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Heart valve repair

Lindsey J Anstine, Chris Bobba, Samir Ghadiali, Joy Lincoln
Risk factors of heart valve disease are well defined and prolonged exposure throughout life leads to degeneration and dysfunction in up to 33% of the population. While aortic valve replacement remains the most common need for cardiovascular surgery particularly in those aged over 65, the underlying mechanisms of progressive deterioration are unknown. In other cardiovascular systems, a decline in endothelial cell integrity and function play a major role in promoting pathological changes, and while similar mechanisms have been speculated in the valves, studies to support this are lacking...
October 15, 2016: Journal of Molecular and Cellular Cardiology
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
Min-Seok Kim, Hong-Gook Lim, Woong Han Kim, Jeong Ryul Lee, Yong Jin Kim
BACKGROUND AND OBJECTIVES: The aim of the study is to evaluate the long-term results after a surgical repair of Ebstein's anomaly. SUBJECTS AND METHODS: Forty-eight patients with Ebstein's anomaly who underwent open heart surgery between 1982 and 2013 were included. Median age at operation was 5.6 years (1 day-42.1 years). Forty-five patients (93.7%) demonstrated tricuspid valve (TV) regurgitation of less than moderate degree. When the patients were divided according to Carpentier's classification, types A, B, C, and D were 11, 21, 12, and 4 patients, respectively...
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
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
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
Salvatore Scandura, Piera Capranzano, Anna Caggegi, Carmelo Grasso, Giuseppe Ronsivalle, Sarah Mangiafico, Yohei Ohno, Guilherme F Attizzani, Stefano Cannata, Sandra Giaquinta, Silvia Farruggio, Margherita Ministeri, Fabio Dipasqua, Anna M Pistritto, Sebastiano Immè, Davide Capodanno, Maria Elena Di Salvo, Corrado Tamburino
BACKGROUND: Although mitral regurgitation (MR) affects a relevant and increasing number of elderly, an optimal management of this high-risk population is challenging. METHODS AND RESULTS: The aim of this prospective, observational study was to compare one-year outcomes of MitraClip therapy in high surgical risk patients with moderate-to-severe or severe MR between patients aged <75 versus ≥75years. A total of 180 patients were included: 92 were <75years and 88 were ≥75years old...
September 24, 2016: International Journal of Cardiology
Charles H Bloodworth, Eric L Pierce, Thomas F Easley, Andrew Drach, Amir H Khalighi, Milan Toma, Morten O Jensen, Michael S Sacks, Ajit P Yoganathan
Computational modeling of the mitral valve (MV) has potential applications for determining optimal MV repair techniques and risk of recurrent mitral regurgitation. Two key concerns for informing these models are (1) sensitivity of model performance to the accuracy of the input geometry, and, (2) acquisition of comprehensive data sets against which the simulation can be validated across clinically relevant geometries. Addressing the first concern, ex vivo micro-computed tomography (microCT) was used to image MVs at high resolution (~40 micron voxel size)...
October 3, 2016: Annals of Biomedical Engineering
Bettina Langhammer, Christoph Huber, Stephan Windecker, Thierry Carrel
Surgical techniques for the treatment of mitral valve disease (MVD) have continuously evolved; however, anatomical details like severe annular calcification remain challenging and require sophisticated surgical strategies. Among patients with symptomatic MVD referred for surgical valve repair or replacement, four presented with circumferential calcification of the mitral annulus precluding conventional surgical techniques. Successful treatment by implanting a balloon-expandable transcatheter aortic heart valve using an antegrade surgical access was performed...
September 27, 2016: European Journal of Cardio-thoracic Surgery
Peyman Sardari Nia, Samuel Heuts, Jean Daemen, Peter Luyten, Jindrich Vainer, Jan Hoorntje, Emile Cheriex, Jos Maessen
OBJECTIVES: Mitral valve repair performed by an experienced surgeon is superior to mitral valve replacement for degenerative mitral valve disease; however, many surgeons are still deterred from adapting this procedure because of a steep learning curve. Simulation-based training and planning could improve the surgical performance and reduce the learning curve. The aim of this study was to develop a patient-specific simulation for mitral valve repair and provide a proof of concept of personalized medicine in a patient prospectively planned for mitral valve surgery...
September 27, 2016: Interactive Cardiovascular and Thoracic Surgery
Travis J Wilder, Brian W McCrindle, Edward J Hickey, Gerhard Ziemer, Christo I Tchervenkov, Marshall L Jacobs, Peter J Gruber, Eugene H Blackstone, William G Williams, William M DeCampli, Christopher A Caldarone, Christian Pizarro
BACKGROUND: For neonates with critical left ventricular outflow tract obstruction (LVOTO), hybrid procedures are an alternative to the Norwood stage 1 procedure. Despite perceived advantages, however, outcomes are not well defined. Therefore, we compared outcomes after stage 1 hybrid and Norwood procedures. METHODS: In a critical LVOTO inception cohort (2005-2014; 20 institutions), a total of 564 neonates underwent stage 1 palliation with the Norwood operation with a modified Blalock-Taussig shunt (NW-BT; n = 232; 41%), Norwood operation with a right ventricle-to-pulmonary artery conduit (NW-RVPA; n = 222; 39%), or a hybrid procedure (n = 110; 20%)...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
Poovendran Saththasivam, Elizabeth Herrera, Gerald Lawrie, Odeaa Al Jabbari, Collin M Barker, Roy Sheinbaum
The MitraClip procedure is an emerging endovascular technique for treating mitral regurgitation and an attractive alternative for patients who are at high risk for open heart mitral valve repair or replacement. We present the case of a failed redo MitraClip procedure that led to acute right ventricular failure in a patient with homozygous familial hypercholesterolemia and a preexisting secundum atrial septal defect. We highlight the sequelae of the failed redo MitraClip procedure and the anesthetic challenges associated with the emergent redo sternotomy and cardiopulmonary bypass procedure required to replace the mitral valve and repair the tricuspid valve and atrial septal defect...
September 23, 2016: A & A Case Reports
Natalie Behrle, Peter Dyke, Abdallah Dalabih
Motor vehicle accident is the most common cause of blunt cardiac injury (BCI) in children (85.3%) due to the height of the child in relation to proper restraints and the compliant pediatric rib cage (J Trauma. 1996;40:200-202). Trauma to the chest wall may lead to injury of the myocardium, resulting in myocardial contusion, ventricular septal defect (VSD), ventricular free wall rupture, or valve compromise (J Trauma. 1996;40; 200-202; Heart Lung. 2012;41:200-202; J Inj Violence Res. 2012;4:98-100). There are several proposed mechanisms for the formation of VSD after blunt chest trauma including rupture of ischemic myocardium related to the initial trauma and reopening of a spontaneously closed congenital VSD...
September 23, 2016: Pediatric Emergency Care
Busheng Zhang, Yue Zheng, Liang Fang, Huangdong Dai, Dan Zhu, Ye Kong
BACKGROUND: Morbidity and mortality risks in patients with end-stage renal disease (ESRD) undergoing mitral valve surgery are high; however, little is known regarding the risks and results of mitral valve repair in these patients. METHODS: We retrospectively reviewed the clinical data of dialysis-dependent patients who underwent mitral valve repair with the "respect" approach between April 2012 and April 2015 in our institution. RESULTS: All five identified patients survived and their data were included in the analysis...
August 2016: Annals of Translational Medicine
Peter E Hammer, Erin G Roberts, Sitaram M Emani, Pedro J Del Nido
OBJECTIVES: Neither heart valve repair methods nor current prostheses can accommodate patient growth. Normal aortic and pulmonary valves have 3 leaflets, and the goal of valve repair and replacement is typically to restore normal 3-leaflet morphology. However, mammalian venous valves have bileaflet morphology and open and close effectively over a wide range of vessel sizes. We propose that they might serve as a model for pediatric heart valve reconstruction and replacement valve design...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
Merrill H Stewart, J Stephen Jenkins
BACKGROUND: Mitral regurgitation (MR) is the second leading cause of valvular heart disease in the United States behind aortic stenosis. The percutaneous repair of the mitral valve (MitraClip, Abbott, Inc.) has been approved in the United States since 2013 as an alternative to traditional mitral valve surgery. However, many questions are left unanswered about when to perform this procedure and whom to perform it on. METHODS: We reviewed major published literature on the MitraClip from 2003-2016 to help guide clinical decision-making...
2016: Ochsner Journal
Rouven Kubicki, Brigitte Stiller, Jochen Grohmann
Pseudoaneurysm formation is a rare but potentially life-threatening complication after surgical repair of congenital heart disease. We present a boy with truncus arteriosus communis 14 years after homograft placement in pulmonary position. On follow-up, he presented progressive chronic homograft degeneration. Moreover, a large pseudoaneurysm in the right ventricular outflow tract was surprisingly depicted. We opted for a two-stage interventional approach.
2016: SpringerPlus
Karsten Hamm, Michael Zacher, Martina Hautmann, Frank Gietzen, Philipp Halbfass, Sebastian Kerber, Anno Diegeler, Bernhard Schieffer, Sebastian Barth
OBJECTIVES: We sought to determine the effects of experience on the Mitraclip(®) procedure steps as well as procedure safety and functional results. BACKGROUND: MR has proven deleterious in heart failure. Mitraclip(®) therapy evolved an important option in patients with severely reduced left ventricular function (LVEF). METHODS: Between 2011 and 2016, 126 consecutive patients were grouped in three groups and investigated in a prospective observational study...
September 21, 2016: Catheterization and Cardiovascular Interventions
Chin Siang Ong, Sriram Shankar, James W L Yip, Edgar L W Tay, Lynette L S Teo, Swee Chye Quek
We report the case of a 23-year-old man who developed constrictive pericarditis within four months after pulmonary valve replacement and repair of partial anomalous pulmonary venous connection. He had previously undergone repair of tetralogy of Fallot in infancy. After an unsuccessful trial of medical management for persistent right heart failure, magnetic resonance imaging was done, which showed a thickened pericardium. He underwent a radical pericardiectomy with a good outcome. The case is presented to illustrate a less well-recognized cause of cardiac failure following congenital cardiac surgery, which may otherwise be attributed to the failure of surgery or residual complications...
September 19, 2016: World Journal for Pediatric & Congenital Heart Surgery
Thomas Martens, Frank Caes, Michel De Pauw, Lineke Hens, Thierry Bove
Significant mitral valve disease with atrial fibrillation after heart transplantation is unusual. We report the diagnosis and minimally invasive surgical treatment 17 years after transplantation, in which mitral valve repair together with left atrial ablation was performed, resulting in a satisfying clinical and echocardiographic improvement.
October 2016: Annals of Thoracic Surgery
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