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Mitral repair

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
Cüneyt Toprak, Gökhan Kahveci, Alev Kılıçgedik, Cevat Kırma, Selçuk Pala, Mustafa Bulut, Cihangir Kaymaz, Nihal Özdemir, İbrahim Akın İzgi, Mehmet İnanır, Anıl Avcı, Ali Metin Esen
OBJECTIVE: Mitral valve regurgitation (MR) is the second most common heart valve disease in Europe. Without intervention, prognosis of severe symptomatic MR is poor. Percutaneous edge-to-edge mitral valve repair with MitraClip is a promising mitral regurgitation treatment technique in select, high-surgical-risk patients. The present objective was to describe the experience of a single center with MitraClip use in a high-risk series in Turkey. METHODS: Between May 2013 and September 2014, 28 high-surgical-risk patients with MR of at least grade 3+ and mean EuroSCORE of 26% underwent MitraClip implantation at our institution...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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
Julia Götte, Wolfgang Hemmer, Detlef Roser, Markus Liebrich, Nicolas Doll
We report the case of a 83-year-old man who had undergone a full root replacement with a stentless bioprosthesis 15 years earlier. He was now diagnosed with severe aortic valve regurgitation secondary to leaflet degeneration, moderate mitral regurgitation, and single-vessel coronary artery disease. To reduce cross-clamp time and technical difficulties a sutureless aortic prosthesis was used. His surgery and postoperative course were uneventful. This is the first report of the successful use of a sutureless aortic valve prosthesis in a patient after bioprosthetic full root replacement who required additional mitral repair and coronary artery bypass surgery...
November 2016: Annals of Thoracic Surgery
Rawn Salenger, Xavier Diao, Murtaza Y Dawood, Daniel L Herr, George A Sample, Augusto Pichard, James S Gammie
We report a case of catastrophic hemodynamic compromise secondary to pannus ingrowth and severe mitral stenosis occurring years after repair of a nonrheumatic mitral valve. The initial repair included closure of a posterior leaflet cleft and implantation of an annuloplasty ring. We describe a hybrid treatment strategy for this severely compromised patient, which included initial placement of a right ventricular assist device followed by percutaneous balloon mitral valvuloplasty and, eventually, a definitive mitral valve reoperation...
November 2016: Annals of Thoracic Surgery
Maria João Sousa, Vasco Alves, Sofia Cabral, Nuno Antunes, Luís Sousa Pereira, Filomena Oliveira, João Silveira, Severo Torres
Mitral valve aneurysms are rare and occur most commonly in association with aortic valve endocarditis. Transesophageal echocardiography is the most sensitive imaging modality for the diagnosis of this entity and its potential complications, such as leaflet rupture and mitral regurgitation, which mandate prompt surgical intervention. We present the case of a 70-year-old male patient with aortic valve endocarditis complicated with a ruptured aneurysm of the anterior mitral valve leaflet and associated severe mitral regurgitation, diagnosed by transesophageal echocardiography, with impressive images...
October 17, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Richard Cheng, Emily Tat, Robert J Siegel, Reza Arsanjani, Asma Hussaini, Moody Makar, Yukiko Mizutani, Alfredo Trento, Saibal Kar
AIMS: Mitral annular calcification (MAC) negatively influences outcomes in surgical mitral valve (MV) repair for mitral regurgitation (MR). However, there are no data on whether MAC impacts on outcomes of MitraClip percutaneous MV edge-to-edge repair. This study sought to investigate whether the presence of MAC impacts on the procedural success and durability of percutaneous transcatheter repair of MR using the MitraClip. METHODS AND RESULTS: One hundred and seventy-three patients undergoing MitraClip repair for significant MR were studied...
October 20, 2016: EuroIntervention
Lachikarathman Devegowda, Prabhavathi Bhat, Cholenahally Nanjappa Manjunath, Prasanna Simha Mohan Rao
MV repair in the rheumatic population is feasible with acceptable long-term results.(1) Incidence of mitral stenosis (MS) following mitral valve (MV) repair for severe rheumatic mitral regurgitation (MR) and usefulness of percutaneous transluminal mitral valvuloplasty (PTMC) in these patients is not described in literature. We report a case of successful PTMC in severe MS following MV repair for severe rheumatic MR.
September 2016: Indian Heart Journal
Abhijeet V Naik, Parag S Bhalgat, Nilesh S Bhadane, Suresh V Joshi
Hemolytic anemia following a mitral valve repair is a very rare complication, with only 70 cases reported worldwide. We present a case of an 8-year-old girl who presented with a very early onset hemolytic anemia following a mitral valve repair with ring annuloplasty, which necessitated a reoperation. The report also discusses the various mechanisms of traumatic hemolysis associated with valve repair and probable lessons learnt and ways to avoid this complication.
September 2016: Indian Heart Journal
Gauranga Majumdar, Surendra Agarwal, Shantanu Pande, Satyendra Tewari
Right atrial myxomas are rare. Its occurrence in a previously operated patient of rheumatic mitral stenosis posed clinical diagnostic challenge. We herein report a case of right atrial myxoma who had undergone mitral valve repair 20 years ago and now presented in congestive heart failure. The tumor was arising from the ostium of the coronary sinus and prolapsed into the right ventricle causing significant right ventricular inflow and outflow obstruction. Urgent repeat cardiac surgery was successfully performed to remove the tumor along with mitral valve replacement...
September 2016: Indian Heart Journal
Philip Y K Pang, Jiasi Zhu, Yoong Kong Sin, Yeow Leng Chua
Most mitral paravalvular leaks (PVLs) occur during the first year after mitral valve replacement (MVR). This report describes the surgical management of 6 patients who developed very late mitral PVLs. The median interval between MVR and initial diagnosis of PVL was 16.5 years. All patients presented with congestive cardiac failure and haemolytic anaemia. The median EuroSCORE II was 9.5%. Two patients (33%) had failed attempts at transcatheter closure. Five patients underwent suture repair of the PVL. One patient underwent MVR after removal of the previous prosthesis...
September 2016: Journal of Thoracic Disease
Boyang Liu, Nicola C Edwards, Simon Ray, Richard P Steeds
Mitral regurgitation (MR) is the second most common form of valvular disease requiring surgery. Correct identification of surgical candidates and optimising the timing of surgery is key in management. For primary MR, this relies upon a balance between the perioperative risks and rates of successful repair in patients undergoing early surgery when asymptomatic with the potential risk of irreversible left ventricular dysfunction if intervention is performed too late. For secondary MR, recognition that this is a highly dynamic condition where MR severity may change is key, although data on outcomes in determining whether concomitant valve intervention is performed with revascularisation has raised questions regarding timing of surgery...
October 13, 2016: Echo Research and Practice
Sten Lyager Nielsen
Transcatheter mitral valve (MV) intervention has emerged as an effective treatment option for symptomatic severe mitral regurgitation (MR) in patients considered to be inoperable or at high operative risk for surgical MV surgery. In primary mitral regurgitation, surgical repair is the standard of care. Transcatheter edge-to-edge MV repair with the MitraClip system has the largest clinical experience to date, and offers a sustained clinical benefit in selected surgical high-risk patients. Surgery for secondary MR remains a challenge...
October 13, 2016: Scandinavian Cardiovascular Journal: SCJ
Anca D Mateescu, Ioan M Coman, Carmen C Beladan, Bogdan Radulescu, Carmen Ginghina, Bogdan A Popescu
We report the case of a rare association of a congenital Gerbode defect with severe mitral regurgitation due to abnormal linear structure of mitral valve, diagnosed in an adult patient. The case highlights the importance of a thorough examination interpreting the echocardiographic findings on a pathophysiological basis. It also underlines the complementary role of different imaging techniques with transesophageal echocardiography, allowing the precise assessment of both structural and functional abnormalities in such a complex case...
September 2016: Korean Circulation Journal
Denise C Joffe, Thomas K Jones, Mark Reisman, Elizabeth Perpetua, Yuk Law, Andreas Schuler, G Burkhard Mackensen
We present the primary report of a paediatric patient who had placement of the MitraClip device for severe functional mitral regurgitation. The patient was a 14-year-old boy with symptomatic end-stage non-compaction type cardiomyopathy secondary to a mitochondrial cytopathy. He had severe mitral regurgitation, tricuspid valve regurgitation, a severely dilated LV with apical non-compaction, severe LV dysfunction and severe pulmonary hypertension. Despite optimal medical therapy he developed progressive symptoms of congestive heart failure and he was not a candidate for an assist device or cardiac transplantation...
October 10, 2016: EuroIntervention
Vincent Chan, Elsayed Elmistekawy, Marc Ruel, Mark Hynes, Thierry G Mesana
BACKGROUND: Repair of mitral regurgitation (MR) caused by prolapse has been well validated. Although favorable early and late results after repair have been reported, few data are available that mechanistically describe how a mitral repair fails beyond the mere need for mitral valve reoperation. We therefore sought to determine the modes of valve repair failure in patients who underwent surgical correction of MR caused by prolapse. METHODS: Between 2001 and 2015, 855 patients underwent repair of MR caused by prolapse...
October 6, 2016: Annals of Thoracic Surgery
Fan Zhang, Jingjing Kanik, Tommaso Mansi, Ingmar Voigt, Puneet Sharma, Razvan Ioan Ionasec, Lakshman Subrahmanyan, Ben A Lin, Lissa Sugeng, David Yuh, Dorin Comaniciu, James Duncan
Transesophageal echocardiography (TEE) is routinely used to provide important qualitative and quantitative information regarding mitral regurgitation. Contemporary planning of surgical mitral valve repair, however, still relies heavily upon subjective predictions based on experience and intuition. While patient-specific mitral valve modeling holds promise, its effectiveness is limited by assumptions that must be made about constitutive material properties. In this paper, we propose and develop a semi-automated framework that combines machine learning image analysis with geometrical and biomechanical models to build a patient-specific mitral valve representation that incorporates image-derived material properties...
September 27, 2016: Medical Image Analysis
Carlos M Mery, R Michael Nieto, Luis E De León, Shaine A Morris, Wei Zhang, John L Colquitt, Iki Adachi, Lauren C Kane, Jeffrey S Heinle, E Dean McKenzie, Charles D Fraser
BACKGROUND: Predictors for single ventricle palliation (SVP) or successful biventricular repair (BVR) in patients with borderline left-side heart structures are not well defined. The goal was to evaluate the role of echocardiography and intracardiac exploration in determining feasibility of BVR. METHODS: All neonates surgically treated from 1995 to 2015 with mitral valve (MV), aortic valve, or left ventricle end-diastolic dimension z score of -2 or less for whom management was controversial were included...
October 4, 2016: Annals of Thoracic Surgery
Andrea Radinovic, Patrizio Mazzone, Giovanni Landoni, Eustachio Agricola, Damiano Regazzoli, Paolo Della Bella
BACKGROUND: Left atrial catheterization through transseptal puncture is frequently performed in cardiac catheterization procedures. Appropriate transseptal puncture is critical to achieve procedural success. AIMS: The aim of the study is to evaluate the feasibility of selective transseptal punctures, using a modified radiofrequency (RF) transseptal needle and transesophageal echocardiography (TEE), in different types of procedures that require specific sites of left atrial catheterization...
October 2016: Annals of Cardiac Anaesthesia
Krzysztof Wróbel, Katarzyna Kurnicka, Marcin Zygier, Wojciech Dyk, Ryszard Wojdyga, Dariusz Zieliński, Małgorzata Jarzębska, Zbigniew Juraszyński, Barbara Lichodziejewska, Piotr Pruszczyk, Andrzej Biederman, Giovanni Speziali, Uwe Kasten
BACKGROUND AND AIM: Artificial chordal implantation in order to repair flail or prolapse mitral valve leaflet requires open heart surgery and cardiopulmonary bypass. Transapical off-pump implantation of neochordae is a new surgical technique proposed to treat degenerative mitral valve regurgitation. The procedure is performed using the NeoChord DS1000 system (NeoChord, Inc., Eden Praire, MN), which facilitates both implantation and tension adjustment of the neochordae under transesophageal echocardiographic 2D and 3D guidance...
October 7, 2016: Kardiologia Polska
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