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Mitral Valve Insufficiency

Glenn J Rapsinski, Jina Makadia, Nitin Bhanot, Zaw Min
BACKGROUND: Gram-negative microorganisms are uncommon pathogens responsible for infective endocarditis. Pseudomonas mendocina, a Gram-negative water-borne and soil-borne bacterium, was first reported to cause human infection in 1992. Since then, it has rarely been reported as a human pathogen in the literature. We describe the first case of native valve infective endocarditis due to P. mendocina in the USA. CASE PRESENTATION: A 57-year-old white man presented with bilateral large leg ulcers, fever, and marked leukocytosis...
October 4, 2016: Journal of Medical Case Reports
Shen Liu, Yi Shi, Ruofan Liu, Minghui Tong, Xiang Luo, Jianping Xu
BACKGROUND: Dilatation of the ascending aorta tends to develop in individuals with aortic valve disease. Reduction ascending aortoplasty (RAA) is an alternative procedure to ascending aortic replacement. This study was designed to identify the early prognosis of RAA for patients with aortic valve disease and dilatation of the ascending aorta. METHODS: From January 2010 to December 2013, 102 patients with aortic valve disease and ascending aortic dilatation who had undergone aortic valve replacement combined with RAA were enrolled...
August 25, 2016: Annals of Thoracic Surgery
Devin W Kehl, Florian Rader, Charles Pollick, Alfredo Trento, Robert J Siegel
Systolic anterior motion of the mitral valve (SAM) occurs intraoperatively after mitral valve repair (MVRr) in up to 14% of cases and typically resolves in the operating room with conservative measures. Less commonly SAM may also occur in the early or late postoperative period. The clinical course and optimal management of such cases is poorly defined, but reoperation is common. We describe our experience using disopyramide to successfully treat postoperative SAM refractory to beta blockade. Seven patients were retrospectively identified with mitral valve prolapse who underwent MVRr from 2003 to 2015 and were found during follow-up to have severe SAM with a left ventricular outflow tract (LVOT) gradient not observed intraoperatively...
October 1, 2016: American Journal of Cardiology
Irfan Siddiqui, Tin Nguyen, Rajasekhar Nekkanti, Assad Movahed
Congenital defects involving anomalous chordae of the mitral valve with attachment in the left atrium are an extremely rare finding and may result in valvular insufficiency. Few cases have been reported in the literature with multiple variations in anatomical location and insertion of aberrant chordae within the left ventricle and left atrium. Reported cases have presented with cardiovascular symptoms leading to diagnosis of anomalous mitral valve chordae. We present a case of a young female in which an aberrant mitral valve chorda was an incidental finding on transesophageal echocardiography...
August 22, 2016: Echocardiography
Giovanni Benfari, Rajesh Dandale, Andrea Rossi, Francesco Onorati, Giacomo Mugnai, Flavio Ribichini, Pier L Temporelli, Corrado Vassanelli
Functional mitral regurgitation is a form of valve insufficiency in the presence of anatomically normal mitral valve. The cause of functional mitral regurgitation is left ventricular remodelling that tethers valve leaflet more apically decreasing their coaptation ability. Given the pathophysiologic relation between functional mitral regurgitation and ventricular dysfunction, the valve insufficiency has long been considered a surrogate of ventricular disease. Accordingly, all potential therapeutic strategies able to decrease functional mitral regurgitation have been associated with improved ventricular function...
November 2016: Journal of Cardiovascular Medicine
H Lan, Y G Cheng, B C Jia, Y L Chai
OBJECTIVE: To summarize the clinical outcome of totally thoracoscopic cardiac surgery for mitral valve replacement. METHODS: Clinical data of 634 cases undergoing totally thoracoscopic cardiac surgery for mitral valve replacement from May 2004 to February 2016 in Department of Thoracoscopic Cardiacsurgery, Shanghai Yodak Cardiothoracic Hospital was analyzed retrospectively. There were 292 male and 342 female patients, aged from 17 to 68 years with a mean of (45±13) years...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Iliona Malaspinas, Ferenc Petak, Lionel Chok, Anne Perrin, Anne-Laure Martin, Maurice Beghetti, Walid Habre
OBJECTIVE: To assess the profile of changes in airway and respiratory tissue mechanics within a follow-up study performed in children with mitral valve disease, before and after surgical valve repair. DESIGN: Perioperative measurements in a prospective, consecutive cross-sectional study. SETTING: University hospital, tertiary care teaching hospital PARTICIPANTS: The study comprised 24 children with congenital or post-rheumatic mitral valve insufficiency...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Paul S Pagel, Brent T Boettcher, Derek J De Vry, Julie K Freed, Zafar Iqbal
OBJECTIVE: Transmitral blood flow produces a vortex ring (quantified using vortex formation time [VFT]) that enhances the efficiency of left ventricular (LV) filling. VFT is attenuated in LV hypertrophy resulting from aortic valve stenosis (AS) versus normal LV geometry. Many patients with AS also have aortic insufficiency (AI). The authors tested the hypothesis that moderate AI falsely elevates VFT by partially inhibiting mitral leaflet opening in patients with AS. DESIGN: Observational study...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Lisa Baumann, Susanne Haen, Christoph Berg, Ferruh Artunc, Reimer Riessen, Werner Spengler, Falko Fend, Michael Haap
HISTORY AND ADMISSION FINDINGS: We report on a 48-year-old man presenting with progressive hepatopathy and encephalopathy for two weeks based on a chronic hepatitis C. He takes ledipasvir and sofosbuvir (Harvoni) and ribavirin for almost 24 weeks. After admission to hospital his state deteriorated rapidly. He is directly transferred to the medical intensive care unit, where he died on day 3. INVESTIGATIONS: During the physical examination, a pronounced jaundice and significant peripheral edema were found...
July 2016: Deutsche Medizinische Wochenschrift
Hiroshi Nakajima, Kaoru Dohi, Masaki Tanabe, Akiko Nakamura, Shinji Kanemitsu, Hideo Wada, Norikazu Yamada, Tsutomu Nobori, Hideto Shinpo, Masaaki Ito
A 76-year-old man was admitted to a community hospital due to a persistent high fever. He became afebrile after the administration of broad-spectrum antibiotics, but developed heart failure due to progressive aortic and mitral valve insufficiency and was transferred to our hospital. Although sequential blood cultures were negative, a broad-range polymerase chain reaction targeting the bacterial 16S-rRNA gene followed by the direct sequencing of whole blood revealed spa(+), mecA(-) and Panton-Valentine leukocidin (PVL)(+)...
2016: Internal Medicine
T Tichelbäcker, M Puls, C Jacobshagen, G Hasenfuß, W Schillinger, M Hünlich, M R Schroeter
BACKGROUND: Percutaneous mitral valve repair using MitraClip® (MC) is a well-established method for a subset of patients with severe mitral regurgitation (MR) and high risk for surgical intervention. Amplatzer® Cardiac Plug (ACP) occludes left atrial appendage and allows the discontinuation of oral anticoagulation and prevention of thromboembolic stroke. Due to the need for femoral and transseptal access in both procedures, a single approach could lead to minor risk of further complications and shorter cumulative intervention time...
October 1, 2016: International Journal of Cardiology
Daniel Lavall, Jan-Christian Reil, Lucia Segura Schmitz, Manuel Mehrer, Stephan H Schirmer, Michael Böhm, Ulrich Laufs
BACKGROUND: Mitral regurgitation represents a volume load on the left ventricle leading to congestion and symptoms of heart failure. The aim of this study was to characterize early hemodynamic adaptions after percutaneous mitral valve (MV) repair. METHODS: Forty-six consecutive patients with symptomatic high-grade MV insufficiency (mean age, 72 years; 54% men) were prospectively included in the study and examined before and after successful catheter-based clip implantation...
September 2016: Journal of the American Society of Echocardiography
Keping Zuo, Thuy Pham, Kewei Li, Caitlin Martin, Zhaoming He, Wei Sun
The mitral valve (MV) is a highly complex cardiac valve consisting of an annulus, anterior and posterior leaflets, chordae tendineae (chords) and two papillary muscles. The chordae tendineae mechanics play a pivotal role in proper MV function: the chords help maintain proper leaflet coaptation and rupture of the chordae tendineae due to disease or aging can lead to mitral valve insufficiency. Therefore, the aim of this study was to characterize the mechanical properties of aged human and ovine mitral chordae tendineae...
September 2016: Journal of the Mechanical Behavior of Biomedical Materials
Luca Di Marco, Davide Pacini, Antonio Pantaleo, Alessandro Leone, Giuseppe Barberio, Giuseppe Marinelli, Roberto Di Bartolomeo
OBJECTIVES: Aortic root replacement using a composite graft is the treatment of choice for a large variety of aortic root conditions with a diseased aortic valve. The objective of the current study was to evaluate the long-term results of this procedure. METHODS: Between 1978 and 2010, 1045 patients aged 58.7 ± 13.6 years underwent aortic root composite graft replacement using the following techniques: 95 Bentall operation; 926 the "button technique;" 24 the Cabrol technique...
October 2016: Journal of Thoracic and Cardiovascular Surgery
G I Salagaev, Yu V Belov, E R Charchyan, A I Katkov, I A Vinokurov
AIM: To analyze long-term surgical results in patients with aortic valve disease and concomitant mitral regurgitation (MR) depending on volume of valve surgery. MATERIAL AND METHODS: It was studied 5-year results in 71 patients with aortic valve disease and different degree of mitral regurgitation. Patients were divided into 3 groups. Control group included 40 patients after aortic valve replacement (AVR) and no mitral insufficiency. The 2nd group consisted of 16 patients after AVR and concomitant mitral regurgitation degree 2-3...
2016: Khirurgiia
L Chu, J Zhang, Y N Li, X Meng, Y Y Liu
OBJECTIVE: To investigate the clinical treatment of infective endocarditis with vegetations in pregnant women and the outcomes of the gestation. METHODS: Nine cases of pregnant women diagnosed as infective endocarditis with vegetations in Beijing Anzhen Hospital, Capital Medical University from January 2001 to October 2015 were enrolled in retrospective analysis. Consultations were held by doctors from department of obstetrics, anesthesiology, cardiology, cardial surgery and extracorporeal circulation to decide the individualized treatment plan for the 9 cases of pregnant women after admissions...
May 25, 2016: Zhonghua Fu Chan Ke za Zhi
Christian T Braun, Meret E Ricklin, Aristomenis K Exadaktylos
We present a rare case of severe ischaemic papillary muscle rupture in a 67-year-old male patient who was admitted to the Emergency Department of the University Hospital Bern, Switzerland, in November 2013 with acute chest pain. On admission, the patient's blood pressure was 60/40 mm/Hg, his pulse was 110 beats per minute and his respiratory rate was 20 breaths per minute. An electrocardiogram was normal and focused assessment with sonography in trauma was negative. Transthoracic echocardiography showed possible thickening of the mitral valve leaflet with no indications of severe mitral insufficiency or wall motion abnormalities...
May 2016: Sultan Qaboos University Medical Journal
Shinichiro Ikeda, Hideo Yoshida, Keiji Yunoki, Kunikazu Hisamochi
We performed coronary artery grafting, mitral valve plasty, and tricuspid plasty in a 75-year-old man who had double-vessel coronary disease and moderate mitral and tricuspid insufficiency. Preoperative transthoracic echocardiography revealed an ejection fraction of 34% and dyssynchronous wall motion of the septum and free wall. We placed pacing leads on the right ventricular outlet and posterior left ventricular wall for cardiac resynchronization therapy. The dyssynchrony disappeared postoperatively and the New York Heart Association functional class improved from IV to I...
May 25, 2016: Asian Cardiovascular & Thoracic Annals
Polydoros N Kampaktsis, Casper N Bang, S Chiu Wong, Nikolaos J Skubas, Harsimran Singh, Konstantinos Voudris, Amiran Baduashvili, Kalliopi Pastella, Rajesh V Swaminathan, Ryan K Kaple, Robert M Minutello, Dmitriy N Feldman, Luke Kim, Ingrid Hriljac, Fay Lin, Geoffrey S Bergman, Arash Salemi, Richard B Devereux
OBJECTIVES: We sought to examine whether baseline diastolic dysfunction (DD) is associated with increased mortality in patients who develop aortic insufficiency (AI) after transcatheter aortic valve replacement (TAVR). BACKGROUND: Significant post-TAVR AI is associated with increased mortality, likely secondary to adverse hemodynamics secondary to volume overload and decreased LV compliance from chronic pressure overload. However, the effect of baseline DD on outcomes of patients with post-TAVR AI has not been studied...
May 24, 2016: Catheterization and Cardiovascular Interventions
Álvaro García-Ropero, Marcelino Cortés García, Gonzalo Aldamiz Echevarría, Jerónimo Farré Muncharaz
A previously non-described cause of mitral regurgitation is presented. An asymptomatic 50-year old male who was casually diagnosed of mitral valve Barlow's disease underwent cardiac surgery due to severe mitral regurgitation. In the operating theatre, a longitudinal fissure of 1.5-2.0 cm length, along the posterior mitral leaflet, was found responsible for the insufficiency. This defect had features of a potential congenital origin and it was successfully repaired with direct suture. Whether it is an atypical mitral cleft, a variation of Barlow's morphology spectrum or a new congenital heart defect remains unclear...
September 2016: Interactive Cardiovascular and Thoracic Surgery
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