scholarly journals Transseptal Approach for Mitral Valve Replacement in Dextrocardia with Situs Inversus Totalis: A Case Report and Review of the Literature

2020 ◽  
Vol 23 (1) ◽  
pp. E030-E033 ◽  
Author(s):  
Ovidiu Stiru ◽  
Roxana Carmen Geana ◽  
Razvan Radu Ilie ◽  
Ovidiu Chioncel ◽  
Raluca Tulin ◽  
...  

We consider mitral valve disease requiring surgery in a patient with dextrocardia and situs inversus totalis to be an exceptional finding. The transseptal approach for mitral valve surgery in dextrocardia represents a technical challenge owing to its anatomic particulars. We present the case of a 56-year-old female patient who had been diagnosed with situs inversus totalis in childhood and with chronic atrial fibrillation in adulthood and was under oral anticoagulant treatment. She was referred to our hospital for increasing dyspnea and palpitation. Transthoracic echocardiography detected severe mitral regurgitation associated with moderate tricuspid regurgitation, with normal left and right ventricular function. Contrast chest computed tomography (CT) and preoperative abdominal CT showed both dextrocardia and situs inversus totalis, with normal continuity of the inferior vena cava. Biatrial cannulation was performed with the surgeon standing on the right side of the patient, and mitral valve replacement using a transseptal approach was performed with the surgeon standing on the left side of the patient. In this case report, we emphasize the rarity of mitral valve disease in a patient with dextrocardia and the inherent potential difficulty that can appear in this particular anatomic condition.

2020 ◽  
Vol 25 (8) ◽  
pp. 3842
Author(s):  
V. I. Ganyukov ◽  
R. S. Tarasov ◽  
I. V. Ganyukov

The review presents current data transseptal transcatheter mitral valve replacement, which is becoming an alternative method of managing mitral valve disease. Despite the fact that the transapical transcatheter approach is technically simpler, the transseptal method is less invasive. It has confirmed effectiveness and is predicted to be the most promising. The review describes the relevance, indications, methodology for selecting the required endoprosthesis, stages of procedure, complications, and the postoperative follow-up of patients. The results of publications on transseptal transcatheter mitral valve replacement are analyzed. A case report is given.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M A Elfeky ◽  
M M A Fadala ◽  
O A Abdelhameed ◽  
R M R Khorshid

Abstract Background Rheumatic mitral valvular disease is more common than degenerative mitral valve disease. Mitral valve repair is not possible in large number of patients because of rheumatic cicatrized subvalvular mitral valve disease. The prosthetic mitral valve replacement is commonly performed in our center. Objective The aim of the study was to evaluate and assess the short outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair. Patients and Methods This study was done in department of Cardiothoracic surgery, Faculty of Medicine at Ain Shams university, after approval of the local ethical committee from 2015 to 2016.The inclusion criteria includes All gender, All age, Primary Mitral valve replacement for severe Mitral valve disease of Rheumatic origin with or without Tricuspid Valve Repair and Primary Mitral valve replacement for severe Mitral valve disease of Degenerative origin with or without Tricuspid Valve Repair and the exclusion criteria includes concomitant coronary artery bypass graft surgery or other cardiac operations or infective endocarditis and Patients with chronic liver, kidney and parenchymal pulmonary disease. Results This study included one hundred and seventy- seven (177) patients; One hundred and thirty one (131) patients did Mitral Valve Replacement without Tricuspid valve Repair, Fourty six (46) patients did Mitral valve Replacement with Tricuspid valve Repair and the outcome was Mortality (3.9%), Reoperaion (5.08%), Stroke (0. 56%), Re-Intubation (1.13%) and Re-Admission to ICU (1.69%) Conclusion The Reoperation has a direct relation and effect on the Mortality,Prolonged bypass time independently predicts postoperative morbidity and mortality and Prolonged aortic cross-clamp time significantly correlates with major post-operative morbidity and mortality.


2021 ◽  
Vol 5 (1) ◽  
pp. 19
Author(s):  
Anshuman Darbari ◽  
Devender Singh ◽  
PrashantL Patil ◽  
Barun Kumar

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Rodrigo ◽  
U Estandia ◽  
P Perez ◽  
C Perez ◽  
A Cortes ◽  
...  

Abstract We report a 62-year-old man with a past medical history of dyslipidemia, paranoid schizophrenia and permanent atrial fibrillation. A ATTE performed at his district hospital revealed rheumatic mitral valve disease with double lesion: severe regurgitation and mild stenosis, plus moderate tricuspid regurgitation and a mean PAP of 32mm Hg. Cardiac catheterization showed no abnormalities of the coronary arteries. He was transferred to our hospital and scheduled for mitral valve replacement and tricuspid ring valvuloplasty. Preoperative transesophageal echocardiography showed an abnormal subvalvular mitral apparatus, with false tendons and multiple papillary muscles, resembling a hammock mitral valve. Most cordae tendinae arose from a single dominant papillary muscle at a posterior medial region, which provoke severe mitral regurgitation due to coaptation defect and mild subvalvular mitral stenosis. It could also be appreciated hypertrabeculation in the lateral medial, basal and apical segments. This suggested no-compaction cardiomyopathy associated with hammock mitral valve. Left ventricular systolic function was preserved. No evidence of rheumatic mitral valve disease was found in transesophageal echocardiographic study performed at our hospital. On the 30th April 2019 he underwent mechanic mitral valve replacement (Bicarbon 29mm) and tricuspid ring valvuloplasty (Edwards Physio 32mm) surgery. Once the patient was weaned from cardiopulmonary bypass, severe left ventricle systolic dysfunction ensued, predominantly localized in the anterior, inferior septal, inferior lateral basal and medial segments. Apical segments had preserved mobility An adrenalin infusion prior weaning from CBP was initiated. Preserved mobility of the mitral prosthesis discs was observed. The patient developed cardiogenic shock in spite of high doses of dobutamin and adrenaline infused. IACB was implanted with 1:1 assistance. The patient was transfered to the hemodynamic room in order to rule out coronary complications. Cardiac catheterization showed no significant angiographic lesions. During the first postoperative hours, the patient was stabilized allowing progressive lowering of the drugs (adrenaline, dobutamine). TTE showed normally functioning prosthetic mitral valve and preserved left ventricle systolic function. An MRI was performed demostrating no-compaction cardiomyopathy Conclusion This case report describes a rare presentation of simultaneous ocurrence of hammock mitral valve and no-compaction cardiomyopathy. Perioperative left ventricle dysfunction in no-compaction cardiomyopathy is related to subendocardial ischemia caused during extracorporeal circulation in the multiple prominent ventricular trabeculations with deep intertrabecular recesses corresponding to non-compacted myocardium .This must be taken account in those patients with no-compaction cardiomyopathy scheduled for cardiac surgery in order to take preventive measures. Abstract 89 Figure. non - compacted myocardium


2016 ◽  
Vol 28 (2) ◽  
pp. 61-68
Author(s):  
Kemal UZUN ◽  
Hayrettin TEKÜMİT ◽  
Cenk TATAROĞLU ◽  
Ali Rıza CENAL ◽  
Esat AKINCI

2016 ◽  
Vol 9 (1) ◽  
pp. 73-74
Author(s):  
Jubayer Ahmad ◽  
Md Mokhlesur Rahman ◽  
Heemel Saha ◽  
Md Aftabuddin ◽  
Asit Baran Adhikary

A 52 year-old male patient of severe MS with mild MR with AF with a giant left atrium (LA size 70 mm) and history of CMC presented with symptoms. Giant left atrium is a condition characterized by huge enlargement of the left atrium with a diameter exceeding 65mm. It is most commonly associated with long standing rheumatic mitral valve disease. The patient underwent successful mitral valve replacement and removal of LA thrombus and discharged from hospital with adviceCardiovasc. j. 2016; 9(1): 73-74


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