scholarly journals QUANTIFICATION OF CHANGES IN 3-D REGURGITANT FRACTION AND LEFT VENTRICULAR STROKE VOLUME IMMEDIATELY AFTER SURGICAL MITRAL VALVE REPAIR FOR DEGENERATIVE MITRAL VALVE DISEASE USING AUTOMATED REAL-TIME VOLUME COLOR FLOW DOPPLER TRANS-ESOPHAGEAL ECHOCARDIOGRAPHY

2016 ◽  
Vol 67 (13) ◽  
pp. 1708
Author(s):  
Shizhen Liu ◽  
Naveen Rajpurohit ◽  
William Whitley ◽  
John Meisinger ◽  
Venkateshwar Polsani ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Stroke Volume ◽  
Real Time ◽  
Mitral Valve Repair ◽  
Mitral Valve Disease ◽  
Left Ventricular ◽  
Left Ventricular Stroke Volume ◽  
Valve Repair ◽  
Regurgitant Fraction ◽  
Color Flow

scholarly journals Visualization and Hemo-Dynamic Evaluation of Edge-to-Edge Mitral Valve Repair Within Reanimated Swine Hearts

2009 ◽  
Vol 3 (2) ◽  
Author(s):  
M. G. Bateman ◽  
J. L. Quill ◽  
J. St. Louis ◽  
P. A. Iaizzo
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Imaging Modality ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Lv Function ◽  
Valve Repair ◽  
Regurgitant Fraction ◽  
Orifice Area ◽  
Leaflet Coaptation

This project aims to investigate the performance of edge-to-edge mitral valve repair (MVR) within reanimated swine hearts. Direct imaging and hemodynamic data of the mitral valve during normal cardiac function (Normal), after an induced prolapse (Prolapse), and post surgical repair (E2E) was obtained. Isolated swine hearts (n=6) were reanimated using a clear Krebs–Henseleit buffer. Mitral prolapse, and regurgitation, in the P2 region was induced by cutting chordae tendinae of the posterior leaflet. An edge-to-edge MVR procedure was performed, suturing the prolapsed P2 region to the A2 region of the anterior leaflet. The mitral valve was imaged using endoscopic cameras in the left atrium and ventricle allowing verification of stitch placement and leaflet coaptation. Analysis of the endoscopic images provided measures of annulus area, orifice area, and regurgitant area. Echocardiography, the standard clinical imaging modality, was used to determine the hemodynamic performance of the valve. Additionally, ECG and left chamber pressures were recorded at a sample rate of 5 kHz. Prolapse of the P2 region was consistently created, and edge-to-edge repair of the mitral leaflet showed full leaflet coaptation. The annulus area of the valve was tracked throughout the procedure and did not show significant variation. The orifice area, defined as the area of the annulus that does not contain leaflets, normalized to the corresponding annulus area for Normal, Prolapse and E2E were: 41±13%, 44±14% and 21±13%, p=0.02. The regurgitant area, normalized to the corresponding annulus area, increased from 2±2% for Normal to 8±3% for the Prolapse and then decreased to 1±1% for the E2E group. The regurgitant fraction, normalized against the maximum observed, for Normal, Prolapse and E2E was 10±6%, 57±26% and 13±13%, p<0.01. Over the course of the experiment the left ventricular (LV) systolic pressure and negative dP/dt reduced from 95 to 54 mm Hg and 743 to 402 mm Hg/s, respectively. Our results show that orifice area was significantly smaller after MVR when compared to Normal and Prolapse periods. There was no significant change in regurgitant area and regurgitant fraction from the Normal to repaired valve as compared to a significant increase in regurgitant area and regurgitant fraction during Prolapse. Low gradients were observed for all three groups, with no indications for symptomatic stenosis. The reduction of LV function was caused by global ischemia and the progressive onset of edema. In this acute assessment of edge-to-edge repair of P2 prolapse, repair does not affect annulus area, decreases orifice area, and successfully eliminates regurgitant area with no evidence of mitral stenosis.

scholarly journals Forward stroke volume is preserved during left ventricular remodeling after mitral valve repair

2003 ◽  
Vol 41 (6) ◽  
pp. 515
Author(s):  
Joon-Han Shin ◽  
Takahiro Shiota ◽  
Jian-Xin Qin ◽  
Yong-Jin Kim ◽  
Zoran B. Popovic ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Stroke Volume ◽  
Mitral Valve Repair ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Valve Repair ◽  
Forward Stroke

scholarly journals Transcatheter echo guided mitral valve repair with neochord implantation for posterior leaflet disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Mahia ◽  
J Cobiella ◽  
D Enriquez ◽  
M Carnero ◽  
L Maroto ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Transesophageal Echocardiography ◽  
Real Time ◽  
Mitral Valve Repair ◽  
Type A ◽  
Left Ventricular ◽  
Reverse Remodeling ◽  
Posterior Leaflet ◽  
Valve Repair ◽  
3D Transesophageal Echocardiography

Abstract Background/Introduction Transapical off-pump mitral valve repair with NeoChord implantation (TOP-MINI) has become applied for patients presenting with severe mitral regurgitation (MR) due to posterior leaflet (PML) prolapse or flail. The procedure is performed under real-time 2D- and 3D-transesophageal echocardiography for both implantation and neochordae tension adjustment allowing real-time monitoring of hemodynamic recovery. Purpose This prospective study sought to evaluate acute safety and efficacy of this innovative, minimally invasive, transcatheter mitral valve repair approach. Methods 33 symptomatic patients patients with severe MR secondary to PML flail/prolapse (March 2017-Dec 2019) were included. Patients were stratified on the basis of the preoperative 3D transesophageal echocardiography assessment of MV morphology: type A, isolated central PML prolapse/flail (25 patients); type B, posterior multisegment prolapse/flail (3 patients); type C and D, anterior or bileaflet prolapse/flail or paracommissural prolapse/flail or any type of disease with the presence of significant leaflet/annular calcifications (5 patients). Type A was considered the more favorable morphology. Results Median age was 67.7±13.4 y. Median EuroSCORE-II 2.7%±1.91. Procedural success was achieved in 28 patients (84,9%). 5 patients, 2 type A and 3 type D, underwent conversion to open surgery for immediate failure. The median number of chords implanted was 3.1±0.6. 1 high-risk patient considered inoperable because of severe comorbidities and extensive annular calcifications died before discharge. Postoperative length of stay was 4.25±1 days. At 12.3±4.9 months median follow-up, MR≤moderate was present in 25 (90%). Overall 1-year survival was 100%. Freedom from reintervention was 97% for overall population. Transthoracic echocardiography at 1 year revealed ventricular reverse remodeling, with a significant decrease in indexed left ventricular end- end-systolic volumes (25.3±6.4 to 21.6±8.2 mL/m2, P&lt;0.001). 92.9% were in New York Heart Association class I. Conclusions TOP-MINI procedure is a feasible, low-risk technique that allows safely repair degenerative mitral valve failure secondary to prolapse/flail valvular and its efficacy is maintained up to 1-year. Funding Acknowledgement Type of funding source: None

scholarly journals Real-Time Left Ventricular Pressure-Volume Loops During Percutaneous Mitral Valve Repair With the MitraClip System

Circulation ◽  
2013 ◽  
Vol 127 (9) ◽  
pp. 1018-1027 ◽  
Author(s):  
Oliver Gaemperli ◽  
Patric Biaggi ◽  
Remo Gugelmann ◽  
Martin Osranek ◽  
Jan J. Schreuder ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Real Time ◽  
Mitral Valve Repair ◽  
Left Ventricular Pressure ◽  
Left Ventricular ◽  
Ventricular Pressure ◽  
Valve Repair ◽  
Percutaneous Mitral Valve Repair ◽  
Mitraclip System

scholarly journals Ventricular arrhythmias in patients with functional mitral regurgitation and implantable cardiac devices: implications of mitral valve repair with Mitraclip

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Benito Gonzalez ◽  
X Freixa ◽  
C Godino ◽  
M Taramasso ◽  
R Estevez-Loureiro ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
One Year ◽  
The Impact

Abstract Background Limited information has been reported regarding the impact of percutaneous mitral valve repair (PMVR) on ventricular arrhythmic (VA) burden. The aim of this study was to address the incidence of VA and appropriate antitachycardia implantable cardiac defibrillator (ICD) therapies before and after PMVR. Methods We retrospectively analyzed all consecutive patients with heart failure with reduce left ventricular ejection fraction, functional mitral regurgitation grade 3+ or 4+ and an active ICD or cardiac resynchronizer who underwent PMVR in any of the eleven recruiting centers. Only patients with complete available device VA monitoring from one-year before to one year after PMVR were included. Baseline clinical and echocardiographic characteristics were collected before PMVR and at 12-months follow-up. Results 93 patients (68.2±10.9 years old, male 88.2%) were enrolled. PMVR was successfully performed in all patients and device success at discharge was 91.4%. At 12-months follow-up, we observed a significant reduction in mitral regurgitation severity, NT-proBNP and prevalence of severe pulmonary hypertension and severe kidney disease. Patients also referred a significant improvement in NYHA functional class and showed a non-significant trend to reserve left ventricular remodeling. After PMVR a significant decrease in the incidence of non-sustained ventricular tachycardia (VT) (5.0–17.8 vs 2.7–13.5, p=0.002), sustained VT or ventricular fibrillation (0.9–2.5 vs 0.5–2.9, p=0.012) and ICD antitachycardia therapies (2.5–12.0 vs 0.9–5.0, p=0.033) were observed. Conclusion PMVR was related to a reduction in arrhythmic burden and ICD therapies in our cohort. Proportion of patients who presented ven Funding Acknowledgement Type of funding source: None

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