scholarly journals AN UNUSUAL CASE OF MITRAL VALVE CHORDAL RUPTURE

2021 ◽  
Author(s):  
Rosa Lillo ◽  
Gessica Ingrasciotta ◽  
Gabriella Locorotondo ◽  
Antonella Lombardo ◽  
Francesca Graziani
Keyword(s):  
Mitral Valve ◽  
Rare Case ◽  
Ventricular Hypertrophy ◽  
Unusual Case ◽  
Left Ventricular ◽  
Severe Mitral Regurgitation ◽  
Valve Leaflet ◽  
Mitral Valve Chordal Rupture ◽  
Leaflet Prolapse

In this report, we present a rare case of severe mitral regurgitation due to isolated mitral valve chordal rupture without valve leaflet prolapse in a patient with Fabry cardiomyopathy. This finding could be due to subvalvular apparatus storage of glycosphingolipids rather than fibro-elastic deficiency, underlying how close cardiological follow-up of Fabry patients must be comprehensive and not only focused on left ventricular hypertrophy and arrhythmias. We feel that our finding could be of interest for the readership of your Journal.

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.

scholarly journals Criteria for adverse prognosis for mitral valve prolapse.

2019 ◽  
Vol 21 (4) ◽  
pp. 64-66
Author(s):  
Yu V Ovchinnikov ◽  
L R Gadzhieva ◽  
M V Palchenkova ◽  
N V Muracheva ◽  
S B Tkachenko
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Left Atrial ◽  
Poor Prognosis ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Severe Mitral Regurgitation ◽  
Valve Leaflet ◽  
Ecg Monitoring ◽  
Mitral Valve Leaflet

On the basis of a survey of 151 patients, diagnostic criteria for an unfavorable prognosis of mitral valve prolapse were revealed according to echocardiography. Transthoracic and transesophageal echocardiography, daily Holter ECG monitoring were performed. Repeated echocardiography was performed in 12-18 months. Statistical analysis of the material allowed us to identify criteria for poor prognosis of mitral valve prolapse according to echocardiography: severe mitral regurgitation, mitral valve leaflet thickness in diastole 6 mm or more, dilatation of the left ventricular cavity, dilatation of the left atrial cavity, dilatation of the mitral ring.

scholarly journals Mitral degenerative valve leaflets suspected as primary valvular tumor: a case report

2021 ◽  
Author(s):  
Shiqiang Wang ◽  
Huaidong Chen ◽  
Ximing Qian ◽  
Fan He
Keyword(s):  
Heart Disease ◽  
Case Report ◽  
Mitral Valve ◽  
Rare Case ◽  
Clinical Symptoms ◽  
Clinical Decision ◽  
Valve Leaflet ◽  
Mitral Valve Leaflet ◽  
Valvular Tumor ◽  
Leaflet Prolapse

Introduction: Echocardiography plays an important role in the diagnosis of heart disease. However, sometimes misdiagnosis information is also provided. Methods and Results: We report a rare case of preoperative echocardiography misdiagnosed as a primary mitral valvular tumor with severe regurgitation. During the surgery procedure, the true lesion was found to be mitral valve leaflet prolapse due to degenerative mitral valve disease. Conclusions: For individual patient, it may need to combine clinical symptoms and wide use of echocardiography and CT or MRI to make the optimal clinical decision.

scholarly journals Combined Aortic and Mitral Valve Stenosis in Mucopolysaccharidosis Syndrome Type I-S: A Report of a Rare Case

2021 ◽  
Author(s):  
Hakimeh Sadeghian ◽  
Afsaneh Sadeghian ◽  
Bahareh Eslami ◽  
Seyed Hesameddin Abbasi ◽  
Masoumeh Lotfi-Tokaldany
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Rare Case ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Mitral Valve Stenosis ◽  
Type I ◽  
Syndrome Type ◽  
Inherited Metabolic Disorder ◽  
Mitral Valves

Mucopolysaccharidosis (MPS) syndrome is an inherited metabolic disorder. In more than half of the patients with MPS syndrome, heart valve involvement is reported; however, combined aortic and mitral valve stenosis in MPS syndrome type I-S is very rare. We describe a 39-year-old man with severe mitral and aortic valve stenosis due to MPS syndrome type I-S. Transthoracic and transesophageal echocardiography revealed severe thickening and calcification in the aortic and mitral valves with severe left ventricular hypertrophy. The coronary arteries were normal in angiography.  

scholarly journals 423 Effects of mitral valve repair on left ventricular remodeling and ventricular arrhythmia in mitral valve prolapse patients: five-year follow-up

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Malev ◽  
M Omelchenko ◽  
L Mitrofanova ◽  
M Gordeev ◽  
B Bondarenko ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Mitral Valve ◽  
Ventricular Arrhythmia ◽  
Mitral Valve Repair ◽  
Mitral Valve Prolapse ◽  
Left Ventricular ◽  
Severe Mitral Regurgitation ◽  
Valve Repair ◽  
Myxomatous Degeneration

Abstract Introduction There is limited data on the efficacy of surgical repair in reducing ventricular arrhythmia (VA) in mitral valve prolapse (MVP) patients. Improvement in malignant ventricular arrhythmias has been reported only in isolated cases after mitral valve surgery. Our aim was to evaluate the possible effects of mitral valve repair on left ventricular (LV) reverse remodeling and incidence of VA in MVP patients in mid-term follow-up. Methods 30 consecutive patients (mean age 53.1 ± 9.4, 47% male) undergoing mitral valve repair for severe mitral regurgitation (MR) due to mitral valve prolapse were enrolled in our observational, prospective, single-center study. Resected abnormal segments of the mitral leaflets were examined by experienced pathologists for signs of myxomatous degeneration. Transthoracic echocardiography extended with speckle-tracking echocardiography and 24-hour Holter monitoring were performed pre- and postoperatively annually. Atrial fibrillation, PVCs and nonsustained ventricular tachycardia (VT) runs were reviewed. Results During 144 person-years of follow-up no deaths, and 3 cases (10%) of recurrent moderate or severe (≥2) MR occurred. The total number of PVCs and non-sustained ventricular tachycardia runs dropped significantly in 1st (p=.04, Wilcoxon matched pairs test) and 2nd (p=.03), years of postoperative follow-up. Postoperative incidence of PVC and VT correlates strongly with postoperative end-diastolic LV diameter (EDD rs=.70; p=.005), moderate negatively with LV ejection fraction (EF rs=-.55; p=.01), but not postoperative MR (p>.05). EDD (58.8 ± 7.6 mm vs. 49.9 ± 5.6 mm; p=.00001) and EDV (156.6 ± 32.1 ml vs. 104.1 ± 22.8 ml; p=.00001) decreased in 1st year after repair with non-significant changes in EF (63.8 ± 12.8% vs. 59.6 ± 14.5%; p=.20), global systolic longitudinal strain –13.8 ± 2.5% vs. –14.6 ± 2.7%; p=.20) and SR (–0.93 ± 0.12 s-1 vs. –0.98 ± 0.13 s-1; p=.09) values. In univariate analysis, postoperative end-diastolic LV diameter (p=.001), low EF (p=.003), myxomatous degeneration (p=.008) were identified as risk factors of persistent PVCs/VT after surgery. Conclusions Mitral valve repair in MVP with severe mitral regurgitation is associated with reduction in ventricular arrhythmia, which strongly correlates with postoperative LV dimensions and function. Further investigation in larger cohorts to evaluate the association between degenerative mitral valve disease and ventricular arrhythmia is needed.

Sign in / Sign up

Export Citation Format

Share Document