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Mitral surgery

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
Pankaj Aggarwal, Anil Bhan
Uniqueness of this case report is that though coronary cameral fistulas are itself rare, we closed fistula effectively in a different way. Since surgery was only good option available as patient had concomitant valvular disease, we closed distal end of fistula in PA and then took deep bites of suture in fistulous track itself. This approach closed fistula effectively and we had no need to dissect and ligate its origin from LAD which is more arduous and dangerous task.
September 2016: Indian Heart Journal
D Sheshagiri Rao, Ramachandra Barik, Akula Siva Prasad
Hemolysis related to occluder, prosthetic valve, and prosthetic ring used for mitral valve annuloplasty are not very unusual. However, hemolysis related to transcathetor closure of post-myocardial infarction ventricular septal defect (PMIVSD) is infrequent. A close follow-up for spontaneous resolution with or without blood transfusion has been reported in a few cases. Occasionally, surgical retrieval is unavoidable or lifelong blood transfusion is required if surgery cannot be done because of higher risk. In this illustration, we have showed a close follow-up of a case of hemolysis induced by atrial septal occluder used for VSD closure after myocardial infarction...
September 2016: Indian Heart Journal
Shegu Gilbert, Devender Singh, M Lawrance Jesuraj
Severe QT interval prolongation >500ms occurs in one quarter of cardiac surgical patients in the perioperative period while moderate prolongation occurs in most of them. Prolonged QT interval may be associated with torsades de pointes and lead to sudden cardiac death. Because of the high incidence of prolonged QT in cardiac surgery patients and its perioperative adverse outcomes, it is vital to identify it early and take necessary precautions. We report and discuss the catastrophic events and management of two patients with long QT syndrome complicating mitral valve replacement...
September 2016: Indian Heart Journal
Jagdish C Mohan, Madhu Shukla, Vishwas Mohan, Arvind Sethi
Left atrial dissection is a very uncommon complication of cardiac surgery and usually causes significant hemodynamic compromise. Little is known about spontaneous dissection of the left atrium. Two patients, one middle-aged man and another elderly woman were evaluated following stroke. Routine trans-thoracic echocardiogram showed vertical division of the left atrium with both chambers communicating with each other through an orifice. Detailed trans-oesophageal echocardiographic study revealed dissection of the left atrium producing an additional false chamber (pseudo-aneurysm) placed posterior to the left atrial appendage and above the postero-lateral aspect of mitral annulus...
September 2016: Indian Heart Journal
Gauranga Majumdar, Surendra Agarwal, Shantanu Pande, Satyendra Tewari
Right atrial myxomas are rare. Its occurrence in a previously operated patient of rheumatic mitral stenosis posed clinical diagnostic challenge. We herein report a case of right atrial myxoma who had undergone mitral valve repair 20 years ago and now presented in congestive heart failure. The tumor was arising from the ostium of the coronary sinus and prolapsed into the right ventricle causing significant right ventricular inflow and outflow obstruction. Urgent repeat cardiac surgery was successfully performed to remove the tumor along with mitral valve replacement...
September 2016: Indian Heart Journal
Linfeng Qian, Junnan Zheng, Hongfei Xu, Liping Shi, Lanjuan Li
BACKGROUND: Patients with respiratory failure caused by H7N9 may benefit from veno-venous, veno-arterial, and veno-veno-arterial extracorporeal membrane oxygenation (ECMO) support. CASE SUMMARY: A 55-year-old male patient was suffering from H7N9-caused acute respiratory distress syndrome (ARDS). He had a mechanical mitral and aortic valve replacement surgery and was using warfarin for anticoagulation. After prolonged mechanical ventilation, oxygen saturation was not improved...
October 2016: Medicine (Baltimore)
Philip Y K Pang, Jiasi Zhu, Yoong Kong Sin, Yeow Leng Chua
Most mitral paravalvular leaks (PVLs) occur during the first year after mitral valve replacement (MVR). This report describes the surgical management of 6 patients who developed very late mitral PVLs. The median interval between MVR and initial diagnosis of PVL was 16.5 years. All patients presented with congestive cardiac failure and haemolytic anaemia. The median EuroSCORE II was 9.5%. Two patients (33%) had failed attempts at transcatheter closure. Five patients underwent suture repair of the PVL. One patient underwent MVR after removal of the previous prosthesis...
September 2016: Journal of Thoracic Disease
Aabid Hussain Mir, Zulfiqar Ali, Bashir Ahmad Dar, Imtiaz A Naqash, Samreena Bashir
Congenital heart defects are associated with various physiological disturbances. They pose anesthetic challenges for both cardiac and noncardiac surgeries. Atrioventricular septal defects are due to a developmental failure in the separation of atria and the ventricles into separate chambers and failure in the separation of mitral and tricuspid valves. We present a case of a child (1½ years), weighing 10 kg, diagnosed as congenital hydrocephalus who was planned for ventriculoperitoneal shunt. Child was having an oxygen saturation of 76% on room air...
September 2016: Anesthesia, Essays and Researches
Matthias Bechtel, Markus Schlömicher, Vadim Moustafine, Justus Thomas Strauch
The technique of rapid deployment aortic valve implantation in patients with concomitant mitral valve surgery is described and the outcome of our first 25 patients reported.
October 15, 2016: European Journal of Cardio-thoracic Surgery
James W Hansen, Alaa Ayyoub, Neil Yager, Sergio Waxman
Isolated congenital single coronary artery (SCA) is rare (incidence 0.024-0.066%). We present a case of a Lipton -1 subtype single coronary artery, incidentally discovered on coronary angiography prior to mitral valve surgery.
September 29, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Junnan Zheng, Liangwei Chen, Linfeng Qian, Jianjie Jiang, Yinglian Chen, Jue Xie, Liping Shi, Yiming Ni, Haige Zhao
We aimed to evaluate whether blood conservation strategies including intraoperative autologous donation (IAD) could reduce perioperative blood transfusion for patients undergoing cardiac valve replacement including mitral valve replacement, aortic valve replacement (AVR), and double valve replacement (DVR).A total of 726 patients were studied over a 3-year period (2011-2013) after the implementation of IAD and were compared with 919 patients during the previous 36-month period (January 2008-December 2010). The method of small-volume retrograde autologous priming, strict blood transfusion standard together with IAD constituted a progressive blood-saving strategy...
October 2016: Medicine (Baltimore)
Santosh Kumar Sinha, Shalini Garg, Ramesh Thakur, Vinay Krishna, Karandeep Singh, Mohit Sachan, Amit Goel, Mahamdula Razi, Umeshwar Pandey, Chandra Mohan Varma
BACKGROUND: The optimal timing of surgery in patients with chronic organic severe mitral regurgitation (MR) continues to be debated, especially for those who are asymptomatic. The aim of the study was to determine independent and additive prognostic value of exercise brain natriuretic peptide (eBNP) in patients with severe asymptomatic MR and normal left ventricular ejection fraction (LVEF). METHODS: Two hundred twenty-three consecutive patients with severe MR defined by effective regurgitant orifice (ERO) area ≥ 40 mm(2) and/or residual volume ≥ 60 mL, LVEF > 60%, and normal LV end-systolic diameter < 40 mm underwent symptom limited exercise treadmill test (TMT)...
November 2016: Journal of Clinical Medicine Research
Boyang Liu, Nicola C Edwards, Simon Ray, Richard P Steeds
Mitral regurgitation (MR) is the second most common form of valvular disease requiring surgery. Correct identification of surgical candidates and optimising the timing of surgery is key in management. For primary MR, this relies upon a balance between the perioperative risks and rates of successful repair in patients undergoing early surgery when asymptomatic with the potential risk of irreversible left ventricular dysfunction if intervention is performed too late. For secondary MR, recognition that this is a highly dynamic condition where MR severity may change is key, although data on outcomes in determining whether concomitant valve intervention is performed with revascularisation has raised questions regarding timing of surgery...
October 13, 2016: Echo Research and Practice
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
A Ammar, K Mahmoud, A Elkersh, Z Kasemy
There is a strong association between pre-operative diastolic dysfunction and difficulty in weaning from cardiopulmonary bypass. We compared the effects of propofol and isoflurane on left ventricular diastolic function in patients with pre-existing diastolic dysfunction undergoing coronary artery bypass grafting. We randomly allocated 60 patients to receive either propofol or isoflurane anaesthesia, and assessed left ventricular diastolic function using transoesophageal echocardiography. We measured early (E), late (A) diastolic velocities, E/A ratio, A-wave duration and deceleration time using pulsed wave Doppler, and early (Em), late (Am) diastolic velocities of the mitral annulus, Em/Am ratio and isovolumetric relaxation time using tissue Doppler...
November 2016: Anaesthesia
Kuk Hui Son, Chang-Hyu Choi, Jae-Ik Lee, Kun Woo Kim, Ji Sung Kim, So Young Lee, Kook Yang Park, Chul Hyun Park
BACKGROUND: Guidelines for esophagogastroduodenoscopy (EGD) in the West allow the continued use of warfarin under therapeutic international normalized ratio (INR) level. In Korea, no guidelines have been issued regarding warfarin treatment before EGD. The authors surveyed Korean cardiac surgeons about how Korean cardiac surgeons handle warfarin therapy before EGD using a questionnaire. Participants were requested to make decisions regarding the continuation of warfarin therapy in two hypothetical cases...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Sten Lyager Nielsen
Transcatheter mitral valve (MV) intervention has emerged as an effective treatment option for symptomatic severe mitral regurgitation (MR) in patients considered to be inoperable or at high operative risk for surgical MV surgery. In primary mitral regurgitation, surgical repair is the standard of care. Transcatheter edge-to-edge MV repair with the MitraClip system has the largest clinical experience to date, and offers a sustained clinical benefit in selected surgical high-risk patients. Surgery for secondary MR remains a challenge...
October 13, 2016: Scandinavian Cardiovascular Journal: SCJ
Juan A Crestanello
No abstract text is available yet for this article.
September 12, 2016: Journal of Thoracic and Cardiovascular Surgery
Hideyuki Hasebe, Akira Takanohashi, Kazuaki Shirota, Hajime Nakamura
Atrioventricular (AV) block and pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) are rare complications of infective endocarditis (IE). A 72-year-old man with severe aortic stenosis was hospitalized due to IE. After admission, intermittent AV block and P-MAIVF were noted. Interestingly, an accelerated junctional rhythm was observed during the process of AV block resolution. Elective surgery, which included patch closure of the fistula and replacement of the aortic valve, was successfully performed...
2016: Internal Medicine
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