Transcatheter Decompression of the Left Atrium in an Adolescent with a Double Inlet Left Ventricle, Severe Parachute Mitral Valve Stenosis and Pulmonary Hypertension

Objective: Surgical outcomes of biventricular repair for hearts with hypoplastic left ventricle with congenital mitral valve stenosis are described. Serial changes of left ventricular geometry and clinical features after biventricular repair were reviewed. Methods: Eight patients with hypoplastic left ventricle and congenital mitral valve stenosis who underwent first surgical intervention for biventricular circulation in neonatal or infantile period between 2001 and 2014 comprise the study population. Serial change in left ventricular end-diastolic diameter, left ventricular mass index, and relative wall thickness after biventricular repair were evaluated by two-dimensional echocardiography. Results: The median Z-scores of left ventricular end-diastolic diameter and mitral valve diameter before the first surgical intervention were −3.0 (range, −4.8 to −2.0) and −1.0 (−2.9 to 2.1), respectively. Mitral valves were surgically treated in five patients; they were replaced in two and repaired in three patients. Left ventricular end-diastolic diameter Z-score at five years after biventricular repair was 0.1 (−3.0 to 1.0), which was significantly larger than before first surgical intervention ( P = .005). Left ventricular mass index, on the other hand, did not change, but relative wall thickness significantly decreased ( P = .009). Postoperative catheter study showed pulmonary hypertension with high left ventricular end-diastolic pressure in more than half of survivors. Conclusions: Left ventricle increased in size after the biventricular repair with appropriate mitral valve procedures before progression of pulmonary hypertension. Left ventricular mass, however, did not accompany the increase. Some patients may have suffered from mild, but certain restrictive left ventricular physiology and subsequent pulmonary hypertension as the result of abnormal remodeling process of the myocardium.

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Biomechanics of the Mitral Valve in Ischemic Heart Disease: Translating From the Bench to the Operating Room

ASME 2010 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2010-19422 ◽

2010 ◽

Author(s):

Muralidhar Padala ◽

Ajit P. Yoganathan

Keyword(s):

Blood Flow ◽

Mitral Valve ◽

Left Ventricle ◽

Left Atrium ◽

Mitral Annulus ◽

Normal Function ◽

Force Balance ◽

Papillary Muscles ◽

Atrioventricular Valve ◽

Main Components

The Mitral Valve (MV) is the left atrioventricular valve that controls blood flow between the left atrium and the left ventricle (Fig 1A-B). It has four main components: (i) the mitral annulus — a fibromuscular ring at the base of the left atrium and the ventricle; (ii) two collagenous planar leaflets — anterior and posterior; (iii) web of chordae and (iv) two papillary muscles (PM) that are part of the left ventricle (LV). Normal function of the mitral valve involves a delicate force balance between different components of the valve.

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P1705 Is mitral stenosis per se worthy of anticoagulation therapy?

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.1068 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

S Suma ◽

N Gaibazzi

Keyword(s):

Atrial Fibrillation ◽

Mitral Valve ◽

Left Atrium ◽

Thrombus Formation ◽

Anticoagulation Therapy ◽

Mitral Valve Regurgitation ◽

Low Flow ◽

Mitral Valve Stenosis ◽

Color Flow ◽

Tight Correlation

Abstract We present the case of a 76-year-old man with hypertension and previous mitral valve repair (MVR) due to severe mitral valve regurgitation. He had never experienced atrial fibrillation (AF), and therefore he was not anticoagulated. He had been asymptomatic for 15 years, however, recently he reported the onset of dyspnoea and a transthoracic echocardiogram showed moderate to severe mitral valve stenosis (MVS) in the context of previous MVR. A transesophageal echocardiogram was then requested and it confirmed the degree of MVS (panel A Color flow on mitral valve, panel B CW Doppler), but, astonishingly, it also showed the presence of a giant thrombus in the roof of the left atrium (Panel C,D,F 2D TOE, Panel E 3D TOE). The maximal dimensions of the mass were 3.3 to 4.5 centimetres and, surprisingly, no thrombus was found in the left appendage, which nevertheless had low-flow. MVS is very often associated with severe left atrial dilation and with the onset of atrial fibrillation. However, when a patient has at least moderate MVS and he is in sinus rhythm, there is no robust evidence supporting the initiation of anticoagulants. Though, this case underlines the tight correlation between MVS and thrombus formation regardless of the detectable presence of AF. Moreover, in contrast to usual AF patients, in this particular case left appendage was not involved and the huge mass occupied most of the left atrium, showing that MVS provokes significant low-flow in the atrium too. Abstract P1705 Figure.

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Lesion of Aggregated Monocytes and Mesothelial Cells: Mesothelial/Monocytic Incidental Cardiac Lesion

Case Reports in Pathology ◽

10.1155/2013/836398 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Hilal Erinanç ◽

Murat Günday ◽

Tonguç Saba ◽

Mehmet Özülkü ◽

Atilla Sezgin

Keyword(s):

Mitral Valve ◽

Left Atrium ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Histopathological Examination ◽

Mesothelial Cells ◽

Mitral Valve Stenosis ◽

Pathology Laboratory ◽

Cardiac Lesion ◽

Replacement Surgery

A 58-year-old woman with a history of childhood acute rheumatic fever and resultant mitral valve stenosis was admitted to our cardiovascular surgery clinic complaining of tachycardia, dyspnea, and chest pain. After clinical and radiological findings were evaluated, mitral valve replacement, tricuspid De Vega annuloplasty and plication, and resection of giant left atrium were performed. Atrial thrombus was removed from the top of the left atrial wall. Operation material considered as thrombus was sent to a pathology laboratory for histopathological examination. It was diagnosed with mesothelial/monocytic incidental cardiac lesion (cardiac MICE). Microscopic sections revealed that morphological features of the lesion were different from thrombus. The lesion was composed of a cluster of histiocytoid cells with abundant cytoplasm and oval shaped nuclei and epithelial-like cells resembling mesothelial cells within a fibrin network. Epithelial-like cells formed a papillary configuration in the focal areas. Mitotic figures were absent. Here we present a case which was incidentally found in a patient who underwent mitral valve replacement surgery, as a thrombotic lesion on the left atrium wall.

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Biaxial Compliance Changes of Mitral Valve Leaflets Following Radiofrequency Ablation

ASME 2009 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2009-206761 ◽

2009 ◽

Author(s):

Carolyn G. Norwood ◽

W. David Merryman

Keyword(s):

Blood Flow ◽

Radiofrequency Ablation ◽

Mitral Valve ◽

Left Ventricle ◽

Left Atrium ◽

Posterior Leaflet ◽

Anterior Leaflet ◽

Retrograde Blood Flow

The mitral valve (MV), located between the left atrium and left ventricle of the heart, is responsible for preventing retrograde blood flow by closing during systole. There are two MV leaflets, anterior and posterior. The anterior is the larger of the two and semicircular; the posterior leaflet is more rectangular and can be subdivided into three scallops, the middle scallop being the largest in most human hearts. The two leaflets are anchored to the wall of the left ventricle by the chordae tendinae. The MV annulus forms a complete fibrous ring anchored along the anterior leaflet (1).

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ATRIAL MYXOMA MIMICKING MITRAL VALVE STENOSIS LEADING TO PULMONARY HYPERTENSION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(19)33446-1 ◽

2019 ◽

Vol 73 (9) ◽

pp. 2840

Author(s):

Muhammad Shabbir Rawala ◽

Syed Rizvi

Keyword(s):

Pulmonary Hypertension ◽

Mitral Valve ◽

Atrial Myxoma ◽

Mitral Valve Stenosis

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Biatrial Approach for Bicameral Myxoma with Mitral Regurgitation

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230000800219 ◽

2000 ◽

Vol 8 (2) ◽

pp. 167-168 ◽

Cited By ~ 1

Author(s):

Pankaj Goel ◽

Nainar Madhu Sankar ◽

Sethurathinam Rajan ◽

Kotturathu Mammen Cherian

Keyword(s):

Mitral Valve ◽

Left Ventricle ◽

Mitral Regurgitation ◽

Left Atrium ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Severe Mitral Regurgitation ◽

Two Dimensional ◽

Dimensional Echocardiography ◽

Two Dimensional Echocardiography

A 16-year-old girl presented with an episode of syncope. Two-dimensional echocardiography revealed masses in the left atrium and left ventricle with severe mitral regurgitation. She underwent removal of myxomas and mitral valve replacement using an extended biatrial approach.

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