scholarly journals Mechanism of Beneficial Effects of Restrictive Mitral Annuloplasty in Patients With Dilated Cardiomyopathy and Functional Mitral Regurgitation

Circulation ◽  
2010 ◽  
Vol 122 (11_suppl_1) ◽  
pp. S3-S9 ◽  
Author(s):  
K. Takeda ◽  
K. Taniguchi ◽  
Y. Shudo ◽  
S. Kainuma ◽  
S. Hamada ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Functional Mitral Regurgitation ◽  
Mitral Annuloplasty ◽  
Beneficial Effects

MitraClip and mitral annuloplasty device as a bridge to transplantation

2017 ◽  
Vol 26 (1) ◽  
pp. 57-59 ◽  
Author(s):  
Nainar Madhu Sankar ◽  
Salla Sweta Ramani ◽  
Rajaram Anantharaman ◽  
Kotturathu Mammen Cherian
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Heart Transplantation ◽  
Dilated Cardiomyopathy ◽  
Functional Mitral Regurgitation ◽  
Bridge To Transplantation ◽  
Mitral Annuloplasty

A 42-year-old man with dilated cardiomyopathy and endstage heart failure was evaluated for heart transplantation. He received a MitraClip and Carillon annuloplasty device for functional mitral regurgitation as palliation for his heart failure. Subsequently, he underwent successful heart transplantation.

scholarly journals Isolated Undersized Mitral Annuloplasty for Functional Mitral Regurgitation in Non-Ischemic Dilated Cardiomyopathy

2008 ◽  
Vol 72 (11) ◽  
pp. 1744-1750 ◽  
Author(s):  
Takashi Miura ◽  
Kiyoyuki Eishi ◽  
Shiro Yamachika ◽  
Koji Hashizume ◽  
Seiichi Tada ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Functional Mitral Regurgitation ◽  
Mitral Annuloplasty ◽  
Non Ischemic Dilated Cardiomyopathy

Surgical Technique: Papillary Muscle Sling for Functional Mitral Regurgitation during Minimally Invasive Valve Surgery

2013 ◽  
Vol 16 (5) ◽  
pp. E295-E297 ◽  
Author(s):  
Joseph Lamelas ◽  
Christos Mihos ◽  
Orlando Santana
Keyword(s):  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Median Sternotomy ◽  
Rational Approach ◽  
Functional Mitral Regurgitation ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Mitral Annuloplasty ◽  
Technical Details ◽  
Mitral Apparatus

In patients with functional mitral regurgitation, the placement of a sling encircling both papillary muscles in conjunction with mitral annuloplasty appears to be a rational approach for surgical correction, because it addresses both the mitral valve and the deformities of the subvalvular mitral apparatus. Reports in the literature that describe the utilization of this technique are few, and mainly involve a median sternotomy approach. The purpose of this communication is to describe the technical details of performing this procedure via a minimally invasive approach.

Percutaneous Mitral Annuloplasty for Treatment of Functional Mitral Regurgitation

2009 ◽  
Vol 5 (1) ◽  
pp. 67
Author(s):  
Lutz Buellesfeld ◽  
Lazar Mandinov ◽  
Eberhard Grube ◽  
◽  
◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Coronary Sinus ◽  
Standard Of Care ◽  
Mitral Annulus ◽  
Functional Mitral Regurgitation ◽  
Invasive Treatment ◽  
Large Variability ◽  
Mitral Annuloplasty ◽  
Number Of Patients ◽  
Anatomical Relationship

Functional mitral regurgitation affects a substantial proportion of patients with congestive heart failure due to myocardial infarction or dilated cardiomyopathy. Functional mitral regurgitation greatly increases morbidity and mortality. Surgical annuloplasty is the standard of care for symptomatic patients with moderate or severe functional mitral regurgitation; however, a large number of patients are refused surgery. Several percutaneous approaches have been developed to address the need for less invasive treatment of mitral annulus dilatation. Devices using coronary sinus to cinch the mitral annulus are relatively easy to use; however, a number of factors may limit their clinical application, such as suboptimal anatomical relationship between the coronary sinus and mitral annulus, risk of coronary artery compression, large variability in the coronary venous anatomy and conflict with other therapies such as ablation or cardiac resynchronisation. Direct mitral annuloplasty is anticipated to be more effective than the coronary sinus approaches; however, it has yet to prove its safety and efficacy in carefully designed clinical trials. The best candidates and the best timing for each percutaneous mitral annuloplasty therapy, whether direct or indirect, have yet to be identified.

Abstract 4827: Role of Left Ventricular Dyssynchrony in Functional Mitral Regurgitation in Patients with Dilated Cardiomyopathy: A Comparison Study with Geometric Parameters of Mitral Apparatus Estimated with 3d Echocardiography

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Woonggil Choi ◽  
Soohyun Kim ◽  
Seongill Woo ◽  
Deahyuk Kim ◽  
Keumsoo Park ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Multivariate Regression Analysis ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Geometric Parameters ◽  
Functional Mitral Regurgitation ◽  
Left Ventricular Dyssynchrony ◽  
Lv Dyssynchrony ◽  
Mitral Apparatus

Objective: Functional mitral regurgitation (FMR) occurs commonly in patients with dilated cardiomyopathy (DCM). The aim of this study was to compare the roles of Left Ventricle(LV) dyssynchrony and geometric parameters of mitral apparatus as determinants of FMR in patients with DCM. Methods: Fourteen DCM patients without FMR and 15 DCM patients with FMR (ERO = 0.11 ± 0.029 cm 2 ) were enrolled. Effective regurgitant orifice (ERO) area and tissue Doppler-derived dyssynchrony index (DI: the standard deviation of time to peak myocardial systolic contraction of eight segments) were measured. The estimated DIs were corrected by the cycle length (CL) of each patient (cDI (%) = DI/CL*100). Using real-time 3D echocardiogrphy, mitral tenting area (MVT) and the degrees of displacement of anterior (APMD) and posterior (PPMD) papillary muscles were estimated. All geometric measurements were corrected (c) by the height of each patient. Results: There was no significant (p > 0.05) difference in LV Ejection Fraction and cLVEDV between two patient groups. cDI, cMVT, cAPMD and cPPMD significantly (p < 0.05) increased in the patient with FMR comparing with those in patients without FMR. cDI (r = 0.42), cMVT (r = 0.74), cAPMD (r = 0.63) and cPPMD (r = 0.64) showed significant (p < 0.05) correlations with ERO. cMVT was found to the strongest independent predictor of ERO with multivariate regression analysis, whereas cDI did not enter into the model. Conclusions: The degree of MV tenting rather than LV dyssynchrony was found to be the main determinant of FMR in DCM. However LV dyssynchrony also has a minor independent association with FMR.

scholarly journals Torsion Mechanics as an Indicator of More Advanced Left Ventricular Systolic Dysfunction in Secondary Mitral Regurgitation in Patients with Dilated Cardiomyopathy: A 2D Speckle-Tracking Analysis

Cardiology ◽  
2018 ◽  
Vol 139 (3) ◽  
pp. 187-196 ◽  
Author(s):  
Elena Kinova ◽  
Natalia Spasova ◽  
Angelina Borizanova ◽  
Assen Goudev
Keyword(s):  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Speckle Tracking ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Compensatory Mechanism ◽  
Structural Wall ◽  
Group 2 ◽  
Group 1

Left ventricular (LV) twist serves as a compensatory mechanism in systolic dysfunction and its degree of reduction may reflect a more advanced stage of disease. Aim: The aim was to investigate twist alterations depending on the degree of functional mitral regurgitation (MR) by speckle-tracking echocardiography. Methods: Sixty-three patients with symptomatic dilated cardiomyopathy (DCM) were included. Patients were divided according to MR vena contracta width (VCW): group 1 with VCW <7 mm (mild/moderate MR) and group 2 with VCW ≥7 mm (severe MR). Results: There were no differences in LV geometry and function between groups. Group 2 showed lower endocardial basal rotation (BR) (–2.04° ± 1.83° vs. –3.23° ± 1.83°, p = 0.012); epicardial BR (–1.54° ± 1.18° vs. –2.31° ± 1.22°, p = 0.015); endocardial torsion (0.41°/cm ± 0.36°/cm vs. 0.63°/cm ± 0.44°/cm, p = 0.033) and mid-level circumferential strain (CSmid) (–6.12% ± 2.64% vs. –7.75% ± 2.90%, p = 0.028), when compared with group 1. Multivariable linear regression analysis identified endocardial BR, torsion and CSmid, as the best predictors of larger VCW. In the ROC curve analysis, endocardial BR and CSmid values greater than or equal to –3.63° and –9.35%, respectively, can differentiate patients with severe MR. Conclusions: In DCM patients, torsional profile was more altered in severe MR. Endocardial BR, endocardial torsion, and CSmid, can be used as indicators of advanced structural wall architecture damage.

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