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https://www.readbyqxmd.com/read/28101839/surgical-treatment-of-ischemic-mitral-regurgitation-valve-repair-versus-replacement
#1
REVIEW
Abhishek Sharma, Sahil Agrawal, Sunny Goel, Jeffrey S Borer
PURPOSE OF REVIEW: Ischemic mitral regurgitation (MR), which occurs in about 20-30% patients with a prior myocardial infarction, is associated with worsening heart failure and an increase in cardiovascular mortality. It should be treated surgically if certain hemodynamic severity criteria are met and in patients who continue to experience symptoms of heart failure despite optimal medical therapy. However, current guidelines do not suggest which of the available approaches to mitral valve surgery-mitral valve (MV) repair or replacement (MVR) is superior for this indication...
January 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28100645/lipoxin-a4-stimulates-endothelial-mir-126-5p-expression-and-its-transfer-via-microvesicles
#2
Marilina Codagnone, Antonio Recchiuti, Paola Lanuti, Anna Maria Pierdomenico, Eleonora Cianci, Sara Patruno, Veronica Cecilia Mari, Felice Simiele, Pamela Di Tomo, Assunta Pandolfi, Mario Romano
The proresolution lipid mediator lipoxin (LX)A4 bestows protective bioactions on endothelial cells. We examined the impact of LXA4 on transcellular endothelial signaling via microRNA (miR)-containing microvesicles. We report LXA4 inhibition of MV release by TNF-α-treated HUVECs, associated with the down-regulation of 18 miR in endothelial microvesicles (EMVs) and the up-regulation of miR-126-5p, both in HUVECs and in EMVs. LXA4 up-regulated miR-126-5p by ∼5-fold in HUVECs and promoted a release of microvesicles (LXA4-EMVs) that enhanced miR-126-5p by ∼7-fold in recipient HUVECs...
January 18, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28072764/antitumour-activity-of-trabectedin-in-myelodysplastic-myeloproliferative-neoplasms
#3
Michela Romano, Matteo Giovanni Della Porta, Anna Gallì, Nicolò Panini, Simonetta Andrea Licandro, Ezia Bello, Ilaria Craparotta, Vittorio Rosti, Elisa Bonetti, Richard Tancredi, Marianna Rossi, Laura Mannarino, Sergio Marchini, Luca Porcu, Carlos M Galmarini, Alberto Zambelli, Marco Zecca, Franco Locatelli, Mario Cazzola, Andrea Biondi, Alessandro Rambaldi, Paola Allavena, Eugenio Erba, Maurizio D'Incalci
BACKGROUND: Juvenile myelomonocytic leukaemia (JMML) and chronic myelomonocytic leukaemia (CMML) are myelodysplastic myeloproliferative (MDS/MPN) neoplasms with unfavourable prognosis and without effective chemotherapy treatment. Trabectedin is a DNA minor groove binder acting as a modulator of transcription and interfering with DNA repair mechanisms; it causes selective depletion of cells of the myelomonocytic lineage. We hypothesised that trabectedin might have an antitumour effect on MDS/MPN...
January 10, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28070866/finite-element-analysis-of-patient-specific-mitral-valve-with-mitral-regurgitation
#4
Thuy Pham, Fanwei Kong, Caitlin Martin, Qian Wang, Charles Primiano, Raymond McKay, John Elefteriades, Wei Sun
Functional mitral regurgitation (FMR) is a significant complication of left ventricular dysfunction and strongly associated with a poor prognosis. In this study, we developed a patient-specific finite element (FE) model of the mitral apparatus in a FMR patient which included: both leaflets with thickness, annulus, chordae tendineae, and chordae insertions on the leaflets and origins on the papillary muscles. The FE model incorporated human age- and gender-matched anisotropic hyperelastic material properties, and MV closure at systole was simulated...
January 9, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28047372/su-f-t-128-dose-volume-constraints-for-particle-therapy-treatment-planning
#5
R Stewart, W Smith, K Hendrickson, J Meyer, N Cao, E Lee, O Gopan, G Sandison, U Parvathaneni, G Laramore
PURPOSE: Determine equivalent Organ at Risk (OAR) tolerance dose (TD) constraints for MV x-rays and particle therapy. METHODS: Equivalent TD estimates for MV x-rays are determined from an isoeffect, regression-analysis of published and in-house constraints for various fractionation schedules (n fractions). The analysis yields an estimate of (α/β) for an OAR. To determine equivalent particle therapy constraints, the MV x-ray TD(n) values are divided by the RBE for DSB induction (RBEDSB ) or cell survival (RBES )...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046333/su-f-t-681-does-the-biophysical-modeling-for-immunological-aspects-in-radiotherapy-precisely-predict-tumor-and-normal-tissue-responses
#6
M Oita, K Nakata, M Sasaki, M Tominaga, H Aoyama, H Honda, Y Uto
PURPOSE: Recent advances in immunotherapy make possible to combine with radiotherapy. The aim of this study was to assess the TCP/NTCP model with immunological aspects including stochastic distribution as intercellular uncertainties. METHODS: In the clinical treatment planning system (Eclipse ver.11.0, Varian medical systems, US), biological parameters such as α/β, D50, γ, n, m, TD50 including repair parameters (bi-exponential repair) can be set as any given values to calculate the TCP/NTCP...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28044989/surgical-mitral-valve-replacement-with-melody-valve-in-infants-and-children-the-italian-experience
#7
Alessandro Frigiola, Francesca Romana Pluchinotta, Antonio Saracino, Alessandro Giamberti, Carmelo Arcidiacono, Luciane Piazza, Matteo Reali, Gianfranco Butera, Alessandro Varrica, Mario Carminati
AIMS: Paediatric patients with mitral valve (MV) disease have limited options for prosthetic MV replacement. Based on a long experience with the stented bovine jugular vein graft (Melody Valve) in the right ventricular outflow tract, we tested the use of the Melody Valve as a surgical implant in the mitral position in patients with congenital mitral disease. METHODS AND RESULTS: Eight patients, age 3 months to 6.2 years, with congenital MV dysplasia had undergone Melody valve implantation in mitral position between March 2014 and October 2015...
January 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28043459/repair-of-parachute-and-hammock-valve-in-infants-and-children-early-and-late-outcomes
#8
Eva Maria Delmo Walter, Mariano Javier, Roland Hetzer
Parachute and hammock valves in children remain one of the most challenging congenital malformations to correct. We report our institutional experience with valve-preserving repair techniques and the early and late surgical outcomes in parachute and hammock valves in infants and children. From January 1990-June 2014, 20 infants and children with parachute (n = 12, median age = 2.5 years, range: 2 months-13 years) and hammock (n = 8, median age = 7 months, range: 1 month-14.9 years) valves underwent mitral valve (MV) repair...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28041699/impact-of-interventional-edge-to-edge-repair-on-mitral-valve-geometry
#9
Robert Schueler, Sarah Kaplan, Charlotte Melzer, Can Öztürk, Marcel Weber, Jan-Malte Sinning, Armin Welz, Nikos Werner, Georg Nickenig, Christoph Hammerstingl
BACKGROUND/OBJECTIVES: The acute and long-term effects of interventional edge-to-edge repair on the mitral valve (MV) geometry are unclear. We sought to assess MV-annular geometry and the association of changes in MV-diameters with functional response one year after MitraClip implantation. METHODS: Consecutive patients (n=84; age 81.2±8.3years, logistic EuroSCORE 21.7±17.9%) with symptomatic moderate-to-severe mitral regurgitation (MR) underwent MitraClip-procedure...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28039280/selection-of-critical-isthmus-in-scar-related-atrial-tachycardia-using-a-new-automated-ultrahigh-resolution-mapping-system
#10
Decebal Gabriel Laţcu, Sok-Sithikun Bun, Frédéric Viera, Tahar Delassi, Mohammed El Jamili, Alaa Al Amoura, Nadir Saoudi
BACKGROUND: Accurate activation mapping of reentrant scar-related atrial tachycardias (AT) allows efficient radiofrequency ablation by targeting the critical isthmus (CI). We aimed to assess the electrophysiological properties of CI channels during mapping with the IntellaMap Orion basket and the Rhythmia system. METHODS AND RESULTS: We prospectively studied 33 AT (post- atrial fibrillation ablation or surgical mitral valve repair). The noise of bipolar electrogram (EGM) was systematically measured at 10 prespecified sites, as well as on a standard catheter and on the surface ECG...
January 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27995395/mitral-valve-chordae-tendineae-topological-and-geometrical-characterization
#11
Amir H Khalighi, Andrew Drach, Charles H Bloodworth, Eric L Pierce, Ajit P Yoganathan, Robert C Gorman, Joseph H Gorman, Michael S Sacks
Mitral valve (MV) closure depends upon the proper function of each component of the valve apparatus, which includes the annulus, leaflets, and chordae tendineae (CT). Geometry plays a major role in MV mechanics and thus highly impacts the accuracy of computational models simulating MV function and repair. While the physiological geometry of the leaflets and annulus have been previously investigated, little effort has been made to quantitatively and objectively describe CT geometry. The CT constitute a fibrous tendon-like structure projecting from the papillary muscles (PMs) to the leaflets, thereby evenly distributing the loads placed on the MV during closure...
December 19, 2016: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27930604/an-automated-expanded-polytetrafluoroethylene-suturing-and-coaxial-fastener-system-for-mitral-chordae-replacement-strength-feasibility-and-healing
#12
Candice Y Lee, Joshua K Wong, Jude S Sauer, Heather R Gorea, Angelo J Martellaro, Andrew R Sifain, Peter A Knight
OBJECTIVE: Mitral valve (MV) chordae replacements can be technically challenging. Technology that remotely delivers and accurately secures artificial chordae may reduce the learning curve and improve the reliability of MV repairs. METHODS: The technology involved two devices: a remote suturing device for delivery of expanded polytetrafluoroethylene (ePTFE) suture to the papillary muscle and a Coaxial titanium suture fastener (TF) device with integrated saline infusion for real-time determination of chordae length during fixation...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27930514/fully-automated-software-for-mitral-annulus-evaluation-in-chronic-mitral-regurgitation-by-3-dimensional-transesophageal-echocardiography
#13
Iolanda Aquila, Covadonga Fernández-Golfín, Luis Miguel Rincon, Ariana González, Ana García Martín, Rocio Hinojar, Jose Julio Jimenez Nacher, Ciro Indolfi, Jose Luis Zamorano
Three-dimensional (3D) transesophageal echocardiography (TEE) is the gold standard for mitral valve (MV) anatomic and functional evaluation. Currently, dedicated MV analysis software has limitations for its use in clinical practice. Thus, we tested here a complete and reproducible evaluation of a new fully automatic software to characterize MV anatomy in different forms of mitral regurgitation (MR) by 3D TEE.Sixty patients were included: 45 with more than moderate MR (28 organic MR [OMR] and 17 functional MR [FMR]) and 15 controls...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27928033/mitral-valve-leaflet-remodelling-during-pregnancy-insights-into-cell-mediated-recovery-of-tissue-homeostasis
#14
Bruno V Rego, Sarah M Wells, Chung-Hao Lee, Michael S Sacks
Little is known about how valvular tissues grow and remodel in response to altered loading. In this work, we used the pregnancy state to represent a non-pathological cardiac volume overload that distends the mitral valve (MV), using both extant and new experimental data and a modified form of our MV structural constitutive model. We determined that there was an initial period of permanent set-like deformation where no remodelling occurs, followed by a remodelling phase that resulted in near-complete restoration of homeostatic tissue-level behaviour...
December 2016: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/27899396/twenty-year-outcome-after-mitral-repair-versus-replacement-for-severe-degenerative-mitral-regurgitation-analysis-of-a-large-prospective-multicenter-international-registry
#15
Siham Lazam, Jean-Louis Vanoverschelde, Christophe Tribouilloy, Francesco Grigioni, Rakesh M Suri, Jean-Francois Avierinos, Christophe de Meester, Andrea Barbieri, Dan Rusinaru, Antonio Russo, Agnès A Pasquet, Hector I Michelena, Marianne Huebner, Joseph Maalouf, Marie-Annick Clavel, Catherine Szymanski, Maurice E Enriquez-Sarano
BACKGROUND: -Mitral valve (MV) repair is preferred over replacement in clinical guidelines and is an important determinant of the indication for surgery in degenerative mitral regurgitation (MR). Yet, the level of evidence supporting current recommendations is low, and recent data cast doubts on its validity in the current era. Accordingly, the aim of the present study was to analyze very long-term outcome after MV repair and replacement for degenerative MR with a flail leaflet. METHODS: -MIDA is a multicenter registry enrolling patients with degenerative MR with a flail leaflet in 6 tertiary European and US centers...
November 29, 2016: Circulation
https://www.readbyqxmd.com/read/27865200/a-review-of-comparative-studies-of-mitraclip-versus-surgical-repair-for-mitral-regurgitation
#16
Hisato Takagi, Tomo Ando, Takuya Umemoto
OBJECTIVES: We summarized comparative studies of MitraClip versus surgical repair for mitral regurgitation (MR) with a systematic literature search and meta-analytic estimates. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through June 2016. Eligible studies were randomized controlled or observational comparative studies of MitraClip versus surgical repair enrolling patients with MR and reporting early (30-day or in-hospital) or late (≥6-month including early) all-cause mortality...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27861426/mastering-mitral-leaflets-coaptation-after-valve-repair-with-adjustable-mitral-annuloplasty-ring-prove-of-concept-in-mock-loop-study
#17
Piergiorgio Tozzi, Daniel Hayoz, Carlo Antona, Gianfranco B Fiore, Giuseppe Siniscalchi, Enrico Ferrari, Gérard Baeriswyl, Riccardo Vismara
This investigation sought to determine the feasibility of a novel mitral ring designed to reshape mitral annulus on beating heart, after surgery. The mitral ring is intended to improve mitral leaflets coaptation to correct residual and recurrent mitral regurgitations. It could also provide progressive correction of mitral regurgitation. The device was tested in ex vivo beating heart model.The novel mitral ring is selectively deformable in P1, P2 and P3 segments using a dedicated angioplasty-type balloon. The deformation should increase leaflets' coaptation reducing distance between the two leaflets...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27837307/outcomes-of-radiofrequency-perforation-for-pulmonary-atresia-and-intact-ventricular-septum-a-single-centre-experience
#18
Steven Rathgeber, Benjamin Auld, Stephanie Duncombe, Martin C K Hosking, Kevin C Harris
Percutaneous radiofrequency perforation (RFP) of the pulmonary valve is used as a primary therapy in neonates with pulmonary atresia and intact ventricular septum (PAIVS). We sought to determine the safety and efficacy of RFP for PAIVS in a single center and assess the pre-intervention anatomical parameters associated with a biventricular outcome. We retrospectively reviewed all cases of PAIVS treated with RFP at a single center from 1999 through 2012. We collected baseline imaging data, technical aspects of the procedure, adverse events and outcomes...
November 11, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27818021/therapeutic-strategy-for-functional-tricuspid-regurgitation-in-patients-undergoing-mitral-valve-repair-for-severe-mitral-regurgitation
#19
Takeshi Kitai, Yutaka Furukawa, Kenta Murotani, Chayakrit Krittanawong, Shuichiro Kaji, Tadaaki Koyama, Yukikatsu Okada
BACKGROUND: The aim of this study was to determine optimal patient selection and selection of a prosthetic ring size for tricuspid valve (TV) repair at the time of mitral valve (MV) repair. METHODS: We prospectively enrolled 167 consecutive patients undergoing MV repair. TV repair was indicated if patients had at least one of the following conditions representing tricuspid annular dilatation: (1) tricuspid regurgitation (TR)≥moderate, (2) history of right heart failure, (3) atrial fibrillation, and (4) pulmonary hypertension...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27798059/quality-of-life-after-mitral-valve-intervention
#20
Matthew K H Tan, Omar A Jarral, Elizabeth H E Thong, Emaddin Kidher, Rakesh Uppal, Prakash P Punjabi, Thanos Athanasiou
Advancements in surgical technique and understanding of the pathophysiology of mitral valve (MV) dysfunction have led to improved outcomes. Seen as a development beyond measures of morbidity and mortality, health-related quality-of-life (HRQOL) outcome measures are becoming increasingly popular. These measures are important because complications following routine (i.e. low-risk) operations on the MV are uncommon and further markers of outcome are needed. Surgeons are increasingly operating earlier on asymptomatic patients and will need to prove that HRQOL is not impacted...
October 20, 2016: Interactive Cardiovascular and Thoracic Surgery
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