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https://www.readbyqxmd.com/read/29769510/surgical-management-of-a-critical-ischemic-mitral-regurgitation-patient
#1
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
#2
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
#3
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/29710128/association-of-timing-of-aortic-valve-replacement-surgery-after-stroke-with-risk-of-recurrent-stroke-and-mortality
#4
Charlotte Andreasen, Mads Emil Jørgensen, Gunnar H Gislason, Andreas Martinsson, Robert D Sanders, Jawdat Abdulla, Per Føge Jensen, Christian Torp-Pedersen, Lars Køber, Charlotte Andersson
Importance: Timing of surgical aortic valve replacement (SAVR) in patients with aortic valve stenosis and previous stroke for the risk of recurrent stroke is insufficiently investigated. Objective: To evaluate the association of time elapsed between previous stroke and SAVR with the risk of recurrent perioperative stroke, major adverse cardiovascular events (MACE), and mortality among patients with aortic valve stenosis. Design, Setting, and Participants: This cohort study using data from Danish administrative registries included all patients with aortic valve stenosis older than 18 years who underwent SAVR between 1996 and 2014 (n = 14 030)...
April 25, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29667898/wernicke-s-encephalopathy-after-cardiac-surgery
#5
Yoshiyuki Nishimura
A 76-year-old woman who had been on hemodialysis for 3 years developed ischemic mitral valve insufficiency, tricuspid insufficiency, and chronic atrial fibrillation, and underwent cardiac surgery. On the 4th postoperative day, she experienced a sudden disturbance of consciousness, aphasia, and limb ataxia. Brain computed tomography and magnetic resonance imaging showed no abnormalities. Wernicke's encephalopathy was suspected and the patient was given vitamin B1, whereupon her symptoms gradually improved. On the 42nd postoperative day, she was free of neurological symptoms and discharged...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29626079/acute-versus-chronic-ischemic-mitral-regurgitation-an-echocardiographic-study-of-anatomy-and-physiology
#6
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
#7
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/29589211/a-modified-multi-patch-technique-for-double-layered-repair-of-ischemic-posterior-ventricular-septal-rupture
#8
Takahiro Katsumata, Masahiro Daimon, Hayato Konishi, Shinji Fukuhara
BACKGROUND: The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett's original technique of multi-patch repair of ruptured posterior septum. CASE PRESENTATION: The technique was employed in the operation of a 67-year-old male who presented with severe heart failure at the 10th day after he developed inferior myocardial infarction...
March 27, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29588148/spontaneous-chordae-tendineae-rupture-during-peripartum
#9
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/29570480/evaluation-of-d-dimer-levels-in-patients-with-prosthetic-valve-thrombosis-relationship-with-thrombus-burden-and-cerebrovascular-events
#10
Sinan Cerşit, Sabahattin Gündüz, Emrah Bayam, Ahmet Güner, Semih Kalkan, Macit Kalçık, Süleyman Karakoyun, Mustafa Ozan Gürsoy, Mahmut Yesin, Özkan Candan, Mehmet Özkan
: Plasma D-dimer level is an indicator of thrombosis and endogenous fibrinolytic activity. We investigated the association between the D-dimer levels and thrombus burden and cerebrovascular events in patients with obstructive prosthetic valve thrombosis (PVT). This retrospective study included 47 patients with obstructive left-sided PVT and 32 controls in whom PVT was excluded with comprehensive transthoracic and transesophageal echocardiography (TEE). The patient group included 11 aortic, 27 mitral, and 9 aortic and mitral valve PVT patients and the control group included 2 aortic, 25 mitral, and 5 aortic and mitral valve patients...
March 22, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29570209/long-term-outcomes-of-mitral-valve-annuloplasty-versus-subvalvular-sparing-replacement-for-severe-ischemic-mitral-regurgitation
#11
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/29569024/soluble-fibrin-monomer-complex-and-prediction-of-cardiovascular-events-in-atrial-fibrillation-the-observational-murcia-atrial-fibrillation-project
#12
José Miguel Rivera-Caravaca, Vanessa Roldán, Marta Romera, María Asunción Esteve-Pastor, Mariano Valdés, Gregory Y H Lip, Vicente Vicente, Francisco Marín
BACKGROUND: Soluble fibrin monomer complex (SFMC) is a biomarker of fibrin formation abnormally elevated in clinical situations of hypercoagulability. OBJECTIVE: We investigated the association and predictive performance of SFMC for stroke, adverse cardiovascular events, cardiovascular mortality and all-cause mortality in a cohort of patients with atrial fibrillation (AF) receiving vitamin K antagonist (VKA) anticoagulant therapy. DESIGN: During the second semester of 2007, we included 1226 AF outpatients stable on VKAs (INR 2...
March 22, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29550522/diagnostic-value-and-prognostic-implications-of-early-cardiac-magnetic-resonance-in-survivors-of-out-of-hospital-cardiac-arrest
#13
Alessandro Zorzi, Angela Susana, Manuel De Lazzari, Federico Migliore, Giovanni Vescovo, Daniele Scarpa, Anna Baritussio, Giuseppe Tarantini, Luisa Cacciavillani, Benedetta Giorgi, Cristina Basso, Sabino Iliceto, Chiara Bucciarelli Ducci, Domenico Corrado, Martina Perazzolo Marra
BACKGROUND: In patients who survived out-of-hospital cardiac arrest (OHCA) it is crucial to establish the underlying cause and its potential reversibility. OBJECTIVE: We assessed the incremental diagnostic and prognostic role of early cardiac magnetic resonance (CMR) in survivors of OHCA. METHODS: Among 139 consecutive OHCA patients, we enrolled 44 (median age 43 years; 84% males) patients who underwent coronary angiography and CMR ≤7 days after admission...
March 14, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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/29501456/contemporary-management-of-ischemic-mitral-regurgitation-a-review
#16
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
#17
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/29441169/perioperative-stroke-pathophysiology-and-management
#18
REVIEW
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29422280/impact-of-intubation-time-on-survival-following-coronary-artery-bypass-grafting-insights-from-the-surgical-treatment-for-ischemic-heart-failure-stich-trial
#19
Nadia Bouabdallaoui, Susanna R Stevens, Torsten Doenst, Krzysztof Wrobel, Denis Bouchard, Marek A Deja, Robert E Michler, Yeow Leng Chua, Renato A K Kalil, Craig H Selzman, Richard C Daly, Benjamin Sun, Ljubomir T Djokovic, George Sopko, Eric J Velazquez, Jean L Rouleau, Kerry L Lee, Hussein R Al-Khalidi
OBJECTIVE: The authors aimed to assess determinants of intubation time and evaluate its impact on 30-day and 1-year postoperative survival in Surgical Treatment for Ischemic Heart Failure (STICH) trial patients. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: A multivariable Cox proportional hazards model was used among the 1,446 surgical patients from the STICH trial who survived 36 hours after operation, in order to identify perioperative factors associated with 30-day and 1-year postoperative mortality...
December 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29416210/assesment-of-rhythm-disorders-in-classical-and-nonclassical-mitral-valve-prolapse
#20
Enisa Hodzic
Introduction: Mitral Valve Prolapse (MVP) is the most common cardiac valve pathology of to day. Aim of article was to identify the types and frequency of potentially malignant arrhythmia and atrial brillation in patients with MVP, to determine the differences in these arrhythmias between classical and non-classical MVP, to evaluate the correlation of potentially malignant arrhythmia and atrial fibrillation with MVP with possible clinical complications of arrhythmogenic sudden cardiac death and potential risk of thromboembolic vascular incident...
February 2018: Medical Archives
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