scholarly journals Robotic mitral valve repair for rheumatic mitral stenosis and regurgitation: a case report

2020 ◽  
Vol 4 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Shin Yajima ◽  
Satsuki Fukushima ◽  
Takashi Kakuta ◽  
Tomoyuki Fujita
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Mitral Stenosis ◽  
Young Patients ◽  
Mitral Annulus ◽  
Prosthetic Material ◽  
Valve Repair ◽  
Case Summary ◽  
History Of ◽  
Children And Young Adults

Abstract Background Rheumatic mitral valve (MV) disease is the major cause of congestive cardiac failure in children and young adults, particularly in developing countries. Mitral valve repair with minimum prosthetic material is the gold standard treatment for this condition. However, MV repair for rheumatic MV disease is known to be technically demanding. Case summary A 27-year-old woman without a history of cardiac disease presented with dyspnoea on exertion. Echocardiography revealed rheumatic severe mitral stenosis and regurgitation, with thickening of the bileaflets, doming of the anterior leaflet, shortening of the posterior leaflet, fusions of the lateral and particularly the medial commissure, and enlargement of the mitral annulus. We successfully performed robot-assisted MV repair with bicommissural release, patch augmentation of the two leaflets, and implantation of an originally sized partial band. Discussion Robotic MV repair can contribute to precise valve inspection and operative procedures. This approach seems feasible for complex rheumatic MV disease particularly in young patients.

scholarly journals Transcatheter mitral valve repair: an overview of current and future devices

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001564
Author(s):  
Ole De Backer ◽  
Ivan Wong ◽  
Maurizio Taramasso ◽  
Francesco Maisano ◽  
Olaf Franzen ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Mitral Annulus ◽  
Therapeutic Strategies ◽  
Heart Team ◽  
Valve Repair ◽  
Careful Patient ◽  
Transcatheter Mitral Valve Repair ◽  
Tailored Approach

The field of transcatheter mitral valve repair (TMVr) for mitral regurgitation (MR) is rapidly evolving. Besides the well-established transcatheter mitral edge-to-edge repair approach, there is also growing evidence for therapeutic strategies targeting the mitral annulus and mitral valve chordae. A patient-tailored approach, careful patient selection and an experienced interventional team is crucial in order to optimise procedural and clinical outcomes. With further data from ongoing clinical trials to be expected, consensus in the Heart Team is needed to address these complexities and determine the most appropriate TMVr therapy, either single or combined, for patients with severe MR.

Development of Mitral Stenosis After Mitral Valve Repair: Importance of Mitral Valve Area

2017 ◽  
Vol 33 (12) ◽  
pp. 1701-1707 ◽  
Author(s):  
Kwan Leung Chan ◽  
Shin-Yee Chen ◽  
Thierry Mesana ◽  
Buu Khanh Lam
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Mitral Stenosis ◽  
Valve Repair ◽  
Mitral Valve Area ◽  
Valve Area

A mitral annulus tracking approach for navigation of off-pump beating heart mitral valve repair

2014 ◽  
Vol 42 (1) ◽  
pp. 456-468 ◽  
Author(s):  
Feng P. Li ◽  
Martin Rajchl ◽  
John Moore ◽  
Terry M. Peters
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Mitral Annulus ◽  
Beating Heart ◽  
Valve Repair ◽  
Off Pump

scholarly journals Mitral annulus dynamics in myxomatous mitral valve disease

2021 ◽  
Vol 31 (1) ◽  
pp. 66-75
Author(s):  
Maria-Magdalena Gurzun ◽  
Monica Rosca ◽  
Andreea Calin ◽  
Carmen Beladan ◽  
Marinela Serban ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Mitral Valve Disease ◽  
Current Trend ◽  
Mitral Annulus ◽  
Valve Disease ◽  
Valve Repair ◽  
Functional Changes ◽  
Different Types

Myxomatous mitral valve disease (MVD) is a common disorder in which the entire mitral valve apparatus seems to be involved. Mitral valve repair is nowadays the method of choice for the correction of mitral regurgitation but the optimal shape and flexibility of the annuloplasty ring remain controversial. Considering that myxomatous MVD covers a wide spectrum from limited fi bro-elastic deficiency to extensive Barlow disease, we presume that the mitral annulus morphological and functional changes are likely different in different types of myxomatous MVD. We analyze the 3-dimensional geometry and the dynamics of the mitral annulus in 110 patients with significant mitral regurgitation due to different types of myxomatous mitral valve disease and 40 normal subjects using 3D transesophageal echocardiography. The mitral annulus differs in patients with limited MVD, extensive MVD and in normal controls in terms of size, shape, and dynamics. Patients with limited MVD have larger, flatter, dysfunctional and more mobile mitral annulus compared to normal, while patients with extensive MVD have even larger, fl atter and more dysfunctional mitral annulus, with reduced mobility. The non-planar dynamics has different patterns during systole, according to the extension of MV disease. Our data may be important for the appropriate choose of annuloplasty mitral annulus in mitral valve repair, the current trend being to choose the ring according to the underlying pathology.

Comparison of the sustainability of mitral annular dynamics between two semi-rigid annuloplasty devices

2019 ◽  
Vol 56 (2) ◽  
pp. 360-368 ◽  
Author(s):  
Stefaan Bouchez ◽  
Frank Timmermans ◽  
Tine Philipsen ◽  
Katrien François ◽  
Thierry Bové
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Cardiac Cycle ◽  
3D Structure ◽  
Mitral Annulus ◽  
Width Ratio ◽  
Valve Repair ◽  
Postoperative Changes ◽  
Folding Dynamics ◽  
Saddle Shape

Abstract OBJECTIVES The choice of annuloplasty device is fundamental at the time of mitral valve repair, the goal being to optimally restore the physiological 3-dimensional (3D) structure and dynamics of the mitral annulus (MA). This study evaluated MA dynamics after annuloplasty with 2 different semi-rigid devices. METHODS Thirty-three patients eligible for mitral valve repair were selected for annuloplasty with the Physio II ring (Edwards Lifesciences, Irving, CA, USA) (n = 17) or the Memo 3D ring (LivaNova, Saluggia, Italy) (n = 16). MA dynamics were assessed with transoesophageal 3D echocardiography intraoperatively and 1 year after repair. RESULTS The postoperative changes in the anteroposterior diameter {3.7% [standard deviation (SD) 2.7] vs 1.9% [SD 1.3]; P = 0.013} and in the annular height [27.7% (SD 8.7) vs 18.0% (SD 13.9); P = 0.003] were significantly larger with the Memo 3D ring during the cardiac cycle. The restoration of the saddle shape at baseline was superior with the Physio II ring, defined by a larger systolic annular height-to-commissural width ratio [15.1% (SD 2.3) vs 7.1% (SD 2.4); P < 0.001]. These observations of MA dynamics were sustained after 1 year, shown by a greater anteroposterior extension [5.1% (SD 1.0) vs 1.7% (SD 1.6); P = 0.002] and change in annular height-to-commissural width ratio [15.7% (SD 12.7) vs 3.1% (SD 3.0); P = 0.020] for the Memo 3D ring. There were no significant differences in mitral valve function between the 2 devices. CONCLUSIONS The MA dynamics after annuloplasty with the Physio II and Memo 3D rings demonstrated a better systolic 3D restoration of the saddle shape with the Physio II ring, whereas the saddle-shaped geometry improved significantly with the Memo 3D ring, as a dynamic phenomenon. The Memo 3D ring also showed increased anteroposterior annular mobility and folding dynamics throughout the cardiac cycle. Moreover, the observed differences in MA dynamics between both devices appeared to be sustainable 1 year after ring implantation.

Sign in / Sign up

Export Citation Format

Share Document