scholarly journals Primary mitral valve regurgitation: Update and review

2017 ◽  
Vol 2017 (1) ◽  
Author(s):  
Andrew D Maslow ◽  
Athena Poppas
Keyword(s):  
Mitral Valve ◽  
Natural History ◽  
Mitral Regurgitation ◽  
Watchful Waiting ◽  
Surgical Intervention ◽  
Mitral Valve Regurgitation ◽  
Current Understanding ◽  
Valve Regurgitation ◽  
Primary Mitral Regurgitation ◽  
Early Surgical Intervention

Mitral regurgitation is the second most common valvular disorder requiring surgical intervention worldwide. This review summarizes the current understanding of primary, degenerative mitral regurgitation with respect to etiology, comprehensive assessment, natural history and management. The new concept of staging of the valvular disorders, newer predictors of adverse and controversy of ‘‘watchful waiting’’ versus ‘‘early surgical intervention’’ for severe, asymptomatic, primary mitral regurgitation are addressed. 

scholarly journals Association Between Early Surgical Intervention vs Watchful Waiting and Outcomes for Mitral Regurgitation Due to Flail Mitral Valve Leaflets

JAMA ◽  
2013 ◽  
Vol 310 (6) ◽  
pp. 609 ◽  
Author(s):  
Rakesh M. Suri ◽  
Jean-Louis Vanoverschelde ◽  
Francesco Grigioni ◽  
Hartzell V. Schaff ◽  
Christophe Tribouilloy ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Watchful Waiting ◽  
Surgical Intervention ◽  
Early Surgical Intervention

Association Between Early Surgical Intervention vs Watchful Waiting and Outcomes for Mitral Regurgitation Due to Flail Mitral Valve Leaflets

2014 ◽  
Vol 58 (6) ◽  
pp. 271-272
Author(s):  
Rakesh M. Suri ◽  
Jean-Louis Vanoverscheide ◽  
Francesco Grigioni ◽  
Hartzell V. Schaff ◽  
Christophe Tribouilloy ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Watchful Waiting ◽  
Surgical Intervention ◽  
Early Surgical Intervention

A Simplified Technique for Correcting Mitral Valve Regurgitation via Minimally Invasive Approach

2018 ◽  
Vol 13 (3) ◽  
pp. 236-238
Author(s):  
Giuseppe Speziale ◽  
Marco Moscarelli
Keyword(s):  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Mitral Valve Regurgitation ◽  
Valve Regurgitation ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Repair Techniques

Mitral valve regurgitation may require complex repair techniques that are challenging in minimally invasive and may expose patients to prolonged cardiopulmonary bypass and cross-clamp times. Here, we present a stepwise operative approach that may facilitate the repair of the mitral valve in a minimally invasive fashion and may be carried out even when multiple posterior segments are involved. This how-to-do article presents a method that was performed in 148 patients that were referred to our institution for severe organic mitral regurgitation between 2008 and 2016. At mean ± SD follow-up of 45.5 ± 27 months, freedom from recurrent of mitral regurgitation 2+ or greater and reoperation was 95.2%.

scholarly journals Mitral regurgitation in Dachshund dogs without heart murmurs

2017 ◽  
Vol 61 (3) ◽  
pp. 363-366
Author(s):  
Magdalena Garncarz ◽  
Marta Parzeniecka-Jaworska ◽  
Magdalena Hulanicka ◽  
Michał Jank ◽  
Olga Szaluś-Jordanow ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Prolapse ◽  
Mitral Valve Disease ◽  
Mitral Valve Regurgitation ◽  
Valve Disease ◽  
Valve Regurgitation ◽  
Heart Murmurs ◽  
Few Data

Abstract Introduction: Older small breed dogs are considered at risk for heart failure secondary to chronic mitral valve disease. However, few data are available on the onset of this disease in such dogs. This study was performed to determine if auscultation alone can be used to eliminate clinically relevant mitral valve regurgitation seen in echocardiography in Dachshund dogs. Material and Methods: Clinical and echocardiographic data were obtained from 107 dogs without heart murmurs. Results: The study revealed that 63.6% of the dogs had mitral regurgitation. Numbers increased with age and a larger percentage of male Dachshunds were affected than female Dachshunds. Mitral valve prolapse and thickening were mild, and the regurgitant area inextensive in most dogs. Conclusions: The study shows that mitral valve regurgitation is prevalent (63.6%) in Dachshunds without heart murmurs. Typical lesions often become apparent during echocardiographic examinations in dogs under 5 years of age.

Successful MitraClipTM implantation in a 15-year-old patient with multiple prior cardiac surgeries

2012 ◽  
Vol 23 (4) ◽  
pp. 620-622 ◽  
Author(s):  
Matthias Gorenflo ◽  
Hugo A. Katus ◽  
Raffi Bekeredjian
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Clinical Improvement ◽  
Mitral Valve Repair ◽  
Aortic Valve Stenosis ◽  
Mitral Valve Regurgitation ◽  
Male Adolescent ◽  
Valve Regurgitation ◽  
Valve Repair

AbstractPercutaneous edge-to-edge mitral valve repair using the MitraClipTM has not been used in children. The patient in this reported case was a 15-year-old male adolescent who presented postnatally with severe aortic valve stenosis and dysplasia of the mitral valve. The boy underwent surgical valvuloplasty at the age of 3 months and an aortoventriculoplasty with three re-operations. At the age of 15 years, he developed severe mitral valve regurgitation. Owing to high surgical risks, a MitraClipTM was implanted with a reduction of mitral regurgitation from grade 4+ to 2+, translating into a rapid clinical improvement.

Practice gaps in the care of mitral valve regurgitation: Insights from the American College of Cardiology mitral regurgitation gap analysis and advisory panel

2016 ◽  
Vol 172 ◽  
pp. 70-79 ◽  
Author(s):  
Andrew Wang ◽  
Paul Grayburn ◽  
Jill A. Foster ◽  
Marti L. McCulloch ◽  
Vinay Badhwar ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Gap Analysis ◽  
Mitral Valve Regurgitation ◽  
Advisory Panel ◽  
Valve Regurgitation ◽  
Practice Gaps

Results of Coronary Bypass and Valve Operations for Mitral Valve Regurgitation

2007 ◽  
Vol 15 (5) ◽  
pp. 396-404 ◽  
Author(s):  
Srikrishna Sirivella ◽  
Isaac Gielchinsky
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Coronary Bypass ◽  
Mitral Valve Regurgitation ◽  
Left Ventricular ◽  
Valve Regurgitation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Coronary Bypass Grafting

Combined coronary bypass grafting and valve procedures for mitral valve regurgitation result in poor outcomes, but the impact of the etiology of valve regurgitation on operative and long-term outcomes is not well defined. A retrospective analysis of 468 patients who had combined coronary bypass grafting and valve operations for mitral regurgitation showed that 78% had valve repairs and 22% had replacements for ischemic (45%) or degenerative (55%) disease. Predictors of operative mortality were ischemic mitral regurgitation, failure to use the internal mammary artery for grafting, severe coronary disease, acute myocardial infarction, low ejection fraction, advanced heart failure, emergency operation, and mitral valve replacement. The 5-year survival rates for propensity-matched patients with ischemic or degenerative disease were similar (66%). Low ejection fraction (< 35%), advanced age (> 67 years), valve replacement surgery, residual mitral regurgitation, and severe coronary artery disease were predictors of poor long-term outcome. Although the operative outcomes of ischemic mitral regurgitation were poor compared to those of degenerative disease, the long-term survival was similar in both groups of propensity-matched patients. Left ventricular remodeling, an optimal valve procedure without residual mitral regurgitation, and left ventricular function are more important determinants of long-term outcome than the etiology of valve regurgitation.

scholarly journals Preliminary Outcome of a Novel Edge-to-Edge Closure Device to Manage Mitral Regurgitation in Dogs

2020 ◽  
Vol 7 ◽  
Author(s):  
Bo Liu ◽  
Stacey B. Leach ◽  
Wenzhi Pan ◽  
Fangyu Zheng ◽  
Liujun Jia ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Regurgitation ◽  
Interquartile Range ◽  
Valve Disease ◽  
Rank Test ◽  
Closure Device ◽  
Valve Regurgitation ◽  
Naturally Occurring ◽  
Procedural Time

Background: Veterinary management of mitral valve regurgitation due to mxyomatous valve disease in dogs is limited to medical treatments, which only postpones the onset of congestive heart failure or alleviates clinical symptoms. Most surgical procedures to manage this condition in humans require cardiopulmonary bypass and have a high risk of complications.Animals: Eight dogs with naturally occurring mitral valve regurgitation.Methods: Prospective observational study. All dogs were treated with a novel edge-to-edge transcatheter device named ValveClamp. The total surgical procedural time and total catheterization time were recorded. Echocardiographic variables measured pre- and post-procedure were compared using Wilcoxin-signed rank test with a P &lt; 0.05 considered significant. Data were expressed as median and interquartile range and absolute numbers and percentages.Results: The procedural success rate was 100% and all the dogs survived without complications. The median (interquartile range) total surgical procedural time was 86.5 (76–96.2) minutes and catheterization time was 23.5 (22–33.8) minutes. Echocardiography revealed a significant reduction in mitral regurgitation severity in all dogs following the procedure based on both a reduced mitral regurgitant maximum jet area (P = 0.012) and a reduced mitral regurgitant maximum jet area to left atrial area (P = 0.018).Conclusion: The ValveClamp device is effective at reducing the severity of mitral regurgitation in dogs with naturally occurring myxomatous valve disease.

scholarly journals Unruptured Left Ventricular Pseudoaneurysm After Silent Myocardial Infarction with Mitral Valve Regurgitation

2021 ◽  
Author(s):  
Tamer Kehibar ◽  
Fatih KIZILYEL ◽  
Mehmet Yilmaz ◽  
Bulent Ketenci
Keyword(s):  
Myocardial Infarction ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Regurgitation ◽  
Left Ventricular ◽  
Valve Regurgitation ◽  
Left Ventricular Pseudoaneurysm ◽  
Acute Mi ◽  
Cardiac Geometry ◽  
Silent Myocardial Infarction

Acquired left ventricular pseudoaneurysm is a rare disorder that occurs after acute myocardial infarction. We present a 55 year-old male patient with a nonruptured pseudoaneurysm after acute MI presenting with severe mitral regurgitation. After resection of sac-like lesion, the defect was 5 cm diameter posterolaterally left ventricular. The aneursym was repaired with pericardium patch to maintain cardiac geometry that diminishes mitral regurgitation without intervention to mitral valve.

Abstract 15253: Significant Discrepancies in Quantification of Regurgitant Volume in Primary Mitral Regurgitation Observed on Multimodality Imaging: Is It Time for Reappraisal?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Agostina M Fava ◽  
Rhonda Miyasaka ◽  
Marc Gillinov ◽  
Per Wierup ◽  
Zoran B Popovic ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Multimodality Imaging ◽  
Mitral Annulus ◽  
Mitral Valve Regurgitation ◽  
Valve Regurgitation ◽  
Regurgitant Volume ◽  
Proximal Isovelocity Surface Area ◽  
The Mean ◽  
Primary Mitral Regurgitation ◽  
Mean Square Errors

Introduction: Mitral valve regurgitation volume (RV) can be quantified using proximal isovelocity surface area (PISA) or stroke volume (SV). SV method incorporates mitral annulus (MA) diameter (assumed circular) on 2D transthoracic echo (2D TTE). However, MA area (MAA) can be precisely measured using 3D transesophageal echocardiographic (3DTEE) or computed tomography (CT). Hypothesis: We sought to compare RV obtained using a) PISA b) standard SV using MA diameter on 2D echo and c) modified SV using MAA on 3D TEE and d) MAA on CT. Methods: 37 patients (63±9 years, 81 % men) with severe primary mitral regurgitation (MR) undergoing surgery were prospectively recruited. RV was calculated using a) PISA b) standard SV method using MA diameter on 2D echo (0.785*diameter 2 MV *VTI MV -0.785*d 2 LVOT *VTI LVOT ) c) & d) modified SV methods where MAA (on 3D TEE and CT) were incorporated instead of MA diameter. Results: The mean MAA (cm 2 ) by 2DTTE, 3DTEE & CT were 10.7±3, 10.9 ±3 & 15.9 ±3. Mean RV (cc) by standard SV method, modified SV (3D TEE & CT) & PISA were 294±126, 276±82, 355±127 & 91±51, respectively. Correlations & agreements of SV-based RV are shown in Figure 1. RV was highest using CT-based MAA. The closest agreement was between 2D TTE & CT with a mean error (ME) of -61 cc. There was a large discrepancy in RV derived from PISA vs all SV methods, with a systemic overestimation using SV methods with root mean square errors (RMSE) ranging from 156 to 293 cc Figure 2. Conclusions: In severe MR,calculating RV using SV vs PISA yields vastly different values. The differences are exaggerated using modified SV method incorporating more accurate MAA on 3D TEE or CT. These techniques should not be interchanged to quantify MR.

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