Robotic, totally endoscopic excision of mitral valve papillary fibroelastoma

2021 ◽  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Benign Tumor ◽  
Pulmonary Valve ◽  
Papillary Fibroelastoma ◽  
Robotic Assisted ◽  
Endoscopic Excision ◽  
Rare Benign Tumor ◽  
Sixth Decade

Papillary fibroelastoma is a rare, benign tumor that affects males more frequently than females and that tends to be diagnosed during the fifth or sixth decade of life. It tends to arise on cardiac valves, with the aortic valve being the most frequent location followed by the mitral valve, the tricuspid valve, and the pulmonary valve. We present the case of a robotic-assisted, totally endoscopic excision of a mitral valve papillary fibroelastoma.

scholarly journals Valvular heart disease in autoimmune diseases in Mexico

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Aceituno Melgar ◽  
JF Fritche-Salazar ◽  
ME Soto-Lopez
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Autoimmune Diseases ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Valvular Heart Disease ◽  
Valve Disease ◽  
Calcium Deposit

Abstract Funding Acknowledgements Type of funding sources: None. Background  The autoimmune diseases (AD) have high morbidity and mortality due to their affection to the heart. Purpose Our objective was to describe the valvular heart disease (VHD) in patients with AD. Methods Patients with systemic lupus erythematous (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SS) diagnosis were included, from January 1st 2008 to December 31th 2018. Prevalence rates of valve involvement were calculated. Results A total of 163 patients (57.6% with SLE, 23.3% with RA, 19.0% with SS) were included. The global prevalence of VHD was 5.4% in SLS, 23.6% en RA, and 15.9% in SS. The more affected valve in SLS was the tricuspid valve in 24% (12% with severe tricuspid regurgitation (STR), p = 0.028), in RA was the aortic valve in 26% (13% with severe aortic stenosis (SAS), p = 0.02), and with SS was the tricuspid valve in 48% (29% with moderate tricuspid regurgitation (MTR)). The calcium deposit was present in 66% in RA (37% in aortic valve, p < 0.001). The valve thickening (>5 mm) was higher in RA (50%, p < 0.001), with predominance in mitral valve (26%). Conclusions We found significant higher rates of STR in SLE, SAS in RA, and MTR in SS compared with the literature. Moreover, calcification and valve thickening were found more often in RA. Early diagnosis of subclinical VHD is mandatory to improve the long-term prognosis of these patients. Valvular heart disease. Autoimmune Disease (n = 163) P value* SLE (n = 94) RA (n = 38) ES (n = 31) Demographic characteristics Age, years. Gender, Male / Female, n Body Mass Index (kg/m2) Arterial hypertension, n (%) Diabetes Mellitus, n (%) 38.8 (12.6) 9/85 26.2 (5.9) 21(22.3%) 6 (6.3%) 62.45 (12.3) 7/31 26.6 (7.1) 14(36.8%) 4 (10.5%) 53.8 (13.3) 2/29 25.4 (4.7) 12 (38.7) 5 (16.1%) <0.001 NS NS NS NS Echocardiographic findings. Valve thickening Aortic Mitral 8 (9%) 1 (1%) 7 (7%) 19 (50%) 9 (24%) 10 (26%) 1 (3%) 0 1 (3%) <0.001 Calcium Deposit Aortic Mitral 4 (4%) 2 (2%) 2 (2%) 25 (66%) 14 (37%) 11 (29%) 8 (26%) 4 (12.8%) 4 (12.9%) <0.001 Aortic valve disease 4 (4%) 10 (26%) 0 Aortic stenosis Moderate Severe 0 0 0 7 (18%) 2 (5%) 5 (13%) 0 0 0 0,02 Moderate Aortic Regurgitation 4 (4%) 3 (8%) 0 NS Mitral valve disease 8 (9%) 2 (5%) 2 (6%) Mitral stenosis Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Mitral Regurgitation Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Tricuspid Regurgitation Moderate Severe 22 (24%) 11 (12%) 11 (12%) 8 (21%) 7 (18%) 1 (3%) 15 (48%) 9 (29%) 6 (19%) 0,028 Pulmonic valve disease Moderate Pulmonic Stenosis Moderate Pulmonic Regurgitation 6 (6%) 1 (1%) 5 (5%) 1 (3%) 0 1 (3%) 0 0 0 NS * Not Significant.

scholarly journals Comparison of Heart Valve Circumference Examined Before and After 10% Formalin Fixation

2021 ◽  
Vol 73 (7) ◽  
pp. 478-484
Author(s):  
Watcharit Anantakal ◽  
◽  
Somboon Thamtakerngkit ◽  
Vijarn Vachirawongsakorn ◽  
◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Heart Valve ◽  
Tricuspid Valve ◽  
Heart Valves ◽  
Formalin Fixation ◽  
Pulmonic Valve ◽  
Fresh State ◽  
Before And After ◽  
Formalin Fixed

Objective: To compare the heart valve circumference before and after 10% formalin fixation. Materials and Methods: The study analyzed 63 Thai human cadaveric hearts. Each heart valve circumference was separately measured in the fresh state by specifically designed equipment. After that, the hearts were fixed in 10% formalin for 3 days. Then each heart valve circumference was measured by the same equipment and by the thread and ruler technique. The results were analyzed using SPSS package to find the association between the heart valve circumference before and after formalin fixation. Results: This study showed that the average circumferences of the heart valve measured in the fresh state were 13.329 cm in the tricuspid valve, 10.617 cm in the mitral valve, 8.416 cm in the pulmonic valve, and 7.122 cm in the aortic valve. The average circumferences of the heart valve measured after 10% formalin fixation were 11.019 cm in the tricuspid valve, 8.714 cm in the mitral valve, 6.751 cm in the pulmonic valve, and 6.089 cm in the aortic valve. The average ratios of the heart valve circumference measured fresh and after 10% formalin fixation were 0.8267 in the tricuspid valve, 0.8235 in the mitral valve, 0.8050 in the pulmonic valve, and 0.8573 in the aortic valve. There were significant differences in the heart valve circumference between the fresh state and after formalin fixation (p < 0.001). Conclusion: This study revealed important information on the dimensional changes of all the formalin-fixed heart valves. We found that the heart valve shrank after formalin fixation, with the formalin-fixed hearts an estimated 0.8 times smaller than the fresh cadaveric hearts.

Unusual location of the Libman–Sacks endocarditis in a teenager: a case report

2015 ◽  
Vol 26 (2) ◽  
pp. 365-367 ◽  
Author(s):  
Anna Wałdoch ◽  
Joanna Kwiatkowska ◽  
Karolina Dorniak
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Lupus Erythematosus ◽  
Teenage Girl ◽  
Systemic Lupus ◽  
Unusual Location ◽  
Anti Phospholipid Syndrome

AbstractLibman–Sacks endocarditis may be the first manifestation of systemic lupus erythematosus. The risk of its occurrence increases with the co-existence of the anti-phospholipid syndrome. Changes usually involve the mitral valve and the aortic valve. In this report, we present a case of Libman–Sacks endocarditis of the tricuspid valve in a teenage girl.

Transoesophageal: Valves

2020 ◽  
pp. 543-600
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Aortic Valve Stenosis ◽  
Transoesophageal Echocardiography ◽  
Differential Diagnoses ◽  
Low Flow ◽  
Mitral Valve Stenosis ◽  
Pulmonary Valve Stenosis

This chapter deals with the valves in transoesophageal echocardiography. It covers the mitral valve (stenosis, regurgitation, and prolapse), the aortic valve (stenosis and low-flow stenosis and regurgitation), the tricuspid valve, the pulmonary valve (stenosis, regurgitation, and prolapse), infective endocarditis (diagnosis, echocardiographic features, and differential diagnoses).

scholarly journals Clinical and echocardiographic characteristics of patients with pathology proven left-sided non-valvular papillary fibroelastoma

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E El-Am ◽  
A Ahmad ◽  
R Kurmann ◽  
A Sorour ◽  
M Bois ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Papillary Fibroelastoma ◽  
Left Ventricular Outflow

Abstract Funding Acknowledgements Type of funding sources: None. Background Papillary fibroelastoma (PFE) is now regarded as the most common primary tumor of the heart. Although benign, they are clinically significant for their high risk of embolization. They are most commonly found on cardiac valves but can also be present on non-valvular endocardial surfaces. The aim of this study was to better characterize patients with left-sided non-valvular PFE and its clinical sequelae. Methods We retrospectively identified patients with pathology-proven PFEs at a single center between January 1995 and December 2018 (n = 279). Patients with left-sided non-valvular PFE were analyzed. Medical records were retrospectively reviewed for clinical characteristics and outcomes. In addition, intra-operative transesophageal echocardiograms were manually reviewed to estimate overall size and location. Results During the study period, we identified 37 patients with left-sided non-valvular PFE (mean age 61 ± 14 years; 62% females) (Table). PFEs were located on the left ventricle in 41%, left atrium in 35%, and left ventricular outflow tract in 24% of patients. Around a quarter of patients (27%) had a diagnosis of hypertrophic cardiomyopathy, 19% had prior cardiac surgery, and 27% had cancer diagnosed prior to PFE diagnosis. Transient ischemic attack or stroke was the presenting symptom in 22% of patients, myocardial infarction in 6% and peripheral embolization in 6%. Median maximal length for PFE on the left ventricle was 11.1 mm [3;18], on the left atrium 9 mm [2;25], and left ventricular outflow tract 8 mm [6;13]. A minority of patients (9/37 [24%]) had associated valvular PFE on the mitral valve and/or aortic valve (1 patient had both mitral valve and aortic valve PFE, 7 had aortic valve PFE and 1 had Mitral valve PFE). Only 13 patients had follow up transthoracic/transesophageal echocardiogram 1 year after PFE removal; 4/13 (31%) had documented PFE recurrence (3 PFE recurred in the same location as the original; 1 in a different location). Conclusion Left-sided non-valvular PFE is associated with thromboembolic events and at least in those that had follow-up echocardiograms, had a high recurrence rate. More studies are needed to evaluate the management of patients with asymptomatic PFE. Abstract Figure. Baseline Characteristics

scholarly journals A Multi Center Experience: Is Valve Replacement Safe for Patients with Hugely Dilated Left Ventricle?

2019 ◽  
Vol 22 (6) ◽  
pp. E452-E455
Author(s):  
Ahmed Ahmed ◽  
Ahmed Toema ◽  
Ahmed Yehia ◽  
Yassin Hashim ◽  
Mohamed Elkahely ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Tricuspid Valve ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Double Valve Replacement

Background: Dilated left ventricle occurs in chronic aortic and mitral regurgitations. We describe the early outcome of mitral and aortic valve replacement for patients with severely dilated left ventricle in different surgical interventions. Methods: From March 2014 to December 2018, 620 patients with left ventricular end-diastolic diameter (LVEDD) of ≥ 70 mm underwent valve replacement procedures in 8 cardiac surgery centers in Egypt. One hundred ninety four cases (31.3%) underwent aortic valve replacement, 173 cases (27.9%) underwent mitral valve replacement, 123 cases (19.9%) underwent double valve replacement, 59 cases (9.5%) underwent double valve replacement with either tricuspid valve repair or replacement, 33 cases (5.3%) underwent mitral valve replacement with either tricuspid valve repair or replacement, 20 cases (3.2%) underwent mitral valve replacement with CABG, 10 cases (1.6%) underwent aortic valve replacement with CABG, while 8 cases (1.3%) underwent aortic valve replacement with ascending aortic aneurysm repair. Results: Four patients (0.6%) developed new postoperative renal failure, which required dialysis. Twenty-nine patients (4.7%) required reoperation for bleeding. One patient (0.2 %) developed sternal dehiscence. Five patients (0.8%) postoperatively developed stroke. Twenty-five patients (4%) died, and the main causes of death were low cardiac output and sepsis with eventual multi-organ failure. Conclusion: Valve replacement in patients with hugely dilated left ventricle are safe operations with satisfactory outcomes even if combined with other procedures, especially with proper preoperative preparation, intraoperative preservation of posterior mitral leaflet, and meticulous postoperative follow up in the surgical ICU.

Anatomy and echocardiography of the normal and abnormal mitral valve

2006 ◽  
Vol 16 (S3) ◽  
pp. 27-34 ◽  
Author(s):  
Alfred Asante-Korang ◽  
Patrick W. O'Leary ◽  
Robert H. Anderson
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Da Vinci ◽  
Leonardo Da Vinci ◽  
Atrioventricular Junction ◽  
Andreas Vesalius

Unlike the tricuspid valve, the mitral valve has frequently received the attention of anatomists. Indeed, the drawings made by Leonardo da Vinci still retain their currency,1whilst it was no less a personage than Andreas Vesalius who, as far as we know, first likened the bifoliate appearance of the valve to the Episcopal mitre. It was also Vesalius who recommended that the two leaflets be described as aortic and mural, reflecting their respective relationships to the aortic valve and the parietal atrioventricular junction. It was Roberts and Perloff,2however, who emphasized the necessity, for clinical purposes, of analyzing not only the valvar leaflets, but also the overall valvar complex. As we will demonstrate in our review, this approach to analysis also proves its worth for the echocardiographic recognition of the congenitally malformed valve.

scholarly journals Papillary fibroelastoma of the aortic valve

2014 ◽  
Vol 71 (6) ◽  
pp. 600-602 ◽  
Author(s):  
Filip Vukmirovic ◽  
Mihailo Vukmirovic ◽  
Irena Tomasevic-Vukmirovic
Keyword(s):  
Aortic Valve ◽  
Benign Tumor ◽  
Clinical Presentation ◽  
Incidental Finding ◽  
Papillary Fibroelastoma ◽  
Cardiac Tumors ◽  
Autopsy Case ◽  
Primary Tumors ◽  
Echocardiographic Examination ◽  
History Of

Introduction. Primary tumors of the heart are rare, usually benign and occur mostly in adults, and usually originate from the endocardium, followed by the myocardium and rarest of the pericardium. Papillary fibroelastoma accounts for less than 10% of all cardiac tumors, but they are most common valvular tumors. The clinical presentation of papillary fibroelastoma varies from asymptomatic cases to cases which have severe clinical presentation that is most likely due to embolic complications. Tumor can usually be discovered by echocardiography or during autopsy. Case report. We reported a case of 53- year-old man submitted to routine echocardiographic examination. The patient had the history of hypertension for five years, without any other symptoms. Echocardiography found a round tumor attached to the noncoronary cuspis of the aortic valve. The tumor was surgically removed and pathohistological examination confirmed diagnosis of papillary fibroelastoma. After surgery the patient fully recovered without tumor recurrence or aortic regurgitation. Conclusion. Histologically, papilary fibroelastoma is benign tumor of the heart. As demonstrated in this case, a papillary fibroelastoma can be an incidental finding discovered during echocardiography in patients with the history of hypertension.

Robotic totally endoscopic excision of aortic valve papillary fibroelastoma: The least invasive approach

2019 ◽  
Vol 34 (12) ◽  
pp. 1492-1497 ◽  
Author(s):  
Sarah M. Nisivaco ◽  
Brooke Patel ◽  
Husam H. Balkhy
Keyword(s):  
Aortic Valve ◽  
Papillary Fibroelastoma ◽  
Invasive Approach ◽  
Endoscopic Excision
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