scholarly journals Left Atrial Mechanical Function Predicts Postoperative AF in Patients with Rheumatic Mitral Valve Disease Who Underwent Mitral Valve Surgery

2020 ◽  
Vol 23 (6) ◽  
pp. E907-E912
Author(s):  
Yan Jin ◽  
Yang Wang ◽  
Jian Zhang ◽  
Fengjie Yue ◽  
Zongtao Yin ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Lateral Wall ◽  
Mitral Annulus ◽  
Mechanical Function ◽  
Diastolic Velocity ◽  
Transvalvular Gradient ◽  
Atrial Mechanical Function

Objective: Postoperative atrial fibrillation (PoAF) is a common complication after surgical mitral valve replacement. Late PoAF is independently associated with long-term mortality. This study aimed to test the utility of preoperative left atrial mechanical function as a predictor of early and late PoAF in clinical practice. Methods: Patients (N = 150) with a rheumatic mitral valve who underwent mitral valve replacement with or without tricuspid valvuloplasty and who were in stable sinus rhythm were included. Baseline characteristics and transthoracic echocardiographic assessment information on the day before surgery were collected. Em, Em´, and Ei´ indicate early diastolic peak velocity of the mitral valve, early diastolic velocity at the lateral wall of the mitral annulus, and early diastolic velocity at the interventricular septal annulus, respectively. Results: Early PoAF was present in 59 of 150 patients (39.3%), and 32 of 150 patients (21.3%) developed late PoAF within 1 year after surgery. Among all of the variables examined, age, diabetes, early mitral filling velocity (Mitral E), left atrial mechanical function (Mitral A), Em/Em´, Em/Ei´, and mitral transvalvular gradient showed a significant correlation with PoAF. Only age, Mitral A, and mitral transvalvular gradient showed strong, significant correlations with the occurrence of late PoAF. In a multivariate analysis, predictors of late PoAF recurrence included early PoAF and Mitral A. Conclusion: Routine evaluation of Mitral A is feasible and useful to predict early and late PoAF in patients with a rheumatic mitral valve undergoing surgical mitral valve replacement.

scholarly journals Tip-to-Base LAMPOON for Transcatheter Mitral Valve Replacement With a Protected Mitral Annulus

2021 ◽  
Vol 14 (5) ◽  
pp. 541-550 ◽  
Author(s):  
John C. Lisko ◽  
Vasilis C. Babaliaros ◽  
Jaffar M. Khan ◽  
Norihiko Kamioka ◽  
Patrick T. Gleason ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Annulus ◽  
Transcatheter Mitral Valve Replacement

scholarly journals A Giant Left Atrium due to Rheumatic Mitral Regurgitation, Outcome after Left Atrial Reduction Surgey with Mitral Valve Replacement

2018 ◽  
Vol 14 (1) ◽  
pp. 42-44
Author(s):  
Istiaq Ahmed ◽  
Sorower Hossain ◽  
Ankan Kumar Paul
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Atrium ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Quick Recovery ◽  
Replacement Surgery ◽  
Atrial Size ◽  
Giant Left Atrium

A trans-thoracic echocardiography and chest radiograph of a 26 year old lady diagnosed as rheumatic mitral regurgitation with atrial fibrillation revealed a giant left atrium of 10.9 cm size with symptoms of dyspnoea and palpitation. The patient was treated with left atrial size reduction along with mitral valve replacement surgery and showed an excellent and quick recovery with total disappearance of symptoms and restoration of sinus rhythm only within few days.University Heart Journal Vol. 14, No. 1, Jan 2018; 42-44

scholarly journals Safe Technique of Removal of Left Atrial Thrombus during Mitral Valve Replacement Surgery

2016 ◽  
Vol 31 (1) ◽  
pp. 26-28
Author(s):  
Rampada Sarker ◽  
Manoz Kumar Sarker ◽  
AM Asif Rahim ◽  
Abdul Khaleque Beg
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Safe Procedure ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Ventricular Cavity

Background: Open mitral operation in patients with massive left atrial thrombus still with high mortality due to intra-operative embolism. To prevent this mortality due to intra-operative embolism and to prevent this danger we practiced a surgical technique which includes careful handling of heart and obliteration of left ventricular cavity by bilateral compression.Method: We used this technique in patients of severe mitral stenosis with atrial thrombus during mitral valve replacement. Our technique was to obliterate the left ventricular cavity and thus keep the mitral cusps in a coapted position by placing gauge posterior to left ventricle and a compression over right ventricle by hand of an assistant with a piece of gauze. This obliteration prevented passage of fragments of left atrial thrombus towards collapsed left ventricle.Result: Before practicing this technique, 4 out 9 patients expired due to cerebral embolism . But after implementation of this technique in 17 patients no mortality or morbidity occurred.Conclusion: This technique of removal of left atrial thrombus during mitral valve replacement may be a safe procedure for preventing peroperative embolism.Bangladesh Heart Journal 2016; 31(1) : 26-28

scholarly journals Early Results of Left Atrial Reduction Plasty in Patients Undergoing Mitral Valve Replacement

2019 ◽  
Vol 5 (3) ◽  
pp. 131-136
Author(s):  
Sunil Dhar ◽  
◽  
Anubhav Gupta ◽  
Sartaj Ahmed Guru ◽  
Ajit Kumar Padhy ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Early Results

New Stent for Transapical Mitral Valve Replacement in Acute Swine Experiment

2020 ◽  
Author(s):  
Yu Zou ◽  
Peng Teng ◽  
Liang Ma
Keyword(s):  
Mitral Valve ◽  
Pressure Gradient ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Annulus ◽  
The Self ◽  
Purse String ◽  
Transcatheter Mitral Valve Replacement ◽  
Before And After ◽  
The Mean

Abstract Background: Many patients with mitral regurgitation are denied open-heart surgery due to high risk. Transcatheter mitral valve replacement offers an alternative treatment. This study aimed to test the feasibility of a new self-expanding valved stent for transcatheter mitral valve replacement via apex in an acute animal model.Methods: Eight porcine experiments were performed in the acute study. A left thoracotomy was performed. The new self-expanding transcatheter valved stent was deployed under fluoroscopic guidance within the native mitral annulus via apex. Hemodynamic data, before and after implantation, were recorded. Mitral annulus diameter and valve area were measured using echocardiography. Transvalvular and left ventricular outflow tract pressure gradient were measured invasively. Results: Seven animals underwent successful transapical mitral valve replacement; the implantation was unsuccessful in one animal. The mean procedure time, defined from placing the purse-string to tightening the purse-string, was 17.14 ± 7.86 min. Hemodynamic data before and after transapical mitral valve replacement showed no difference in statistical analysis. The mean diameter and mean functional area of the self-expanding device after implantation were 2.58 ± 1.04 cm and 2.70 ± 0.26 cm2, respectively. Trace to mild central and paravalvular leak was detected in 7 valves. Mean pressure gradient across the self-expanding device was 2.00 ± 0.82 mm Hg; the corresponding gradients across the LVOT were 3.28± 1.11 mm Hg. Postmortem examinations confirmed precise device positioning in 7 animals with no signs of LVOT obstruction.Conclusion: Transcatheter mitral replacement of the new valved stent was confirmed feasible in acute preclinical models. The new stent reveals optimal design parameters.

Sign in / Sign up

Export Citation Format

Share Document