Practice gaps in the care of mitral valve regurgitation: Insights from the American College of Cardiology mitral regurgitation gap analysis and advisory panel

2016 ◽  
Vol 172 ◽  
pp. 70-79 ◽  
Author(s):  
Andrew Wang ◽  
Paul Grayburn ◽  
Jill A. Foster ◽  
Marti L. McCulloch ◽  
Vinay Badhwar ◽  
...  
Author(s):  
Giuseppe Speziale ◽  
Marco Moscarelli

Mitral valve regurgitation may require complex repair techniques that are challenging in minimally invasive and may expose patients to prolonged cardiopulmonary bypass and cross-clamp times. Here, we present a stepwise operative approach that may facilitate the repair of the mitral valve in a minimally invasive fashion and may be carried out even when multiple posterior segments are involved. This how-to-do article presents a method that was performed in 148 patients that were referred to our institution for severe organic mitral regurgitation between 2008 and 2016. At mean ± SD follow-up of 45.5 ± 27 months, freedom from recurrent of mitral regurgitation 2+ or greater and reoperation was 95.2%.


2017 ◽  
Vol 61 (3) ◽  
pp. 363-366
Author(s):  
Magdalena Garncarz ◽  
Marta Parzeniecka-Jaworska ◽  
Magdalena Hulanicka ◽  
Michał Jank ◽  
Olga Szaluś-Jordanow ◽  
...  

Abstract Introduction: Older small breed dogs are considered at risk for heart failure secondary to chronic mitral valve disease. However, few data are available on the onset of this disease in such dogs. This study was performed to determine if auscultation alone can be used to eliminate clinically relevant mitral valve regurgitation seen in echocardiography in Dachshund dogs. Material and Methods: Clinical and echocardiographic data were obtained from 107 dogs without heart murmurs. Results: The study revealed that 63.6% of the dogs had mitral regurgitation. Numbers increased with age and a larger percentage of male Dachshunds were affected than female Dachshunds. Mitral valve prolapse and thickening were mild, and the regurgitant area inextensive in most dogs. Conclusions: The study shows that mitral valve regurgitation is prevalent (63.6%) in Dachshunds without heart murmurs. Typical lesions often become apparent during echocardiographic examinations in dogs under 5 years of age.


2012 ◽  
Vol 23 (4) ◽  
pp. 620-622 ◽  
Author(s):  
Matthias Gorenflo ◽  
Hugo A. Katus ◽  
Raffi Bekeredjian

AbstractPercutaneous edge-to-edge mitral valve repair using the MitraClipTM has not been used in children. The patient in this reported case was a 15-year-old male adolescent who presented postnatally with severe aortic valve stenosis and dysplasia of the mitral valve. The boy underwent surgical valvuloplasty at the age of 3 months and an aortoventriculoplasty with three re-operations. At the age of 15 years, he developed severe mitral valve regurgitation. Owing to high surgical risks, a MitraClipTM was implanted with a reduction of mitral regurgitation from grade 4+ to 2+, translating into a rapid clinical improvement.


2007 ◽  
Vol 15 (5) ◽  
pp. 396-404 ◽  
Author(s):  
Srikrishna Sirivella ◽  
Isaac Gielchinsky

Combined coronary bypass grafting and valve procedures for mitral valve regurgitation result in poor outcomes, but the impact of the etiology of valve regurgitation on operative and long-term outcomes is not well defined. A retrospective analysis of 468 patients who had combined coronary bypass grafting and valve operations for mitral regurgitation showed that 78% had valve repairs and 22% had replacements for ischemic (45%) or degenerative (55%) disease. Predictors of operative mortality were ischemic mitral regurgitation, failure to use the internal mammary artery for grafting, severe coronary disease, acute myocardial infarction, low ejection fraction, advanced heart failure, emergency operation, and mitral valve replacement. The 5-year survival rates for propensity-matched patients with ischemic or degenerative disease were similar (66%). Low ejection fraction (< 35%), advanced age (> 67 years), valve replacement surgery, residual mitral regurgitation, and severe coronary artery disease were predictors of poor long-term outcome. Although the operative outcomes of ischemic mitral regurgitation were poor compared to those of degenerative disease, the long-term survival was similar in both groups of propensity-matched patients. Left ventricular remodeling, an optimal valve procedure without residual mitral regurgitation, and left ventricular function are more important determinants of long-term outcome than the etiology of valve regurgitation.


2017 ◽  
Vol 2017 (1) ◽  
Author(s):  
Andrew D Maslow ◽  
Athena Poppas

Mitral regurgitation is the second most common valvular disorder requiring surgical intervention worldwide. This review summarizes the current understanding of primary, degenerative mitral regurgitation with respect to etiology, comprehensive assessment, natural history and management. The new concept of staging of the valvular disorders, newer predictors of adverse and controversy of ‘‘watchful waiting’’ versus ‘‘early surgical intervention’’ for severe, asymptomatic, primary mitral regurgitation are addressed. 


2020 ◽  
Vol 7 ◽  
Author(s):  
Bo Liu ◽  
Stacey B. Leach ◽  
Wenzhi Pan ◽  
Fangyu Zheng ◽  
Liujun Jia ◽  
...  

Background: Veterinary management of mitral valve regurgitation due to mxyomatous valve disease in dogs is limited to medical treatments, which only postpones the onset of congestive heart failure or alleviates clinical symptoms. Most surgical procedures to manage this condition in humans require cardiopulmonary bypass and have a high risk of complications.Animals: Eight dogs with naturally occurring mitral valve regurgitation.Methods: Prospective observational study. All dogs were treated with a novel edge-to-edge transcatheter device named ValveClamp. The total surgical procedural time and total catheterization time were recorded. Echocardiographic variables measured pre- and post-procedure were compared using Wilcoxin-signed rank test with a P &lt; 0.05 considered significant. Data were expressed as median and interquartile range and absolute numbers and percentages.Results: The procedural success rate was 100% and all the dogs survived without complications. The median (interquartile range) total surgical procedural time was 86.5 (76–96.2) minutes and catheterization time was 23.5 (22–33.8) minutes. Echocardiography revealed a significant reduction in mitral regurgitation severity in all dogs following the procedure based on both a reduced mitral regurgitant maximum jet area (P = 0.012) and a reduced mitral regurgitant maximum jet area to left atrial area (P = 0.018).Conclusion: The ValveClamp device is effective at reducing the severity of mitral regurgitation in dogs with naturally occurring myxomatous valve disease.


Author(s):  
Tamer Kehibar ◽  
Fatih KIZILYEL ◽  
Mehmet Yilmaz ◽  
Bulent Ketenci

Acquired left ventricular pseudoaneurysm is a rare disorder that occurs after acute myocardial infarction. We present a 55 year-old male patient with a nonruptured pseudoaneurysm after acute MI presenting with severe mitral regurgitation. After resection of sac-like lesion, the defect was 5 cm diameter posterolaterally left ventricular. The aneursym was repaired with pericardium patch to maintain cardiac geometry that diminishes mitral regurgitation without intervention to mitral valve.


Author(s):  
Patrizio Lancellotti ◽  
Julien Magne

Mitral regurgitation is increasingly prevalent. Doppler echocardiography not only detects the presence of regurgitation but also permits to understand mechanisms of regurgitation, quantification of its severity, and repercussions. The present chapter aims to provide clues for the assessment of mitral regurgitation using multi-modality imaging.


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