scholarly journals BLOOD CYSTS OF THE CARDIAC VALVES IN ADULTS Review and analysis of published cases

2021 ◽  
Author(s):  
Uberto Bortolotti ◽  
Igor Vendramin ◽  
Andrea Lechiancole ◽  
Sandro Sponga ◽  
Angela Pucci ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Pulmonary Valve ◽  
Multimodality Imaging ◽  
Imaging Techniques ◽  
Fibrous Tissue ◽  
Surgical Removal ◽  
Cardiac Valves ◽  
Pertinent Literature ◽  
Systemic Complications ◽  
Life Threatening

Background and aim of the study: Blood cysts of cardiac valves are generally seen in newborns and infants and very rarely in adults. Although in most cases they are incidental findings they may be associated to severe cardiac or systemic complications. This study analyzes incidence, presentation and treatment of valvular blood cysts in adults. Methods: A review of the pertinent literature through a search mainly on PubMed and Medline was performed. Results: In patients ≥ 18 years of age, our search disclosed 54 patients with mitral blood cysts (mean age, 48±18 years), 9 with a tricuspid valve cyst (mean age, 67±15 years), 3 with a blood cyst on the pulmonary valve (age 31, 43 and 44 years) and 1 aortic valve cyst in a 22-year-old man. Most patients were asymptomatic while stroke, syncope or myocardial infarction occurred in 6 patients with a mitral valve cyst. Blood cysts were removed surgically in 70% of patients with a mitral cyst, in 55% with a tricuspid cyst and in all those with a pulmonary or aortic cyst. At histology the cyst wall was composed mainly by fibrous tissue and with the inner surface lined with typical endothelium. Conclusions: Blood cysts of cardiac valves are rare in adults but may cause life-threatening complications particularly when located on the mitral valve. For such reason surgical removal appears advisable, with low-risk procedures. Widespread use of multimodality imaging techniques will most likely increase the number of valvular blood cysts diagnosed also in adults.

Abstract 15426: Comparison of Multimodality Imaging in Mitral Leaflet Lengths in Patients Undergoing Surgical Myectomy: A Prospective Study in Hypertrophic Obstructive Cardiomyopathy Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Agostina M Fava ◽  
Anand Mehta ◽  
Barbara Bittel ◽  
Andrew Bauer ◽  
Zoran B Popovic ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Multimodality Imaging ◽  
Imaging Techniques ◽  
Ventricular Outflow Tract ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Posterior Leaflet ◽  
Anterior Leaflet ◽  
Average Deviation ◽  
Basal Septum

Introduction: In hypertrophic obstructive cardiomyopathy (HOCM), mitral valve (MV) leaflets in often contribute to left ventricular outflow tract obstruction (LVOTO). Hence, MV assessment is crucial during surgical planning. 2 or 3-dimensional transesophageal echocardiography (2D or 3D TEE) & cardiac magnetic resonance (CMR) are used to measure MV length. Hypothesis: We sought to compare MV leaflet lengths using intraoperative TEE [2D, zoom 3D, automatic quantification of mitral valve (AMVQ)], & preoperative CMR. Methods: We prospectively studied 50 HOCM patients (59±12 years, 46% men, basal septum 18±5 mm, LVOT gradient 87 ±56 mmHg) undergoing surgical relief of LVOTO. We compared MV leaflet length on a) long-axis 2DTEE b) 3DTEE using multiplanar reconstruction c) AMVQ, EchoPAC, General Electric & d) CMR. Results: Mean anterior leaflet lengths (mm) were as follows: 2D TEE (3.3 ±0.3), 3DTEE (2.9±0.5), CMR (3.1±0.4), & AMVQ (2.9±0.5). Mean posterior leaflet lengths were 1.7±0.3, 1.7±0.4, & 1.7±0.2 & 1.9±0.4 mm, respectively. Assuming 3DTEE as the gold standard, the closest correlation for anterior leaflet was with CMR (average overestimation by CMR of 0.5 mm [root mean square deviation or RMSE% 17]), intermediate correlation with 2DTEE (average deviation of 0.6 mm [RMSE%:21]) & no correlation with AMVQ (deviation of 0.7mm [RMSE% 24]), Fig 1A-C & 2A-C. No correlation was found for posterior leaflet,Fig 1D-F & 2D-F. Conclusions: There are significant differences in measuring MV lengths using different imaging techniques. In HOCM patients undergoing surgery, precise measurement of MV leaflet lengths is crucial & extrapolation from one technique to other is not recommended.

Multimodality imaging assessment of mitral annular disjunction in mitral valve prolapse

Heart ◽  
2020 ◽  
Vol 107 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Valentina Mantegazza ◽  
Valentina Volpato ◽  
Paola Gripari ◽  
Sarah Ghulam Ali ◽  
Laura Fusini ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Ventricular Arrhythmias ◽  
Multimodality Imaging ◽  
Imaging Techniques ◽  
Transoesophageal Echocardiography ◽  
Small Length ◽  
Imaging Approach

ObjectiveMitral annular disjunction (MAD) is an abnormality linked to mitral valve prolapse (MVP), possibly associated with malignant ventricular arrhythmias. We assessed the agreement among different imaging techniques for MAD identification and measurement.Methods131 patients with MVP and significant mitral regurgitation undergoing transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) were retrospectively enrolled. Transoesophageal echocardiography (TOE) was available in 106 patients. MAD was evaluated in standard long-axis views (four-chamber, two-chamber, three-chamber) by each technique.ResultsConsidering any-length MAD, MAD prevalence was 17.3%, 25.5%, 42.0% by TTE, TOE and CMR, respectively (p<0.05). The agreement on MAD identification was moderate between TTE and CMR (κ=0.54, 95% CI 0.49 to 0.59) and good between TOE and CMR (κ=0.79, 95% CI 0.74 to 0.84). Assuming CMR as reference and according to different cut-off values for MAD (≥2 mm, ≥4 mm, ≥6 mm), specificity (95% CI) of TTE and TOE was 99.6 (99.0 to 100.0)% and 98.7 (97.4 to 100.0)%; 99.3 (98.4 to 100.0)% and 97.6 (95.8 to 99.4)%; 97.8 (96.2 to 99.3)% and 93.2 (90.3 to 96.1)%, respectively; sensitivity (95% CI) was 43.1 (37.8 to 48.4)% and 74.5 (69.4 to 79.5)%; 54.0 (48.7 to 59.3)% and 88.9 (85.2 to 92.5)%; 88.0 (84.5 to 91.5)% and 100.0 (100.0 to 100.0)%, respectively. MAD length was 8.0 (7.0-10.0), 7.0 (5.0-8.0], 5.0 (4.0-7.0) mm, respectively by TTE, TOE and CMR. Agreement on MAD measurement was moderate between TTE and CMR (ρ=0.73) and strong between TOE and CMR (ρ=0.86).ConclusionsAn integrated imaging approach could be necessary for a comprehensive assessment of patients with MVP and symptoms suggestive for arrhythmias. If echocardiography is fundamental for the anatomic and haemodynamic characterisation of the MV disease, CMR may better identify small length MAD as well as myocardial fibrosis.

scholarly journals The curious case of a massive right heart thrombosis: a case report

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Jessica Artico ◽  
Manuel Belgrano ◽  
Rossana Bussani ◽  
Gianfranco Sinagra
Keyword(s):  
Multimodality Imaging ◽  
Cardiac Computed Tomography ◽  
Rare Condition ◽  
Surgical Removal ◽  
Large Area ◽  
Good Clinical Condition ◽  
Life Threatening ◽  
Thrombotic Complications ◽  
The Right ◽  
Complete Investigation

Abstract Background Intraventricular masses are a relatively rare condition ranging from asymptomatic to potentially life-threatening situations. Case summary Herein, we report a case of a 49-year-old woman under investigation for a massive right ventricular (RV) mass who underwent complete investigation for possible differential diagnosis, in the suspect of RV tumour. Multimodality imaging with cardiac computed tomography and magnetic resonance imaging showed the presence of a massive thrombus partially obliterating the right ventricle. Surgical removal of the mass showed a large area of stratified thrombosis with an underlying area of endocardial fibrosis. The patient has been then discharged in good clinical condition and with lifetime oral anticoagulation. Discussion  Massive RV thrombosis is a rare yet potentially fatal condition. Invasive management is preferable and lifetime anticoagulation is required to reduce possible downstream thrombotic complications.

scholarly journals Mechanistic insights of the left ventricle structure and fibrosis in the arrhythmogenic mitral valve prolapse

2018 ◽  
Vol 2018 (1) ◽  
Author(s):  
Leticia Fernández-Friera ◽  
Rafael Salguero ◽  
Luca Vannini ◽  
Ana Fidalgo Argüelles ◽  
Fernando Arribas ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Imaging Techniques ◽  
Current Evidence ◽  
Special Focus ◽  
Benign Condition ◽  
Life Threatening

Mitral valve prolapse (MVP) is a common and benign condition. However, some anatomic forms have been recently associated with life-threatening ventricular arrhythmias and sudden cardiac death. Imaging MVP holds the promise of individualized MVP risk assessment. Noninvasive imaging techniques available today are playing an increasingly important role in the diagnosis, prognosis and monitoring of MVP. In this article, we will review the current evidence on arrhythmogenic MVP, with special focus on the utility of echocardiography and CMR for identifying benign and ‘‘malignant’’ forms of MVP. The clinical relevance of this manuscript lies in the value of imaging technology to improve MVP risk prediction, including those arrhythmic-MVP cases with a higher risk of sudden cardiac death. 

scholarly journals Multimodality Imaging of the Anatomy of Tricuspid Valve

2021 ◽  
Vol 8 (9) ◽  
pp. 107
Author(s):  
Susanne Anna Schlossbauer ◽  
Francesco Fulvio Faletra ◽  
Vera Lucia Paiocchi ◽  
Laura Anna Leo ◽  
Giorgio Franciosi ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Tricuspid Valve ◽  
Multimodality Imaging ◽  
Imaging Techniques ◽  
Noninvasive Imaging ◽  
Tricuspid Annulus ◽  
Atrioventricular Junction ◽  
Extreme Variability ◽  
Similarities And Differences ◽  
The Right

Even though the tricuspid valve is no longer “forgotten”, it still remains poorly understood. In this review, we focus on some controversial and still unclear aspects of tricuspid anatomy as illustrated by noninvasive imaging techniques. In particular, we discuss the anatomical architecture of the so-called tricuspid annulus with its two components (i.e., the mural and the septal annulus), emphasizing the absence of any fibrous “ring” around the right atrioventricular junction. Then we discussed the extreme variability in number and size of leaflets (from two to six), highlighting the peculiarities of the septal leaflet as part of the septal atrioventricular junction (crux cordis). Finally, we describe the similarities and differences between the tricuspid and mitral valve, suggesting a novel terminology for tricuspid leaflets.

Updates and Advances: Pediatric Musculoskeletal Infection Imaging Made Easier for Radiologists and Clinicians

2021 ◽  
Vol 25 (01) ◽  
pp. 167-175
Author(s):  
Michael S. Furman ◽  
Ricardo Restrepo ◽  
Supika Kritsaneepaiboon ◽  
Bernard F. Laya ◽  
Domen Plut ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Imaging Techniques ◽  
Daily Clinical Practice ◽  
Infants And Children ◽  
Imaging Evaluation ◽  
Musculoskeletal Infection ◽  
Wide Range ◽  
Life Threatening ◽  
Optimal Patient Management

AbstractInfants and children often present with a wide range of musculoskeletal (MSK) infections in daily clinical practice. This can vary from relatively benign superficial infections such as cellulitis to destructive osseous and articular infections and life-threatening deep soft tissue processes such as necrotizing fasciitis. Imaging evaluation plays an essential role for initial detection and follow-up evaluation of pediatric MSK infections. Therefore, a clear and up-to-date knowledge of imaging manifestations in MSK infections in infants and children is imperative for timely and accurate diagnosis that, in turn, can result in optimal patient management. This article reviews an up-to-date practical imaging techniques, the differences between pediatric and adult MSK infections, the spectrum of pediatric MSK infections, and mimics of pediatric MSK infections encountered in daily clinical practice by radiologists and clinicians.

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.

THE USE OF MULTIMODALITY IMAGING FOR THE DIAGNOSIS OF MALIGNANT MITRAL VALVE PROLAPSE

2018 ◽  
Vol 71 (11) ◽  
pp. A2280
Author(s):  
Abdulwahab Hritani ◽  
A. Jamil Tajik ◽  
Eric Weiss ◽  
Rahul Sawlani ◽  
Anthony DeFranco
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Multimodality Imaging

scholarly journals The Role of Multimodality Imaging in Left-Sided Prosthetic Valve Dysfunction

2022 ◽  
Vol 9 (1) ◽  
pp. 12
Author(s):  
Manuela Muratori ◽  
Laura Fusini ◽  
Maria Elisabetta Mancini ◽  
Gloria Tamborini ◽  
Sarah Ghulam Ali ◽  
...  
Keyword(s):  
Prosthetic Valve ◽  
Multimodality Imaging ◽  
Integrated Approach ◽  
Advanced Imaging ◽  
Valve Dysfunction ◽  
Clinical Presentations ◽  
Imaging Approach ◽  
Treatment Administration ◽  
Life Threatening

Prosthetic valve (PV) dysfunction (PVD) is a complication of mechanical or biological PV. Etiologic mechanisms associated with PVD include fibrotic pannus ingrowth, thrombosis, structural valve degeneration, and endocarditis resulting in different grades of obstruction and/or regurgitation. PVD can be life threatening and often challenging to diagnose due to the similarities between the clinical presentations of different causes. Nevertheless, identifying the cause of PVD is critical to treatment administration (thrombolysis, surgery, or percutaneous procedure). In this report, we review the role of multimodality imaging in the diagnosis of PVD. Specifically, this review discusses the characteristics of advanced imaging modalities underlying the importance of an integrated approach including 2D/3D transthoracic and transesophageal echocardiography, fluoroscopy, and computed tomography. In this scenario, it is critical to understand the strengths and weaknesses of each modality according to the suspected cause of PVD. In conclusion, for patients with suspected or known PVD, this stepwise imaging approach may lead to a simplified, more rapid, accurate and specific workflow and management.

Sign in / Sign up

Export Citation Format

Share Document