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Treatment acute mitral regurgitation

Varun Kumar, Santosh Sinha, Prakash Kumar, Mohammed Razi, Chandra Mohan Verma, Ramesh Thakur, Umeshwar Pandey, Rajpal Singh Bhardwaj, Mohammed Ahmad, R K Bansal, Shalini Gupta
OBJECTIVE: The primary aim of the present study was to evaluate the complications, particularly conduction blocks, subsequent morbidity and mortality, and effect of thrombolytic therapy in Indian patients with inferior wall myocardial infarction (IWMI). METHODS: This was a prospective, observational, single-center study conducted at LPS Institute of Cardiology, Kanpur, from December 2011 to May 2014. Patients who presented with typical chest pain and were subsequently diagnosed by standardized diagnostic criteria as having IWMI were enrolled...
October 12, 2016: Anatolian Journal of Cardiology
Paola Gripari, Gloria Tamborini, Vera Bottari, Francesco Maffessanti, Maria Chiara Carminati, Manuela Muratori, Carlo Vignati, Antonio L Bartorelli, Francesco Alamanni, Mauro Pepi
BACKGROUND: Percutaneous mitral valve repair (PMVR) is an alternative treatment in patients with significant mitral regurgitation (MR) who are denied surgery. Although in surgical patients, outcomes have been related both to acute hemodynamic favorable results and to positive cardiac remodeling in the midterm, in the case of PMVR the effect on cardiac chamber remodeling has never been extensively studied. The aims of this study were (1) to evaluate the short- and mid-term remodeling induced by PMVR on cardiac chamber volume using two- and three-dimensional (3D) transthoracic echocardiographic (TTE) imaging and (2) to assess changes in left ventricular (LV) shape on the basis of 3D TTE data...
October 2016: Journal of the American Society of Echocardiography
Isabelle Claus, Koen Cathenis, Dominique Goossens, Philippe Ballaux
Ventricular septal rupture (VSR) occurs in approximately 1% of the patients who experience an acute myocardial infarction. The operative mortality of VSR repair decreases if surgery can be delayed until the infarct has healed and tissue strength improved. Because of heart failure or impending cardiogenic shock, surgical treatment can often not be delayed. We present a case in which a delayed repair of a VSR was possible. The patient was initially stabilized with an intra-aortic balloon pump. She was discharged and readmitted 5 weeks later for definitive repair...
July 29, 2016: Acta Chirurgica Belgica
Amornpol Anuwatworn, Christopher Milnes, Vishesh Kumar, Amol Raizada, Verlyn Nykamp, Adam Stys
Papillary muscle rupture is a rare, life-threatening post myocardial infarction mechanical complication. Without surgical intervention, prognosis is very poor. Clinicians need to recognize this complication early, as prompt therapy is crucial. We present a case of inferior ST elevation myocardial infarction complicated by posteromedial papillary muscle rupture resulting in severe acute mitral regurgitation (flail anterior mitral leaflet), acute pulmonary edema and cardiogenic shock. In our patient, a new mitral regurgitation murmur suggested this mechanical complication...
June 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
M Kucuk, R Ozdemir, C Karadeniz, K Celegen, M Demirol, M M Yilmazer, T Mese, N Unal
INTRODUCTION: In this study, we aimed to evaluate Red blood cell distribution width (RDW) in patients with acute rheumatic carditis during the acute phase and after anti-inflammatory therapy. METHODS: Pediatric patients diagnosed with acute rheumatic carditis (ARC) between 2006 and 2014 and age- and sex-matched controls were retrospectively analyzed. At the time of diagnosis and after 2 months of medical therapy, we reviewed the obtained demographic features; echocardiographic data; complete blood count reports, including RDW; acute phase reactants, including C-reactive protein; and erythrocyte sedimentation rate values...
October 2016: International Journal of Laboratory Hematology
Y F Tang, L Han, F L Lu, Z G Song, X L Lang, L J Zou, Z Y Xu
OBJECTIVE: To summarize the results and methods of left subclavian artery revascularization by stented trunk fenestration for acute Stanford type A aortic dissection. METHODS: Clinical data of 67 patients (54 male and 13 female, mean age of (50±10) years) underwent surgical treatment of left subclavian artery fenestration for acute Stanford A aortic dissection in Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical College between September 2008 and December 2014 were analyzed retrospectively...
July 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Neil Ruparelia, Antonio Mangieri, Marco Ancona, Francesco Giannini, Eustachio Agricola, Matteo Montorfano, Michele De Bonis, Ottavio Alfieri, Antonio Colombo, Azeem Latib
OBJECTIVES: To report procedural and 30-day outcomes following percutaneous transcatheter valve-in-valve (VIV) implantation for tricuspid bioprosthesis failure, with a new generation balloon-expandable transcatheter aortic valve implantation prosthesis. BACKGROUND: Severe tricuspid regurgitation is associated with a reduction in survival and increased morbidity. Many patients previously treated with tricuspid valve replacement require further intervention due to bioprosthesis failure...
May 17, 2016: Catheterization and Cardiovascular Interventions
L M Predescu, L Zarma, P Platon, M Postu, A Bucsa, M Croitoru, B Prodan, O Chioncel, D Deleanu
Cardiovascular manifestations of tertiary syphilis infections are uncommon, but represent an important cause of mortality and morbidity. Syphilitic aortitis is characterized by aortic regurgitation, dilatation of ascending aorta and ostial coronary artery lesions. We report a case of 36 years old man admitted to our hospital for acute anterior ST segment elevation myocardial infarction complicated with cardiogenic shock (hypotension 75/50 mmHg). Transthoracic echocardiography revealed a dilated left ventricle with severe systolic dysfunction (ejection fraction = 25%), severe mitral regurgitation, moderate aortic regurgitation and mildly dilated ascending aorta...
January 2016: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Legate Philip, Neil Andrews
Acute mitral regurgitation (acute MR) is a rare cause of acute respiratory distress, which can present diagnostic challenges. We present the case of a 57 year old man who developed acute shortness of breath subsequently associated with fever, raised white cells and elevated CRP. Chest x-ray revealed unilateral shadowing and he was treated for pneumonia, despite the finding of severe mitral regurgitation on echo. Failure to respond to antibiotic treatment following 3 weeks on ITU led to the consideration of acute MR as the cause of his symptoms and he responded well to diuretics...
2016: Acute Medicine
Tamás Ruttkay, Gábor Jancsó, Károly Gombocz, Balázs Gasz
Severe mitral regurgitation due to prolapse of the valve demands early surgical intervention. Recently artificial chord implantation is the prefered solution, which requires cardioplegia and application of cardiopulmonary bypass using the left atrial approach. Transoesophageal echocardiography guided transapical neochord implantation is an emerging new technique for the treatment of mitral regurgitation. It enables the operation through left minithoracotomy on beating heart using a special instrument introduced into the left ventricle...
May 1, 2016: Orvosi Hetilap
Mohammad Vaezi, Cyrous Gharib, Maryam Souri, Ardeshir Ghavamzadeh
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is currently the only curative treatment for acute leukemia. As HSCT improves the long-term survival, it is necessary to assess the late-onset complications affecting the quality of life following HSCT. SUBJECTS AND METHODS: The study included 122 patients (65 male, 57 female) with leukemia (72 AML and 50 ALL) who received transplants from fully- matched siblings, unrelated donors and unrelated cord blood donors between February 2013 and August 2014 in Shariati Hospital...
January 1, 2016: International Journal of Hematology-oncology and Stem Cell Research
Subbarao Elapavaluru, Sulaiman Alhassan, Fawad Khan, Ramzi Khalil, Amy Schuett, Stephen Bailey
We report the case of a 61-year-old woman with acute decompensated heart failure secondary to acute traumatic mitral regurgitation, resulting from polymethylmethacrylate cement found in the left ventricle less than 24 hours after fluoroscopic percutaneous vertebroplasty. The patient had a history of ovarian cancer and had undergone treatment for symptomatic osteoporotic compression fractures of the vertebrae (T11, L1, and L3). The patient underwent a successful emergency open-heart operation, mitral valve replacement, closure of an atrial septal defect, and video-assisted removal of the cement foreign body from the left ventricle...
March 2016: Annals of Thoracic Surgery
Norbert Klein, Dietrich Pfeiffer, Steven Goldberg, Maika Klein
BACKGROUND AND AIMS: One option for interventional treatment of secondary mitral regurgitation is the placement of an indirect mitral annuloplasty device (Carillon Mitral Contour System) cinching the mitral annulus to facilitate coaptation of the mitral leaflets. The aim of this study is to evaluate the implantation success and hemodynamic results. METHODS AND RESULTS: Seventeen consecutive patients (11 females, 6 males) suffering from moderate to severe secondary mitral regurgitation (40% ischemic, 59% non-ischemic) received a Carillon Mitral Contour System device, which was evaluated prospectively in a single-center setting...
March 2016: Journal of Invasive Cardiology
Christos G Mihos, Orlando Santana, Andrés M Pineda, Gregg W Stone, Frederick Hasty, Nirat Beohar
OBJECTIVE: The optimal treatment strategy in patients with coronary artery disease and ischemic mitral regurgitation (IMR) remains controversial. A staged approach of percutaneous coronary intervention (PCI) followed by minimally invasive valve surgery, rather than combined median sternotomy coronary artery bypass and valve surgery, may be a viable alternative. METHODS: We retrospectively evaluated 31 consecutive patients with coronary artery disease and severe IMR who underwent a staged procedure at our institution between February 2009 and April 2014...
November 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Yin Wu, WuQiang Fan, Laura Chachula, Gary Costacurta, Rajeev Rohatgi, Farhad Elmi
INTRODUCTION: Takotsubo cardiomyopathy (TCM) can be complicated by left ventricular outflow tract (LVOT) obstruction and severe acute mitral regurgitation (MR), leading to hemodynamic instability in an otherwise benign disorder. Despite the severity of these complications, there is a paucity of literature on the matter. Because up to 20-25% of TCM patients develop LVOT obstruction and/or MR, it is important to recognize the clinical manifestations of these complications and to adhere to specific management in order to reduce patient morbidity and mortality...
2015: Journal of Community Hospital Internal Medicine Perspectives
Lucien Marchand, Bérénice Segrestin, Marion Lapoirie, Véronique Favrel, Julie Dementhon, Emmanuel Jouanneau, Gérald Raverot
Cardiovascular impairments are frequent in Cushing's syndrome and the hypercortisolism can result in cardiac structural and functional changes that lead in rare cases to dilated cardiomyopathy (DCM). Such cardiac impairment may be reversible in response to a eucortisolaemic state.A 43-year-old man with a medical past of hypertension and history of smoking presented to the emergency department with global heart failure. Coronary angiography showed a significant stenosis of a marginal branch and cardiac MRI revealed a nonischemic DCM...
November 2015: Medicine (Baltimore)
Rishi Puri, Omar Abdul-Jawad Altisent, Maria del Trigo, Francesco Campelo-Parada, Ander Regueiro, Henrique Barbosa Ribeiro, Robert DeLarochellière, Jean-Michel Paradis, Eric Dumont, Josep Rodés-Cabau
BACKGROUND: Transcatheter mitral valve implantation (TMVI) for severely calcified native mitral valve disease recently emerged as a treatment option in patients deemed inoperable by conventional techniques. Yet no systematic appraisal currently exists characterizing this novel treatment paradigm. METHODS: A systematic literature review summarizing the clinical, anatomical, peri- and post-procedural characteristics underscoring the technical feasibility of this procedure was performed...
February 15, 2016: Catheterization and Cardiovascular Interventions
Yuko Wada, Takahiro Ohara, Akira Funada, Takuya Hasegawa, Yasuo Sugano, Hideaki Kanzaki, Hiroyuki Yokoyama, Satoshi Yasuda, Hisao Ogawa, Toshihisa Anzai
BACKGROUND: Functional mitral regurgitation (FMR) is a common complication of heart failure (HF) and worsens in acute decompensation. It is unclear whether FMR on admission or discharge determines the outcome. This study aimed to elucidate the prognostic significance of FMR on admission or discharge in patients admitted with acute decompensated HF. METHODS AND RESULTS: From 2006 to 2009, 349 patients admitted with acute decompensated HF were enrolled. They were followed with the composite endpoint of all-cause death and hospitalization for HF; 74 (21%) died and 113 (32%) developed the composite endpoint during 2...
2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Edgar Tay, Nasir Muda, Jonathan Yap, David W M Muller, Teguh Santoso, Darren L Walters, Xianbao Liu, Eric Yamen, Paul Jansz, James Yip, Robaayah Zambahari, Jurgen Passage, Zee Pin Ding, Jian'an Wang, Gregory Scalia, Amiliana M Soesanto, Khung Keong Yeo
OBJECTIVES: The objective of this study is to describe and compare the use of the MitraClip therapy in mitral regurgitation (MR) patients with degenerative MR (DMR) and functional MR (FMR). INTRODUCTION: Percutaneous edge-to-edge repair of severe MR using the MitraClip device is approved for use in the USA for high risk DMR while European guidelines include its use in FMR patients as well. METHODS: The MitraClip in the Asia-Pacific Registry (MARS) is a multicenter retrospective registry, involving eight sites in five Asia-Pacific countries...
June 2016: Catheterization and Cardiovascular Interventions
Bonaventura Schmid, Katrin Fink, Manfred Olschewski, Stephan Richter, Tilmann Schwab, Michael Brunner, Hans-Joerg Busch
Hemodynamic monitoring plays a crucial role in the supportive treatment of critically ill patients. In this setting, the use of the pulmonary artery catheter (PAC) is a standard procedure. In this study we prospectively compare the accuracy and precision of pulmonary thermodilution (PTD) by PAC and transcardiopulmonary thermodilution (TC-PTD) in patients with cardiogenic shock following an acute cardiac event. In this prospective study 77 hemodynamic measurements were taken in 11 patients presenting cardiogenic shock (CS) treated at the medical intensive care unit of our university hospital...
October 1, 2015: Journal of Clinical Monitoring and Computing
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