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chordae rupture

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
Sabina PW Guenther, Maximilian A Pichlmaier, Erik Bagaev, Florian Herrmann, René Schramm, Steffen Massberg, Christian Hagl, Nawid Khaladj
BACKGROUND: Currently, the use of transcatheter aortic valve implantation (TAVI) is constantly increasing, whilst cardiosurgical back-up varies substantially. Besides immediate conversion to surgical aortic valve replacement (SAVR) for periprocedural complications, SAVR for TAV failure may be necessary within the early or late post-implant course. The etiology, incidence, risk-stratification, management and outcome for both scenarios are largely unclear. The study aim was to provide details of the authors' experience of SAVR after the failure of TAVI at a single institution...
September 2016: Journal of Heart Valve Disease
Seyedvahid Khodaei, Nasser Fatouraee, Malikeh Nabaei
Heart failure is one of the most important issues that has been investigated in recent research studies. Variations that occur in apparatus of mitral valve, such as chordae tendineaea rupture, can affect the valve function during ventricular contraction and lead to regurgitation from the left ventricle into the left atrium. One method for understanding mitral valve function in such conditions is computational analysis. In this paper, we develop a finite element model of mitral valve prolapse, considering the direct effect of left ventricular motion on blood flow interacting with the mitral valve...
December 28, 2016: Mathematical Biosciences
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...
March 2017: 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...
June 22, 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
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