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Ischemic mitral regurgitation

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https://www.readbyqxmd.com/read/29888544/should-the-mitral-valve-be-repaired-for-moderate-ischemic-mitral-regurgitation-at-the-time-of-revascularization-surgery
#1
REVIEW
Mohammad Y Salmasi, Amer Harky, Mohammed F Chowdhury, Ali Abdelnour, Anastasia Benjafield, Farah Suker, Stephanie Hubbard, Hunaid A Vohra
BACKGROUND: Ischemic mitral regurgitation (IMR) is associated with increased mortality and recurrent congestive heart failure following coronary artery bypass graft (CABG) surgery. While mitral surgery should be undertaken for severe MR during CABG, the treatment of moderate IMR remains controversial. We conducted a meta-analysis to determine the outcomes of CABG alone and combine with mitral valve repair (MVr) in moderate IMR. METHODS: A literature search was conducted by Pubmed, Ovid, and Embase, which included 643 articles...
June 10, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29778453/mitral-valve-repair-complicated-by-left-circumflex-coronary-artery-occlusion-an-under-recognized-but-potentially-deadly-complication
#2
Tariq A Ahmad, Matthew Nudy, Dirk Pabst, Mark Kozak
Mitral valve repair is becoming an increasingly frequent surgery for patients with mitral valve regurgitation. Iatrogenic coronary artery injury and ischemic myocardial compromise have been previously reported in the literature as a rare but serious complication of surgical mitral valve repair. This potentially life-threatening complication should be considered and quickly recognized during perioperative mitral valve repair or replacement to prevent morbidity and mortality. To increase awareness and to prevent this complication from being missed in the future, we present a case report of iatrogenic left circumflex artery dynamic occlusion and subsequent myocardial infarction from mitral valve annuloplasty resulting in severe peri-operative heart failure and death...
April 25, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29777670/the-impact-of-mitral-disease-etiology-on-operative-mortality-following-mitral-valve-operations
#3
J Scott Rankin, Maria Grau-Sepulveda, David M Shahian, A Marc Gillinov, Rakesh Suri, James S Gammie, Steven F Bolling, Patrick M McCarthy, Vinod H Thourani, Niv Ad, Sean M O'Brien, Jeffrey P Jacobs, Vinay Badhwar
BACKGROUND: The patho-etiology of mitral regurgitation (MR) has been suggested as a mediator of outcomes following mitral valve (MV) operations, particularly in ischemic functional mitral regurgitation (IMR). This study examined the independent association of MV etiology with mortality. METHODS: Using the Society of Thoracic Surgeons Database, all patients undergoing mitral valve replacement or repair from 2011-2014 were assessed. Patients who underwent concomitant surgical ablation, septal defect closure, tricuspid valve repair, or coronary artery bypass grafting were included...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29769510/surgical-management-of-a-critical-ischemic-mitral-regurgitation-patient
#4
S A Sunny, S Moinuddin, A B Adhikary, M A Hossain
Functional ischemic mitral regurgitation is strongly associated with poor outcomes in patient with coronary artery disease. The best management for mitral regurgitation at the time of coronary revascularization remains controversial. We report, a case of 58 years-old men admitted to GKNM hospital, Coimbatore, Tamil Nadu, India with chest pain and respiratory distress for last 6 hours during my fellowship training in that hospital. ECG showed acute antero-septal MI. The transthoracic echocardiogram revealed severe left ventricular dysfunction with moderate mitral regurgitation...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29762929/trileaflet-mitral-valve-treated-with-the-mitraclip%C3%A2-system
#5
Miguel Rodríguez-Santamarta, Rodrigo Estévez-Loureiro, Tomás Benito-González, Javier Gualis, Carmen Garrote, Armando Pérez de Prado, Felipe Fernández-Vázquez
A 79-year-old woman with a history of ischemic dilated cardiomyopathy, severely depressed left ventricular ejection fraction and significant mitral regurgitation (MR) was admitted to the authors´ institution for percutaneous mitral valve repair. Transesophageal echocardiography (TEE) revealed the presence of a posterior mitral cleft at the P2 level, causing a trileaflet mitral valve that contributed significantly to the regurgitant jet. The procedure was performed under general anesthesia and guided by real-time three-dimensional TEE...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29747569/systolic-characteristics-and-dynamic-changes-of-the-mitral-valve-in-different-grades-of-ischemic-mitral-regurgitation-insights-from-3d-transesophageal-echocardiography
#6
Caroline Morbach, Diego Bellavia, Stefan Störk, Lissa Sugeng
BACKGROUND: Mitral regurgitation in ischemic heart disease (IMR) is a strong predictor of outcome but until now, pathophysiology is not sufficiently understood and treatment is not satisfying. We aimed to systematically evaluate structural and functional mitral valve leaflet and annular characteristics in patients with IMR to determine the differences in geometric and dynamic changes of the MV between significant and mild IMR. METHODS: Thirty-seven patients with IMR (18 mild (m)MR, 19 significant (moderate+severe) (s)MR) and 33 controls underwent TEE...
May 10, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29738331/intraoperative-3-dimensional-transesophageal-echocardiography-assessment-of-valvular-geometry-after-implantation-of-basal-annuloplasty-of-cardia-externally-device-for-ischemic-mitral-regurgitation
#7
https://www.readbyqxmd.com/read/29735313/calculation-of-left-ventricular-diastolic-time-constant-tau-in-dogs-with-mitral-regurgitation-using-continuous-wave-doppler
#8
Chaoyang Wen, Jing Sun, Chunzhi Fan, Jianping Dou
The left ventricular diastolic time constant (Tau) cannot be practically measured non-invasively. Thus, the aim of this study was to investigate a new method for the evaluation of Tau using continuous-wave (CW) Doppler in dogs with mitral regurgitation. Guided by ultrasound, we created 12 beagle models of mitral regurgitation and acute ischemic left ventricular diastolic dysfunction. Raw audio signals of the CW Doppler spectra were collected, and new mitral regurgitation Doppler spectra were observed after computer re-processing...
May 4, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29687703/surgical-myocardial-revascularization-in-patients-with-reduced-systolic-left-ventricular-function
#9
Piergiorgio Bruno, Mauro Iafrancesco, Massimo Massetti
Surgical myocardial revascularization in patients with reduced left ventricular function has been a matter of debate for decades. Recently published 10-years extension follow-up of the STICH trial have conclusively demonstrated benefit of surgical myocardial revascularization in patients with significant coronary artery disease and low left ventricular ejection fraction. However, selection of patients for surgery remains challenging as well as decision to perform percutaneous rather than surgical revascularization in this class of patients...
April 20, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29626079/acute-versus-chronic-ischemic-mitral-regurgitation-an-echocardiographic-study-of-anatomy-and-physiology
#10
Shun Nishino, Nozomi Watanabe, Toshiyuki Kimura, Nehiro Kuriyama, Yoshisato Shibata
BACKGROUND: Little is known on the mechanism of acute ischemic mitral regurgitation (IMR) caused by sudden-onset left ventricular dysfunction in acute myocardial infarction (MI). We sought to investigate the mitral valve (MV) complex geometry in acute IMR in comparison with chronic IMR by 2-dimensional and 3-dimensional transthoracic echocardiography. METHODS AND RESULTS: Forty-four first-onset acute MI and 36 previous MI with ≥moderate IMR were examined by 2-dimensional/3-dimensional transthoracic echocardiography...
April 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29617497/opcabg-for-moderate-cimr-in-elderly-patients-a-superior-option
#11
Amber Malhotra, Chandrasekaran Ananthanarayanan, Vivek Wadhawa, Sumbul Siddiqui, Pranav Sharma, Kartik Patel, Komal Shah, Pratik Shah
OBJECTIVE: To compare the early and late outcomes of off-pump coronary artery bypass grafting and coronary artery bypass graft + mitral valve repair in elderly patients with moderate chronic ischemic mitral regurgitation. METHODS: One hundred and fifty elderly (age > 70 years) patients with moderate chronic ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting (n=95) or coronary artery bypass graft + mitral valve repair (n=55) between January 2007 and December 2014 were studied...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29588148/spontaneous-chordae-tendineae-rupture-during-peripartum
#12
Feng-Han Chiu, Chih-Jen Yang, Chih-Kang Huang, Chih-Yuan Lin, Shih-Hung Tsai
Acute cardiopulmonary distress in pregnancy always carries exceptionally arduous challenge for physicians. Here we report a patient who sustained spontaneous chordae tendineae rupture complicated with severe mitral regurgitation and acute pulmonary edema during peripartum period. Probable causes of chordae tendineae rupture include mitral valve prolapse, infectious endocarditis, congenital heart disease, rheumatic heart disease, ischemic heart disease, connective tissue diseases, previous mitral valve surgery or pregnancy itself...
March 19, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29570209/long-term-outcomes-of-mitral-valve-annuloplasty-versus-subvalvular-sparing-replacement-for-severe-ischemic-mitral-regurgitation
#13
Baotong Li, Hengchao Wu, Hansong Sun, Jianping Xu, Yunhu Song, Wei Wang, Shuiyun Wang
BACKGROUND: Although practice guidelines recommend surgery for patients with severe chronic ischemic mitral regurgitation (CIMR), they do not specify whether to repair or replace the mitral valve. The purpose of this study was to evaluate the long-term outcomes in patients with severe CIMR undergoing mitral valve annuloplasty (MVA) versus subvalvular sparing mitral valve replacement (MVR). METHODS: 392 consecutive patients who underwent MVA or subvalvular sparing MVR for treatment of severe CIMR were retrospectively reviewed...
March 23, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29532654/moderate-ischemic-mitral-regurgitation-coronary-artery-bypass-grafting-with-versus-without-simultaneous-treatment-of-the-mitral-valve-is-associated-with-comparable-long-term-survival
#14
Jonathan Rilinger, Claudia Heilmann, Ulrich Beitinger, Christoph B Olivier, Philipp Diehl, Friedhelm Beyersdorf, Matthias Siepe
BACKGROUND: Ischemic mitral regurgitation (IMR) is a frequent complication of coronary artery heart disease and is associated with increased mortality. Controversies exists whether patients with moderate IMR may benefit from a combined procedure with coronary artery bypass grafting (CABG) and treatment of mitral regurgitation. METHODS: 451 patients with moderate IMR (grade 2) receiving either CABG alone (CABG only) or additional mitral valve repair or replacement (CABG+MV) were included in this observational single-centre study...
March 12, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29512090/predicting-functional-mitral-stenosis-after-restrictive-annuloplasty-for-ischemic-mitral-regurgitation
#15
Baotong Li, Hengchao Wu, Hansong Sun, Jianping Xu, Yunhu Song, Wei Wang, Shuiyun Wang
BACKGROUND: Although it has been realized that restrictive mitral valve annuloplasty (MVA) may result in clinically significant functional mitral stenosis (MS), it still cannot be predicted. The purpose of this study was to identify risk factors for clinically significant functional MS following restrictive MVA surgery for chronic ischemic mitral regurgitation (CIMR). METHODS: 114 patients who underwent restrictive MVA with coronary artery bypass grafting (CABG) for treatment of CIMR were retrospectively reviewed...
March 7, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29505505/a-case-report-with-shock-induced-by-tolvaptan-in-an-elderly-patient-with-congestive-heart-failure
#16
Zhi-Gang Zhang, Xin-Min Liu
RATIONALE: Tolvaptan (TLV) is a new vasopressin type 2 receptor antagonist effective in patients with heart failure (HF). Accumulating evidences have revealed that treatment with TLV does not alter the blood pressure significantly. PATIENT CONCERNS: An 84-year-old man was diagnosed with acute exacerbation of chronic HF due to ischemic cardiomyopathy, arrhythmia, mitral and aortic regurgitation. Treatment with TLV increased the urine volume and improved the dyspnea...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29501661/ischemic-mitral-regurgitation-abnormal-strain-overestimates-non-viable-myocardium-commentary
#17
Olga N Kislitsina
No abstract text is available yet for this article.
February 28, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29501456/contemporary-management-of-ischemic-mitral-regurgitation-a-review
#18
REVIEW
Yader Sandoval, Paul Sorajja, Kevin M Harris
Ischemic mitral regurgitation occurs relatively frequently in patients with coronary artery disease and is associated with an increased long-term risk. The pathophysiology of ischemic mitral regurgitation is vexing and poses both diagnostic and therapeutic challenges, leading to the need for a comprehensive, multidisciplinary approach. The management is largely focused on medical therapy, and for those eligible, coronary revascularization or cardiac resynchronization therapy may be considered. In select patients, mitral valve surgery or catheter-based therapy may be undertaken with careful consideration of the underlying pathophysiology, surgical risk, and expected long-term outcomes...
February 28, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29459111/a-trial-of-two-anesthetic-regimes-for-minimally-invasive-mitral-valve-repair
#19
Marco Moscarelli, Nora Terrasini, Anna Nunziata, Prakash Punjabi, Gianni Angelini, Marco Solinas, Alba Buselli, Paolo Del Sarto, Dorela Haxhiademi
OBJECTIVE: Minimally invasive mitral valve repair may be associated with prolonged cardioplegic arrest times and ischemic reperfusion injury. Intravenous (propofol) and volatile (sevoflurane) anesthesia are used routinely during cardiac surgery and are thought to provide cardioprotection; however, the individual contribution of each regimen to cardioprotection is unknown. Therefore, the authors sought to compare the cardioprotective effects of propofol and sevoflurane anesthesia in patients undergoing minimally invasive mitral valve repair...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29399763/significant-mitral-regurgitation-predicts-the-long-term-prognosis-in-patients-receiving-cardiac-resynchronization-therapy
#20
Han Jin, Shengwen Yang, Wei Hua, Min Gu, Hongxia Niu, Ligang Ding, Jing Wang, Cong Xue, Shu Zhang
BACKGROUND: Cardiac resynchronization therapy (CRT) has been shown to reduce Functional mitral regurgitation (FMR), although the relationship between significant mitral regurgitation (SMR) and the clinical prognosis of CRT remains uncertain. AIM: To investigate the association of baseline of SMR with long-term outcomes in patients undergoing CRT. METHODS: A total of 296 consecutive patients undergoing CRT were enrolled. SMR was quantified by color Doppler in all the patients at baseline and defined as grading scale ≥ 3...
February 5, 2018: Kardiologia Polska
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