Murmur on top of the head: bioprosthetic mitral valve insufficiency

In 1961, K Merendino ‘in pure curiosity’, while tracking the murmur of mitral regurgitation, placed his stethoscope ‘on the vertex of the head’, and ultimately led to a medical curiosity and exam finding that not only bears his name, but awes medical learners at all stages of their careers. Merendino and colleagues collected seven such cases of the ‘Murmur on Top of the Head’ building on the work of others who provided a detailed description of mitral regurgitation and noted murmur radiation to the neck and cervical/lumbosacral spine. The majority of patients suffered from rheumatic heart disease or subacute bacterial endocarditis in native heart valves. Here, we report on a case of the ‘Murmur on Top of the Head’ and provide the reader/listener with a direct recording of the ‘Merendino murmur’ (as well as its spinal correlate) in an elderly woman with a bioprosthetic mitral valve.

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Surgical Repair of Congenital Left Atrial Aneurysm and Mitral Valve Insufficiency in a Four-Year-Old Child

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135116678416 ◽

2016 ◽

Vol 9 (3) ◽

pp. 357-359 ◽

Cited By ~ 1

Author(s):

C. Tayyar Sarioglu ◽

Yasemin Turkekul ◽

Ahmet Arnaz ◽

Emrah Sisli ◽

Yusuf Kenan Yalcinbas ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Left Atrial ◽

Giant Aneurysm ◽

Mitral Valve Insufficiency ◽

Pulmonary Venous Obstruction ◽

Supraventricular Arrhythmia ◽

Severe Mitral Regurgitation ◽

Systemic Embolization ◽

Valve Insufficiency

Left atrial aneurysm is an extremely rare anomaly, which can be associated with supraventricular arrhythmia, compression of coronary arteries, intracardiac thrombus, life-threatening systemic embolization, pulmonary venous obstruction, mitral valve insufficiency, and congestive heart failure. Herein, we report a four-year-old boy who had a giant aneurysm of the left atrium and severe mitral regurgitation. The aneurysm and mitral valve cleft causing severe mitral regurgitation were successfully repaired.

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Diagnosis of mitral insufficiency using impedance cardiography technique ICG

Journal of Electrical Bioimpedance ◽

10.5617/jeb.2872 ◽

2019 ◽

Vol 7 (1) ◽

pp. 28-34 ◽

Cited By ~ 3

Author(s):

Souhir Chabchoub ◽

Sofienne Mansouri ◽

Ridha B. Salah

Keyword(s):

Mitral Valve ◽

Heart Valves ◽

Impedance Cardiography ◽

Characteristic Parameter ◽

Mitral Valve Insufficiency ◽

Mitral Insufficiency ◽

Hemodynamic Parameters ◽

Control Subjects ◽

Impedance Cardiogram ◽

Valve Insufficiency

Abstract Impedance cardiography (ICG) is a non-invasive tool for assessing the hemodynamic parameters. It has been used for diagnosing several cardiovascular diseases, such as heart failure, cardio-myopathy, and valvular diseases. Particularly, the valvular heart disease is characterized by the damage in one of the four heart valves: the mitral, aortic, tricuspid or pulmonary valves. The mitral valve insufficiency and the aortic valve stenos are the most frequent valve diseases in the world. In this paper, we propose to diagnosis the mitral valve insufficiency using the impedance cardiography technique. The study group consisted of 40 subjects (20 control subjects and 20 patients with mitral insufficiency). A parameter “I” is calculated from the impedance cardiogram waveform and it is used to differentiate control subjects from patients with mitral insufficiency. The parameter “I” was related significantly to the abnormalities of the impedance cardiogram waveform. For patients with mitral insufficiency, “I” was higher than for the healthy subjects with a difference ratio of 89% (p<0.001). To improve the diagnosis, we determined the stroke volume, cardiac output, and other hemodynamic parameters for the two groups of subjects. Finally, we concluded that we could identify, easily, patients with mitral insufficiency based on the abnormalities of the impedance cardiogram tracings and a characteristic parameter “I”.

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A Complex Mitral Valve Reconstruction: A Case Report

The Heart Surgery Forum ◽

10.1532/hsf.648 ◽

2005 ◽

Vol 6 (2) ◽

pp. 27

Author(s):

Dimitrios Buklas ◽

Massimo Massetti ◽

Eric Saloux ◽

Eugenio Neri ◽

Olivier LePage ◽

...

Keyword(s):

Mitral Valve ◽

Surgical Techniques ◽

Mitral Valve Insufficiency ◽

Left Ventricular ◽

Mitral Valve Reconstruction ◽

Mitral Repair ◽

Valve Reconstruction ◽

Valve Insufficiency ◽

Valve Function ◽

Valvular Function

Several techniques are currently in use for mitral valve reconstruction. We report a mitral repair case in which the use of a combination of different surgical techniques resulted in the necessary correction. A 47-year-old woman underwent surgical intervention to treat severe mitral valve insufficiency due to A1/A2/A3 and P2 prolapsed valve tissue. A combination of quadrangular resection, sliding leaflet, single chordal transposition, "flip-over" leaflet, and ring annuloplasty techniques were applied, and postsurgical correct valve function was documented by results of a left ventricular saline filling test and transesophageal echocardiography control. Complex mitral valve repairing techniques can be combined to reestablish valvular function.

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