scholarly journals Rare aneurysm of anterior mitral valve leaflet-a case report

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Muhammad Tariq ◽  
Ibrahim Zahid ◽  
Shahid Sami
Keyword(s):  
Mitral Valve ◽  
Surgical Intervention ◽  
Good Prognosis ◽  
Valve Leaflet ◽  
Rare Entity ◽  
Valve Repair ◽  
Mitral Valve Leaflet ◽  
Case Presentation ◽  
Suitable Treatment

Abstract Background Mitral valve aneurysm (MVA) is a saccular outpouching of the mitral leaflet which expands on systole and collapses during diastole. The case of MVA was first described in 1729 by Morand. It is one of the rare entities with a reported incidence of only 0.2–0.29% and no such case reported in Pakistan before. Case presentation A 51 year old female presented with dyspnea and chest pain for 3 months. Upon investigating, trans-esophageal echocardiography (TEE) revealed thickened anterior mitral valve leaflet with rolled up margins, forming an aneurysm, with severe mitral regurgitation. Subsequently, the valve was evaluated intra-operatively for repair but eventually had to be excised and then successfully replaced with a bioprosthetic valve. Conclusions TEE is an excellent technique to confirm the diagnosis of a mitral valve leaflet aneurysm, and depending upon the severity of the defect, valve repair can be attempted but replacement becomes the most suitable treatment modality, once repair is deemed impossible. We hereby report a rare case, where timely diagnosis, appropriate surgical intervention and regular post-operative follow up helped in achieving good prognosis of this rare entity.

Incidence and standardised definitions of mitral valve leaflet adverse events after transcatheter mitral valve repair: the EXPAND study

2021 ◽  
Vol 17 (11) ◽  
pp. e932-e941
Author(s):  
Federico M. Asch ◽  
Stephen H. Little ◽  
G. Burkhard Mackensen ◽  
Paul A. Grayburn ◽  
Paul Sorajja ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Adverse Events ◽  
Mitral Valve Repair ◽  
Valve Leaflet ◽  
Valve Repair ◽  
Mitral Valve Leaflet ◽  
Transcatheter Mitral Valve Repair

Idiopathic Acute Mitral Regurgitation Due to Chordal Rupture in Infants: Surgical Management and Results

2019 ◽  
Vol 10 (1) ◽  
pp. 37-41
Author(s):  
Kosuke Yoshizawa ◽  
Keiichi Fujiwara ◽  
Nobuhisa Ohno ◽  
Kentaro Watanabe ◽  
Hisanori Sakazaki
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Surgical Intervention ◽  
Valve Repair ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Acute Mitral Regurgitation ◽  
Artificial Chordae

Objective: Emergency surgical treatment is required for idiopathic acute mitral regurgitation due to chordae rupture in infants. Nevertheless, mitral valve repair for such a patient population still remains challenging. We report our experience with mitral valve repair for idiopathic acute mitral regurgitation due to chordae rupture in infants. Methods: From 2005 to 2017, six infants (four boys) were diagnosed with acute mitral regurgitation due to chordae rupture and underwent mitral valve repair. The median age, mean body weight, and median follow-up period were 5.5 months (range: 4-9 months), 6.8 kg (range: 5.5-8.0 kg), and 6.4 years (range: 6 months to 10 years), respectively. Results: In all cases, surgical intervention was performed within 24 hours of admission. Artificial chordae reconstruction and paracommissural edge-to-edge repair were utilized in three and four cases, respectively, while Kay’s annuloplasty was performed in all cases. Mean cardiopulmonary bypass time and aortic cross-clamp time were 117 minutes (range: 70-143 minutes) and 73 minutes (range: 35-108 minutes), respectively. No early or late deaths and reoperations had occurred during the follow-up period. Moreover, postoperative mitral regurgitation was significantly reduced, while no chronologic progression of mitral regurgitation was observed. Conclusions: The combination of various techniques, such as artificial chordae reconstruction, paracomissural edge-to-edge repair, and Kay’s annuloplasty, can be a promising surgical option for idiopathic acute mitral regurgitation due to chordae rupture in infants.

scholarly journals Mitral valve repair in Barlow’s disease with bileaflet prolapse: the effect of annular stabilization on functional mitral valve leaflet prolapse†

2017 ◽  
Vol 26 (4) ◽  
pp. 559-565 ◽  
Author(s):  
Anton Tomšič ◽  
Yasmine L Hiemstra ◽  
Daniella D Bissessar ◽  
Thomas J van Brakel ◽  
Michel I M Versteegh ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Leaflet ◽  
Valve Repair ◽  
Mitral Valve Leaflet ◽  
Barlow’S Disease ◽  
Leaflet Prolapse

scholarly journals Successful percutaneous mitral valve leaflet repair for primary mitral regurgitation results in functional improvement and positive cardiac reverse remodelling

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
TP Craven ◽  
PG Chew ◽  
M Gorecka ◽  
LAE Brown ◽  
A Das ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Valve Leaflet ◽  
Reference Standard ◽  
Mitral Valve Leaflet ◽  
Reverse Remodelling ◽  
Primary Mitral Regurgitation

Abstract Funding Acknowledgements Type of funding sources: None. Background Percutaneous mitral valve leaflet repair can be an effective treatment for primary mitral regurgitation (MR) patients deemed high-risk for surgery. Accurate assessment of cardiac reverse remodelling is essential to optimise future patient selection. Cardiovascular magnetic resonance (CMR) is the reference standard for cardiac volumetric assessment and compared to transthoracic echocardiography (TTE) provides superior reproducibility in MR quantification. Prior CMR studies have analysed cardiac reverse remodelling following percutaneous intervention in combined cohorts of primary and secondary MR patients. However, as aetiology of MR can significantly impact outcomes, focused studies are warranted. Purpose Assess cardiac reverse remodelling and quantify changes in MR following percutaneous mitral valve leaflet repair for primary MR using the reference standard (CMR). Methods 12 patients with at least moderate-severe MR on TTE were prospectively recruited to undergo CMR imaging and 6-minute walk tests (6MWT) at baseline and 6 months following percutaneous mitral valve leaflet repair (MitraClip). CMR protocol involved: left-ventricular (LV) short axis cines (bSSFP, SENSE-2, 10mm, no gap), transaxial right-ventricular (RV) cines (bSSFP, SENSE-2, 8mm, no gap), two and four chamber cines and aortic through-plane phase contrast imaging, planned at the sino-tubular junction. MR was quantified indirectly using LV and aortic stroke volumes. Results 12 patients underwent percutaneous mitral valve leaflet repair (MitraClip) for posterior mitral valve leaflet prolapse, however 1 patient declined follow up after single-leaflet clip detachment resulting in 11 patients (age 83 ± 5years, 9 male) completing follow up imaging. At 6-months: significant improvements occurred in New York Heart Association functional class (Table 1) and 6MWT distances (223 ± 71m to 281 ± 65m, p = 0.005) and significant reductions occurred in indexed left ventricular end-diastolic volumes (LVEDVi) (118 ± 21ml/m2 to 94 ± 27ml/m2, p = 0.001), indexed left ventricular end-systolic volumes (58 ± 19ml/m2 to 48 ± 21ml/m2, p = 0.007) and quantitated MR volume (55 ± 22ml to 24 ± 12ml, p = 0.003) and MR fraction (49 ± 9.4% to 29 ± 14%, p= <0.001). There were no statistically significant changes in left ventricular ejection fraction (LVEF), right ventricular dimensions/ejection fraction or bi-atrial dimensions (Table 1). All patients demonstrated decreased LVEDVi and quantified MR (Figure 1). Conclusion Successful percutaneous mitral valve leaflet repair for primary MR results in reduction in MR, positive LV reverse remodelling, preservation of LVEF, and functional improvements. Larger CMR studies are now required to further guide optimal patient selection.

Patch repair in infective native mitral valve endocarditis

2021 ◽  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Streptococcus Agalactiae ◽  
Patch Repair ◽  
Valve Leaflet ◽  
Valve Repair ◽  
Mitral Valve Leaflet ◽  
Video Tutorial

Infective native mitral valve endocarditis occurs rarely. Mitral valve repair, although surgically challenging, is favored over replacement in the latest European and American guidelines. In this video tutorial, patch repair of the posterior mitral valve leaflet is performed in a 61-year-old patient with endocarditis caused by Streptococcus agalactiae.

Early Recurrence of an Infantile Endodermal Oculomotor Nerve Cyst following Surgical Fenestration: A Case Report

2021 ◽  
Vol 56 (2) ◽  
pp. 157-162
Author(s):  
Victor M. Lu ◽  
Aditya Raghunathan ◽  
Michael J. Link ◽  
David J. Daniels
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Early Recurrence ◽  
Oculomotor Nerve ◽  
Rare Entity ◽  
Oculomotor Palsy ◽  
Case Presentation ◽  
Postoperative Course

Introduction: Infantile endodermal oculomotor nerve cyst (EONC) is an extremely rare entity. There are very few pediatric cases reported in the literature, and as expected, oculomotor palsy is the most common presenting symptom. To date however, the risk of recurrence of these lesions following surgical intervention is unclear due to a lack of long-term radiological follow-up. Case Presentation: We present a case of a 13-month-old male patient with an EONC and detail his surgical fenestration and postoperative course. Somewhat surprisingly, re-expansion occurred within 6 months and remained stable 2 years later. Discussion: A surgical approach to fenestration of an EONC in an infant is possible and should be performed by an expert neurosurgeon. Early recurrence is underreported in the current literature, and we encourage longer term radiological surveillance of these lesions after surgery to optimize primary and recurrent management in the future.

scholarly journals Anterior Mitral Leaflet Tear during Balloon Mitral Valvotomy in a Case of Juvenile Mitral Restenosis

2021 ◽  
pp. 8-12
Author(s):  
Rohit Rai ◽  
Gajanan D. Gawande ◽  
Shakil S. Shaikh ◽  
Narender O. Bansal
Keyword(s):  
Mitral Valve ◽  
Rheumatic Fever ◽  
Valve Replacement ◽  
Mitral Stenosis ◽  
Valve Leaflet ◽  
Mitral Leaflet ◽  
Valve Repair ◽  
Mitral Valve Leaflet ◽  
Mitral Valvotomy ◽  
Severe Fibrosis

Recurrent attacks of rheumatic fever can lead to mitral stenosis. In a country like India mitral stenosis can develop in the first decade of life. Our patient presented with recurrent mitral stenosis at twelve years of age. He had undergone balloon mitral valvotomy at the age of seven. However this time he developed anterior mitral valve leaflet tear after balloon mitral valvotomy and had to be taken for mitral valve repair. Due to severe fibrosis of mitral valve the patient underwent mitral valve replacement. He was started on warfarin and dose titrated according to PT / INR. Patient was discharged but has to be on lifelong anticoagulation from the age of twelve.

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