfemoral-aortic-and-transseptal-mitral-valve-replacement-utilising-sapien-3-valves-in-native-aortic-and-mitral-valves
#2
Mohammad Bashir, Gardar Sigurdsson, Phillip A Horwitz, Firas Zahr
AIMS: Concomitant severe calcific aortic and mitral stenosis is a relatively uncommon but very challenging valvular heart disease to manage. We sought to evaluate the feasibility of a fully percutaneous approach to replace both stenotic native mitral and aortic valves using SAPIEN 3 valves. METHODS AND RESULTS: An 87-year-old woman with chronic kidney disease stage 3, pul-monary hypertension, chronic obstructive pulmonary disease, a permanent pacemaker, and atrial fibrillation was referred with Class III heart failure symptoms...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28104197/simplified-mitral-valve-repair-in-pediatric-patients-with-connective-tissue-disorders
#3
Luca A Vricella, William A Ravekes, Eloisa Arbustini, Robert D B Jaquiss, Constantine Mavroudis, Harry C Dietz, Marshall L Jacobs, Narutoshi Hibino, Duke E Cameron
BACKGROUND: In pediatric patients with connective tissue disorders (CTDs), early cardiac presentation often involves severe mitral regurgitation (MR) associated with severe bileaflet prolapse and, less frequently, aortic root enlargement. We adopted a simplified repair to address MR and prevent systolic anterior motion (SAM) in this unique group of patients. MATERIALS AND METHODS: Retrospective review of clinical and echocardiographic data of all pediatric patients (age < 18 years) with CTD and MR undergoing simplified repair at 3 institutions (2000-2014)...
February 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28101839/surgical-treatment-of-ischemic-mitral-regurgitation-valve-repair-versus-replacement
#4
REVIEW
Abhishek Sharma, Sahil Agrawal, Sunny Goel, Jeffrey S Borer
PURPOSE OF REVIEW: Ischemic mitral regurgitation (MR), which occurs in about 20-30% patients with a prior myocardial infarction, is associated with worsening heart failure and an increase in cardiovascular mortality. It should be treated surgically if certain hemodynamic severity criteria are met and in patients who continue to experience symptoms of heart failure despite optimal medical therapy. However, current guidelines do not suggest which of the available approaches to mitral valve surgery-mitral valve (MV) repair or replacement (MVR) is superior for this indication...
January 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28100876/primary-percutaneous-coronary-intervention-followed-by-valve-surgery-for-acute-coronary-syndrome-at-left-main-trunk-complicated-with-severe-aortic-stenosis
#5
Akira Shikuma, Jun Shiraishi, Kazunari Okawa, Masaki Yashige, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Akiyuki Takahashi, Takahisa Sawada
An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function...
January 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28100340/-outcome-comparison-of-different-therapy-procedures-in-surgical-high-risk-elderly-patients-with-severe-aortic-stenosis
#6
Y Q Ye, Y T Wang, Z Li, M Y Wang, H Y Xu, W J Zhang, Q R Liu, G N Niu, Y J Wu
Objective: To compare the outcome of surgical high-risk elderly patients with severe aortic stenosis(SAS) treated by different therapy procedures, including transcatheter aortic valve implantation(TAVI), surgical aortic valve replacement(SAVR), and drug therapy. Methods: We retrospectively analyzed the clinical data of 242 surgical high-risk elderly (age ≥65 years old) SAS patients hospitalized in Fuwai Hospital between September 2012 and June 2015. According to the treatment method, patients were divided into TAVI group (81 cases), SAVR group (59 cases) and drug therapy group (102 cases)...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28100277/stress-echo-2020-the-international-stress-echo-study-in-ischemic-and-non-ischemic-heart-disease
#7
Eugenio Picano, Quirino Ciampi, Rodolfo Citro, Antonello D'Andrea, Maria Chiara Scali, Lauro Cortigiani, Iacopo Olivotto, Fabio Mori, Maurizio Galderisi, Marco Fabio Costantino, Lorenza Pratali, Giovanni Di Salvo, Eduardo Bossone, Francesco Ferrara, Luna Gargani, Fausto Rigo, Nicola Gaibazzi, Giuseppe Limongelli, Giuseppe Pacileo, Maria Grazia Andreassi, Bruno Pinamonti, Laura Massa, Marco A R Torres, Marcelo H Miglioranza, Clarissa Borguezan Daros, José Luis de Castro E Silva Pretto, Branko Beleslin, Ana Djordjevic-Dikic, Albert Varga, Attila Palinkas, Gergely Agoston, Dario Gregori, Paolo Trambaiolo, Sergio Severino, Ayana Arystan, Marco Paterni, Clara Carpeggiani, Paolo Colonna
BACKGROUND: Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS: In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information...
January 18, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28097185/immediate-improvement-in-severe-mitral-regurgitation-after-aortic-valve-replacement-for-severe-aortic-insufficiency
#8
Ahmad Zeeshan, Mojun Zhu, John A Elefteriades
A 57-year-old male with ascending aortic aneurysm, severe aortic regurgitation, and severe mitral regurgitation (MR) underwent ascending aortic replacement and aortic valve replacement. MR in this patient with normal mitral valve morphology was considered secondary to aortic valve incompetency. Consequently, a surgical approach to restore aortic valve function was adopted with successful MR resolution. This case report demonstrates the possibility of reversing early functional mitral regurgitation without surgically approaching the mitral valve...
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28096824/extended-myectomy-in-the-treatment-of-patients-with-hypertrophic-obstructive-cardiomyopathy
#9
Mateusz Kuć, Piotr Kołsut, Jacek Różański, Maciej Dąbrowski, Mariusz Kłopotowski, Magda Kumor, Mirosław Kowalski, Natalia Kopyłowska, Jarosław Kuriata, Mariusz Kuśmierczyk
INTRODUCTION: Partial resection of the septal muscle is a well-established and effective method of surgical treatment for patients with hypertrophic obstructive cardiomyopathy (HOCM). The procedure is characterized by a low operative mortality rate and long-term clinical improvement that has been confirmed in numerous publications. Mitral insufficiency in patients with HOCM is mostly functional due to the effect of systolic anterior motion (SAM). AIM: To present the early results of surgical treatment provided to HOCM patients and to compare the effectiveness of two surgical procedures: isolated myectomy and myectomy combined with mitral valve replacement...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28095388/the-use-of-mitraclip-for-symptomatic-patients-with-hypertrophic-obstructive-cardiomyopathy
#10
Felix Thomas, Florian Rader, Robert J Siegel
OBJECTIVES: Current nonpharmacological therapies for symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM), including septal myectomy and alcohol septal ablation (ASA), carry significant risks for serious cardiac conduction abnormalities. We present a review of the currently available published data regarding the novel use of the relatively low-risk MitraClip® system in the treatment of symptomatic patients. METHODS: Data were collected from 4 separate studies on the use of the MitraClip on 15 symptomatic HOCM patients with systolic anterior motion (SAM) of the mitral valve apparatus...
January 18, 2017: Cardiology
https://www.readbyqxmd.com/read/28093494/exercise-dynamics-in-secondary-mitral-regurgitation-pathophysiology-and-therapeutic-implications
#11
Philippe B Bertrand, Ehud Schwammenthal, Robert A Levine, Pieter M Vandervoort
Secondary mitral valve regurgitation (MR) remains a challenging problem in the diagnostic workup and treatment of patients with heart failure. Although secondary MR is characteristically dynamic in nature and sensitive to changes in ventricular geometry and loading, current therapy is mainly focused on resting conditions. An exercise-induced increase in secondary MR, however, is associated with impaired exercise capacity and increased mortality. In an era where a multitude of percutaneous solutions are emerging for the treatment of patients with heart failure, it becomes important to address the dynamic component of secondary MR during exercise as well...
January 17, 2017: Circulation
https://www.readbyqxmd.com/read/28091966/aortic-regurgitation-generates-a-kinematic-obstruction-which-hinders-left-ventricular-filling
#12
Ikechukwu Okafor, Vrishank Raghav, Jose F Condado, Prem A Midha, Gautam Kumar, Ajit P Yoganathan
An incompetent aortic valve (AV) results in aortic regurgitation (AR), where retrograde flow of blood into the left ventricle (LV) is observed. In this work, we parametrically characterized the detailed changes in intra-ventricular flow during diastole as a result of AR in a physiological in vitro left-heart simulator (LHS). The loss of energy within the LV as the level of AR increased was also assessed. The validated LHS consisted of an optically-clear, flexible wall LV and a modular AV holder. Two-component, planar, digital particle image velocimetry was used to visualize and quantify intra-ventricular flow...
January 13, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28090292/a-new-look-at-bronchopulmonary-dysplasia-postcapillary-pathophysiology-and-cardiac-dysfunction
#13
Arvind Sehgal, Andra Malikiwi, Eldho Paul, Kenneth Tan, Samuel Menahem
Pulmonary hypertension (PH) and right ventricular function are the focus of cardiovascular effects of bronchopulmonary dysplasia (BPD). We assessed cardiac indexes reflecting systemic afterload and pulmonary venous back pressure as pathophysiologic factors. Cardiac parameters were measured by conventional echocardiography in 20 preterm infants with severe BPD and compared with those of 10 preterm infants with no BPD and 20 healthy term infants. In infants with severe BPD, PH was noted in 5 (25%) by tricuspid regurgitation Doppler jet ≥2...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28089953/transcatheter-treatment-of-severe-tricuspid-regurgitation-using-the-edge-to-edge-repair-technique
#14
Daniel Braun, Michael Nabauer, Mathias Orban, Martin Orban, Lisa Gross, Andrea Englmaier, Diana Rösler, Julinda Mehilli, Axel Bauer, Christian Hagl, Steffen Massberg, Jörg Hausleiter
AIMS: The aim of this study was to investigate the procedural feasibility and short-term durability of the transcatheter tricuspid valve edge-to-edge repair technique in highly symptomatic patients with severe tricuspid regurgitation (TR). METHODS AND RESULTS: Eighteen consecutive patients suffering from severe right-sided heart failure (NYHA Class III-IV), primarily due to moderate to severe tricuspid regurgitation, were included in the study. Applying a modified steering technique for the clip delivery system, six patients were treated for isolated severe TR, while 12 patients were treated for moderate to severe TR and concomitant severe mitral regurgitation...
January 17, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28089952/impact-of-tricuspid-valve-regurgitation-in-surgical-high-risk-patients-undergoing-mitraclip-implantation-results-from-the-trami-registry
#15
Daniel Kalbacher, Ulrich Schäfer, R Stephan Von Bardeleben, Christine S Zuern, Raffi Bekeredjian, Taoufik Ouarrak, Horst Sievert, Georg Nickenig, Peter Boekstegers, Jochen Senges, Wolfgang Schillinger, Edith Lubos
AIMS: We sought to assess the impact of TR severity on patient outcome in a collective with relevant mitral regurgitation undergoing MitraClip implantation. METHODS AND RESULTS: From 08/2010-07/2013, 766 patients (age 75.3±8.5 years, 61% male gender, median EuroSCORE 24.3%±18.4) were prospectively enrolled in the TRAMI registry and stratified by echocardiography in no/mild, moderate and severe TR. Overall, the mean of implanted MitraClips was higher in patients with severe TR but increasing TR severity was not associated with procedural success...
January 17, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28079765/early-recurrence-of-tako-tsubo-cardiomyopathy-in-an-elderly-woman-with-amyotrophic-lateral-sclerosis-different-triggers-inducing-different-apical-ballooning-patterns
#16
Francesco Santoro, Riccardo Ieva, Armando Ferraretti, Elena Carapelle, Luisa De Gennaro, Luigi Maria Specchio, Matteo Di Biase, Natale Daniele Brunetti
We report the case of early recurrence of Tako-Tsubo cardiomyopathy in an elderly woman with amyotrophic lateral sclerosis triggered by different stressors. A first episode with typical apical ballooning was anticipated by an emotional stress; a second, characterized by systolic anterior motion of the mitral valve associated with mitral regurgitation and severe intra-ventricular gradient, was precipitated by surgical stress and hypovolemia. We therefore hypothesize both a possible link between amyotrophic lateral sclerosis and Tako-Tsubo cardiomyopathy, and between different stressors and different Tako-Tsubo patterns...
January 11, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28077510/mitral-implant-of-the-inovare-transcatheter-heart-valve-in-failed-surgical-bioprostheses-a-novel-alternative-for-valve-in-valve-procedures
#17
Diego Felipe Gaia, Ademir Massarico Braz, Matheus Simonato, Danny Dvir, João Roberto Breda, Gustavo Calado Ribeiro, Carolina Baeta Ferreira, José Augusto Marcondes Souza, Enio Buffolo, José Honório Palma
OBJECTIVES: Reoperative procedure for the treatment of a failed mitral bioprosthesis is associated with considerable risk. In some cases, mortality is high and might contraindicate the benefit of the procedure. The minimally invasive valve-in-valve (ViV) transcatheter mitral valve implant offers an alternative less-invasive approach, reducing morbidity and mortality. The objective of this paper was to evaluate the mitral ViV approach using the Braile Inovare prosthesis. METHODS: The transcatheter balloon-expandable Braile Inovare prosthesis was used in 12 cases...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28077468/integrated-imaging-of-echocardiography-and-computed-tomography-to-grade-mitral-regurgitation-severity-in-patients-undergoing-transcatheter-aortic-valve-implantation
#18
Philippe J van Rosendael, Suzanne E van Wijngaarden, Vasileios Kamperidis, William K F Kong, Melissa Leung, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
AIMS: Quantitative mitral regurgitation (MR) grading remains challenging. This study evaluated the concept of integrating echocardiography and computed tomography for grading MR severity. Specifically, an integrated parameter was developed that combines the true cross-sectional mitral regurgitant orifice area (ROA) assessed with multi-detector row computed tomography (MDCT) with flow data from echocardiography. METHODS AND RESULTS: Systolic MDCT data of 73 patients, referred for transcatheter aortic valve implantation (TAVI) who also had MR, were evaluated...
January 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28073864/mitraclip-improves-mitral-valve-geometry-in-complex-organic-mitral-regurgitation-insights-from-three-dimensional-echocardiography
#19
Philippe Debonnaire, Frank van der Kley, Nina Ajmone Marsan, Victoria Delgado
No abstract text is available yet for this article.
January 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28070866/finite-element-analysis-of-patient-specific-mitral-valve-with-mitral-regurgitation
#20
Thuy Pham, Fanwei Kong, Caitlin Martin, Qian Wang, Charles Primiano, Raymond McKay, John Elefteriades, Wei Sun
Functional mitral regurgitation (FMR) is a significant complication of left ventricular dysfunction and strongly associated with a poor prognosis. In this study, we developed a patient-specific finite element (FE) model of the mitral apparatus in a FMR patient which included: both leaflets with thickness, annulus, chordae tendineae, and chordae insertions on the leaflets and origins on the papillary muscles. The FE model incorporated human age- and gender-matched anisotropic hyperelastic material properties, and MV closure at systole was simulated...
January 9, 2017: Cardiovascular Engineering and Technology
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