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Mitral valve replacement

Gaby Aphram, Laurent De Kerchove, Stefano Mastrobuoni, Emiliano Navarra, Silvia Solari, Saadallah Tamer, Jerome Baert, Alain Poncelet, Jean Rubay, Parla Astarci, Philippe Noirhomme, Gebrine El Khoury
OBJECTIVES: Mitral valve (MV) repair is the gold standard for treatment of degenerative mitral regurgitation. A variety of surgical techniques allow surgeons to achieve a high rate of MV repair even with MV diseases of other aetiologies. However, a certain number of repairs fail over time. The aim of this study was to review our single-centre experience of MV re-repair and analyse the mode of repair failure, re-repair safety and efficiency in relation to the initial aetiology. METHODS: Between 1997 and 2015, 91 patients underwent redo MV re-repair...
March 14, 2018: European Journal of Cardio-thoracic Surgery
Felix Kreidel, Hannes Alessandrini, Peter Wohlmuth, Michael Schmoeckel, Stephan Geidel
OBJECTIVE: To assess the results of catheter-based and surgical reintervention in primary mitral regurgitation (PMR) after failed MitraClip therapy. METHODS: We report on 21 consecutive symptomatic patients with PMR (median age 78 years) who underwent either repeat MitraClip therapy (n=7) or mitral valve surgery (n=14) after failure of the index procedure with 1-2 MitraClip implantations. At the time of reinterventions, 193 [IQR: 32 to 622] days after index procedure, patients had recurrent or persistent grade 3 MR...
March 12, 2018: Seminars in Thoracic and Cardiovascular Surgery
Parwis B Rahmanian, Kaveh Eghbalzadeh, Süreyya Kaya, Hruy Menghesha, Stephen Gerfer, Oliver J Liakopoulos, Yeong-Hong Choi, Thorsten Wahlers
OBJECTIVES: Rapid-deployment aortic valve replacement (RD-AVR) potentially reduces procedure times providing excellent haemodynamic results compared to standard tissue aortic valve replacement. However, concerns have been raised regarding higher rates of postoperative pacemaker (PPM) requirement compared to standard aortic valve replacement. In this study, we sought to determine the PPM rate and its potential risk factors in RD-AVR patients. METHODS: Between 2011 and 2017, 193 patients underwent RD-AVR...
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Hsiu-An Lee, Chun-Yu Lin, Yung-Chang Chen, Shao-Wei Chen, Yu-Yun Nan, Kuo-Sheng Liu, Meng-Yu Wu, Yu-Sheng Chang, Jaw-Ji Chu, Pyng-Jing Lin, Feng-Chun Tsai
The feasibility and durability of mitral valve (MV) repair in active infective endocarditis (IE) has been reported, but proper management of perioperative neurological complications and surgical timing remains uncertain and may crucially affect the outcome.In this single-center retrospective observational study, patients who underwent isolated MV surgery for active native IE in our institution between August 2005 and August 2015 were reviewed and analyzed. Patients who were operated on for healed IE or who required combined procedures were excluded from this study...
March 2018: Medicine (Baltimore)
Shinya Higuchi, Iwao Matsunaga, Kiyokazu Koga, Eiichi Teshima, Atsuhiro Nakashima, Ryuji Tominaga, Tsuyoshi Ito
In almost every type of artificial valve, structural failure has been described. We are reporting on a case of a sudden leaflet escape of an Edwards TEKNA mitral valve prosthesis 12 years after implantation. The patient had a sudden onset of dyspnea and severe pulmonary edema with subsequent cardiogenic shock. An emergency mitral replacement was successfully performed. A multi-detector computed tomography scanning and three-dimensional imaging showed two fragments that had embolized in the terminal aorta and the left common iliac artery...
March 13, 2018: General Thoracic and Cardiovascular Surgery
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
Andrew Maslow, Maurice F Joyce, Tzong-Huei Chen, Michelle Gorgone, James Dinardo
No abstract text is available yet for this article.
February 2, 2018: Journal of Cardiothoracic and Vascular Anesthesia
R Jansen, A M Wind, M J Cramer, F Nijhoff, P Agostoni, F Z Ramjankhan, W J Suyker, P R Stella, S A J Chamuleau
The purpose of this study was to evaluate mitral regurgitation (MR) severity in patients undergoing transcatheter aortic valve replacement (TAVR) by standardized assessment of two-dimensional (2D) transthoracic echocardiography (TTE) and 1-year echocardiographic and clinical outcomes. Pre- and post-procedural TTE's of patients undergoing TAVR between 2008 and 2014 were analyzed. MR was graded according to current guidelines with a systematic and integrated approach. Longitudinal echocardiographic and clinical results were analyzed...
March 10, 2018: International Journal of Cardiovascular Imaging
Enrico Ferrari, Luigi Biasco, Francesco Faletra, Anson Cheung, Marco Moccetti, Giovanni Pedrazzini, Stefanos Demertzis, Tiziano Moccetti
Transcatheter mitral valve replacement with the TiaraTM valve can be performed in inoperable patients with severe functional regurgitation. Risk of left ventricular outflow tract obstruction can be prevented using preoperative 3D-imaging and 3D-printed models. However, in case of mono-disk mechanical prosthesis previously implanted in aortic position (Bjork-Shiley) there is an additional risk of mechanical interference leading to reduced leaflet motion and aortic valve dysfunction. Hereafter, we describe the case of a patient with a 27mm mono-disk mechanical aortic valve implanted in 1978, Euroscore-II of 18% and STS-score (mortality) of 16% who successfully underwent a transapical TiaraTM valve implantation...
March 5, 2018: Seminars in Thoracic and Cardiovascular Surgery
Masahide Komagamine, Nobuyuki Furukawa, Jan Gummert, Jochen Börgermann
Transapical transcatheter aortic valve implantation is a well-established alternative in patients at a high risk for conventional aortic valve replacement. We performed transapical transcatheter aortic valve implantation on an 83-year-old woman with symptomatic severe aortic stenosis. Intraoperative transoesophageal echocardiography (TOE) after transcatheter aortic valve implantation showed mild mitral regurgitation without intracardiac structural injury. In the intensive care unit, the patient gradually had haemodynamic instability; TOE revealed severe mitral regurgitation with A2 and A3 prolapse due to rupture of the posterior papillary muscle...
March 5, 2018: European Journal of Cardio-thoracic Surgery
Rominder Grover, Mickael Ohana, Chesnal Dey Arepalli, Stephanie L Sellers, John Mooney, Shaw-Hua Kueh, Ung Kim, Philipp Blanke, Jonathon A Leipsic
PURPOSE OF REVIEW: Recent advancements in transcatheter valvular interventions have resulted in a growing demand for advanced cardiac imaging to help guide these procedures. RECENT FINDINGS: Both echocardiography and multi-detector computed tomography have played essential roles in the maturation of transcatheter aortic valve replacement and are now building on these experiences and helping inform the nascent field of transcatheter mitral interventions. Advanced imaging is essential to aid in the diagnosis and determination of the mechanism of mitral regurgitation...
March 6, 2018: Current Cardiology Reports
Gian Manuel Jiménez-Rodríguez, Sergio Criales-Vera, Mario Adrian Juárez-Peñaloza, Luis Alonso González-Tapia, Mariana Chaire-Hernández
We present the case of a 72-year-old woman diagnosed with rheumatic fever at the age of 6. In 1972, she was diagnosed with mitral valve insufficiency and mitral valve stenosis, then in 1974, a decision was made to perform mitral valve replacement surgery with a 32-mm Braunwald-Cutter ball cage prosthesis. An echocardiogram performed in 2014 revealed normal biventricular systolic function, mechanical prosthesis in mitral position with maximum speed of 1.9 m/s, maximum gradient of 15 mmHg, mean gradient of 6 mmHg, severe tricuspid valve insufficiency, inferior vena cava measuring 15 mm with more than 50% collapse and pulmonary artery systolic pressure of 40 mmHg...
February 2018: Oxford Medical Case Reports
Nazan Puluca, Melchior Burri, Julie Cleuziou, Markus Krane, Rüdiger Lange
OBJECTIVES: Most patients (75%) with Marfan syndrome present with aortic root dilatation that may require surgical intervention. However, associated cardiovascular disorders are not limited to the aortic root. These patients frequently require consecutive operations on the remaining thoracic aorta or the heart valves. Our intent was to characterize the spectrum of such procedures. METHODS: Data from all patients with Marfan syndrome undergoing aortic root surgery at our centre between 1988 and 2016 were analysed retrospectively...
February 28, 2018: European Journal of Cardio-thoracic Surgery
Robert Zilberszac, Andreas Gleiss, Thomas Binder, Günther Laufer, Michael Grimm, Harald Gabriel, Gerald Maurer, Raphael Rosenhek
Aims: Although concomitant mitral regurgitation (MR) and tricuspid regurgitation (TR) are frequently present in patients with aortic stenosis (AS), outcome data are scarce and treatment strategies are controversial. The aim of the present study was to assess the presentation and outcome of patients with AS and coexisting MR and TR. Methods and results: Eighty-nine consecutive patients with severe AS and at least moderate MR (72 functional and 17 degenerative) were included and followed...
March 1, 2018: European Heart Journal Cardiovascular Imaging
Prashant Joshi, Raj Shukla, William Y Shi, Julian A Smith
Ascertaining the correct length of neochords during mitral valve repair is challenging. We describe a modified technique of chordal replacement where GoreTex sutures are repeatedly tied so as to braid the suture to the optimal length before sutures are passed through the mitral leaflet. The length of the braided chord remains fixed when tying on the atrial side. For bileaflet repairs, a second suture is incorporated into the initial chord to create a "Y" braided neo-chord configuration. This technique facilitates precision in mitral repair...
August 19, 2017: Heart, Lung & Circulation
Byron H Gottschalk, Jonathan Blankenstein, Linrui Guo
Cardiac ochronosis is a rare complication of alkaptonuria, a disorder of tyrosine metabolism characterized by a triad of dark urine, pigmentation of tissues, and ochronotic arthropathies. When present, cardiac ochronosis generally affects the aortic valve resulting in aortic stenosis. More rarely, it may affect the mitral valve and the coronary arteries. We describe the case of a 67-year-old lady with a history of alkaptonuria with severe ochronosis of the coronary arteries and mitral valve, requiring coronary bypass and mitral valve replacement...
March 1, 2018: Annals of Thoracic Surgery
Sachin S Goel, Vincent Zuck, Nasaraiah Nallamothu, Nilesh J Goswami
No abstract text is available yet for this article.
February 22, 2018: JACC. Cardiovascular Interventions
Xianqiu Wu, Wuli Wei, Yi He, Huajing Qin, Fenqiang Qi
BACKGROUND: To apply the cumulative sum (CUSUM) failure analysis to assess the performance of a single surgeon during mitral valve replacement via the right anterolateral minithoracotomy (RAMT) approach and to analyse the learning curve for the procedure. METHODS: A total of 100 mitral valve replacements were performed using the RAMT approach from June 2011 to April 2013 by a single surgeon with no prior experience of this technique. Patients were divided into five blocks according to the operation date...
February 14, 2018: Heart, Lung & Circulation
Oliver J Liakopoulos
No abstract text is available yet for this article.
February 8, 2018: Journal of Thoracic and Cardiovascular Surgery
Yoshinari Niimi, Seiichiro Murata, Yumi Mitou, Yusuke Ohno
We developed a novel open cardiopulmonary bypass (CPB) system, a drainage flow servo-controlled CPB system (DS-CPB), in which rotational speed of the main roller pump is servo-controlled to generate the same amount of flow as the systemic venous drainage. It was designed to safely decrease the priming volume while maintaining a constant reservoir level, even during fluctuations of the drainage flow. We report a successful use of a novel DS-CPB system in an elderly Jehovah's Witness patient with dehydration who underwent mitral valve replacement...
March 1, 2018: Perfusion
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