Anatomy and echocardiography of the normal and abnormal mitral valve

2006 ◽  
Vol 16 (S3) ◽  
pp. 27-34 ◽  
Author(s):  
Alfred Asante-Korang ◽  
Patrick W. O'Leary ◽  
Robert H. Anderson
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Da Vinci ◽  
Leonardo Da Vinci ◽  
Atrioventricular Junction ◽  
Andreas Vesalius

Unlike the tricuspid valve, the mitral valve has frequently received the attention of anatomists. Indeed, the drawings made by Leonardo da Vinci still retain their currency,1whilst it was no less a personage than Andreas Vesalius who, as far as we know, first likened the bifoliate appearance of the valve to the Episcopal mitre. It was also Vesalius who recommended that the two leaflets be described as aortic and mural, reflecting their respective relationships to the aortic valve and the parietal atrioventricular junction. It was Roberts and Perloff,2however, who emphasized the necessity, for clinical purposes, of analyzing not only the valvar leaflets, but also the overall valvar complex. As we will demonstrate in our review, this approach to analysis also proves its worth for the echocardiographic recognition of the congenitally malformed valve.

scholarly journals Valvular heart disease in autoimmune diseases in Mexico

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Aceituno Melgar ◽  
JF Fritche-Salazar ◽  
ME Soto-Lopez
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Autoimmune Diseases ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Valvular Heart Disease ◽  
Valve Disease ◽  
Calcium Deposit

Abstract Funding Acknowledgements Type of funding sources: None. Background  The autoimmune diseases (AD) have high morbidity and mortality due to their affection to the heart. Purpose Our objective was to describe the valvular heart disease (VHD) in patients with AD. Methods Patients with systemic lupus erythematous (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SS) diagnosis were included, from January 1st 2008 to December 31th 2018. Prevalence rates of valve involvement were calculated. Results A total of 163 patients (57.6% with SLE, 23.3% with RA, 19.0% with SS) were included. The global prevalence of VHD was 5.4% in SLS, 23.6% en RA, and 15.9% in SS. The more affected valve in SLS was the tricuspid valve in 24% (12% with severe tricuspid regurgitation (STR), p = 0.028), in RA was the aortic valve in 26% (13% with severe aortic stenosis (SAS), p = 0.02), and with SS was the tricuspid valve in 48% (29% with moderate tricuspid regurgitation (MTR)). The calcium deposit was present in 66% in RA (37% in aortic valve, p < 0.001). The valve thickening (>5 mm) was higher in RA (50%, p < 0.001), with predominance in mitral valve (26%). Conclusions We found significant higher rates of STR in SLE, SAS in RA, and MTR in SS compared with the literature. Moreover, calcification and valve thickening were found more often in RA. Early diagnosis of subclinical VHD is mandatory to improve the long-term prognosis of these patients. Valvular heart disease. Autoimmune Disease (n = 163) P value* SLE (n = 94) RA (n = 38) ES (n = 31) Demographic characteristics Age, years. Gender, Male / Female, n Body Mass Index (kg/m2) Arterial hypertension, n (%) Diabetes Mellitus, n (%) 38.8 (12.6) 9/85 26.2 (5.9) 21(22.3%) 6 (6.3%) 62.45 (12.3) 7/31 26.6 (7.1) 14(36.8%) 4 (10.5%) 53.8 (13.3) 2/29 25.4 (4.7) 12 (38.7) 5 (16.1%) <0.001 NS NS NS NS Echocardiographic findings. Valve thickening Aortic Mitral 8 (9%) 1 (1%) 7 (7%) 19 (50%) 9 (24%) 10 (26%) 1 (3%) 0 1 (3%) <0.001 Calcium Deposit Aortic Mitral 4 (4%) 2 (2%) 2 (2%) 25 (66%) 14 (37%) 11 (29%) 8 (26%) 4 (12.8%) 4 (12.9%) <0.001 Aortic valve disease 4 (4%) 10 (26%) 0 Aortic stenosis Moderate Severe 0 0 0 7 (18%) 2 (5%) 5 (13%) 0 0 0 0,02 Moderate Aortic Regurgitation 4 (4%) 3 (8%) 0 NS Mitral valve disease 8 (9%) 2 (5%) 2 (6%) Mitral stenosis Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Mitral Regurgitation Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Tricuspid Regurgitation Moderate Severe 22 (24%) 11 (12%) 11 (12%) 8 (21%) 7 (18%) 1 (3%) 15 (48%) 9 (29%) 6 (19%) 0,028 Pulmonic valve disease Moderate Pulmonic Stenosis Moderate Pulmonic Regurgitation 6 (6%) 1 (1%) 5 (5%) 1 (3%) 0 1 (3%) 0 0 0 NS * Not Significant.

Robotic, totally endoscopic excision of mitral valve papillary fibroelastoma

2021 ◽  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Benign Tumor ◽  
Pulmonary Valve ◽  
Papillary Fibroelastoma ◽  
Robotic Assisted ◽  
Endoscopic Excision ◽  
Rare Benign Tumor ◽  
Sixth Decade

Papillary fibroelastoma is a rare, benign tumor that affects males more frequently than females and that tends to be diagnosed during the fifth or sixth decade of life. It tends to arise on cardiac valves, with the aortic valve being the most frequent location followed by the mitral valve, the tricuspid valve, and the pulmonary valve. We present the case of a robotic-assisted, totally endoscopic excision of a mitral valve papillary fibroelastoma.

scholarly journals Comparison of Heart Valve Circumference Examined Before and After 10% Formalin Fixation

2021 ◽  
Vol 73 (7) ◽  
pp. 478-484
Author(s):  
Watcharit Anantakal ◽  
◽  
Somboon Thamtakerngkit ◽  
Vijarn Vachirawongsakorn ◽  
◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Heart Valve ◽  
Tricuspid Valve ◽  
Heart Valves ◽  
Formalin Fixation ◽  
Pulmonic Valve ◽  
Fresh State ◽  
Before And After ◽  
Formalin Fixed

Objective: To compare the heart valve circumference before and after 10% formalin fixation. Materials and Methods: The study analyzed 63 Thai human cadaveric hearts. Each heart valve circumference was separately measured in the fresh state by specifically designed equipment. After that, the hearts were fixed in 10% formalin for 3 days. Then each heart valve circumference was measured by the same equipment and by the thread and ruler technique. The results were analyzed using SPSS package to find the association between the heart valve circumference before and after formalin fixation. Results: This study showed that the average circumferences of the heart valve measured in the fresh state were 13.329 cm in the tricuspid valve, 10.617 cm in the mitral valve, 8.416 cm in the pulmonic valve, and 7.122 cm in the aortic valve. The average circumferences of the heart valve measured after 10% formalin fixation were 11.019 cm in the tricuspid valve, 8.714 cm in the mitral valve, 6.751 cm in the pulmonic valve, and 6.089 cm in the aortic valve. The average ratios of the heart valve circumference measured fresh and after 10% formalin fixation were 0.8267 in the tricuspid valve, 0.8235 in the mitral valve, 0.8050 in the pulmonic valve, and 0.8573 in the aortic valve. There were significant differences in the heart valve circumference between the fresh state and after formalin fixation (p < 0.001). Conclusion: This study revealed important information on the dimensional changes of all the formalin-fixed heart valves. We found that the heart valve shrank after formalin fixation, with the formalin-fixed hearts an estimated 0.8 times smaller than the fresh cadaveric hearts.

scholarly journals NOTAS SOBRE A ATITUDE MODERNA E O CORPO: DISSECAÇÃO, REGISTRO VISUAL, DEMONSTRAÇÃO E EXPERIMENTOS

2018 ◽  
Vol 24 (1) ◽  
pp. 227
Author(s):  
João Dias
Keyword(s):  
Da Vinci ◽  
Leonardo Da Vinci ◽  
Andreas Vesalius

O artigo busca evidenciar nuances da atitudemoderna sobre corpo humano, tendo como centralidade investigações e sistematizações realizadas por Leonardo da Vinci, Andreas Vesalius, e William Harvey. Ao nos aproximarmos de seus mapas de compreensão do corpo humano, apresentamos alguns tensionamentos com relação aos saberes da tradição, antiga e medieval, bem como algumas de suas proposições, que constituem certa epistémê moderna do corpo humano. 

Unusual location of the Libman–Sacks endocarditis in a teenager: a case report

2015 ◽  
Vol 26 (2) ◽  
pp. 365-367 ◽  
Author(s):  
Anna Wałdoch ◽  
Joanna Kwiatkowska ◽  
Karolina Dorniak
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Lupus Erythematosus ◽  
Teenage Girl ◽  
Systemic Lupus ◽  
Unusual Location ◽  
Anti Phospholipid Syndrome

AbstractLibman–Sacks endocarditis may be the first manifestation of systemic lupus erythematosus. The risk of its occurrence increases with the co-existence of the anti-phospholipid syndrome. Changes usually involve the mitral valve and the aortic valve. In this report, we present a case of Libman–Sacks endocarditis of the tricuspid valve in a teenage girl.

Transoesophageal: Valves

2020 ◽  
pp. 543-600
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Aortic Valve Stenosis ◽  
Transoesophageal Echocardiography ◽  
Differential Diagnoses ◽  
Low Flow ◽  
Mitral Valve Stenosis ◽  
Pulmonary Valve Stenosis

This chapter deals with the valves in transoesophageal echocardiography. It covers the mitral valve (stenosis, regurgitation, and prolapse), the aortic valve (stenosis and low-flow stenosis and regurgitation), the tricuspid valve, the pulmonary valve (stenosis, regurgitation, and prolapse), infective endocarditis (diagnosis, echocardiographic features, and differential diagnoses).

scholarly journals Η εξέλιξη της ανατομίας στις ευρωπαϊκές ιατρικές σχολές του Μεσαίωνα και της Αναγέννησης

2018 ◽  
Author(s):  
Αθανάσιος Τσαρακλής
Keyword(s):  
Da Vinci ◽  
Leonardo Da Vinci ◽  
Ambroise Paré ◽  
Andreas Vesalius ◽  
Ambroise Pare

Η ανατομία από την αρχή της εξέλιξης της ιατρικής επιστήμης θεωρήθηκε από τον Ιπποκράτη ως η σημαντικότερη ειδικότητα της ιατρικής εκπαίδευσης. Αν και θρησκευτικοί και ηθικοί λόγοι περιόριζαν για αιώνες τους ανατόμους, εντούτοις μέσω της χειρουργικής και της συγκριτικής ανατομίας, η γνώση καταγράφηκε από πολλούς συγγραφείς της αρχαιότητας. Οι αρχαίες σχολές της Αιγύπτου, της Κίνας, της Ινδίας και της Ελλάδας, ήταν αυτές που κυρίως ώθησαν την ιατρική μέσω της φιλοσοφίας, στην ανέλιξή της σε ανθρώπινη τέχνη. Ο Αλκμαίων, ο Ιπποκράτης, ο Ηρόφιλος, ο Ερασίστρατος θεμελίωσαν την ανατομία στην αρχαία Ελλάδα, δεχόμενοι επιρροές από τις υπόλοιπες σχολές της αρχαιότητας. Κατά τον Μεσαίωνα και την Αναγέννηση, πολλοί καλλιτέχνες όπως ο Leonardo da Vinci ασχολήθηκαν με αυτή, μέσω των ανατομικών τους απεικονίσεων. Σχολές και πανεπιστημιακά κέντρα σε όλη την Ευρώπη, με προεξάρχουσα την Ιταλική χερσόνησο, διαμόρφωσαν τις συνθήκες για την εξέλιξη της ανατομικής τέχνης στη σύγχρονη επιστημονική μορφή της. Ο Κωνσταντίνος ο Αφρικανός, ο Guy de Chauliac, ο Henri de Mondeville, ο Gabriel Fallopius, ο Hieronymus Fabricius ab Aquapendente, ο Andreas Vesalius, ο Guglielmo Saliceti, ο Jacques Dubois, ο Ambroise Paré, ο Αndrea Cesalpino και ο Thomas Willis, είναι μερικές από τις σπουδαίες προσωπικότητες της ανατομίας που μελετώνται εντός της διατριβής. Μαζί με τους κορυφαίους επιστήμονες καταγράφονται και οι σπουδαιότερες σχολές ανατομίας, όπως του Σαλέρνο, της Μπολόνια, της Πάδοβας, του Μονπελιέ, των Παρισίων, του Κέιμπριτζ και της Οξφόρδης, με τα επιτεύγματά τους στην ανατομική, καθώς και ο τρόπος με τον οποίο βοήθησαν στην εξέλιξη της.

scholarly journals A Multi Center Experience: Is Valve Replacement Safe for Patients with Hugely Dilated Left Ventricle?

2019 ◽  
Vol 22 (6) ◽  
pp. E452-E455
Author(s):  
Ahmed Ahmed ◽  
Ahmed Toema ◽  
Ahmed Yehia ◽  
Yassin Hashim ◽  
Mohamed Elkahely ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Tricuspid Valve ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Double Valve Replacement

Background: Dilated left ventricle occurs in chronic aortic and mitral regurgitations. We describe the early outcome of mitral and aortic valve replacement for patients with severely dilated left ventricle in different surgical interventions. Methods: From March 2014 to December 2018, 620 patients with left ventricular end-diastolic diameter (LVEDD) of ≥ 70 mm underwent valve replacement procedures in 8 cardiac surgery centers in Egypt. One hundred ninety four cases (31.3%) underwent aortic valve replacement, 173 cases (27.9%) underwent mitral valve replacement, 123 cases (19.9%) underwent double valve replacement, 59 cases (9.5%) underwent double valve replacement with either tricuspid valve repair or replacement, 33 cases (5.3%) underwent mitral valve replacement with either tricuspid valve repair or replacement, 20 cases (3.2%) underwent mitral valve replacement with CABG, 10 cases (1.6%) underwent aortic valve replacement with CABG, while 8 cases (1.3%) underwent aortic valve replacement with ascending aortic aneurysm repair. Results: Four patients (0.6%) developed new postoperative renal failure, which required dialysis. Twenty-nine patients (4.7%) required reoperation for bleeding. One patient (0.2 %) developed sternal dehiscence. Five patients (0.8%) postoperatively developed stroke. Twenty-five patients (4%) died, and the main causes of death were low cardiac output and sepsis with eventual multi-organ failure. Conclusion: Valve replacement in patients with hugely dilated left ventricle are safe operations with satisfactory outcomes even if combined with other procedures, especially with proper preoperative preparation, intraoperative preservation of posterior mitral leaflet, and meticulous postoperative follow up in the surgical ICU.

scholarly journals Transthoracic echocardiogram by protocol apical-subcostal in prone position during invasive mechanical ventilation

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
C Del Castillo Gordillo ◽  
F Appiani Florit ◽  
A Begazo Gonzales ◽  
F Yanez Vidal ◽  
R Mora Valdes ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mitral Valve ◽  
Pericardial Effusion ◽  
Aortic Valve ◽  
Prone Position ◽  
Tricuspid Valve ◽  
Continuous Wave ◽  
Invasive Mechanical Ventilation ◽  
Function Parameter ◽  
Apical View

Abstract Funding Acknowledgements Type of funding sources: None. Introduction During COVID-19 pandemic reports increased of transthoracic echocardiography (TTE) in prone and invasive mechanical ventilation (IMV), mostly describing four and five chamber apical views, and inferior vena cava (IVC) by lateral IVC window (from right side of the patient). Purpose Evaluate quality of images obtained with protocol of apical-subcostal TTE in patients with IMV and prone position. Methods Prospective study, between August and December 2020, in adults who required prone position during IMV. After placing the patient in the prone position, left arm was extended overhead, and a pillow was placed only under the left hemithorax to elevate and facilitate the apical window and space below the patient for subcostal window. Operator stands on the left side of the patient and takes images with the transducer in your right hand, starting with apical window and subsequently subcostal window. Apical views were apical four, two and three-chambers, to obtain function parameter of right and left ventricle (LV), evaluation of aortic valve, mitral and tricuspid valve. Subcostal views were four cardiac chambers and IVC, to obtain qualitative ventricle function, presence of pericardial effusion, and volume status and estimation of pulmonary pressure (together to peak systolic tricuspid pressure gradient from apical views). The images were acquired by cardiologist, then were saved, and finally evaluated by two echocardiography cardiologist experts. Results 16 ETTs were performed. Male gender and obesity predominate. Positive end-expiratory pressure average was 10.8 cm of water. One patient cannot be assessed by absence of acoustic window and the rest (n = 15) were analyzed with experts. It was achieved a four-chamber apical view in 100% (n = 15), a two-chambers apical view in 60% (n = 9) and a three-chambers apical view in 100% (n = 15). It was possible to assess global function of the LV in 100% (n = 15), LV segmental function in 53% (n = 8), LV outflow tract velocity time integral in 100% (n = 15) and tricuspid annular plane systolic excursion in 100% (n = 15). Pulsed wave doppler of mitral valve in 100% (n = 15) and tissue doppler of lateral mitral valve annulus 100% (n = 15). Continuous wave doppler of aortic valve in 100% (n = 15) and tricuspid valve in 93% (n = 14). Subcostal four-chamber 80% (n = 12), presence pericardial effusion 100% (n = 15) and IVC 93% (n = 14). Non-complications associated with obtaining the position. Conclusions ETT in the prone position during IMV was possible and interpretable images were achieved. The position described allows assessment by apical and subcostal views at the same time and position of the operator and the patient. In addition, it was a safe technique, and the position was easy to be incorporated by the health team. Limitations were obtaining the two-chamber apical view and evaluation of segmental alterations of the LV. Better validation requires a larger sample.

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