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Ischemic mitral regurgitation

Romain Capoulade, Xin Zeng, Jessica R Overbey, Gorav Ailawadi, John H Alexander, Deborah Ascheim, Michael Bowdish, Annetine C Gelijns, Paul Grayburn, Irving L Kron, Robert A Levine, Michael J Mack, Serguei Melnitchouk, Robert E Michler, John C Mullen, Patrick O'Gara, Michael K Parides, Peter Smith, Pierre Voisine, Judy Hung
BACKGROUND: In ischemic mitral regurgitation (IMR), ring annuloplasty is associated with a significant rate of recurrent MR. Ring size is based on intertrigonal distance without consideration of left ventricular (LV) size. However, LV size is an important determinant of mitral valve (MV) leaflet tethering before and after repair. We aimed to determine whether LV-MV ring mismatch (mismatch of LV size relative to ring size) is associated with recurrent MR in patients with IMR after restrictive ring annuloplasty...
October 25, 2016: Circulation
Francesco Nappi, Cristiano Spadaccio, Antonio Nenna, Mario Lusini, Massimiliano Fraldi, Christophe Acar, Massimo Chello
OBJECTIVE: The symmetry of mitral valve tethering and regional left ventricle wall dysfunction are reported to play a fundamental role in the outcomes and long-term durability of surgical repair in ischemic mitral regurgitation (IMR). We recently demonstrated in a randomized clinical trial (the Papillary Muscle Approximation trial) the superiority of papillary muscle approximation (PMA) in combination with standard restrictive annuloplasty (RA) in severe IMR over annuloplasty alone in terms of adverse left ventricular remodeling and mitral regurgitation (MR) recurrence...
September 24, 2016: Journal of Thoracic and Cardiovascular Surgery
Joyce Bischoff, Guillem Casanovas, Jill Wylie-Sears, Dae-Hee Kim, Philipp Bartko, J Guerrero, Jacob Dal-Bianco, Jonathan Beaudoin, Michael Garcia, Suzanne Sullivan, Margo Seybolt, Brittan Morris, Joshua Keegan, Whitney Irvin, Elena Aikawa, Robert Levine
RATIONALE: Ischemic mitral regurgitation (IMR), a complication after myocardial infarction (MI), induces adaptive mitral valve (MV) responses that may be initially beneficial, but eventually lead to leaflet fibrosis and MV dysfunction. We sought to examine the MV endothelial response and its potential contribution to IMR. OBJECTIVE: Endothelial, interstitial and hematopoietic cells in MVs from post-MI sheep were quantified. MV endothelial CD45, found post-MI, was analyzed in vitro...
October 6, 2016: Circulation Research
Joe Luis Pantoja, Ashley E Morgan, Eugene A Grossi, Morten O Jensen, Jonathan W Weinsaft, Robert A Levine, Liang Ge, Mark B Ratcliffe
BACKGROUND: Recurrence of mitral regurgitation (MR) after undersized mitral annuloplasty (MA) for ischemic MR is as high as 60%, with the recurrence rate likely due to continued dilation of the left ventricle (LV). To better understand the causes of recurrent MR, we studied the effect of undersized MA on strain in the LV wall. We hypothesize that the acute change in ventricular shape induced by MA will cause increased strain in regions nearest the mitral valve. METHODS: Finite element models were previously reported, based on cardiac magnetic resonance images of 5 sheep with mild to moderate ischemic MR...
October 5, 2016: Annals of Thoracic Surgery
Liangshan Wang, Bo Li, Changcheng Liu, Tianhua Rong, Yang Yu, Chengxiong Gu
OBJECTIVE: To investigate the short- and medium-term effects of combined mitral valve surgery (MVS) and coronary artery bypass grafting (CABG) versus CABG alone for patients with moderate ischemic mitral regurgitation (IMR). DESIGN: Meta-analysis of 4 randomized controlled trials (RCTs) and 5 observational studies. SETTING: Hospitals that perform cardiac surgery. PARTICIPANTS: The study included 1,256 cardiac surgery patients from 4 RCTs and 5 observational studies...
June 29, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Vincent Chan, Olivier Levac-Martinho, Benjamin Sohmer, Elsayed Elmistekawy, Marc Ruel, Thierry G Mesana
BACKGROUND: Data comparing outcomes after repair versus replacement of chronic ischemic mitral regurgitation (MR) is evolving. Recent data suggest that repair is associated with recurrent MR, but not survival, when compared with replacement. However, it remains unclear when either surgical strategy should be applied based on preoperative mitral valve anatomy. METHODS: Between 2001 and 2013, 161 patients underwent repair or replacement of chronic ischemic MR. The mean age of these patients was 68...
September 22, 2016: Annals of Thoracic Surgery
Donghee Kim, Seung-Yul Lee, Kwon-Duk Seo
Introduction. Fluid-attenuated inversion recovery hyperintense vessels (FHVs) can be seen in patients with occlusion or severe stenosis of the cerebral arteries. FHVs are known to reflect stagnant or slow blood flow within the cerebral artery. Case Report. A 75-year-old woman presented with suddenly developed gait disturbance. She had a history of hypertension, heart failure, and dementia. Brain MRI demonstrated FHVs within both middle cerebral arteries (MCAs). However, there was no acute ischemic lesion and severe stenosis or occlusion of the cerebral arteries...
2016: Case Reports in Neurological Medicine
Christos G Mihos, Andres M Pineda, Sofia A Horvath, Orlando Santana
Ischemic mitral regurgitation (MR) after myocardial infarction is associated with poor long-term survival, and the optimal treatment strategy remains debated. The most common repair technique used is a restrictive annuloplasty. However, up to 15% to 30% of patients experience recurrent MR owing to progressive left ventricular remodeling and geometric distortion of the mitral valve apparatus. Anterior mitral leaflet augmentation using a pericardial patch, in combination with a true-sized mitral annuloplasty, has been proposed as an adjunctive technique to increase the durability of valve repair for ischemic MR...
July 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Yushu Wang, Xiuli Shi, Meiqin Wen, Yucheng Chen, Qing Zhang
BACKGROUND: No agreement has been reached for the best surgical treatment for patients with chronic ischemic mitral regurgitation (IMR) undergoing coronary artery bypass grafting (CABG). Our objective was to meta-analyze the clinical outcomes of repair and replacement. METHODS: A computerized search was performed using Pubmed, Embase, Ovid medline and Cochrane Library. The search terms "ischemic or ischaemic" and "mitral valve" and "repair or replacement or annuloplasty" and "coronary artery bypass grafting" were entered as MeSH terms and keywords...
September 1, 2016: Journal of Cardiothoracic Surgery
Yan Tu, Qing-Chun Zeng, Ying Huang, Jian-Yong Li
Ischemic mitral regurgitation (IMR) is a common complication of acute myocardial infarction (AMI). Current evidences suggest that revascularization of the culprit vessels with percutaneous coronary artery intervention (PCI) or coronary artery bypass grafting can be beneficial for relieving IMR. A 2.5-year follow-up data of a 61-year-old male patient with ST-segment elevation AMI complicated with IMR showed that mitral regurgitation area increased five days after PCI, and decreased to lower steady level three months after PCI...
September 2016: Journal of Geriatric Cardiology: JGC
Shi-Min Yuan, Song-Li Yan
Mitral valve prolapse is a benign condition. Mitral regurgitation is only complicated in patients with severe mitral valve prolapse. Women with mitral valve prolapse in the absence of other cardiovascular disorders tolerate pregnancy well and do not develop remarkable cardiac complications. Nevertheless, serious complications of mitral valve prolapse, including arrhythmia, infective endocarditis and cerebral ischemic events, can be present in pregnancy. Debates remain with regard to the use of prophylactic antibiotics and β-blockers in the pregnant women with mitral valve prolapse...
April 2016: Brazilian Journal of Cardiovascular Surgery
M Wagrowska-Danilewicz, M Danilewicz, I Fisiak, J Piskorska
We report a case of IgA-dominant postinfectious glomerulonephritis in a 49-year-old man presenting with acute kidney injury, nephrotic range proteinuria and hematuria. He suffered from ischemic heart disease, cardiac insufficiency, mitral regurgitation, tricuspid insufficiency, septal aneurysm and hypertension. Renal biopsy revealed segmental and focal endocapillary and mesangial hypercellularity, and thickening of the glomerular capillary wall. Immunofluorescence showed co-dominant strong coarse granular immunostaining of IgA, IgG and C3 mainly along the glomerular capillary wall...
June 2016: Polish Journal of Pathology: Official Journal of the Polish Society of Pathologists
David D Yuh
No abstract text is available yet for this article.
September 2016: Journal of Thoracic and Cardiovascular Surgery
Inez J Wijdh-den Hamer, Wobbe Bouma, Eric K Lai, Melissa M Levack, Eric K Shang, Alison M Pouch, Thomas J Eperjesi, Theodore J Plappert, Paul A Yushkevich, Judy Hung, Massimo A Mariani, Kamal R Khabbaz, Thomas G Gleason, Feroze Mahmood, Michael A Acker, Y Joseph Woo, Albert T Cheung, Matthew J Gillespie, Benjamin M Jackson, Joseph H Gorman, Robert C Gorman
OBJECTIVES: Repair for ischemic mitral regurgitation with undersized annuloplasty is characterized by high recurrence rates. We sought to determine the value of pre-repair 3-dimensional echocardiography over 2-dimensional echocardiography in predicting recurrence at 6 months. METHODS: Intraoperative transesophageal 2-dimensional echocardiography and 3-dimensional echocardiography were performed in 50 patients undergoing undersized annuloplasty for ischemic mitral regurgitation...
September 2016: Journal of Thoracic and Cardiovascular Surgery
Salvatore Campisi, Jean F Fuzellier, Benjamain Haber, Jean P Favre, Antoine Gerbay, Marco Vola
BACKGROUND: Ischemic mitral regurgitation (IMR) is a common complication of coronary artery disease and represents an independent predictor of mortality. In the IMR the pattern of mitral valve annular dilatation is asymmetrical: this can explain the long-term incidence of recurrent mitral regurgitation after surgical annular size reduction with a symmetrical ring. The aim of this study is to analyze early and mid-term results of mitral valve repair (MVR) with the CMA IMR ETlogix ring, specifically developed for the surgical correction of IMR...
November 1, 2016: International Journal of Cardiology
Anna Sannino, Paul A Grayburn
No abstract text is available yet for this article.
August 2016: Circulation. Cardiovascular Imaging
Shun Nishino, Nozomi Watanabe, Toshiyuki Kimura, Maurice Enriquez-Sarano, Tatsuya Nakama, Makoto Furugen, Hiroshi Koiwaya, Keiichi Ashikaga, Nehiro Kuriyama, Yoshisato Shibata
BACKGROUND: Previously published evidence on ischemic mitral regurgitation (IMR) and its adverse prognosis after myocardial infarction has been based on the severity of IMR in the subacute or chronic period of myocardial infarction. However, the state of IMR can vary from the early stage to the chronic stage as a result of various responses of myocardium after primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: Standard echocardiography was serially performed in 546 consecutive patients with first-onset acute myocardial infarction (1) immediately after their arrival (pre-PCI), (2) before discharge (early post-PCI), and (3) 6 to 8 months after PCI (late post-PCI)...
August 2016: Circulation. Cardiovascular Imaging
Marwa A Sabe, Sharif A Sabe, Kenya Kusunose, Scott D Flamm, Brian P Griffin, Deborah H Kwon
BACKGROUND: Decreased right ventricular (RV) ejection fraction (RVEF) portends poor prognosis in patients with ischemic cardiomyopathy, and previous studies have suggested an association between mitral regurgitation (MR) and RVEF. We sought to evaluate this association and whether mitral valve repair or replacement affects the relationship between RV function and mortality. METHODS: We included 588 patients (mean age, 63±11 years; 75% male) with ischemic cardiomyopathy who underwent cardiac magnetic resonance imaging between 2002 and 2008...
August 30, 2016: Circulation
Elena Abate, Georgette E Hoogslag, Ibtihal Al Amri, Philippe Debonnaire, Ron Wolterbeek, Jeroen J Bax, Victoria Delgado, Nina Ajmone Marsan
BACKGROUND: Ischemic mitral regurgitation (MR) is a known complication of ST-segment elevation myocardial infarction (STEMI) with important prognostic implications. We evaluated changes over time in ischemic MR after STEMI and the prevalence and predictors of significant (grade ≥2) MR at 12 months. Furthermore, the prognostic additional value of significant MR at 12-month follow-up over acute MR was assessed. METHODS: STEMI patients (n = 1,599; 77% male; 60 ± 12 years) treated with primary percutaneous coronary intervention underwent echocardiography <48 hours of admission (baseline) and at 12 months...
August 2016: American Heart Journal
Daniel Hernandez-Vaquero, Rocío Díaz, Rubén Álvarez-Cabo, Carlota Vigil-Escalera, Jacobo Silva
No abstract text is available yet for this article.
July 2016: Journal of Thoracic Disease
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