chordae rupture

OBJECTIVES: We investigated the role and molecular mechanisms of RNA-binding proteins (RBPs) and their regulated alternative splicing events (RASEs) in the pathogenesis of mitral valve prolapse (MVP). METHODS: For RNA extraction, we obtained peripheral blood mononuclear cells (PBMCs) from five patients with MVP, with or without chordae tendineae rupture, and five healthy individuals. High-throughput sequencing was used for RNA sequencing (RNA-seq). Differentially expressed genes (DEGs) analysis, alternative splicing (AS) analysis, functional enrichment analysis, co-expression of RBPs, and alternative splicing events (ASEs) analysis were conducted...

BACKGROUND: Double orifice mitral valve (DOMV), a rare congenital heart disease, is characterized by a 2-orifice mitral valve (MV) separated by a tissue bridge, causing a spectacles-like morphology. DOMV can present with various severity ranging from asymptomatic to severe valvular dysfunction including mitral regurgitation (MR) and mitral stenosis (MS), as well as symptoms from coexisting congenital anomalies. Echocardiography is the mainstay of the investigation for a DOMV. We described two cases with DOMV who presented with different disease severity resulting in different treatment decisions...

BACKGROUND: From a variety of ring types, semirigid ring is more preferred for mitral annuloplasty during mitral valve repair particularly in patients whose native mitral saddle shape annulus is well maintained. During mitral annuloplasty artificial chord implantation with the appropriate neochord length is surgically challenging. We present our experience of using the Memo 3D ReChord, a semirigid ring with additional chordal guiding system for mitral valve repair. PATIENTS AND METHODS: From September 2018 to February 2020, we successfully treated ten patients with severe (4+/4+) degenerative mitral valve regurgitation due to posterior leaflet prolapse with chordal rupture with the implantation Memo 3D ReChord and neo-chords...

The prevalence of patent foramen ovale (PFO) is 20-25% among adults. The role of right-to-left shunting through the PFO in systemic hypoxemia remains poorly understood. Right-to-left shunting through the PFO can occur either due to elevated right atrial pressure (pressure-driven) or directed venous flow toward the PFO (flow-driven). Herein, we report a rare case of flow-driven right-to-left shunting via the PFO in a patient with traumatic tricuspid regurgitation. A 45-year-old Chinese woman was admitted due to progressive dyspnea for 3 years, presenting with cyanosis and digital clubbing...

Unguarded severe tricuspid regurgitation caused by rupture of papillary muscle or chordae tendineae is rare but fatal in neonates. The experience in the management of these patients is still limited. A newborn presenting severe cyanosis after delivery was diagnosed with severe tricuspid regurgitation secondary to rupture of chordae tendineae by echocardiography (Echo), then treated by surgical reconstruction of chordae/papillary muscle connection without artificial materials. A takeaway lesson from this case is that Echo is an important method to diagnose a rupture of chordae tendineae or papillary muscle and that prompt diagnosis and timely surgery can be life-saving...

Pulmonary oedema of uncertain aetiology is a diagnostic challenge to clinicians worldwide. Many indicators are proposed to differentiate between cardiogenic and non-cardiogenic pulmonary oedema. Mixed pulmonary oedema is an overlap between high hydrostatic pressure and increased permeability at the microvascular level. In our case, a 77-year-old patient presented with a nine-day history of shortness of breath. He was hypoxemic in the emergency department, had a pan-systolic murmur on auscultation, and blood results showed raised inflammatory markers without any fever...

• Several conditions such as IE and papillary muscle rupture can cause acute MR. • A ruptured papillary muscle may in rare cases mimic an infectious vegetation. • Echocardiography can in most cases accurately diagnose the cause of MR. • Image quality should be considered in the diagnostic progression. • Papillary muscle rupture may be entangled by chordae preventing complete flail.

The use of mechanical circulatory support devices in cardiovascular practice has risen exponentially over the past decade. These devices are currently used for hemodynamic support in patients with cardiogenic shock, high-risk percutaneous coronary intervention, left ventricular unloading, protection of kidneys, and right ventricular failure. The Impella (Abiomed) percutaneous microaxial flow pump devices are rapidly gaining popularity. However, despite their increasing use, there are limited randomized clinical trials (RCTs) to support the benefits of the therapy and growing concern regarding complication rates...

BACKGROUND: Abnormalities of the mitral valve (MV) apparatus are typical features of hypertrophic cardiomyopathy (HCM). These abnormalities include leaflet elongation, thick leaflets, displacement of papillary muscle, and systolic anterior motion (SAM) of the MV anterior leaflet. Mitral valve chordal rupture associated with HCM is a rare but serious issue capable of change the clinical apparence and the prognosis of the patient. CASE SUMMARY: A 57-year-old lady with a history of diabetes, dyslipidemia, and a previous single episode of atrial fibrillation (treated with pharmacological cardioversion), presented to the Emergency Department for worsening dyspnea (New York Heart Association Classification class IV)...

The chordae tendinae connect the papillary muscles (PMs) to the mitral valve. While the first-order chordae serve to secure the leaflets to maintain valve closure and prevent mitral valve prolapse, the second-order chordae are believed to play a role in maintaining normal left ventricle size and geometry. The PMs, from where the chordae tendinae originate, function as shock absorbers that compensate for the geometric changes of the left ventricular wall. The second-order chordae connect the PMs to both trigons under tension...

BACKGROUND: Mitral valve repair is preferred for pediatric mitral valve disease. However, it is technically difficult because of complex lesions, poor surgical exposure, and tissue fragility, especially in infants. We investigated the midterm outcomes of mitral valve surgery for mitral regurgitation in infancy. METHODS: We retrospectively reviewed 18 patients (aged <12 months old) undergoing mitral valve surgery for mitral regurgitation at our institution between October 2005 and March 2019...

Transcatheter aortic valve replacement (TAVR) has become an established alternative to surgical aortic valve replacement for high-, intermediate-, and low-risk patients. Paravalvular leak (PVL) is a complication of TAVR that can be effectively treated with balloon dilation and vascular plugs. We report a case of an 86-year-old male presenting with symptomatic severe aortic stenosis. After the index TAVR procedure, mild-to-moderate PVL was noted. Two years post-operation, the patient presented with symptomatic severe PVL, which was initially treated by balloon dilation with additional volume...

BACKGROUND: Mitral valve repair using expanded polytetrafluoroethylene sutures to replace mitral chordae tendineae is a well-established procedure. However, the incidence of neo-chordae failure causing recurrent mitral regurgitation is not well defined. METHODS: We have reviewed the reported cases of complications after mitral valve repair related to the use of neo-chordae. This study was mainly carried out through PubMed, Medline, and Google Chrome websites. RESULTS: We have identified a total of 26 patients presenting with rupture of polytetrafluoroethylene neo-chordae, mostly being described as isolated cases...

Blunt cardiac injury after motor vehicle collision in a 23-year-old male resulting in left ventricular septal avulsion, ruptured chordae tendinae and moderate to severe tricuspid regurgitation necessitated operative intervention. Patient underwent successful resection of prolapsed avulsed septal wall segment and concomitant tricuspid valve repair.

Mitral regurgitation in hypertrophic obstructive cardiomyopathy (HOCM) is mainly due to systolic anterior motion (SAM) and may be abolished in most of the patients by extended myectomy alone. However, a minority of HOCM patients may present mitral regurgitation due to organic mitral valve (MV) anomalies (such as MV leaflet prolapse, chordal rupture, leaflet cleft, and fibrosis) which need to be addressed. In addition, when the thickness of the interventricular septum is not particularly pronounced, shallow myectomy may not be enough to eliminate SAM and additional procedures have been proposed, including MV replacement, anterior leaflet plication/extension, reorientation of papillary muscles, secondary chordae cutting, and edge-to-edge technique...

Mitral valve insufficiency is a pathological condition frequently caused by etiologies such as rheumatic heart disease, ischemic cardiomyopathy, leaflets prolapse, endocarditis, rupture of a chordae tendineae, ventricular disorders or congenital heart defects among others. Nevertheless, blunt thoracic trauma, although as a rare cause, can produce valve abnormalities. We describe a case of surgical mitral valve repair of a severe insufficiency caused by blunt chest trauma in a high energy road motorbike accident...

Traumatic accidents sometimes cause primary traumatic tricuspid regurgitation (TR), and the diagnosis is occasionally delayed due to the load adaptability of the right ventricle, which may lead to fatal outcomes. Here, we report a case of a 28-year-old man with traumatic TR, which presented with late-onset exertional dyspnea 5 years after a blunt chest injury from a bicycle accident. The chordae tendineae of anterior tricuspid leaflet was ruptured with right heart dilatation, and he underwent surgical tricuspid valvuloplasty...

Summary: Graves' disease can have multiple cardiac manifestations. A rare complication is that of severe mitral regurgitation secondary to mitral valve chordae rupture, due to both compromise of valve integrity by deposition of glycosaminoglycans and the hemodynamic stresses of thyrotoxicosis. Pregnancy, with its related hemodynamic changes, is another setting in which mitral valve chordae rupture has occasionally been documented. We present a unique case of a 36-year-old female with uncontrolled Graves' disease who presented during pregnancy at 13 weeks gestation with atrial flutter and features of congestive heart failure...

BACKGROUND: Mitral valve prolapse (MVP) is an etiologically heterogeneous disorder. Early diagnosis and prompt treatment of the underlying disease are of great significance. Herein, we present a rare case of MVP caused by anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). CASE PRESENTATION: A 22-year-old female presented with a 16-year history of anterior mitral leaflet prolapse. However, she had never experienced any discomfort before...

BACKGROUND In cardiac amyloidosis (CA), misfolded proteins deposit in the extracellular space of cardiac tissue. These deposits classically cause restrictive cardiomyopathy with diastolic dysfunction. Although there are at least 30 proteins known to cause amyloid aggregates, 2 main types make up most diagnosed cases: light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR). Since CA is considered a rare condition, it is often underdiagnosed or recognized in the advanced stages. Once amyloid deposits involve the heart tissue, they are associated with a worse outcome and higher mortality rates, especially in patients presenting symptoms of heart failure...