scholarly journals Staged Endovascular Repair of Aortic Coarctation followed by Double Valve Surgery

Aorta ◽  
2021 ◽  
Author(s):  
Dimitrios V. Avgerinos ◽  
Rajeev Dayal ◽  
Charles Mack ◽  
Samuel Lang ◽  
Konstantinos S. Mylonas
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Endovascular Repair ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Mitral Valve Insufficiency ◽  
Valve Surgery ◽  
Valve Repair ◽  
Unique Case ◽  
Valve Insufficiency

AbstractWe present a unique case of late diagnosis of coarctation of the aorta in an adult, presenting with congestive heart failure associated with severe aortic and mitral valve insufficiency. To minimize operative risk, staged endovascular repair of the coarctation was initially performed, followed by aortic valve replacement and mitral valve repair. Six months postoperatively, the 41-year-old patient remains completely asymptomatic.

Very Long-Term Results (More Than 20 Years) of Valve Repair With Carpentier's Techniques in Nonrheumatic Mitral Valve Insufficiency

Circulation ◽  
2001 ◽  
Vol 104 (Supplement 1) ◽  
pp. I-8-I-11 ◽  
Author(s):  
E. Braunberger ◽  
A. Deloche ◽  
A. Berrebi ◽  
F. Abdallah ◽  
J.A Celestin ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Insufficiency ◽  
Long Term Results ◽  
Valve Repair ◽  
Valve Insufficiency

scholarly journals Comparison of Anterior Mitral Leaflet Repair Techniques with and without the Use of Chordal Replacement in Patients with Degenerative Mitral Valve Insufficiency

2019 ◽  
Vol 22 (3) ◽  
pp. E234-E240
Author(s):  
Ersin Kadiroğulları ◽  
Ömer Faruk Çiçek ◽  
Serkan Mola ◽  
Emre Yaşar ◽  
İbrahim Erkengel ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Insufficiency ◽  
Anterior Leaflet ◽  
Valve Repair ◽  
Valve Insufficiency ◽  
Group A ◽  
Group B ◽  
Chordal Replacement ◽  
Repair Techniques

Background: The aim of our study was to compare the outcome of patients who underwent mitral valve anterior leaflet repair with and without chordal replacement for degenerative mitral valve insufficiency. Methods: This study was conducted at our center between May 2006 and May 2013. The study included 125 patients with degenerative mitral valve insufficiency (64 males, 61 females; mean age 47 years, age range 16-78 years) who underwent mitral valve repair with anterior leaflet procedures. The patients were divided into 2 groups. Group A consisted of 56 patients with chordal replacement, and group B consisted of 69 patients with other repair techniques performed. Results: No significant difference was determined between the 2 groups in mortality, recurrence, and reoperation rates. The mortality rate was 3.6% in group A and 1.4% in group B. During the follow-up period, 3 patients were reoperated on (mitral valve replacement) because of severe mitral valve insufficiency. Two of these patients were from group A (3.6%), and the other was from group B (1.4%). One patient in group A underwent intraoperative mitral valve replacement after unsuccessful chordal replacement. Fifty patients (89.3%) in group A and 65 patients (94.2%) in group B exhibited no or mild recurrence of mitral valve insufficiency. Conclusion: Mitral valve repair in patients with degenerative mitral valve insufficiency resulting from anterior leaflet pathology is a safe procedure because of its durability and good long-term results. Despite the difficulty of the chordal replacement procedure, it may be used as an alternative technique for anterior mitral valve leaflet repair.

scholarly journals Mitral Valve Disease in Thyroid Storm

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A941-A942
Author(s):  
Sandra Rocio Rivera Menjura ◽  
Lia G Moyano Rivas ◽  
Camila Parraguez Gamboa ◽  
Cristobal Balmaceda ◽  
Juan P Peralta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Invasive Mechanical Ventilation ◽  
Mitral Valve Insufficiency ◽  
Left Ventricular ◽  
Thyroid Storm ◽  
Multiple Infections ◽  
Mitral Insufficiency ◽  
Type I ◽  
Valve Insufficiency

Abstract Introduction: The cardiovascular effects that thyroid gland causes are widely studied. In fact, there is a known correlation between Graves’ Disease and mitral valve damage. We present the case of a patient admitted with thyroid storm and heart failure associated with severe structural damage of the mitral valve papillary muscle. Case Report: 24 year old woman with hyperthyroidism diagnosed 12 years ago, treated irregularly with thiamazole and propranolol, leaving treatment a year ago, presents dyspnea, class III functional capacity, diarrhea and logic dysphagia of a month of evolution. Heart rate over 170 bpm, respiratory rate 48 rpm and blood pressure 143/84 mmHg. Physical exam positive for exophthalmos, grade III goiter, crackles in both lung bases, pretibial myxedema and fulfilling criteria for a thyroid storm (65 points in Burch-Wartofsky Point Scale). First Lab Results: TSH<0.005µU/mL, free T4>7.7ng/dl and TRAB 37.8UI/L. Chest ray: Global cardiomegaly and pulmonary edema. EKG: Narrow complex supraventricular tachycardia. Thyroid ultrasound: Intrathoracic goiter. Transesophageal echocardiogram: Severe mitral insufficiency (Carpentier Type I and IIIB), right cavities and left ventricular enlargement, preserved right ventricular function and severe pulmonary hypertension (PSAP 71-76 mmHg). First treated with thiamazole, hydrocortisone IV, cholestyramine and sedation, falling time after into ventilatory failure and developing delirium, requiring invasive mechanical ventilation. Tested positive for COVID- 19. Starts preparation with Lugol and undergoes Total Thyroidectomy. After surgery develops severe hypocalcemia secondary to transitory hypoparathyroidism. During hospitalization presents multiple infections including pneumonia (Pseudomonas Aeruginosa), lung aspergillosis, bacteriuria (Enteroccocus Faecium) and candiduria (Candida Albicans and Glabrata), each one treated with multiple antibiotics and vasoactive drugs. Once stable, mitral valve replacement is realized, after which, the patient progresses favorably being discharged with programmed ambulatory controls. Conclusion: We report a case of a patient who was presented with positive thyroid storm criteria associated with heart failure and severe mitral valve insufficiency. The case gets complicated as multiple infections take place, including COVID-19. Fortunately, because of the early and aggressive multidisciplinary management, the patient evolved favorably, overcoming the life-threatening conditions she went through. Key Words: Thyroid storm, mitral valve insufficiency, heart failure. Bibliography: Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007 Oct 9;116(15):1725-35. doi: 10.1161/CIRCULATIONAHA.106.678326. Erratum in: Circulation. 2008 Jan 22;117(3):e18. PMID: 17923583.

scholarly journals MORPHOFUNCTIONAL FEATURES OF THE MYOCARDIUM IN ITS DIASTOLIC OVERLOAD

2021 ◽  
Vol 17 (2) ◽  
pp. 39-46
Author(s):  
A.A. Balabai ◽  
A.A. Krikunov ◽  
P.M. Semeniv ◽  
E.V. Rudenko ◽  
V.P. Zakharova
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Blood Volume ◽  
Interstitial Fibrosis ◽  
Mitral Valve Insufficiency ◽  
Diastolic Filling ◽  
Myocardial Oxygen Demand ◽  
Statistical Research ◽  
Valve Insufficiency

Relevance. Adaptation of the heart chambers to their volume overload, which increases with diastolic filling of the left ventricle (LV) or systolic regurgitation in the left atrium (LA) in case of mitral valve insufficiency leads to remodeling of the myocardium of these chambers. Longitudinal hypertrophy of cardiomyocytes (CMCs), realized by building up new sarcomeres at the end of existing myofibrils, is an adaptation mechanism in the early stages, but eventually turns into maladjustment, which leads to heart failure. Hypertrophied CMCs, damaged during decompensation, are replaced by connective tissue due to excessive activation of fibroblasts with deposition of the extracellular matrix, which is also an element of the myocardial remodeling. The progression of heart failure is also associated with a mismatch between blood supply and myocardial oxygen demand, since an increase in the size of the CMCs is accompanied by a rarefaction of the intramural network of microvessels. It is believed that the violation of the ratio of the size of the heart, angiogenesis and cardiac function are the basis for the transition of adaptive compensation of the heart to decompensation with the progression of heart failure. Objective: to study morphological changes in the myocardium of the LV and LA in patients with mitral valve insufficiency. Materials and methods. Macroscopically, the condition of the myocardium was studied on the material of 14 autopsies of patients who died of NdMK insufficiency. History of NdMK – from 3 months. up to 2.4±1.1 years. As a control, the hearts of 3 deaths without cardiopathology were studied. The material for light microscopy was pieces of myocardium from different segments of the left ventricle, as well as from the walls of the left ventricle, obtained during autopsy.Morphological (macroscopic, histological and electron microscopic), morphometric and statistical research methods were used. Results. With LV dilatation associated with chronic mitral valve insufficiency, lengthening of each CMCs provides an increase in the area of ​​the myocardial walls, and, accordingly, the size of the cavity of the corresponding chamber of the heart, which compensates to some extent for the increase in diastolic blood volume in the LV and systolic blood volume in the LA. However, the factor limiting this compensation mechanism is the deficiency of the myocardial microvasculature associated with limited capillary growth. The contradiction between the need for the myocardium to lengthen the CMCs and the inability of capillaries to provide them with oxygen leads to a breakdown in compensation with an increase in fibrotic changes. This is a factor limiting the further increase in the volume of the cavity. Conclusions. Overloading of the myocardium with volume leads to an increase in the length of the CMCs, on average, from 57.3±9.1 µm to 93.7±12.4 µm. The increase in the length of the CMCs is due to the increase in the number of sarcomeres from 43.7±8.4 to 62.5±14.5. The diameter of the CMCs in this case does not increase reliably. Overloading of the heart cavities with volume is often accompanied by desynchronization of the CMCs contraction, which leads to disruption of the integrity of the myocytic "working syncytium" and pronounced interstitial fibrosis.

Very Long-Term Results (More Than 20 Years) of Valve Repair With Carpentier’s Techniques in Nonrheumatic Mitral Valve Insufficiency

Circulation ◽  
2001 ◽  
Vol 104 (suppl 1) ◽  
pp. I-8-I-11 ◽  
Author(s):  
E. Braunberger ◽  
A. Deloche ◽  
A. Berrebi ◽  
A. Fayssoil ◽  
J.A Celestin ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Insufficiency ◽  
Long Term Results ◽  
Valve Repair ◽  
Valve Insufficiency

Robot-Assisted Mitral Valve Repair with Posterior Leaflet Extension for Rheumatic Disease

2017 ◽  
Vol 12 (1) ◽  
pp. 60-63
Author(s):  
Burak Onan ◽  
Unal Aydin ◽  
Zeynep Kahraman ◽  
Korhan Erkanli ◽  
Ihsan Bakir
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Mitral Valve Insufficiency ◽  
Posterior Leaflet ◽  
Valve Repair ◽  
Mitral Repair ◽  
Autologous Pericardial Patch ◽  
Valve Insufficiency ◽  
Robot Assistance ◽  
Mitral Disease

Mitral valve repair has been one of the widely used applications of robotic surgery. Patients with rheumatic mitral disease usually present at an early age with thickening, retraction, or fusion of the leaflets and subvalvular apparatus. Robotic mitral repair can be feasible among this group of patients, rather than replacement. Herein, we describe a young woman who presented with rheumatic mitral valve insufficiency. A complex mitral repair with posterior leaflet extension with an autologous pericardial patch was successfully conducted using robot assistance.

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