Database : MEDLINE
Search on : Mitral and Valve and Insufficiency [Words]
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[PMID]: 29470257
[Au] Autor:Ginty OK; Moore JM; Xu Y; Xia W; Fujii S; Bainbridge D; Peters TM; Kiaii BB; Chu MWA
[Ti] Title:Dynamic Patient-Specific Three-Dimensional Simulation of Mitral Repair: Can We Practice Mitral Repair Preoperatively?
[So] Source:Innovations (Phila);13(1):11-22, 2018 Jan/Feb.
[Is] ISSN:1559-0879
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Planned mitral repair strategies are generally established from preoperative echocardiography; however, specific details of the repair are often determined intraoperatively. We propose that three-dimensional printed, patient-specific, dynamic mitral valve models may help surgeons plan and trial all the details of a specific patient's mitral repair preoperatively. METHODS: Using preoperative echocardiography, segmentation, modeling software, and three-dimensional printing, we created dynamic, high-fidelity, patient-specific mitral valve models including the subvalvular apparatus. We assessed the accuracy of 10 patient mitral valve models anatomically and functionally in a heart phantom simulator, both objectively by blinded echocardiographic assessment, and subjectively by two mitral repair experts. After this, we attempted model mitral repair and compared the outcomes with postoperative echocardiography. RESULTS: Model measurements were accurate when compared with patients on anterior-posterior diameter, circumference, and anterior leaflet length; however, less accurate on posterior leaflet length. On subjective assessment, Likert scores were high at 3.8 ± 0.4 and 3.4 ± 0.7, suggesting good fidelity of the dynamic model echocardiogram and functional model in the phantom to the preoperative three-dimensional echocardiogram, respectively. Mitral repair was successful in all 10 models with significant reduction in mitral insufficiency. In two models, mitral repair was performed twice, using two different surgical techniques to assess which provided a better outcome. When compared with the actual patient mitral repair outcome, the repaired models compared favorably. CONCLUSIONS: Complex mitral valve modeling seems to predict an individual patient's mitral anatomy well, before surgery. Further investigation is required to determine whether deliberate preoperative practice can improve mitral repair outcomes.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1097/IMI.0000000000000463

  2 / 22745 MEDLINE  
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[PMID]: 28453792
[Au] Autor:Risteski P; Monsefi N; Miskovic A; Josic T; Bala S; Salem R; Zierer A; Moritz A
[Ad] Address:Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany.
[Ti] Title:Triple valve surgery through a less invasive approach: early and mid-term results.
[So] Source:Interact Cardiovasc Thorac Surg;24(5):677-682, 2017 05 01.
[Is] ISSN:1569-9285
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: A partial upper sternotomy has become established as a less invasive approach mainly for single and double valve surgery. This report evaluates the clinical outcomes of triple valve surgery performed through a partial upper sternotomy. METHODS: We reviewed the medical records of 37 consecutive patients (28 men, 76%) who underwent triple valve surgery through a partial upper sternotomy between 2005 and 2015. The patients' mean age was 67 ± 17 years; 27 (73%) were in New York Heart Association Class III or IV. Aortic and mitral valve insufficiency was more common than stenosis. Ninety-three percent of surviving patients were followed for a mean period of 58 ± 24 months. RESULTS: Aortic valve procedures consisted of 24 (65%) replacements and 13 (35%) repairs. The mitral valve was repaired in 28 (76%) patients, whereas tricuspid valve repair was feasible in all patients. No conversion to full sternotomy was necessary. Myocardial infarction was not observed. Chest tube drainage was 330 ± 190 ml, and 4 patients required reopening for bleeding (1, 3%) or tamponade (3, 8%). One stroke was observed due to heparin-induced thrombocytopaenia after initial unremarkable neurological recovery. Early mortality included 5 (13.5%) patients. Actuarial survival at 5 years was 52 ± 10%. CONCLUSIONS: A partial upper sternotomy provides adequate exposure to all heart valves. We did not experience technical limitations with this approach. Wound dehiscence, postoperative bleeding, intensive care unit and hospital stay and early deaths were low compared to data from other published series of triple valve surgery through a full median sternotomy. Early and mid-term outcomes were not adversely affected by this less invasive approach.
[Mh] MeSH terms primary: Aortic Valve/surgery
Cardiac Surgical Procedures/methods
Heart Valve Diseases/surgery
Minimally Invasive Surgical Procedures/methods
Mitral Valve/surgery
Sternotomy/methods
Tricuspid Valve/surgery
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Length of Stay
Male
Middle Aged
Mitral Valve Insufficiency/surgery
Retrospective Studies
Time Factors
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivw430

  3 / 22745 MEDLINE  
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[PMID]: 29416208
[Au] Autor:Hodzic E; Granov N
[Ad] Address:Clinic for Heart, Blood Vessel and Rheumatic Diseases. University Clinical Center Sarajevo, Rajevo, Bosnia and Herzegovina.
[Ti] Title:Gigantic Thrombus of the Left Atrium in Mitral Stenosis.
[So] Source:Med Arch;71(6):449-452, 2017 Dec.
[Is] ISSN:0350-199X
[Cp] Country of publication:Bosnia and Herzegovina
[La] Language:eng
[Ab] Abstract:Introduction: Excess dilatation of the left atrium >65 mm is known in the literature as gigantic atrium. This dilation is most commonly encountered in the mitral insufficiency of rheumatic etiology, but also in severe prolapses of the mitral valve, permanent atrial fibrillation, and at the left right shunt with cardiac insufficiency. Case report: In this paper is presented a case study of echocardiographically verified giant thrombus in left atrium in a 50 years old female patient aged 50 hospitalized because of tiredness, choking, heartburn and urinary tract symptoms. The patient had rheumatic fever at age of 18 years. At age of 35, she was diagnosed with mitral stenosis. In permanent atrial fibrillation with anamnestic data on the previous cerebrovascular stroke (CVI) and the repeated transitional ischemic seizures. Echocardiographic examination confirmed severe mitral stenosis with moderate aortic insufficiency and gigantic left atrium (LA) with gigantic thrombus. Invasive diagnostics were indicated and performed, followed by an acute cardiac surgery including left atrial thrombectomy and implantation of the mechanical aortic and mitral valve. The surgical course was without complications. Conclusion: On eleven postoperative day, after mobilization, the patient experiences stroke with motor aphasia. She was clinically recovering from stroke consequences, and remains cardiollogically stable.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process
[do] DOI:10.5455/medarh.2017.71.449-452

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[PMID]: 29449412
[Au] Autor:Bakkestrøm R; Banke A; Christensen NL; Pecini R; Irmukhamedov A; Andersen M; Borlaug BA; Møller JE
[Ad] Address:From the Department of Cardiology, Odense University Hospital, Denmark (R.B., A.B., N.L.C., R.P., A.I., J.E.M.); Odense Patient Data Explorative Network, University of Southern Denmark, Denmark (R.B., J.E.M.); Department of Cardiology, Aarhus University Hospital, Denmark (M.A.); and Department of Ca
[Ti] Title:Hemodynamic Characteristics in Significant Symptomatic and Asymptomatic Primary Mitral Valve Regurgitation at Rest and During Exercise.
[So] Source:Circ Cardiovasc Imaging;11(2):e007171, 2018 Feb.
[Is] ISSN:1942-0080
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: In severe asymptomatic primary mitral valve regurgitation without risk factors, surgery strategy is controversial. We sought to clarify whether being symptomatic corresponds to the hemodynamic burden and reduced exercise capacity. A better understanding of this may contribute to optimize timing of surgery. METHODS AND RESULTS: Subjects with asymptomatic (New York Heart Association functional class I, n=29) or symptomatic (New York Heart Association functional class II and III, n=28) significant primary mitral valve regurgitation (effective regurgitant orifice, ≥0.30 cm ; left ventricular ejection fraction, >60%) were included. Right heart catheterization during rest and exercise, echocardiography, magnetic resonance imaging, and peak oxygen consumption test was performed. Symptomatic subjects had significantly higher pulmonary capillary wedge pressure at rest (14±4 versus 11±3 mm Hg; =0.003) and at maximal exercise (30±6 versus 25±7 mm Hg; =0.02) and higher mean pulmonary artery pressure (PAP) at rest (22±7 versus 18±4 mm Hg; =0.005) and maximal exercise (46±8 versus 39±7 mm Hg; =0.005) than asymptomatic subjects. Among asymptomatic subjects with normal resting value, exercise testing revealed a systolic PAP >60 mm Hg in 34%. Also the reverse response with minimal increase in pulmonary capillary wedge pressure and mean PAP during exercise was seen, especially in asymptomatic subjects. Among symptomatic subjects, we found a significant inverse correlation between resting mean PAP and left ventricular ejection fraction ( =-0.52; =0.02) and right ventricular ejection fraction ( =-0.67; <0.01). Peak oxygen consumption was equal and normal in both groups and correlated with left ventricular stroke volume but not with pulmonary capillary wedge pressure. CONCLUSIONS: Symptoms in patients with severe mitral valve regurgitation relate to congestion (pulmonary capillary wedge pressure and PAP), but not to peak oxygen consumption, which is determined by forward left ventricular stroke volume. Exercise testing reveals a higher mitral valve regurgitation burden in apparently asymptomatic patients. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02961647.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Data-Review
[do] DOI:10.1161/CIRCIMAGING.117.007171

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[PMID]: 29478744
[Au] Autor:David TE; David CM; Manlhiot C
[Ad] Address:Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address: tirone.david@uhn.ca.
[Ti] Title:Tricuspid annulus diameter does not predict the development of tricuspid regurgitation after mitral valve repair for mitral regurgitation due to degenerative diseases.
[So] Source:J Thorac Cardiovasc Surg;, 2018 Feb 01.
[Is] ISSN:1097-685X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Heart valve surgery guidelines suggest that tricuspid valve annuloplasty may be beneficial in patients with a tricuspid annulus (TA) ≥40 mm even in the absence of functional tricuspid regurgitation (TR) at the time of surgery for left-sided valve lesions (class 2a). Given the broad spectrum of degenerative diseases that affect the atrioventricular valves, we hypothesize that this measurement might not be predictive of TR after mitral valve (MV) repair. METHODS: The diameter of the TA was measured preoperatively in a cohort of 312 consecutive patients who had isolated MV repair for degenerative diseases. The mean TA diameter was 36 mm (95% confidence interval [CI], 35-37 mm). TA ≥40 mm was present in 80 patients. The median duration of echocardiographic follow-up was 6.7 years (interquartile range, 5.4-8.4 years), and was 100% complete. The main study endpoint was postoperative TR of moderate or greater degree. RESULTS: Thirty patients had new or persistent TR at some point during follow-up. The probability of postoperative TR at 7 years was 6.6% (95% CI, 4.6%-9.4%) for all patients, 6.8% (95% CI, 4.6%-10.4%) for TA <40 mm, and 6.0% (95% CI, 2.9%-12.2%) for TA ≥40 mm. Preoperative TA diameter was not associated with the odds of postoperative TR in either the univariable or multivariable regression models. In these analyses, preoperative TR was the strongest predictor of postoperative TR. CONCLUSIONS: TA ≥40 mm is not predictive of the development of postoperative TR after MV repair for degenerative diseases.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher

  6 / 22745 MEDLINE  
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[PMID]: 29357688
[Au] Autor:Tajima K; Honda K; Yuzaki M; Kunimoto H; Okada Y; Nishimura Y
[Ad] Address:1 Department of Thoracic and Cardiovascular Surgery, 13145 Wakayama Medical University , Wakayama city, Japan.
[Ti] Title:Congenital mitral regurgitation with Down syndrome.
[So] Source:Asian Cardiovasc Thorac Ann;26(2):139-141, 2018 Feb.
[Is] ISSN:1816-5370
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:A 19-year-old man with Down syndrome had congenital mitral regurgitation. He had slight mental retardation and difficulty in performing independent oral drug administration. We planned mitral valve plasty to avoid postoperative anticoagulant therapy. The mitral valve lesions were complicated. A prolapsed anterior mitral leaflet, shortened posterior leaflet, abnormal cleft, abnormal papillary muscle, and enlarged annulus were observed. Successful mitral valve plasty was performed using several techniques. The postoperative course was uneventful, and no significant mitral regurgitation was found.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180224
[Lr] Last revision date:180224
[St] Status:In-Process
[do] DOI:10.1177/0218492318755584

  7 / 22745 MEDLINE  
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[PMID]: 29466170
[Au] Autor:Sandrikov VA; Kulagina TY; Ivanov VA; Krylov AS; Yatchenko AM; Кhadzhieva DR; Tsyganov AV; Gavrilov AV; Arkhipov IV
[Ad] Address:Federal State Budgetary Scientific Institution "Petrovsky national research centre of surgery".
[Ti] Title:[Phenomenological Regularities of Assessment of Left Ventricle Function in Mitral Valve Insufficiency].
[So] Source:Kardiologiia;(1):32-40, 2018 Jan.
[Is] ISSN:0022-9040
[Cp] Country of publication:Russia (Federation)
[La] Language:rus
[Ab] Abstract:OBJECTIVE: to examine relationship between anatomical changes of the left ventricle (LV), dynamics of velocity of its volume modification, and blood flows in the LV in patients with mitral regurgitation (MR) before and after surgical treatment. MATERIALS AND METHODS: We included into this study 58 patients with severe 3-4 degree MR (38 men, 20 women aged 24-69 [mean age 51±9] years) in sinus rhythm (96 %) or atrial fibrillation (4 %). The control group included 86 healthy volunteers, mean age 39±7 years. Transthoracic echocardiographic studies were performed in both groups by standard technique at rest using a high-quality echocardiograph Vivid E9, equipped with a 3.5-4.6 MHz multi frequency transducer (in patients before and after surgical repair - mitral valve [MV] replacement and MV reconstruction with annuloplasty ring). The analysis of files recorded was performed off-line by vector analysis technique including estimation of myocardial deformation velocities and dynamics of LV volume modification, construction of "flow-volume" diagram, calculation of the expended kinetic energy, and registration of intraventricular blood flows. RESULTS: End diastolic volume (EDV), end systolic volume (ESV) and total stroke volume (TSV) (effective + retrograde) were significantly increased in patients with severe LV volume overload before surgery in comparison with the control group (p.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[St] Status:In-Data-Review

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[PMID]: 29384880
[Au] Autor:Rong S; Qiu X; Jin X; Shang M; Huang Y; Tang Z; Yuan W
[Ad] Address:Department of Nephrology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai.
[Ti] Title:Risk factors for heart valve calcification in chronic kidney disease.
[So] Source:Medicine (Baltimore);97(5):e9804, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Cardiovascular disease (CVD) is a common cause of death in patients with chronic kidney disease (CKD). Aortic and mitral valve calcification (AVC and MVC, respectively) are critical indicators of CVD and all-cause mortality in CKD patients.We conducted a single center retrospective study of Chinese inpatients with CKD to identify risk factors associated with valve calcification (VC).Of 288 enrolled CKD patients, 22.9% had VC, all of which exhibited AVC, while 21.2% exhibited MVC. The VC group were significantly older than the non-VC group (70.42 ±â€Š11.83 vs 56.47 ±â€Š15.00, P < .001), and contained more patients with history of coronary artery disease (12.1% vs 4.5%, P = .025) or stroke (18.2% vs 5.4%, P < .001). Subjective global assessment scoring indicated that more VC patients were mid/severely malnourished. Levels of prealbumin, cholesterol (Ch), triglycerides, low-density lipoprotein (LDL), apolipoprotein E, ejection fraction, and fraction shortening were significantly lower, and blood C reactive protein, IL-6, left ventricular internal end diastole diameter measured in end diastole, and interventricular septum thickness (IVST) levels were significantly higher in the VC group. Bone metabolism did not differ significantly between the 2 groups. Multivariable logistic regression analysis indicated that age, blood Ch, and LDL levels were significantly associated with VC.Advanced age, increased IVST, hypocholesterolemia, and hyper-LDL cholesterolemia were key risk factors for VC in Han patients with CKD.
[Mh] MeSH terms primary: Calcinosis/etiology
Heart Valve Diseases/etiology
Renal Insufficiency, Chronic/complications
[Mh] MeSH terms secundary: Adult
Age Factors
Aged
Aged, 80 and over
Calcinosis/diagnosis
Calcinosis/therapy
China
Female
Heart Valve Diseases/diagnosis
Heart Valve Diseases/therapy
Humans
Male
Middle Aged
Renal Insufficiency, Chronic/metabolism
Renal Insufficiency, Chronic/therapy
Retrospective Studies
Risk Factors
[Pt] Publication type:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Entry month:1802
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009804

  9 / 22745 MEDLINE  
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[PMID]: 29449413
[Au] Autor:Gillam LD; Marcoff L
[Ad] Address:From the Department of Cardiovascular Medicine, Morristown Medical Center, Atlantic Health System, NJ. linda.gillam@atlantichealth.org.
[Ti] Title:Hemodynamics in Primary Mitral Regurgitation: Support for and Challenges to the Conventional Wisdom.
[So] Source:Circ Cardiovasc Imaging;11(2):e007471, 2018 Feb.
[Is] ISSN:1942-0080
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:EDITORIAL
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Data-Review
[do] DOI:10.1161/CIRCIMAGING.118.007471

  10 / 22745 MEDLINE  
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[PMID]: 29275952
[Au] Autor:Kawamoto N; Fujita T; Fukushima S; Shimahara Y; Kume Y; Matsumoto Y; Yamashita K; Kobayashi J
[Ad] Address:Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
[Ti] Title:Late onset of atrial fibrillation in patients undergoing mitral valve repair for type II dysfunction.
[So] Source:J Cardiol;71(4):346-351, 2018 Apr.
[Is] ISSN:1876-4738
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: There are few reports regarding factors related to late-onset of atrial fibrillation (Af) after mitral valve repair, which can compromise long-term outcome. We analyzed the risk factors for late Af after mitral valve repair. METHODS AND RESULTS: Between 2001 and 2015, 318 patients (214 males; median, 57.7 years) underwent mitral valve repair for degenerative mitral insufficiency (MI) without concomitant aortic valve disease in our institute. Patients with a history of paroxysmal or chronic Af preoperatively were excluded. Serial follow-up echocardiography was used to evaluate cardiac function. The follow-up rate was 99%. The mean follow-up period was 6.0±4.1 years. There was no early death and there were nine late deaths. A total of 29 (9.1%) patients developed late Af. Freedom from late Af was 94.0% at 5 years and 82.9% at 10 years. Small ring annuloplasty, left atrial diameter, and pressure half time, which were measured at follow-up echocardiography, were considered as significant (p<0.05) risk factors for late Af. Patients who had late Af developed recurrent MI more frequently than those who did not (p<0.05). CONCLUSIONS: Remodeling of the atrium caused by functional mitral stenosis is important for late Af, as well as recurrent MI. To prevent these problems, avoiding selection of a small ring at primary mitral repair for type II dysfunction and durable repair are required.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Data-Review


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