scholarly journals Biomechanical Engineering Comparison of Four Leaflet Repair Techniques for Mitral Regurgitation Using a Novel 3D-Printed Left Heart Simulator

2021 ◽  
Author(s):  
Michael J. Paulsen ◽  
Mateo Marin Cuartas ◽  
Annabel Imbrie-Moore ◽  
Hanjay Wang ◽  
Robert Wilkerson ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Left Heart ◽  
3D Printed ◽  
Biomechanical Engineering ◽  
Repair Techniques

A Simplified Technique for Correcting Mitral Valve Regurgitation via Minimally Invasive Approach

2018 ◽  
Vol 13 (3) ◽  
pp. 236-238
Author(s):  
Giuseppe Speziale ◽  
Marco Moscarelli
Keyword(s):  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Mitral Valve Regurgitation ◽  
Valve Regurgitation ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Repair Techniques

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%.

Abstract 20149: Effect of Mitral Valve Area Following Surgical Repair for Degenerative Mitral Regurgitation on Exercise Hemodynamics and Functional Consequences

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kwan Chan ◽  
Thierry Mesana ◽  
Buu-Khanh Lam
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Exercise Capacity ◽  
Ventricular Dysfunction ◽  
Bicycle Exercise ◽  
Functional Consequences ◽  
Exercise Hemodynamics ◽  
Repair Techniques ◽  
Valve Area

Introduction: Mitral valve (MV) area is the key measure of mitral stenosis (MS) in rheumatic MV disease, but its role in the follow-up of patients who had MV repair for degenerative mitral regurgitation (MR) remains uncertain. Our objective is to evaluate the relationships of MV area with hemodynamic effects at rest and during exercise, and with functional measures in patients following MV repair for degenerative MR. Methods: We prospectively assessed 110 patients who had MV repair for degenerative MR and no more than mild residual MR. Patients with aortic valve disease and ventricular dysfunction were excluded. The patients underwent comprehensive echo assessment at rest and during supine bicycle exercise. Brain natriuretic peptide (BNP) levels and SF36 questionnaires were also performed. MV area was calculated using the continuity equation. The patients were divided into 2 groups for comparison (MV area < 1.5 cm 2 vs > 1.5 cm 2 ). Results: 22 patients (20%) had MV area < 1.5 cm 2 . The 2 groups were similar in age. Patients with MVR < 1.5 cm 2 had worse resting and exercise hemodynamics, more limited exercise capacity and higher BNP levels compared to those with larger MV area (Table). These patients also had lower scores in physical functioning, vitality (p=0.01) and social function (p=0.04), based on the SF36 questionnaires. Multivariate analysis showed that MV area is an independent predictor of exercise capacity (p=0.003). Conclusion: In patients following MV repair for degenerative MR, MV area is a useful measure of MS severity because it is associated with resting and exercise hemodynamics and functional consequences. MV area should be routinely measured in this clinical setting, and refinement in MV repair techniques is needed to optimize MV area in addition to eliminate MR.

Tracings of Left Heart Failure—Not Mitral Regurgitation

1977 ◽  
Vol 47 (4) ◽  
pp. 395-395 ◽  
Author(s):  
Donn A. Chambers ◽  
Joel A. Kaplan
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Left Heart ◽  
Left Heart Failure

scholarly journals Right versus left heart reverse remodelling after treating ischaemic mitral and tricuspid regurgitation

2020 ◽  
Author(s):  
Haytham Elgharably ◽  
Hoda Javadikasgari ◽  
Marijan Koprivanac ◽  
Ashley M Lowry ◽  
Kimi Sato ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Tricuspid Regurgitation ◽  
Tricuspid Valve Repair ◽  
Left Heart ◽  
Valve Repair ◽  
Right Heart ◽  
Reverse Remodelling ◽  
The Right

Abstract OBJECTIVES Repair outcomes of tricuspid regurgitation (TR) associated with ischaemic mitral regurgitation (IMR) are inferior to functional TR in terms of TR recurrence and right ventricular (RV) reverse remodelling. Our objective is to analyse right versus left heart reverse remodelling after surgery for IMR-associated TR. METHODS From 2001 to 2011, 568 patients with severe IMR underwent mitral valve surgery (repair 87%, replacement 13%), and 131 had concomitant tricuspid valve repair. Median follow-up was 3.0 years; 25% of living patients were followed up for 6.3 years. Longitudinal analysis of 1527 follow-up echocardiograms was performed to assess ventricular reverse remodelling and function. RESULTS Unlike the left heart, the right heart failed to reverse remodel (failed to recover ventricular function or halt dilatation). During follow-up after surgery, the right ventricle continued to dilate while the left ventricle regressed in size. RV ejection fraction decreased (46% at 1 month and 44% at 5 years), while left ventricular ejection fraction increased (33% and 37%, respectively). RV strain showed early (−11% at 1 month) and late (−12% at 5 years) dysfunction. Patients who underwent tricuspid valve repair had worse RV function. Mitral regurgitation remained stable after surgical intervention, and TR gradually recurred (37% moderate, 20% severe at 7 years). CONCLUSIONS Surgical treatment of IMR and TR along with revascularization failed to induce reverse remodelling of the right heart. These findings warrant further investigations to identify optimal timing and approach of intervention for IMR-associated TR with respect to RV remodelling.

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