Computational Modeling of a Novel Mitral Valve Stent

2012 ◽  
Author(s):  
Gideon Praveen Kumar ◽  
Cui Fangsen ◽  
Asawinee Danpinid ◽  
Chan Zhi Wei ◽  
Su Boyang ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Heart Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Prosthetic Heart Valve ◽  
Aortic Valves ◽  
Old Patients ◽  
Design Engineers ◽  
Cardiovascular Surgical Procedures ◽  
Percutaneous Heart Valve

Although percutaneous heart valve replacement is getting known amongst cardiovascular surgical procedures, as it was recently introduced, and reports of early clinical experience been published, this technique is limited to the replacement of pulmonary and aortic valves in old patients who cannot undergo open heart surgery. One of the reasons is the uphill challenges in the generation of an ideal design that would address anchorage and leakage issues. Stent anchorage and paravalvular leaks prove to the greatest challenge posed to biomedical design engineers. This paper describes a novel Nitinol based mitral valve stent that addresses migration and paravalvular leaks associated with the bioprosthetic mitral valve. The geometry-based model presented here specifically addresses issues of valve migration and paravalvular leaks This is of great interest to designers of new prosthetic heart valve models, as well as to surgeons involved in valve sparing surgery. Simulation results show that the studied stent design seemed to be good by virtue of its acceptable maximum crimping strain.

scholarly journals Healthcare-associated prosthetic heart valve, aortic vascular graft, and disseminatedMycobacterium chimaerainfections subsequent to open heart surgery

2015 ◽  
Vol 36 (40) ◽  
pp. 2745-2753 ◽  
Author(s):  
Philipp Kohler ◽  
Stefan P. Kuster ◽  
Guido Bloemberg ◽  
Bettina Schulthess ◽  
Michelle Frank ◽  
...  
Keyword(s):  
Heart Valve ◽  
Vascular Graft ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Prosthetic Heart Valve ◽  
Open Heart ◽  
Healthcare Associated

99mTc-Labelled Anti NCA-95 Antibodies in Prosthetic Heart Valve Endocarditis

1991 ◽  
Vol 30 (04) ◽  
pp. 149-150 ◽  
Author(s):  
H.-J. Bair ◽  
H.-J. Volkholz ◽  
F. Wolf ◽  
W. Becker
Keyword(s):  
Mitral Valve ◽  
Heart Valve ◽  
Prosthetic Valve ◽  
Clinical Signs ◽  
Prosthetic Heart Valve ◽  
Prosthetic Valve Endocarditis ◽  
Aortic Valves ◽  
Radionuclide Uptake ◽  
Echocardiographic Findings

A 54-y old women with earlier replacement of the mitral and aortic valves and clinical signs of localized endocarditis was studied with 99mTc-labelled anti NCA-95 antibody. Whereas echocardiographic findings were negative, increased radionuclide uptake was observed left parasternal over the mitral valve as a sign of prosthetic valve endocarditis. This result could be confirmed by a similar study with leukocytes labelled in vitro with 111ln-oxine.

scholarly journals Mitral valve disease and open heart surgery in osteogenesis imperfecta tarda.

Heart ◽  
1973 ◽  
Vol 35 (1) ◽  
pp. 103-106 ◽  
Author(s):  
S J Wood ◽  
J Thomas ◽  
M V Braimbridge
Keyword(s):  
Mitral Valve ◽  
Osteogenesis Imperfecta ◽  
Mitral Valve Disease ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Valve Disease ◽  
Open Heart

scholarly journals Early results of a real-world series with two transapical transcatheter mitral valve replacement devices

2020 ◽  
Author(s):  
S. Ludwig ◽  
D. Kalbacher ◽  
N. Schofer ◽  
A. Schäfer ◽  
B. Koell ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Functional Improvement ◽  
Study Cohort ◽  
Early Results ◽  
Transcatheter Mitral Valve Replacement

Abstract Aims Transcatheter mitral valve replacement (TMVR) with dedicated devices promises to fill the treatment gap between open-heart surgery and edge-to-edge repair for patients with severe mitral regurgitation (MR). We herein present a single-centre experience of a TMVR series with two transapical devices. Methods and results A total of 11 patients were treated with the Tendyne™ (N = 7) or the Tiara™ TMVR systems (N = 4) from 2016 to 2020 either as compassionate-use procedures or as commercial implants. Clinical and echocardiographic data were collected at baseline, discharge and follow-up and are presented in accordance with the Mitral Valve Academic Research Consortium (MVARC) definitions. The study cohort [age 77 years (73, 84); 27.3% male] presented with primary (N = 4), secondary (N = 5) or mixed (N = 2) MR etiology. Patients were symptomatic (all NYHA III/IV) and at high surgical risk [logEuroSCORE II 8.1% (4.0, 17.4)]. Rates of impaired RV function (72.7%), severe pulmonary hypertension (27.3%), moderate or severe tricuspid regurgitation (63.6%) and prior aortic valve replacement (63.6%) were high. Severe mitral annulus calcification was present in two patients. Technical success was achieved in all patients. In 90.9% (N = 10) MR was completely eliminated (i.e. no or trace MR). Procedural and 30-day mortality were 0.0%. At follow-up NYHA class was I/II in the majority of patients. Overall mortality after 3 and 6 months was 10.0% and 22.2%. Conclusions TMVR was performed successfully in these selected patients with complete elimination of MR in the majority of patients. Short-term mortality was low and most patients experienced persisting functional improvement. Graphic abstract

Mycobacterium chimaera Infection: A Case Report and Review of Literature

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S131-S131
Author(s):  
Dongpo Salas ◽  
Xing Zhao ◽  
Stephen Cavalieri
Keyword(s):  
Weight Loss ◽  
Incubation Period ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Signs And Symptoms ◽  
Its2 Region ◽  
Aortic Valves ◽  
Night Sweats ◽  
Patients At Risk ◽  
Clinical Awareness

Abstract Mycobacterium chimaera (MCH) is a non-tuberculous mycobacterium commonly found in the environment. It is a member of the M. avium complex (MAC), and rarely causes infections in humans. However, invasive MCH infections have been reported associated with heater-cooler devices during cardiac surgery. Detection of MCH infections in this setting has been impeded by inadequate clinical awareness and laboratory tests. A 77-year-old man had aorta valve replacement 3 years ago. He recently presented with constitutional symptoms, including fatigue, night sweats, and 50 pounds of weight loss. PET CT showed ground-glass and nodular opacities in the lungs. Bone marrow biopsy demonstrated noncaseating granulomas. Transesophageal echocardiogram revealed severe stenosis and regurgitation of aortic valves. Despite antibiotics and heart surgery to relieve stenosis, the patient succumbed. Autopsy showed multiple small granulomas in the lung and multifocal chronic inflammation in the heart. Premortem mycobacterial cultures of aortic valves were performed, which grew MAC by DNA probe in 1 week. Subsequently, it was identified as MCH by sequencing of the ITS1/ITS2 region. The cause of death was heart failure due to MCH endocarditis. MCH infection is rare but potentially fatal if not promptly treated. Therefore, it is critical to identify patients at risk for infection. Since 2013, over 100 cases of MCH endocarditis have been reported worldwide, specifically associated with contaminated heater-cooler units during heart surgery. Characteristically, MCH infection has a long incubation period after exposure (median 17 months, range 3-72 months). Signs and symptoms are generally nonspecific and often include fatigue, fever, and weight loss. The risk of MCH infection in patients undergoing open heart surgery is low, but clinicians should be aware of the risks especially when heater-cooler units are utilized. A close follow-up over a long period may be necessary due to the long incubation period of this infection.

scholarly journals Case report of simultaneous transcatheter mitral valve-in-valve implantation and percutaneous closure of two paravalvular leaks

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Masahiko Asami ◽  
Thomas Pilgrim ◽  
Stephan Windecker ◽  
Fabien Praz
Keyword(s):  
Mitral Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Transoesophageal Echocardiography ◽  
Paravalvular Leak ◽  
Open Heart ◽  
Surgical Risk ◽  
Significant Difference ◽  
Valve In Valve ◽  
Valve Implantation

Abstract Background Concomitant structural degeneration of surgical mitral bioprostheses and paravalvular leak (PVL) is rare but potentially fatal. Data pertaining to simultaneous transcatheter mitral valve implantation (TMVI) and percutaneous PVL closure are limited, and the optimal treatment strategy remains undetermined. We report a case of simultaneous TMVI and double percutaneous PVL closure in a patient with a degenerated bioprosthetic mitral valve and associated medial and lateral PVLs. Case summary A 75-year-old woman who underwent combined aortic (Edwards Perimount Magna 19 mm) and mitral (Edwards Perimount Magna 25 mm) surgical valve replacement 6 years ago was referred for treatment of new-onset orthopnoea and severely reduced exercise capacity. Transoesophageal echocardiography revealed severe mitral stenosis and concomitant moderate to severe mitral regurgitation, originating from two PVLs located medial and lateral from the surgical bioprosthesis. Due to high surgical risk, we performed successful transseptal mitral valve-in-valve (ViV) implantation combined with the closure of two PVLs during the same procedure. Discussion Although surgery should be considered as a first-line treatment in this setting, most patients have extremely high or prohibitive surgical risk inherent to repeat open heart surgery. Mitral ViV implantation appears a reasonable treatment option for patients with failed mitral bioprostheses. Furthermore, a recent study of percutaneous PVL closure showed no significant difference in long-term all-cause mortality compared with redo open-heart surgery. Simultaneous TMVI and percutaneous PVL closure appears feasible in selected high-risk patients.

Open heart surgery with mitral valve replacement - ordeal of an undiagnosed haemophilia patient.

2003 ◽  
Vol 25 (2) ◽  
pp. 131-133 ◽  
Author(s):  
K. Ghosh ◽  
M. Madkaikar ◽  
F. Jijina ◽  
S. Gandhi ◽  
S. Shetty ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart

Robotic mitral valve surgery: how soon will we be moving away from open heart surgery?

2012 ◽  
Vol 8 (6) ◽  
pp. 797-799
Author(s):  
Saina Attaran ◽  
Jon Anderson ◽  
Prakash Punjabi
Keyword(s):  
Mitral Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Open Heart

Pseudoepidemic of Endocarditis in Patients Undergoing Open Heart Surgery

1980 ◽  
Vol 1 (2) ◽  
pp. 97-99 ◽  
Author(s):  
Robert C. Aber ◽  
Peter C. Appelbaum
Keyword(s):  
Heart Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Careful Analysis ◽  
Screening Procedure ◽  
Gram Positive ◽  
Replacement Surgery ◽  
Usual Procedure ◽  
Gram Staining ◽  
Gram Positive Cocci

AbstractBetween July 2 and July 16, 1979, three patients were reported to have gram-positive cocci as seen on Gram stain of excised, macerated heart valve tissue. No organisms were isolated in culture; however, our usual procedure for handling such valves is not adequate for isolation of strict anaerobes. The first patient was treated for presumed endocarditis; this resulted in three additional weeks of hospitalization.Review of the remaining 34 patients who had heart valve replacement surgery between February 1 and July 20, 1979 revealed three additional cases.Careful analysis revealed that nonviable, gram-positive cocci present in commercially prepared trypticase soy broth were being added to the tissue just prior to mortar and pestle grinding in the microbiology laboratory. The contaminated tubes were noted to have a visible sediment when carefully examined.The procedure for handling the broth has been revised; a simple screening procedure is used now to identify potentially contaminated broth. No further instances of false positive results on Gram-staining of heart value tissue have occurred since this screening procedure was introduced.

scholarly journals Simulation Based Design and Evaluation of a Transcatheter Mitral Heart Valve Frame

2012 ◽  
Vol 6 (3) ◽  
Author(s):  
Melissa Young ◽  
Ahmet Erdemir ◽  
Samantha Stucke ◽  
Ryan Klatte ◽  
Brian Davis ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Heart Surgery ◽  
Large Diameter ◽  
Open Heart Surgery ◽  
Element Analysis ◽  
Mechanical Fracture ◽  
Simulation Based Design ◽  
Simulation Based ◽  
Desirable Feature ◽  
Computational Modeling And Simulation

In certain populations, open heart surgery to replace a diseased mitral valve is not an option, leaving percutaneous delivery a viable alternative. However, a surgical transcatheter based delivery of a metallic support frame incorporating a tissue derived valve puts considerable constraints on device specifications. Expansion to a large diameter from the catheter diameter without mechanical fracture involves advanced device design and appropriate material processing and selection. In this study, a new frame concept is presented with a desirable feature that incorporates wings that protrude during expansion to establish adequate fixation. Expansion characteristics of the design in relation to annulus fixation were quantified through finite element analysis predictions of the frame wing span and angles. Computational modeling and simulation was used to identify many favorable design features for the transcatheter mitral valve frame and obtain desired expansion diameters (35–45 mm), acceptable radial stiffness (2.7 N/mm), and ensure limited risk of failure based on predicted plastic deformations.

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