Management of Valvular Heart Failure Due To Mechanical Mitral Valve Thrombosis During Pregnancy

Bioprosthetic valve thrombosis has been considered to be extremely unlikely, typically freeing patients from the potential complications of long-term anticoagulation. However, there have been several documented cases of bioprosthetic valve thrombosis and there are concerns that its incidence may be underreported. Experience with diagnosis and management of this condition is limited. Here, we present a case of acute massive bioprosthetic mitral thrombosis manifesting as fulminant heart failure.

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An uncommon case of bioprosthetic mitral valve thrombosis with subsequent prosthesis dehiscence

Proceedings of Singapore Healthcare ◽

10.1177/20101058211019434 ◽

2021 ◽

pp. 201010582110194

Author(s):

Raja Ezman Faridz Raja Shariff ◽

Sazzli Kasim

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Intracerebral Haemorrhage ◽

New Left ◽

Signs And Symptoms ◽

Transoesophageal Echocardiography ◽

Anterior Portion ◽

Valve Thrombosis ◽

Uncommon Case ◽

Bioprosthetic Mitral Valve

Bioprosthetic valve thrombosis (BVT) is uncommon. An 82-year-old gentleman presented following a cardioembolic stroke due to a mitral valve infective endocarditis. The patient underwent bioprosthetic mitral valve replacement. Following discharge, he re-presented with weakness due to a new left-sided stroke and right-sided occipital intracerebral haemorrhage. Both transthoracic and transoesophageal echocardiography revealed BVT on the anterior portion of the prosthesis. Following a multidisciplinary team discussion, it was felt that thrombolytics and anticoagulation would be detrimental. The patient continued to worsen and eventually succumbed to congestive cardiac failure. BVT is uncommon, and patients often present with signs and symptoms of heart failure, shock or embolism. There are no guidelines available on managing BVT in patients with concurrent intracerebral haemorrhage, highlighting the importance of multidisciplinary efforts and patient inclusivity in decision making.

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Surgical treatment of a case of acute left heart failure caused by prosthetic valve thrombosis after mitral valve replacement

10.22541/au.161256027.70797916/v1 ◽

2021 ◽

Author(s):

pengying zhao ◽

ruisheng liu ◽

bing song

Keyword(s):

Heart Failure ◽

Surgical Treatment ◽

Mitral Valve ◽

Valve Replacement ◽

Prosthetic Valve ◽

Prosthetic Heart Valve ◽

Left Heart ◽

Left Heart Failure ◽

Prosthetic Valve Thrombosis ◽

Valve Thrombosis

Prosthetic valve thrombosis ( PVT) is a serious complication after prosthetic heart valve replacement.When thrombosis causes the prosthetic valve to disfunction, it may cause the patient to die.We successfully treated a patient with acute left heart failure due to prosthetic valve thrombosis. The report is as follows.

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298 Mitral valve repair is the key in surgical treatment of primary dilated cardiomyopathy with heart failure

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(06)80200-6 ◽

2006 ◽

Vol 5 (1) ◽

pp. 69-69

Author(s):

N RADOVANOVIC ◽

B MIHAJLOVIC ◽

S NICIN ◽

Z JONJEV ◽

L PETROVIC ◽

...

Keyword(s):

Heart Failure ◽

Surgical Treatment ◽

Mitral Valve ◽

Dilated Cardiomyopathy ◽

Mitral Valve Repair ◽

Valve Repair

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Assessment of Respiratory Rate in Dogs during the Sleep with Mitral Valve Endocardiosis, Complicated by Congestive Heart Failure Syndrome: the Degree of Adherence for this Test by Animal Owners and its Impact on Patient Survival

Systematic Reviews in Pharmacy ◽

10.31838/srp.2020.5.51 ◽

2020 ◽

Vol 11 (05) ◽

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Mitral Valve ◽

Respiratory Rate ◽

Patient Survival

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Predictors of outcomes in patients with mitral regurgitation undergoing percutaneous valve repair

European Heart Journal ◽

10.1093/ehjci/ehaa946.2008 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Polimeni

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Primary Endpoint ◽

Cardiovascular Death ◽

Volume Index ◽

Valve Repair ◽

Percutaneous Valve Repair ◽

Percutaneous Valve

Abstract Background Percutaneous mitral valve repairs has been increasingly performed worldwide. The MITRA-UMG registry provides a snapshot of a real-world clinical data and outcomes. Purpose We sought to investigate predictors of clinical outcomes in patients with mitral regurgitation undergoing percutaneous valve repair. Methods The MITRA-UMG registry retrospectively collected data from consecutive patients with symptomatic moderate-to-severe or severe MR underwent MitraClip implantation. The primary endpoint of interest was the composite of cardiovascular death or rehospitalization for HF. Results Between March 2012 and July 2018, a total of 133 consecutive patients admitted to our institution were included. Acute procedural success was obtained in 95.4% of patients, with no intraprocedural death. The composite primary endpoint of cardiovascular death or rehospitalization for heart failure was met in 50 patients (38%) with cumulative incidences of 7%, 25%, at 30 days and 1 year, respectively. In the Cox multivariate model, NYHA functional class IV, left ventricular end-diastolic volume index (LVEDVi), Euroscore II, independently increased the risk of the primary endpoint at long-term follow-up. At Kaplan-Meier analysis, a LVEDVi >92 ml/m2 was associated with an increased incidence of the primary endpoint. Conclusions In searching the ideal phenotype of patients who benefit most of percutaneous mitral valve repair, those presenting with severely dilated ventricles (LVEDVi >92 ml/m2), high operative risk (EUROSCORE II >7%) or advanced heart failure symptoms (NYHA IV) at baseline carried the worst prognosis at long-term. Funding Acknowledgement Type of funding source: None

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Case report: Buddy wire technique to facilitate atrial septal crossing during transcatheter transseptal mitral valve implantation

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa373 ◽

2020 ◽

Author(s):

Ashvarya Mangla ◽

Ameer Musa ◽

Clifford J Kavinsky ◽

Hussam S Suradi

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Heart Valve ◽

Interatrial Septum ◽

Chronic Obstructive ◽

Mitral Valve Stenosis ◽

Heart Team ◽

Transcatheter Heart Valve ◽

Valve Implantation ◽

Buddy Wire

Abstract Background Transcatheter mitral valve-in-valve implantation (MVIV) has emerged as a viable treatment option in patients at high risk for surgery. Occasionally, despite appropriate puncture location and adequate dilation, difficulty is encountered in advancing the transcatheter heart valve across interatrial septum. Case summary We describe a case of a 79-year-old woman with severe chronic obstructive pulmonary disease (COPD), prior surgical bioprosthetic aortic and mitral valve replacement implanted in 2007, atrial fibrillation, and Group II pulmonary hypertension who presented with progressively worsening heart failure symptoms secondary to severe bioprosthetic mitral valve stenosis and moderate-severe mitral regurgitation. Her symptoms had worsened over several months, with multiple admissions at other institutions with treatment for both COPD exacerbation and heart failure. Transoesophageal echocardiogram demonstrated preserved ejection fraction, normal functioning aortic valve, and dysfunctional mitral prosthesis with severe stenosis (mean gradient 13 mmHg) and moderate-severe regurgitation. After a multi-disciplinary heart team discussion, the patient underwent a transcatheter MVIV implantation. During the case, inability in advancing the transcatheter heart valve (THV) across interatrial septum despite adequate septal balloon pre-dilation was successfully managed with the support of a stiff ‘buddy wire’ anchored in the left upper pulmonary vein using the same septal puncture. The patient tolerated the procedure well and was discharged home. Discussion Operators should be aware of potential strategies to advance the THV when difficulty is encountered in crossing the atrial septum despite adequate septal preparation. One such strategy is the use of stiff ‘buddy wire’ for support which avoids the need for more aggressive septal dilatation.

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What Factors Should Be Considered to Improve Outcome of Mechanical Mitral Valve Replacement in Children?

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135121994084 ◽

2021 ◽

Vol 12 (3) ◽

pp. 367-374

Author(s):

Mohamed F. Elsisy ◽

Joseph A. Dearani ◽

Elena Ashikhmina ◽

Prasad Krishnan ◽

Jason H. Anderson ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Multivariable Analysis ◽

Permanent Pacemaker ◽

Early Mortality ◽

Prosthetic Valve Thrombosis ◽

Valve Size ◽

Valve Thrombosis

Objective: To identify risk factors for pediatric mechanical mitral valve replacement (mMVR) to improve management in this challenging population. Methods: From 1993 to 2019, 93 children underwent 119 mMVR operations (median age, 8.8 years [interquartile range [IQR]: 2.1-13.3], 54.6% females) at our institution. Twenty-six (21.8%) patients underwent mMVR at ≤2 years and 93 (78.2%) patients underwent mMVR at >2 years. Median follow-up duration was 7.6 years [IQR: 3.2-12.4]. Results: Early mortality was 9.7%, but decreased with time and was 0% in the most recent era (13.9% from 1993 to 2000, 7.3% from 2001 to 2010, 0% from 2011 to 2019, P = .04). It was higher in patients ≤2 years compared to patients >2 years (26.9% vs 2.2%, P < .01). On multivariable analysis for mitral valve reoperation, valve size <23 mm was significant with a hazard ratio of 5.38 (4.87-19.47, P = .01);. Perioperative stroke occurred in 1% and permanent pacemaker was necessary in 12%. Freedom from mitral valve reoperation was higher in patients >2 years and those with a prosthesis ≥23 mm. Median time to reoperation was 7 years (IQR: 4.5-9.1) in patients >2 years and 3.5 years (IQR: 0.6-7.1) in patients ≤2 years ( P = .0511), but was similar between prosthesis sizes ( P = .6). During follow-up period (median 7.6 years [IQR: 3.2-12.4], stroke occurred in 10%, prosthetic valve thrombosis requiring reoperation in 4%, endocarditis in 3%, and bleeding in 1%. Conclusion: Early and late outcomes of mMVR in children are improved when performed at age >2 years and with prosthesis size ≥23 mm. These factors should be considered in the timing of mMVR.

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