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chordae rupture

Milan Toma, Charles H Bloodworth, Eric L Pierce, Daniel R Einstein, Richard P Cochran, Ajit P Yoganathan, Karyn S Kunzelman
The chordal structure is a part of mitral valve geometry that has been commonly neglected or simplified in computational modeling due to its complexity. However, these simplifications cannot be used when investigating the roles of individual chordae tendineae in mitral valve closure. For the first time, advancements in imaging, computational techniques, and hardware technology make it possible to create models of the mitral valve without simplifications to its complex geometry, and to quickly run validated computer simulations that more realistically capture its function...
September 13, 2016: Annals of Biomedical Engineering
Luca T Giurgea, Tim Lahey
Haemophilus parainfluenzae, which uncommonly causes endocarditis, has never been documented to cause mural involvement. A 62-year-old immunocompetent female without predisposing risk factors for endocarditis except for poor dentition presented with fever, emesis, and dysmetria. Echocardiography found a mass attached to the left ventricular wall with finger-like projections. Computed tomography showed evidence of embolic phenomena to the brain, kidneys, spleen, and colon. Cardiac MRI revealed involvement of the chordae tendineae of the anterior papillary muscles...
2016: Case Reports in Infectious Diseases
Oğuz Karaca, Günhan Demir, Arda Özyüksel, Atıf Akçevin
Cardiac valve injury, a condition that can follow blunt thoracic trauma, has a wide range of clinical presentations, depending on the structures involved. Post-traumatic tricuspid regurgitation is relatively rare, caused by increase in intrathoracic pressure when the tricuspid valve leaflets close, leading to rupture of the chordae tendineae. A case of severe tricuspid regurgitation due to chordal rupture presenting with atrial flutter following a motorbike accident is described in the present report.
June 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Didier de Cannière, Jean-Luc Vandenbossche, Elias Nouar, Sebastian Faict, Alessandro Falchetti, Philippe Unger
We report the case of a patient who presented with sequential rupture of two papillary muscle bellies after emergent mitral valve replacement with subvalvular apparatus preservation for acute severe mitral regurgitation and cardiogenic shock during acute myocardial infarction. We discuss the possibility that the remaining chordae may have meanwhile contributed to muscle avulsion by exerting traction on ischemic myocardium and prevented embolization of the secondarily detached papillary muscle heads.
July 2016: Annals of Thoracic Surgery
Nithima Ratanasit, Khemajira Karaketklang, Rungroj Krittayaphong
BACKGROUND: The common pathophysiological consequences of chronic mitral regurgitation (MR) are left atrial (LA) remodeling/dilatation and pulmonary hypertension (PH). We aimed to study the association between LA volume (LAV) and PH in patients with chronic organic MR. METHODS: We prospectively studied 154 patients (age 55.0 ± 16.4 years, 39.6 % female) with isolated moderate to severe chronic organic MR. Severity of MR was assessed using proximal isovelocity surface area method...
2016: BMC Cardiovascular Disorders
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
Jerry Fan, Alexa Timbrook, Sarmad Said, Kamran Babar, Mohamed Teleb, Debabrata Mukherjee, Aamer Abbas
BACKGROUND: Myxomatous mitral valve with prolapse are classically seen with abnormal leaflet apposition during contraction of the heart. Hemodynamic disorders can result from eccentric mitral regurgitation usually caused by chordae tendinae rupture or papillary muscle dysfunction. Echocardiography is the gold standard for evaluation of leaflet flail and prolapse due to high sensitivity and specificity. Though most mitral valve prolapse are asymptomatic those that cause severe regurgitation need emergent surgical intervention to prevent disease progression...
2016: Polish Journal of Radiology
Sarah Ghulam Ali, Laura Fusini, Gloria Tamborini, Manuela Muratori, Paola Gripari, Massimo Mapelli, Marco Zanobini, Francesco Alamanni, Mauro Pepi
A recent histological study of resected scallop-P2 in mitral valve (MV) prolapse, showed that chordae tendinae may be missing or hidden in superimposed fibrous tissue of the leaflets, contributing to their thickening. This may have relevant clinical implication because detailed analysis of MV leaflets has a central role in the evaluation of patients undergoing repair. The aim of this study was to analyze MV leaflets focusing on thickness of prolapsing segments and the presence of chordal rupture (CR). We enrolled 246 patients (age 63 ± 13 years, 72 men) with isolated P2 prolapse and also 50 age-matched patients with normal MV anatomy as control group...
July 1, 2016: American Journal of Cardiology
Robert W Loar, Shiraz A Maskatia, Ericka Scheller McLaughlin, Antonio R Mott, Iki Adachi, Charles D Fraser
Traumatic injury to the tricuspid valve can result from severe nonpenetrating chest wall trauma. We present the case of an initially asymptomatic 11-year-old girl who was kicked in the chest by a horse. The trauma resulted in avulsed papillary muscles, ruptured chordae, and right heart failure. She underwent early tricuspid valve reconstruction and annuloplasty. We advocate for routine use of echocardiography to assess for traumatic injury to intracardiac structures. In addition, we believe that early surgical intervention may prevent right-sided heart dysfunction, atrial arrhythmias, and the need for valve replacement...
March 2016: Annals of Thoracic Surgery
Sadahiro Sai, Akinobu Konishi, Mitsuru Sato, Satoshi Matsuo, Megumi Nitta
Early surgical intervention is required for sudden onset, severe mitral regurgitation (MR) due to chordal rupture in infants with normal development younger than 1 year. The condition has been recognized as idiopathic. However, the surgical options in children are limited because of their size and somatic growth. We sought to examine the efficacy of mitral valve plasty by artificial chordal reconstruction for these infants in mid-to-long term. From August 2005 through June 2012, 8 consecutive patients aged 1-7 months underwent mitral valve plasty by chordal reconstruction using expanded polytetrafluoroethylene sutures for MR, owing to leaflet prolapse...
2015: Seminars in Thoracic and Cardiovascular Surgery
Wenhui Gong, Sen Li, Dong Lei, Peng Huang, Zhize Yuan, Zhengwei You, Xiaofeng Ye, Qiang Zhao
Chordae tendineae are essential for maintaining mitral valve function. Chordae replacement is one of the valve repair procedures commonly used to treat mitral valve regurgitation. But current chordae alternatives (polytetrafluoroethylene, ePTFE) do not have the elastic and self-regenerative properties. Moreover, the ePTFE sutures sometimes fail due to degeneration, calcification and rupture. Tissue-engineered chordae tendineae may overcome these problems. The utility of xenogeneic chordae for tissue-engineered chordae tendineae has not yet been adequately explored...
March 2016: Journal of the Mechanical Behavior of Biomedical Materials
Andrea Colli, Erica Manzan, Fabio Zucchetta, Eleonora Bizzotto, Laura Besola, Lorenzo Bagozzi, Roberto Bellu, Cristiano Sarais, Demetrio Pittarello, Gino Gerosa
BACKGROUND: This prospective study aims to assess early clinical outcomes in patients undergoing Transapical Off-Pump Mitral Valve Intervention with Neochord Implantation (TOP-MINI). METHODS AND RESULTS: Forty-nine patients with severe symptomatic degenerative mitral regurgitation (MR) were treated. Median age was 72 years (IQR 58-78) and median Euroscore-I was 3.26% (IQR 0.88-8.15). Forty-four patients (89.8%) presented with posterior leaflet prolapse (LP), 4 (8...
February 1, 2016: International Journal of Cardiology
Aysel Kalayci Yigin, Mehmet Bulent Vatan, Ramazan Akdemir, Muhammed Necati Murat Aksoy, Mehmet Akif Cakar, Harun Kilic, Unal Erkorkmaz, Keziban Karacan, Suleyman Kaleli
Polymorphisms in Lys939Gln XPC gene may diminish DNA repair capacity, eventually increasing the risk of carcinogenesis. The aim of the present study was to evaluate the significance of polymorphism Lys939Gln in XPC gene in patients with mitral chordae tendinea rupture (MCTR). Twenty-one patients with MCTR and thirty-seven age and sex matched controls were enrolled in the study. Genotyping of XPC gene Lys939Gln polymorphism was carried out using polymerase chain reaction- (PCR-) restriction fragment length polymorphism (RFLP)...
2015: Disease Markers
Claudia Cajas-Morales, Citlalic Martinez-Beltran, Sergio Criales-Vera, Jose Antonio Arias-Godinez, Nilda Espinola-Zavaleta
No abstract text is available yet for this article.
April 2016: Echocardiography
Yasutaka Hirata
The acute mitral regurgitation of the infants are believed to be very rare until recently. However, there have been increasing number of reports of acute massive mitral regurgitation attributable to rupture of the chordae tendaniae escecially in Japan. If undiagnosed or the optimal treatment including surgery is delayed, it may cause cardiogenic shock and death in infants. Thus pediatricians, pediatric cardiologists and pediatric caridiac surgeons should consider this diagnosis when previously healthy infant suddenly develop cardiorespiratory collapse...
July 2015: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Hiroaki Fujita, Itaru Nakamura, Ayaka Tsukimori, Akihiro Sato, Kiyofumi Ohkusu, Tetsuya Matsumoto
A case of severe endocarditis, with complications of multiple infarction, meningitis, and ruptured mitral chordae tendineae, caused by Streptococcus agalactiae in a healthy man, is reported. Emergency cardiovascular surgery was performed on the day of admission. Infective endocarditis caused by S. agalactiae is very rare, particularly in a healthy adult. In addition, microbiological analysis revealed that S. agalactiae of sequence type (ST) 19, which belongs to serotype III, was present in the patient's vegetation, mitral valve, and blood culture...
September 2015: International Journal of Infectious Diseases: IJID
Burak Acar, Muhammed Suleymanoglu, Cengiz Burak, Burcu Mecit Demirkan, Yesim Guray, Omac Tufekcioglu, Sinan Aydogdu
Blunt chest traumas mostly occur due to car accidents and can cause many cardiac complications such as septal rupture, free-wall rupture, coronary artery dissection or thrombosis, heart failure, arrhythmias, and chordae and papillary muscle rupture. One of the most serious complication is tricuspid regurgitation (TR), which can be simply diagnosed by physical examination and confirmed by echocardiography. We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident...
2015: Journal of Tehran Heart Center
Gillian M Gunning, Bruce P Murphy
Mitral valve prolapse is often caused by either elongated or ruptured chordae tendineae (CT). In many cases, rupture is spontaneous, meaning there is no underlying cause. We hypothesised that spontaneous rupture may be due to mechanical fatigue. To investigate this hypothesis, we tested porcine marginal CT: in uniaxial tension, and in fatigue at a range of peak stresses (n=12 at 15, 10 and 7.5MPa respectively, n=6 at 5MPa). The rupture surfaces of failed CT were observed histologically, under polarised light microscopy, and SEM...
September 2015: Acta Biomaterialia
Pietro Pugliatti, Concetta Zito, Rosaria Adamo, Salvatore Calcaterra, Salvatore Patanè
No abstract text is available yet for this article.
September 15, 2015: International Journal of Cardiology
Sulafa K M Ali, Riyadh Abu-Sulaiman, Rihab Beshir Agouba
UNLABELLED: Noncompaction cardiomyopathy (NCCM) is a primary, genetic cardiomyopathy with variable clinical manifestations that include mitral regurgitation (MR). METHODS: This study comprised patients diagnosed with NCCM and MR in two cardiac centers (King Abdul-Aziz Cardiac Center, Riyadh, Kingdom of Saudi Arabia and Sudan Heart Institute, Khartoum, Sudan), and seen in the period between 2002 and 2013. The study describes follow up, clinical, echocardiographic, and histopathological findings...
April 2015: Journal of the Saudi Heart Association
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