Acute Mitral Regurgitation: an important cause of respiratory distress

2016 ◽  
Vol 15 (1) ◽  
pp. 30-32
Author(s):  
Legate Philip ◽  
◽  
Neil Andrews ◽  

Acute mitral regurgitation (acute MR) is a rare cause of acute respiratory distress, which can present diagnostic challenges. We present the case of a 57 year old man who developed acute shortness of breath subsequently associated with fever, raised white cells and elevated CRP. Chest x-ray revealed unilateral shadowing and he was treated for pneumonia, despite the finding of severe mitral regurgitation on echo. Failure to respond to antibiotic treatment following 3 weeks on ITU led to the consideration of acute MR as the cause of his symptoms and he responded well to diuretics. He subsequently underwent mitral valve repair. The causes and clinical presentations of this condition are discussed.

2012 ◽  
Vol 93 (6) ◽  
pp. e165
Author(s):  
Mohammad Q. Najib ◽  
Hari P. Chaliki ◽  
Satya S. Vittala ◽  
Amol Raizada ◽  
Roger L. Click

2020 ◽  
Vol 47 (3) ◽  
pp. 207-209
Author(s):  
Anil Ozen ◽  
Ertekin Utku Unal ◽  
Hamdi Mehmet Ozbek ◽  
Gorkem Yigit ◽  
Hakki Zafer Iscan

Determining the optimal length of artificial chordae tendineae and then effectively securing them is a major challenge in mitral valve repair. Our technique for measuring and stabilizing neochordae involves tying a polypropylene suture loop onto the annuloplasty ring. We used this method in 4 patients who had moderate-to-severe mitral regurgitation from degenerative posterior leaflet (P2) prolapse and flail chordae. Results of intraoperative saline tests and postoperative transesophageal echocardiography revealed only mild insufficiency. One month postoperatively, echocardiograms showed trivial regurgitation in all 4 patients. We think that this simple, precise method for adjusting and stabilizing artificial chordae will be advantageous in mitral valve repair.


2015 ◽  
Vol 68 (3) ◽  
pp. 259-261
Author(s):  
Miguel Rodríguez-Santamarta ◽  
Rodrigo Estévez-Loureiro ◽  
Javier Gualis ◽  
David Alonso ◽  
Armando Pérez de Prado ◽  
...  

Author(s):  
Abu Ghosh Z ◽  
◽  
Beeri R ◽  
Falah B ◽  
Pertz A ◽  
...  

Oncology patients with Heart Failure (HF) and severe Mitral Regurgitation (MR) are often considered to have a prohibitive risk for surgical mitral valve repair/replacement. We describe a patient with active multiple myeloma and significant HF and MR who was treated with MitraClip, which improved symptoms and allowed delivery of optimal oncological treatment.


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Daisuke Kaneyuki ◽  
Hiroyuki Nakajima ◽  
Toshihisa Asakura ◽  
Akihiro Yoshitake ◽  
Chiho Tokunaga ◽  
...  

Abstract Background Good mid-term durability of mitral valve repair of bileaflet lesions has been reported; however, patients may develop failure during follow-up. This study assessed late outcomes and mechanisms of failure associated with mitral valve repair of bileaflet lesions. Methods Fifty-six patients (mean age 67 ± 12 years) underwent mitral valve repair of bileaflet lesions due to degenerative disease in 2011–2018. Mitral annuloplasty was added to all procedures except for 1 patient with annular calcification. Mitral valve lesions were identified by surgical inspection. Mean clinical and echocardiography follow-up occurred at 2.7 ± 2.1 and 2.5 ± 1.9 years, respectively. Results Additional mitral valve repair techniques involved triangular resection (n = 15 patients), quadrangular resection with sliding plasty (n = 12), neochordoplasty (n = 52), and commissural plication (n = 26). Prolapse of ≥2 anterior and posterior leaflet scallops occurred in 22 (39%) and 30 (54%) patients, respectively. During follow-up, 10 (17.8%) patients developed moderate or severe mitral regurgitation. Whereas prolapse or tethering was observed early after neochordoplasty or quadrangular resection, recurrent regurgitation occurred late after commissural repair. Five-year freedom from recurrent moderate or severe mitral regurgitation rates was 71.1 ± 11.0%. Conclusions Seventeen percent of patients developed recurrent mitral regurgitation during follow-up. Repair failure in the early phase occurred owing to aggressive resection of the posterior mitral leaflet or maladjustment of the artificial neochordae. Recurrent mitral regurgitation might occur in the late phase even after acceptable commissural repair. A sequential approach may be useful to improve the quality of mitral valve repair in bileaflet lesions.


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