scholarly journals Clinical and echocardiographic characteristics of patients with pathology proven left-sided non-valvular papillary fibroelastoma

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E El-Am ◽  
A Ahmad ◽  
R Kurmann ◽  
A Sorour ◽  
M Bois ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Papillary Fibroelastoma ◽  
Left Ventricular Outflow

Abstract Funding Acknowledgements Type of funding sources: None. Background Papillary fibroelastoma (PFE) is now regarded as the most common primary tumor of the heart. Although benign, they are clinically significant for their high risk of embolization. They are most commonly found on cardiac valves but can also be present on non-valvular endocardial surfaces. The aim of this study was to better characterize patients with left-sided non-valvular PFE and its clinical sequelae. Methods We retrospectively identified patients with pathology-proven PFEs at a single center between January 1995 and December 2018 (n = 279). Patients with left-sided non-valvular PFE were analyzed. Medical records were retrospectively reviewed for clinical characteristics and outcomes. In addition, intra-operative transesophageal echocardiograms were manually reviewed to estimate overall size and location. Results During the study period, we identified 37 patients with left-sided non-valvular PFE (mean age 61 ± 14 years; 62% females) (Table). PFEs were located on the left ventricle in 41%, left atrium in 35%, and left ventricular outflow tract in 24% of patients. Around a quarter of patients (27%) had a diagnosis of hypertrophic cardiomyopathy, 19% had prior cardiac surgery, and 27% had cancer diagnosed prior to PFE diagnosis. Transient ischemic attack or stroke was the presenting symptom in 22% of patients, myocardial infarction in 6% and peripheral embolization in 6%. Median maximal length for PFE on the left ventricle was 11.1 mm [3;18], on the left atrium 9 mm [2;25], and left ventricular outflow tract 8 mm [6;13]. A minority of patients (9/37 [24%]) had associated valvular PFE on the mitral valve and/or aortic valve (1 patient had both mitral valve and aortic valve PFE, 7 had aortic valve PFE and 1 had Mitral valve PFE). Only 13 patients had follow up transthoracic/transesophageal echocardiogram 1 year after PFE removal; 4/13 (31%) had documented PFE recurrence (3 PFE recurred in the same location as the original; 1 in a different location). Conclusion Left-sided non-valvular PFE is associated with thromboembolic events and at least in those that had follow-up echocardiograms, had a high recurrence rate. More studies are needed to evaluate the management of patients with asymptomatic PFE. Abstract Figure. Baseline Characteristics

Echocardiographic assessment of the aortic valve and left ventricular outflow tract

2005 ◽  
Vol 15 (S1) ◽  
pp. 27-36 ◽  
Author(s):  
Alfred Asante-Korang ◽  
Robert H. Anderson
Keyword(s):  
Aortic Valve ◽  
Left Ventricle ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Heart ◽  
Transesophageal Echocardiogram ◽  
Left Ventricular Outflow ◽  
Echocardiographic Assessment

The previous reviews in this section of our Supplement1,2 have summarized the anatomic components of the ventriculo-arterial junctions, and then assessed the echocardiographic approach to the ventriculo-arterial junction or junctions as seen in the morphologically right ventricle. In this complementary review, we discuss the echocardiographic assessment of the comparable components found in the morphologically left ventricle, specifically the outflow tract and the arterial root. We will address the echocardiographic anatomy of the aortic valvar complex, and we will review the causes of congenital arterial valvar stenosis, using the aortic valve as our example. We will also review the various lesions that, in the outflow of the morphologically left ventricle, can produce subvalvar and supravalvar stenosis. We will then consider the salient features of the left ventricular outflow tract in patients with discordant ventriculo-arterial connections, and double outlet ventricles. To conclude the review, we will briefly address some rarer anomalies that involve the left ventricular outflow tract, showing how the transesophageal echocardiogram is used to assist the surgeon preparing for repair. The essence of the approach will be to consider the malformations as seen at valvar, subvalvar, or supravalvar levels,1 but we should not lose sight of the fact that aortic coarctation or interruption, hypoplasia of the left heart, and malformations of the mitral valve are all part of the spectrum of lesions associated with obstruction to the left ventricular outflow tract. These additional malformations, however, are beyond the scope of this review.

Outcomes Following Surgery to Address Shone Syndrome in Children

2021 ◽  
Vol 12 (3) ◽  
pp. 360-366
Author(s):  
Tyler J. Dalton ◽  
William K. Johnson ◽  
Evelyn M. Kuhn ◽  
Benjamin H. Goot ◽  
Ronald K. Woods ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricular Outflow Tract ◽  
Heart Association ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Lv Function ◽  
Mitral Valve Stenosis ◽  
Left Ventricular Outflow

Background: Shone syndrome is characterized by coincident mitral valve stenosis and left ventricular outflow tract obstruction. Although first described in 1963, little research has expounded surgical outcomes. We sought to evaluate our experience with this cohort, emphasizing outcomes including mortality, morbidity, and cardiac function. Methods: A retrospective chart review of 46 patients who underwent operation for Shone syndrome between 1990 and May 2018 was conducted. Index operations included 32 repairs of the left ventricular outflow tract, four mitral valve repair/replacements, nine combined repairs, and one non-Shone’s repair. Median age at index procedure was 22 days (2 days-10 years). Mean follow-up was 9.1 years (2 months-21 years), and 70 additional operations (51 reoperations) were required. Three patients were lost to follow-up. Results: Overall survival was 95.7% with two late deaths. Freedom from death or transplant was 93.5%. Thirteen (28.3%) patients remained free from reoperation. Thirty-three patients required 51 reoperations of the left ventricle outflow tract (n = 12), mitral valve (n = 16), combined repairs (n = 21), and transplant (n = 1). At most recent follow-up, patients exhibited mitral stenosis (n = 21), aortic stenosis (n = 7), and diminished LV function (n = 2). Conclusion: Surgical correction of Shone’s offers excellent survival benefit, but reoperation burden is high, with >70% of patients requiring reintervention in the follow-up period. A total of 65% of patients developed recurrent obstruction of left ventricular inflow or outflow, however, ventricular function is preserved in the majority of patients. All but one patient had no functional deficits, classified as New York Heart Association I with > 60% requiring no medication.

scholarly journals Subaortinė stenozė ir dviburio vožtuvo anoma-lijos: chirurginio gydymo ypatumai

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Daina Liekienė ◽  
Virgilijus Lebetkevičius ◽  
Virgilijus Tarutis ◽  
Rimantas Karalius ◽  
Rita Sudikienė ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Subaortic Stenosis ◽  
Left Ventricular Outflow ◽  
Vilnius University

Daina Liekienė1, Virgilijus Lebetkevičius1, Virgilijus Tarutis2, Rimantas Karalius1, Rita Sudikienė2, Kęstutis Lankutis2, Giedrė Nogienė1, Alicija Dranenkienė1, Vytautas Sirvydis11 Vilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Subaortinės stenozės diagnozė apima didelį spektrą anatominių pakitimų – nuo paprastos membranos iki fibroraumeninio tunelio. Straipsnyje aprašoma reta subaortinė stenozė, sukelta dviburio vožtuvo priekinės burės ir papilinio raumens anomalijos. Trys pacientai, operuoti dėl subaortinės stenozės, sukeltos dviburio vožtuvo anomalijos, dviem atlikta dviburio vožtuvo plastika ir kairiojo skilvelio infundibulinės dalies raumenų rezekcija. Vienam ligoniui atliktas mitralinio vožtuvo (MV) protezavimas ir kairiojo skilvelio infundibulinės dalies raumenų rezekcija.Dviburį vožtuvą išsaugančias operacijas dažniau pavyksta padaryti, kai dviburio vožtuvo yda yra antrinė liga. Dviburio vožtuvo plastika galima rečiau, jei anomalaus dviburio vožtuvo audiniai siaurina kairiojo skilvelio infundibulinę dalį. Pagrindiniai žodžiai: subaortinė stenozė, dviburio vožtuvo anomalija, kairiojo skilvelio išvarymo trakto obstrukcija Subaortic stenosis and mitral valve anomaly: surgical treatment aspects Daina Liekienė1, Virgilijus Lebetkevičius1, Virgilijus Tarutis2, Rimantas Karalius1, Rita Sudikienė2, Kęstutis Lankutis2, Giedrė Nogienė1, Alicija Dranenkienė1, Vytautas Sirvydis11 Vilnius University, Cardiac Surgery Centre, Santariškių str. 2, LT-08661 Vilnius, Lithuania2 Vilnius University Hospital „Santariškių klinikos“, Cardiac Surgery Centre,Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] The diagnosis of subaortic stenosis contains a broad spectrum of anatomical changes varying from discrete membrane to fibromuscular tunnel. We review a rare subaortic stenosis caused by anomaly of mitral valve anterior leaflet and papillary muscle. We review three patients who underwent surgery because of subaortic stenosis caused by anomalous mitral valve. Two patients underwent mitral valve plastic and resection of the left ventricular outflow tract muscles. One patient underwent mitral valve replacement and resection of the left ventricular outflow tract muscles.Valve preserving operations are more easy to perform when mitral valve disease is a comorbidity. Mitral valvoplasty is more complicated to perform when the mass of anomalous mitral valve obstructs the outflow tract of the left ventricle. Key words: subaortic stenosis, anomalous mitral valve, left ventricle outflow tract obstruction

scholarly journals Incidence, Predictors, and Outcome of Paravalvular Leak after Transcatheter Aortic Valve Implantation

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Abdullah Hagar ◽  
Yijian Li ◽  
Xin Wei ◽  
Yong Peng ◽  
Yuanning Xu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Left Ventricular Outflow Tract ◽  
Independent Predictor ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Paravalvular Leak ◽  
Transcatheter Aortic Valve ◽  
Left Ventricular Outflow ◽  
Valve Implantation

Background. Paravalvular leak (PVL) is common after transcatheter aortic valve implantation (TAVI) and has been linked with worse survival. This study aimed to investigate the determinants and outcome of PVL after TAVI and determine the role of aortic valve calcification (AVC) distribution in predicting PVL. Methods and Results. This was a retrospective cohort study of 270 consecutive patients who underwent TAVI. Determinants and outcomes of ≥mild PVL were assessed. Matching rates of PVL jet with AVC distribution were calculated. AVC volume, larger annulus dimensions, and transvalvular peak velocity were risk factors for ≥mild PVL after TAVI. AVC volume was an independent predictor of ≥mild PVL. On the other hand, annulus ellipticity, left ventricular outflow tract nontubularity, and diameter-derived prosthesis mismatch were not found to predict PVL after TAVI. PVL jet matched, in varying proportions, with calcification at all aortic root regions, and the highest matching rate was with calcifications at body of leaflets. Moreover, matching rates were less with commissure compared to cusp calcifications. Mild or greater PVL was not associated with all-cause and cardiovascular mortality up to 1-year follow-up. Conclusion. ≥mild PVL after TAVI is common and can be predicted by aortic root calcification volume, larger annulus dimensions, and pre-TAVI transvalvular peak velocity, with calcification volume being an independent predictor for PVL. However, annulus ellipticity, left ventricular outflow tract nontubularity, and diameter-derived prosthesis mismatch had no role in predicting PVL. Importantly, body of leaflet calcifications (versus annulus and tip of leaflet) and cusp calcifications (versus commissure calcification) are more important in predicting PVL. No association between ≥mild PVL and increased risk of all-cause and cardiovascular mortality at 1-year follow-up.

Left ventricular outflow tract to left atrial fistula associated with endocarditis in a dog

2000 ◽  
Vol 36 (2) ◽  
pp. 133-136 ◽  
Author(s):  
AN Smith ◽  
ST Finn-Bodner ◽  
AR Dillon
Keyword(s):  
Mitral Valve ◽  
Left Atrium ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Aortic Insufficiency ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Doppler Imaging ◽  
Intact Male ◽  
Left Ventricular Outflow

A one-year-old, intact male, 28-kg, mixed-breed dog developed neurological episodes consistent with emboli. An acquired III/VI holosystolic heart murmur was ausculted in the mitral area, and valvular endocarditis with pulmonic and aortic insufficiency were noted at echocardiographic examination. An abnormal communication (i.e., fistula) between the left ventricular outflow tract (LVOT) and the left atrium adjacent to the mitral valve annulus was noted with Doppler imaging and confirmed with angiography. Infective valvular endocarditis was confirmed based on two of three blood cultures being positive for Staphylococcus intermedius. In humans, a sequela to infective endocarditis of the aortic or mitral valve, or both, is rupture of the mitral-aortic intervalvular fibrosa, resulting in a communication between the LVOT and the left atrium. This is the first report of this sequela in the dog.

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