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chordae rupture

Pierre-Frederic Villard, Peter E Hammer, Douglas P Perrin, Pedro J Del Nido, Robert D Howe
BACKGROUND: Common surgical procedures on the mitral valve of the heart include modifications to the chordae tendineae. Such interventions are used when there is extensive leaflet prolapse caused by chordae rupture or elongation. Understanding the role of individual chordae tendineae before operating could be helpful to predict whether the mitral valve will be competent at peak systole. Biomechanical modelling and simulation can achieve this goal. METHODS: We present a method to semi-automatically build a computational model of a mitral valve from micro CT (computed tomography) scans: after manually picking chordae fiducial points, the leaflets are segmented and the boundary conditions as well as the loading conditions are automatically defined...
January 22, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
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
Petar Saric, Benjamin D Ravaee, Toral R Patel, Brian D Hoit
Myocardial contusion and aortic injury are well-known cardiac complications of blunt chest trauma, but valvular injury is rare. Traumatic valve injuries most commonly involve the aortic valve, with isolated mitral valve injury being quite rare. We report a case of acute severe mitral regurgitation due to ruptured chordae tendineae requiring surgical repair following a motor vehicle accident.
February 2018: Echocardiography
Ikuo Misumi, Masanobu Ishii
We present two cases with a mid-diastolic mitral inflow peak called an "L wave" due to underlying diseases. Case 1 was an 81-year-old woman with severe anemia (hemoglobin level of 3.9 g/dL). Pulsed Doppler echocardiography showed an L wave that disappeared after transfusion of red cell concentrates. Case 2 was a 72-year-old woman with severe mitral regurgitation due to ruptured chordae tendineae. Pulsed Doppler echocardiography showed an L wave that disappeared after mitral valve repair. The present report suggests that both severe anemia and mitral regurgitation might have contributed to L wave formation, which suggests hemodynamic deterioration...
December 7, 2017: Journal of Medical Ultrasonics
Burak Onan, Ersin Kadirogullari, Serdar Basgoze, Murat Bulent Rabus
Totally endoscopic robotic surgery is a safe approach to atrial septal defect closure in adults. Robotic approach can be an alternative to traditional incisions in the management of concomitant tricuspid valve regurgitation with ruptured chordae tendineae. Herein, we describe a woman who presented with atrial septal defect and tricuspid insufficiency after an unsuccessful percutaneous intervention with device removal from the right ventricle. Concomitant closure of septal defect and tricuspid valve repair with artificial chords was successfully performed using robot assistance...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Hyun Suk Chai, Suk Woo Lee, Jung Soo Park, Sang Chul Kim, Ji Han Lee, Hoon Kim
Blunt chest trauma can cause not only damage to the thoracic cage, but can also injure intracardiac structures including the papillary muscles, chordae tendineae, and valve leaflets. Aortic valve (AV) injury secondary to blunt chest trauma is a rare occurrence. Clinically, AV injury may be missed during the initial post-trauma assessment due to the lack of suspicion of cardiac involvement. Thus, the diagnosis of AV injury is often delayed or missed for a time interval of days to months. As a consequence, the traumatic AV regurgitation can rapidly or progressively lead to congestive heart failure unless surgically corrected...
February 2018: American Journal of Emergency Medicine
Victoria Birlutiu, Rares Mircea Birlutiu
RATIONALE: Endocarditis with Abiotrophia defectiva represents 4.3% to 6% of all streptococcal endocarditis. The article presents diagnosis issues and the complexity of the treatment. PATIENT CONCERNS: We present the case of a female white patient, aged 26 years, who developed infectious endocarditis caused by A defectiva, in the last trimester of pregnancy, a biofilm-related infection associated with the presence of fixed braces. DIAGNOSES: The diagnosis of infectious endocarditis was confirmed by the cardiac ultrasound examination that revealed a voluminous vegetation on the mitral valve, and acute mitral regurgitation caused by chordae tendinae rupture, and also by isolating Abiotrophia defectiva from two positive blood cultures...
November 2017: Medicine (Baltimore)
Silje Ekroll Jahren, Samuel Hurni, Paul Philipp Heinisch, Bernhard Winkler, Dominik Obrist, Thierry Carrel, Alberto Weber
OBJECTIVES: Many surgical and interventional methods are available to restore patency for patients with degenerative severe mitral valve regurgitation. Leaflet resection and neochordoplasty, which both include ring annuloplasty, are the most frequently performed techniques for the repair of posterior mitral leaflet flail. It is unclear which technique results in the best haemodynamics. In this study, we investigated the effect of different mitral valve reconstruction techniques on mitral valve haemodynamics and diastolic transvalvular pressure gradient in an ex vivo porcine model...
October 3, 2017: Interactive Cardiovascular and Thoracic Surgery
Nicolas Geis, Philip Raake, Derliz Mereles, Emmanuel Chorianopoulos, Gabor Szabo, Hugo A Katus, Raffi Bekeredjian, Sven T Pleger
OBJECTIVES: The aim of this study was to assess feasibility and clinical effectiveness of the MitraClip device in octogenarians suffering from severe mitral valve regurgitation due to chordae rupture. BACKGROUND: The MitraClip procedure is a suitable technique in high-risk surgical patients to achieve safe and effective percutaneous repair of mitral valve regurgitation. Octogenarians show cumulative risk and social aspects hindering mitral valve surgery. No data exists regarding the use of the MitraClip device in high-risk octogenarians suffering from mitral valve chordae rupture...
October 12, 2017: Journal of Interventional Cardiology
Ahnryul Choi, David D McPherson, Hyunggun Kim
Degenerative mitral valve (MV) disease involving mitral prolapse is one of the most prevalent MV pathologies. Quadrangular leaflet resection and neochordoplasty demonstrate excellent clinical outcomes for the treatment of posterior leaflet prolapse. We evaluated the functional and biomechanical characteristics of a virtual pathologic MV model suffering from chordal rupture, performed virtual neochordoplasty and quadrangular leaflet resection, and compared the two post-repair MV functions. The pre-repair MV demonstrated severe posterior leaflet prolapse due to the ruptured P2 chordae and excessive stress concentration...
September 13, 2017: Computers in Biology and Medicine
Matthew Fischer, Ali Salehi, Michael J Sopher, Gabriel Vorobiof, Richard J Shemin
Bioprosthetic valve-associated masses in the perioperative period are rare. This report describes the case of a 68-year-old man with perivalvular masses that were initially discovered on a routine postoperative transthoracic echocardiogram 7 days after chordae-preserving mitral valve replacement and coronary artery bypass grafting. An intraoperative transesophageal echocardiogram demonstrated ruptured papillary muscles. This case report describes the differential diagnosis and surgical management of this rare finding...
September 2017: Annals of Thoracic Surgery
Mehmet Celik, Ahmet Güner, Alev Kılıçgedik, Sabahattin Gunduz, Abdulrahman Naser, Elif Eroglu Büyüköner, Muzaffer Kahyaoglu, Cagatay Onal, Gokhan Kahveci
A 28-year-old man was admitted to our emergency service with a shortness of breath and palpitation. On admission, his blood pressure was high and he was in hypertensive pulmonary edema. His physical examination showed rales in both lungs and pansystolic murmur at mitral focus. His medical history included aortic valve replacement (AVR) because of native aortic valve infective endocarditis. Transthoracic echocardiography (TTE) showed normal functional aortic valve. Color flow imaging demonstrated severe mitral regurgitation with posterior eccentric jet...
August 2017: Echocardiography
Tatjana Lejko Zupanc, Mateja Logar
A 21-year-old man with Wolff-Parkinson-White syndrome presented to the authors' hospital with ventricular fibrillation. Coronary angiography failed to demonstrate coronary stenosis, but temporary mechanical circulatory support resolved the ventricular fibrillation and the patient was extubated eight days later. On the next day, however, he had to be re-intubated with symptoms of congestive heart failure. Echocardiography revealed new severe mitral regurgitation and a mobile mass, while emergency surgery revealed a posteromedial papillary muscle rupture (PMR)...
March 2017: Journal of Heart Valve Disease
Marina Leitman, Vladimir Tyomkin, Ehud Raanani, Ram Sharony, Ludmila Tzatskin, Eli Peleg, Alex Blatt, Zvi Vered
BACKGROUND: Acute severe mitral regurgitation (MR) is a serious medical condition. Whilst clear guidelines exist regarding the management of chronic MR, acute severe MR is usually treated on an individual basis. Currently, few data exist regarding acute MR in the era of primary coronary interventions (PCI). The present study included patients admitted to the Department of Cardiology during recent years with acute severe MR of different etiologies, and an analysis of these data in the light of previous investigations...
March 2017: Journal of Heart Valve Disease
David S Thompson, Prakash P Punjabi
A 54-year-old gentleman presented with pulmonary oedema secondary to anterolateral papillary muscle (PPM) rupture and acute mitral regurgitation subsequent to myocardial ischaemia (MI). Angiography revealed complete occlusion of the first obtuse marginal (OM1) branch of the circumflex coronary artery and a 70% occlusion of the left anterior descending (LAD) coronary artery. Operatively, unusual anatomy was noted; an accessory head was attached superiorly to the anterior lateral PPM. This gave rise to chordae that were subsequently attached to the posterior second (P2) scallop...
July 1, 2017: Perfusion
Yan Cheng, Lei Yao, Shengjun Wu
Traumatic tricuspid regurgitation is a rare and progressive disease. Early diagnosis and surgical valve repair are very important. A 57-year-old male was referred to our hospital with a history of blunt chest trauma. Three-dimensional echocardiography showed severe tricuspid regurgitation and demonstrated two main anterior leaflet chordaes of the tricuspid valve rupture and the whole anterior leaflet prolapsed. The diagnosis was severe tricuspid regurgitation due to leaflet chordae rupture secondary to blunt chest trauma...
May 31, 2017: International Heart Journal
V Mecarocci, F Mori
Background: Outcome of Mitral Valve Prolapse (MVP) was controversial for long time. Many studies reported great differences in the incidence of cardiovascular events due, above all, to heterogeneous and small studied populations. Most of theme were also published to late '80 of the last century till early '00. Purpose: To make a contemporary survey on the incidence of cardiovascular events in a selected population of patients affected by primary MVP referred to a tertiary cardiovascular center for the medical and surgical care of valvular heart disease...
December 1, 2016: European Heart Journal Cardiovascular Imaging
Toshiharu Sassa, Ken Okamoto, Hirokazu Tazume, Ryo Noguchi, Ayumi Koga, Toshihiro Fukui
We evaluated a 49-year-old man with severe tricuspid valve regurgitation and coronary artery disease who had undergone congenital ventricular septal defect repair four decades previously. We found an enlarged, prolapsed commissure between the anterior and septal leaflets and a ruptured septal leaflet chorda. Two mattress sutures closed the commissure, with the leaflets' height matched by inverting the prolapsed site ventricularly. After implanting the annuloplasty band, we undertook chordal replacement using expanded polytetrafluoroethylene sutures...
April 2017: Annals of Thoracic Surgery
Elena V Dolmatova, Kasra Moazzami, James Maher, Marc Klapholz, Justin Sambol, Alfonso H Waller
OBJECTIVES: To describe national trends in the incidence and outcomes of patients with chordae tendineae rupture (CTR). METHODS: Patients who were diagnosed with CTR between 2000 and 2012 were identified in National (Nationwide) Inpatient Sample (NIS) registry. CTR was defined using validated International Classification of Diseases, 9th Edition, Clinical Modification diagnosis (ICD9-CM) codes. Results: A total of 37,287 (14,833 mitral valve repair, 7780 mitral valve replacement) CTR cases were identified...
February 27, 2017: Heart Surgery Forum
Mehmet Bulent Vatan, Aysel Kalaycı Yigin, Ramazan Akdemir, Mustafa Tarik Agac, Mehmet Akif Cakar, Murat Aksoy, Ersan Tatli, Harun Kilic, Huseyin Gunduz, Derya Guzel, Keziban Karacan
BACKGROUND: Mitral chordae tendineae rupture (MCTR) is a progressive disorder which leads to severe mitral regurgitation. Despite its importance, the precise pathogenetic mechanism of MCTR remains unclear. The study aim was to investigate the expression profile of circulating microRNAs (miRNAs) as being potentially involved in the development of MCTR. METHODS: Twenty-one patients with 'primary' MCTR, and 30 age- and gender-matched controls, were enrolled in the study...
September 2016: Journal of Heart Valve Disease
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