scholarly journals Long-term Result of Surgical Correction of Ischemic Mitral Insufficiency in a Patient With Posterior Basal Post-Infarction Left Ventricular Aneurysm

2021 ◽  
Vol 10 (2) ◽  
pp. 408-412
Author(s):  
V. A. Sapunov ◽  
S. Y. Boldyrev ◽  
I. P. Pavlenko
Keyword(s):  
Mitral Valve Insufficiency ◽  
Left Ventricular ◽  
Surgical Correction ◽  
Left Ventricular Aneurysm ◽  
Mitral Insufficiency ◽  
Inferior Wall ◽  
Term Result ◽  
Long Term Result ◽  
Valve Insufficiency

The article presents a long-term result of surgical correction of ischemic mitral valve insufficiency, left ventricle inferior wall reconstruction. 

scholarly journals Mitral Valve Disease in Thyroid Storm

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A941-A942
Author(s):  
Sandra Rocio Rivera Menjura ◽  
Lia G Moyano Rivas ◽  
Camila Parraguez Gamboa ◽  
Cristobal Balmaceda ◽  
Juan P Peralta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Invasive Mechanical Ventilation ◽  
Mitral Valve Insufficiency ◽  
Left Ventricular ◽  
Thyroid Storm ◽  
Multiple Infections ◽  
Mitral Insufficiency ◽  
Type I ◽  
Valve Insufficiency

Abstract Introduction: The cardiovascular effects that thyroid gland causes are widely studied. In fact, there is a known correlation between Graves’ Disease and mitral valve damage. We present the case of a patient admitted with thyroid storm and heart failure associated with severe structural damage of the mitral valve papillary muscle. Case Report: 24 year old woman with hyperthyroidism diagnosed 12 years ago, treated irregularly with thiamazole and propranolol, leaving treatment a year ago, presents dyspnea, class III functional capacity, diarrhea and logic dysphagia of a month of evolution. Heart rate over 170 bpm, respiratory rate 48 rpm and blood pressure 143/84 mmHg. Physical exam positive for exophthalmos, grade III goiter, crackles in both lung bases, pretibial myxedema and fulfilling criteria for a thyroid storm (65 points in Burch-Wartofsky Point Scale). First Lab Results: TSH<0.005µU/mL, free T4>7.7ng/dl and TRAB 37.8UI/L. Chest ray: Global cardiomegaly and pulmonary edema. EKG: Narrow complex supraventricular tachycardia. Thyroid ultrasound: Intrathoracic goiter. Transesophageal echocardiogram: Severe mitral insufficiency (Carpentier Type I and IIIB), right cavities and left ventricular enlargement, preserved right ventricular function and severe pulmonary hypertension (PSAP 71-76 mmHg). First treated with thiamazole, hydrocortisone IV, cholestyramine and sedation, falling time after into ventilatory failure and developing delirium, requiring invasive mechanical ventilation. Tested positive for COVID- 19. Starts preparation with Lugol and undergoes Total Thyroidectomy. After surgery develops severe hypocalcemia secondary to transitory hypoparathyroidism. During hospitalization presents multiple infections including pneumonia (Pseudomonas Aeruginosa), lung aspergillosis, bacteriuria (Enteroccocus Faecium) and candiduria (Candida Albicans and Glabrata), each one treated with multiple antibiotics and vasoactive drugs. Once stable, mitral valve replacement is realized, after which, the patient progresses favorably being discharged with programmed ambulatory controls. Conclusion: We report a case of a patient who was presented with positive thyroid storm criteria associated with heart failure and severe mitral valve insufficiency. The case gets complicated as multiple infections take place, including COVID-19. Fortunately, because of the early and aggressive multidisciplinary management, the patient evolved favorably, overcoming the life-threatening conditions she went through. Key Words: Thyroid storm, mitral valve insufficiency, heart failure. Bibliography: Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007 Oct 9;116(15):1725-35. doi: 10.1161/CIRCULATIONAHA.106.678326. Erratum in: Circulation. 2008 Jan 22;117(3):e18. PMID: 17923583.

scholarly journals Immediate and Long-Term Results after Surgical Correction of Left Ventricular Aneurysm

2020 ◽  
pp. 43-48
Author(s):  
M. M. Furman ◽  
G. U. Baltayeva ◽  
S. V. Varbanets
Keyword(s):  
Left Ventricular ◽  
Surgical Correction ◽  
Long Term Results ◽  
Left Ventricular Ejection ◽  
Left Ventricular Aneurysm ◽  
Ventricular Aneurysm ◽  
Group A ◽  
Group B ◽  
Long Term Mortality

In the majority of cases, left ventricular aneurysm is a result of a sustained transmural myocardial infarction, which leads to progressive cardiac insufficiency. The overriding priority of a surgical correction is to remove the non-functional myocardium and restore the geometric configuration of the left ventricle. The aim. To analyze the immediate and long-term results after surgical correction of left ventricular aneurysm. Materials and methods. Within the period from 2012 till 2017 at the Ukrainian Children`s Cardiac Center, 88 patients with left ventricular aneurysm were operated. However, we were able to assess long-term outcomes in 71 (80.1%) patients, due to the inaccessibility of patients owing to the difficult geopolitical situation in the country. Depending on the method of surgical correction, two groups were formed: group A (Dor procedure) comprising 17 patients, group B (linear repair) including 71 patients. In group A (n = 17), the vast majority of patients were male (n = 16, 94.1%) vs. only 1 female patient (5.9%). A similar trend was observed in group B: there were 56 male (78.9%) and 15 (21.1%) female patients. The following parameters were considered during the echocardiographic examination: left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic index (LVEDI), left ventricular endsystolic volume (LVESV), left ventricular end-systolic index (LVESI), localization of the aneurysm and its prevalence. Results and discussion. During the clinical and instrumental examination, ischemic cardiomyopathy was diagnosed in 6 (35.3%) patients of group A and in 8 (11.3%) patients of group B. Long-term mortality was higher in group B (n = 10, 17.2%) than in group A (n = 1, 7.7%). Conclusion. According to our study, long-term mortality was 7.7% in group A and 17.2% in group B. The factors that could influence the results were higher Euroscore II and incorrectly chosen tactics for patients with extensive akinesis of the walls of the heart in group B. We deem appropriate to perform cardiac MRI in all patients with left ventricular aneurysm at the stage of diagnosis in order to develop clear plan for surgical tactics.

A Complex Mitral Valve Reconstruction: A Case Report

2005 ◽  
Vol 6 (2) ◽  
pp. 27
Author(s):  
Dimitrios Buklas ◽  
Massimo Massetti ◽  
Eric Saloux ◽  
Eugenio Neri ◽  
Olivier LePage ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Surgical Techniques ◽  
Mitral Valve Insufficiency ◽  
Left Ventricular ◽  
Mitral Valve Reconstruction ◽  
Mitral Repair ◽  
Valve Reconstruction ◽  
Valve Insufficiency ◽  
Valve Function ◽  
Valvular Function

Several techniques are currently in use for mitral valve reconstruction. We report a mitral repair case in which the use of a combination of different surgical techniques resulted in the necessary correction. A 47-year-old woman underwent surgical intervention to treat severe mitral valve insufficiency due to A1/A2/A3 and P2 prolapsed valve tissue. A combination of quadrangular resection, sliding leaflet, single chordal transposition, "flip-over" leaflet, and ring annuloplasty techniques were applied, and postsurgical correct valve function was documented by results of a left ventricular saline filling test and transesophageal echocardiography control. Complex mitral valve repairing techniques can be combined to reestablish valvular function.

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