Valve dysfunction in patients with cardiac myxomas: mechanism of damage and methods of correction

The aim – to analyze the frequency and nature of lesions of the valve apparatus, to evaluate the results of surgical correction of the affected valves in heart myxomas. Materials and methods. In one-centre study, during period from 01.01.1969 to 01.10.2020, 962 patients with morphologically verified primary heart tumors were observed. Myxomas of the heart were found in 856 (89.0 %) patients. The pathology of the valve apparatus in combination with cardiac myxomas was noted in 70 (8.1 %) patients. The volume and nature of valve damage differed and depended on size, consistency and localization of myxoma, the degree of its mobility, and the presence of areas of pronounced fibrosis and calcification on the tumor. Results. Surgical correction of lesions of valve structures was performed in 65 patients. In 5 patients, it was possible to remove tumor tissue from the valve apparatus, followed by prevention of disease recurrence without damaging valve and subvalvular structures. Surgical techniques included both plastic manipulation and valve replacement. The features of the long-term postoperative period in such patients include progressive valve dysfunction manifested by the progression of insufficiency due to further deformation of the valve apparatus. Conclusions. Alongside with myxoma removal, it is necessary to conduct a thorough examination of the valve apparatus and correction of valve damage by various methods, including plastic surgery and valve replacement, depending on the nature and severity of the damage. Key words: cardiac tumors, myxoma, valve structures, surgical treatment.

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Tricuspid valve replacement with bioprostheses: long-term results and causes of valve dysfunction

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(00)02149-4 ◽

2001 ◽

Vol 71 (1) ◽

pp. 105-109 ◽

Cited By ~ 38

Author(s):

Kiyoharu Nakano ◽

Hatsue Ishibashi-Ueda ◽

Junjiro Kobayashi ◽

Yoshikado Sasako ◽

Toshikatsu Yagihara

Keyword(s):

Valve Replacement ◽

Tricuspid Valve ◽

Long Term Results ◽

Tricuspid Valve Replacement ◽

Valve Dysfunction

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Mitral valverepair: types of correction, immediateand long-term results

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2008-14-1-91-96 ◽

2008 ◽

Vol 14 (1) ◽

pp. 91-96

Author(s):

N. Shikhverdiev ◽

G. Khubulava ◽

S. Marchenko ◽

M. Askerov

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Mitral Valve Repair ◽

Surgical Correction ◽

Long Term Results ◽

Valve Repair ◽

Reconstructive Procedures ◽

Valve Pathology

The types of surgical correction of the mitral valve pathology, hospital and long-term results were studied. The mitral valve repair being compared to the mitral valve replacement is procedure of choice as it provides stable results. In the study we demonstrate that the long-term results of reconstructive procedures on the mitral valve have advantages over mitral valve replacement in terms of survival, freedom from reoperation and tromboembolc complications.

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Surgical Treatment of Heart Mixomas: the Analysis of 10 Years’ Experience

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2021-10-2-385-392 ◽

2021 ◽

Vol 10 (2) ◽

pp. 385-392

Author(s):

V. V. Vladimirov ◽

A. I. Kovalev ◽

A. V. Redkoborody ◽

V. V. Sokolov ◽

N. M. Bikbova ◽

...

Keyword(s):

Surgical Treatment ◽

Heart Surgery ◽

Open Heart Surgery ◽

Well Being ◽

Surgical Removal ◽

Cardiac Tumors ◽

Heart Neoplasms ◽

Results Of Treatment ◽

Heart Tumors

Introduction. Primary cardiac tumors are rare, and the autopsy detection rate does not exceed 0.003%. Approximately 80% of primary heart tumors are benign, 50% of them are myxomas. Diagnosis of cardiac tumors at present in the presence of transesophageal echocardiography is not difficult in most cases. Surgical treatment of mixomas became possible after the introduction of open-heart surgery under cardiopulmonary bypass into clinical practice. After verification of the tumor, its surgical removal is indicated. In the practice of large cardiac surgery clinics, the experience of radical treatment of heart neoplasms is relatively small; therefore, the analysis of tactical approaches and results of operations in this pathology is of absolute interest.Aim of study. To present an analysis of 10 years’ experience in surgical treatment of cardiac mixomas. Material and methods The results of treatment of 58 patients with myxomas who underwent surgical removal of the neoplasm of the heart are presented.Results. Hospital mortality after surgical removal of myxoma was 1.7%, 1 patient died. All patients, we have the long-term period data about, noted a significant improvement in well-being, a decrease or disappearance of dyspnea at rest and/or during exertion, and no recurrence of myxoma was noted. Conclusion. The data obtained indicate, on the whole, good immediate results and high quality of life of patients in the long-term period operated on for heart mixomas.

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Perioperative and Long-Term Outcomes of Ross versus Mechanical Aortic Valve Replacement

10.22541/au.163638627.73083148/v1 ◽

2021 ◽

Author(s):

Chelsea Wenos ◽

Jeremy Herrmann ◽

Lava Timsina ◽

Parth M. Patel ◽

John W. Fehrenbacher ◽

...

Keyword(s):

Overall Survival ◽

Aortic Valve ◽

Propensity Score ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Perioperative Outcomes ◽

Ross Procedure ◽

Major Hemorrhage ◽

Valve Dysfunction

Background The ideal aortic valve replacement strategy in young- and middle-aged adults remains up for debate. Clinical practice guidelines recommend mechanical prostheses for most patients less than 50 years of age undergoing aortic valve replacement. However, risks of major hemorrhage and thromboembolism associated with long-term anticoagulation may make the pulmonary autograft technique, or Ross procedure, a preferred approach in select patients. Methods Data were retrospectively collected for patients 18 to 50 years of age who underwent either the Ross procedure or mechanical aortic valve replacement (mAVR) between January 2000 and December 2016 at a single institution. Propensity score matching was performed and yielded 32 well-matched pairs from a total of 216 eligible patients. Results Demographic and preoperative characteristics were similar between the two groups. Median follow-up was 7.3 and 6.9 years for Ross and mAVR, respectively. There were no early mortalities in either group and no statistically significant differences were observed with respect to perioperative outcomes or complications. Major hemorrhage and stroke events were significantly more frequent in the mAVR population ( p < 0.01). Overall survival ( p = 0.93), freedom from reintervention and valve dysfunction free survival ( p = 0.91) were equivalent. Conclusions In this mid-term propensity score-matched analysis, the Ross procedure offers similar perioperative outcomes, freedom from reintervention or valve dysfunction as well as overall survival compared to traditional mAVR but without the morbidity associated with long-term anticoagulation. At specialized centers with sufficient expertise, the Ross procedure should be strongly considered in select patients requiring aortic valve replacement.

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Long-term outcomes of mitral valve replacement in patients weighing less than 10 kg

10.21203/rs.3.rs-27771/v1 ◽

2020 ◽

Author(s):

Haoyong Yuan ◽

Zhongshi Wu ◽

Ting Lu ◽

Yilun Tang ◽

Jinlan Chen ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Surgical Techniques ◽

Weight Ratio ◽

Somatic Growth ◽

Left Ventricular ◽

Long Term Outcomes ◽

Mechanical Prostheses

Abstract Background: The techniques of mitral valve repair（MVP ) in children have been well established and provide acceptable long-term outcomes; certain pediatric patients require mitral valve replacement (MVR) after an unsuccessful MVP. The outcomes of MVR in pediatrict especially in the patients weighning are not always favorable. This study aimed to measure long-term outcomes of MVR at our institute.Methods: Nine young children weighing less than 10 kg underwent MVR from November 2006 to April 2019. Their mean age was 11.88 ± 11.29 months and mean body weight was 6.83 ± 2.56 kg at the time of initial MVR. Four patients (44.4%) had undergone at least one previous cardiac surgical procedure prior to MVR. Several surgical techniques were used to implant mechanical bileaflet prostheses.Results: All patients received bileaflet mechanical prostheses. The surgical technique varied among the patients with valves implanted intra-annularly (n = 5), supra-annularly (n=1), or supra-annularly with a tilt (n = 3). The valve size/weight ratio ranged from 2.11 to 5.00. After a mean follow-up period of 80.67 ± 63.37 months, the survival rate was 66.67%. One (11.1%) patient underwent an immediate revision MVR after initial MVR for the preprosthetic leak. No patients required surgical reintervention for the development of left ventricular outflow tract obstruction or permanent pacemaker placement during long-term follow-up.Conclusions: The tailored surgical strategy utilized for MVR in infants resulted in reliable valve function and excellent survival. Although revision is inevitable due to somatic growth, the bileaflet mechanical prostheses displayed appropriate durability.

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TETRALOGY OF FALLOT – «OLD» CONGENITAL HEART DEFECT IN THE XXI CENTURY – UNRESOLVED QUESTIONS OF STAGE-BY-STAGE SURGICAL CORRECTION

Emergency Cardiology and Cardiovascular Risks ◽

10.51922/2616-633x.2021.5.2.1210 ◽

2021 ◽

Vol 5 (1) ◽

pp. 1210-1216

Author(s):

P.F. Charnahlaz ◽

Keyword(s):

Ductus Arteriosus ◽

Surgical Techniques ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Surgical Correction ◽

Long Term Results ◽

Low Weight ◽

Long Time ◽

The Right

Despite the fact that the defect has been known for a long time and methods of surgical correction have been developed that allow achieving excellent immediate and long-term results, the tactical issues of stage-by-stage correction of the defect in situations where primary radical correction is impossible due to such reasons as a severe initial condition, low weight of the patient, underdevelopment of the branches of the pulmonary artery (PA) have not yet been fully resolved. In addition to classical Blalock-Taussig intersystem anastomoses, such endovascular techniques of maintaining pulmonary blood flow as stenting of the right ventricular outflow tract (RVOT) and stenting of the patent ductus arteriosus (PDA) are being introduced into clinical practice. These techniques, with all the advantages of minimally invasive technologies in certain clinical and anatomical situations, are not inferior, and in most cases surpass classical surgical techniques.

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