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TY - JOUR. T1 - The impact of intraoperative residual mild regurgitation after repair of degenerative mitral regurgitation. AU - Imielski, Bartlomiej. AU - Malaisrie, S. Chris. AU - Pham, Duc Thinh. AU - Kruse, Jane. AU - Andrei, Adin Cristian. AU - Liu, Menghan. AU - Cox, James L.. AU - McCarthy, Patrick M.. PY - 2019/1/1. Y1 - 2019/1/1. N2 - Objectives: During degenerative mitral repair, surgeons must decide if further repair is warranted for residual mild mitral regurgitation. We examined the incidence of mild mitral regurgitation, late echocardiographic and clinical outcomes, and influence of surgical experience in decision making. Methods: From April 2004 to June 2018, 1155 of 1195 patients with pure degenerative disease underwent repair (97% repair rate). Propensity score matching was performed between patients with trace/no mitral regurgitation and patients with mild residual mitral regurgitation. Late echocardiographic outcome and freedom from reoperation were compared using ...
Coronary Atherosclerosis & Mitral Valve Insufficiency & Thickening of the Mitral Valve Leaflets Symptom Checker: Possible causes include Mitral Valve Prolapse. Check the full list of possible causes and conditions now! Talk to our Chatbot to narrow down your search.
The outcome in functional mitral regurgitation after aortic valve replacement is unclear. A frail 82-year-old woman with severe aortic valve regurgitation and mild to moderate functional mitral valve regurgitation (NYHA functional class III) was referred to our clinic. In consideration of her frail condition, aortic valve replacement without mitral surgery was performed. She had hemodynamic instability and difficulty to wean off cardiopulmonary bypass caused by severe functional mitral valve regurgitation with left ventricular dilatation. A central Alfieri edge-to-edge stitch was placed between the anatomical middle of the two leaflets of the mitral valve after reinstitution of cardiopulmonary bypass. This eliminated the mitral regurgitation, which enabled successful separation from cardiopulmonary bypass.
Mitral valve insufficiency (MI) is inadequate closure of the valve that separates the left atrium from the left ventricle. This disorder can be due to backward movement of the valve (prolapsing), thickening of the valve, gradual (chronic) degeneration of the valve, bacterial infection of the valve, narrowing of the opening in the valve or dysfunction of the muscles or chords controlling the valve. Chronic degeneration of the valve is the most common cause of MI in dogs and cats.. This inability to close the mitral valve completely causes regurgitation (backward flow) of blood into the left atrium of the heart. This regurgitation increases the amount of blood that the left atrium has to pump, which may lead to volume overloading. As a means of compensation, the left atrium may dilate (expand). This is a condition known as left atrial enlargement. In later stages of disease, the left ventricle and veins of the lungs are generally enlarged as well.. Signs of MI include coughing, increased heart ...
Concomitant mitral valve surgery in patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting
Cardiosurgery: Mitral valve insufficiency (prolapse) | Prosthetic (replacement) of mitral valve (minimally invasive). Treatment in Tuebingen, Germany ✈ Find the best medical programs at BookingHealth - ✔Compare the prices ✔Online booking.
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Echocardiography is currently the technique of choice to assess the etiology and severity of mitral regurgitation (MR). Multiple 2D and Doppler parameters are assessed in an integrated fashion and the proximal flow convergent zone of the mitral regurgitation jet is used to calculate effective regurgitant orifice area and regurgitant volume. These measurements have been shown to have important prognostic information. In the last two years, the development of transesophageal imaging with 3D capability has allowed a better visualization of mitral leaflet pathology. Color Doppler 3D studies have shown that 2D methods generally underestimate mitral regurgitant volume. Magnetic resonance techniques have recently been developed to quantitate flow and calculate regurgitant volumes.. The purpose of this study is to evaluate newer methods of quantitating mitral regurgitation severity using real-time 3D echocardiography (RT3DE) and cardiac magnetic resonance imaging (CMR). Although RT3DE measurements have ...
Veterinarian Dr.Jan answers your questions and gives expert pet advice about natural remedies for dogs with mitral valve insufficiencies.
TY - JOUR. T1 - Myocardial contractile state in dogs with chronic mitral regurgitation. T2 - Echocardiographic approach to the peak systolic pressure/end-systolic area relationship. AU - Dávila-Román, Víctor G.. AU - Creswell, Lawrence L.. AU - Rosenbloom, Michael. AU - Pérez, Julio E.. PY - 1993/7. Y1 - 1993/7. N2 - Analysis of the pressure-dimension relationship provides a sensitive index of myocardial contractility, but widespread application of this method is limited because it requires invasive measurement techniques. The recent development of two-dimensional echocardiographic automatic boundary detection permits accurate and reproducible on-line measurement of ventricular cavity areas that can be combined with ventricular pressure measurements to derive instantaneous pressure-area relationships. In anesthetized closed-chest dogs with chronic mitral regurgitation, the slope of the ventricular pressure-area relationship was determined by obtaining baseline measurements (at baseline and ...
Children with ventricular septal defect (VSD) often demonstrate failure to thrive (Ff1). Such patients usually have reduced systemic cardiac output which has been postulated as a cause for their growth retardation. This study was conducted to ascertain the mechanism of the reduced cardiac output in children with VSD and FT11 and also in a porcine model of VSD. Forward stroke volume was reduced in VSD-FIT children, 31±8 ml/m2, compared to normal children, 49±15 ml/m2 (P , 0.05), but was not reduced in children with VSD and normal growth and development (41±16 ml/m2). Forward stroke volume was also reduced in swine with VSD compared to controls. Contractility assessed by mean velocity of circumferential shortening (Vd) corrected for afterload was similar in normals and VSD-FTI children. Contractile performance was also similar in normal and VSD swine. Afterload assessed as systolic stress was similar in FIT-VSD children and normal subjects. Preload assessed as end-diastolic stress was ...
BACKGROUND AND AIM OF THE STUDY: Leaflet curvature is a primary determinant of leaflet stress, but no quantitative in-vivo leaflet curvature data exist. Chronic ischemic mitral regurgitation (CIMR) is associated with remodeling of the valvular-ventri
Chronic ischemic mitral regurgitation (cIMR) remains a vexing problem for a large number of patients and their respective clinicians. It is estimated that ≈2 million Americans experience cIMR, and this number is likely to increase with an aging general population and improved survival rates for myocardial infarction.1 Despite the large number of patients with this disease, relatively few patients are referred for surgical therapy. This is reflected in the fact that the largest surgical series to date consist of only a few hundred patients operated on over a several-year interval.2,3. Article see p 2720. One important reason for the small number of cIMR surgical referrals is the lack of evidence of a survival benefit associated with surgery,4 despite observed improvements in heart failure symptoms and left ventricular (LV) dimensions.5 Improvements in reverse LV remodeling and functional status have also been demonstrated in patients with idiopathic dilated cardiomyopathy who undergo a ...
In recent years, transcatheter mitral valve repair using the MitraClip (Abbott Vascular, Abbott Park, Illinois) has become a prevalent approach to treat significant mitral regurgitation (MR) in patients deemed inoperable or at high surgical risk (1-3). The technique emulates the surgical "edge-to-edge" suture (4) by using 1 or more transseptally introduced clips to approximate the mitral leaflets at the origin of the regurgitant jet. Although the reduction in MR severity achieved by MitraClip implantation has been shown to persist in the majority of patients, recurrence of significant MR has been reported (2,3,5).. Different mechanisms may account for MR recurrence. On the one hand, progression of the underlying disease that originally gave rise to (functional or degenerative) MR may lead to recurrent regurgitation despite initially successful MitraClip therapy. On the other hand, loss of leaflet insertion (LLI) into the clip imperatively causes a relapse of MR. LLI may be the consequence of ...
Ischemic mitral regurgitation (IMR) is associated with decreased quality of life and long-term survival. Although extensive mechanistic research has been conducted, the optimal management of IMR remains elusive. Clinical studies in the past often included MR of multiple etiologies, including degenerative or nonischemic origin and IMR grouped into the same category, leading to confusion and incorrect conclusions regarding the natural history and true long-term impact of IMR. It is important to distinguish IMR from mitral regurgitation resulting from nonischemic etiologies. Mitral regurgitation is often associated with coronary artery disease without a direct cause-and-effect relationship. Given the prevalence of coronary artery disease, the association of myocardial infarction and nonischemic mitral regurgitation is a common clinical association. IMR must be distinguished from mitral insufficiency caused by degenerative, rheumatic, congenital, and infectious etiologies, as well as that arising ...
Percutaneous mitral valve repair using the MitraClip (Abbott Vascular, Santa Clara, California) is a promising technique to treat symptomatic severe mitral regurgitation (MR) in patients at high or prohibitive surgical risk. Large observational registries of patients treated with this device for predominantly secondary MR show symptomatic relief and improvement of hemodynamics at rest (1,2). Comparative data on exercise hemodynamics before versus after percutaneous mitral valve repair therapy are currently lacking, although such data are most relevant in secondary MR. First, secondary MR is characteristically dynamic and sensitive to changes in ventricular geometry and loading conditions (3). It remains unclear whether, besides a reduction in resting MR, percutaneous mitral valve repair therapy is effective in reducing secondary MR during exercise. Second, mitral valve area is typically reduced following the procedure (4). It remains to be determined whether such mild iatrogenic stenosis might ...
Systematic overestimation of the MV SV or underestimation of ISVS R could cause the traditional PISA method to appear to underestimate continuity-based MR EROA. Identifying orifice location is often challenging, allowing both underestimation and overestimation of ISVS R. However, because flow must converge along the leaflets ventricular surface, the orifice cannot be behind this surface. Importantly, our theoretical predictions of expected ISVS R with elongation and leaflet tenting agreed closely with our empiric R measurements, and our control series PISA EROA agreed well with their corresponding continuity EROAs, validating our measurement technique and supporting the absence of systematic errors in our ISVS R measurements.. The major potential source of overestimation of MV SV is mitral annular diameter. Our mean diameter was 3.3 cm. Mihalatos et al. (13) reported that the MV orifice becomes circular and its diameter increases progressively with MR severity. They found mean end-systolic and ...
Mitral reguritation is a relatively common finding in coronary heart disease. In this series of 127 patients, selected with a view to coronary or left ventricular surgery on the basis of severity of symptoms, the incidence was 39 (31%). Mitral regurgitation is significantly more common in patients with a history or electrocardiographic evidence of previous myocardial infarction. Clinically it may present as a pan- or late systolic or even a mid-systolic, ejection type murmur at the apex or at the left sternal edge; but in 39 per cent of the patients with angiographic mitral regurgitation no murmur was present. Angiographically important mitral regurgitation (grades 2-4/4) was usually associated with a systolic murmur; this finding was independent of ejection fractions. Left ventricular enlargement clinically or radiographically is likely to accompany mitral regurgitation but left atrial enlargement (electrocardiographically or on chest x-ray) is a more reliable pointer to mitral regurgitation ...
TY - JOUR. T1 - Independent prognostic value of functional mitral regurgitation in patients with heart failure. A quantitative analysis of 1256 patients with ischaemic and non-ischaemic dilated cardiomyopathy. AU - Rossi, Andrea. AU - Dini, Frank L.. AU - Faggiano, Pompilio. AU - Agricola, Eustachio. AU - Cicoira, Mariantonietta. AU - Frattini, Silvia. AU - Simioniuc, Anca. AU - Gullace, Mariangela. AU - Ghio, Stefano. AU - Enriquez-Sarano, Maurice. AU - Temporelli, Pier Luigi. PY - 2011/10. Y1 - 2011/10. N2 - Background: Functional mitral regurgitation (FMR) is a common finding in patients with heart failure (HF), but its effect on outcome is still uncertain, mainly because in previous studies sample sizes were relatively small and semiquantitative methods for FMR grading were used. Objective: To evaluate the prognostic value of FMR in patients with HF. Methods and results: Patients with HF due to ischaemic and non-ischaemic dilated cardiomyopathy (DCM) were retrospectively recruited. The ...
BACKGROUND: The aim of this study was to develop and validate an automated method for extracting forward stroke volume (FSV) using indicator dilution theory directly from dynamic positron emission tomography (PET) studies for two different tracers and scanners.. METHODS: 35 subjects underwent a dynamic (11)C-acetate PET scan on a Siemens Biograph TruePoint-64 PET/CT (scanner I). In addition, 10 subjects underwent both dynamic (15)O-water PET and (11)C-acetate PET scans on a GE Discovery-ST PET/CT (scanner II). The left ventricular (LV)-aortic time-activity curve (TAC) was extracted automatically from PET data using cluster analysis. The first-pass peak was isolated by automatic extrapolation of the downslope of the TAC. FSV was calculated as the injected dose divided by the product of heart rate and the area under the curve of the first-pass peak. Gold standard FSV was measured using phase-contrast cardiovascular magnetic resonance (CMR).. RESULTS: FSVPET correlated highly with FSVCMR (r = 0.87, ...
Catheter-based percutaneous edge-to-edge repair using the MitraClip device (Abbott Vascular; Abbott Park, IL, USA) is a well-established, effective, and safe procedure that can be utilized in...
The most complete and elaborate follow-up for mitral repair in contemporary literature is probably the series of Flameng and associates4 who report a series of 242 consecutive mitral repairs with serial follow-up echocardiography done at 6 month intervals. They found a freedom from moderate or severe mitral regurgitation of 71% at 7 years and found that new recurrent mitral regurgitation appeared at a rate of 3.7% per year (Figure 2). The data of Flameng and colleagues4 suggest that durability of many mitral repairs is limited; the linear recurrence rate implies that recurrent mitral regurgitation is likely a reflection of progression of underlying valve disease. This hypothesis is supported by data from mitral re-operations after previous repair, as the previous repairs are found to be intact in two-thirds of patients, with recurrent regurgitation usually due to new valve lesions (chordal rupture, fibrosis, calcification, leaflet perforation)5. Technical failure can be a major cause of ...
There is controversy as to the best timing for surgery. Patients presenting with acute severe mitral regurgitation are generally critically ill and require urgent surgery. However, in patients with chronic mitral regurgitation, the timing is more uncertain.. In the past, cardiologists recommended waiting until severe symptoms developed before proceeding to surgery. However, waiting often was associated with a bad outcome, and left ventricular function did not respond well to the sudden change in afterload imposed by putting an artificial valve in a patient who had severe regurgitation. Now, many recommend operating as soon as significant symptoms develop. Some, in fact, even recommend that these patients not be treated with medication so as not to mask symptoms and that surgery be done as soon as any symptom presents.. However, replacement of a native valve with a prosthetic one is not a cure for the patient, but rather a shift to a new set of problems associated with the prosthetic valve. Newer ...
BACKGROUND: Functional mitral regurgitation (MR) is common in patients with heart failure and left ventricular (LV) dysfunction, and its severity may vary over time, depending primarily on the loading conditions. Because dynamic changes in the severity of functional MR may affect forward stroke volume, we hypothesized that exercise-induced changes in MR severity influence the stroke volume response of patients with LV dysfunction to exercise, and hence their exercise capacity. METHODS AND RESULTS: Heart failure patients (n=25; mean age 53+/-12 years) with LV dysfunction underwent dynamic bicycle exercise at steady-state levels of 30%, 60%, and 90% of predetermined peak VO2. During each exercise level, right heart pressures, cardiac output, VO2, and MR severity were measured simultaneously. During exercise, MR severity, as evaluated by the ratio of MR jet over left atrium area, increased from 15+/-8% to 33+/-15%. Peak VO2, exercise-induced changes in stroke volume, and those in capillary wedge ...
The presence and severity of MR associated with myocardial infarction has been shown to be an important prognostic factor in ischemic heart disease.1-4 Lamas et al1 reported that the 3-year survival rate after myocardial infarction was significantly lower in patients with than without residual MR (71% versus 88%), and mortality risk has been shown to be directly related to the severity of ischemic MR.2 Because revascularization alone may not resolve ischemic MR,20 MV repair together with CABG may be preferable to CABG alone, but only if correction of MR can be performed safely. We have shown here that for patients with severe MR, MV repair was superior to CABG alone in reducing ischemic MR and LV size, without increasing operative or long-term mortality rates. In patients with moderate MR, however, the operative mortality rate of the combination of CABG and MV repair was significantly higher than that of CABG alone, whereas the MR improvement rates were similar in the 2 procedures. Even if MV ...
We sought to evaluate the geometric changes of the mitral leaflets, local and global LV remodeling in patients with left ventricular dysfunction and varying degrees of Functional mitral regurgitation (FMR). Functional mitral regurgitation (FMR) occurs as a consequence of systolic left ventricular (LV) dysfunction caused by ischemic or nonischemic cardiomyopathy. Mitral valve repair in ischemic MR is one of the most controversial topic in surgery and proper repairing requires an understanding of its mechanisms, as the exact mechanism of FMR are not well defined. 136 consecutive patients mean age of 55 with systolic LV dysfunction and FMR underwent complete echocardiography and after assessing MR severity, LV volumes, Ejection Fraction, LV sphericity index, C-Septal distance, Mitral valve annulus, Interpapillary distance, Tenting distance and Tenting area were obtained. There was significant association between MR severity and echocardiogarphic indices (all p values | 0.001). Severe MR occurred more
Mitral surgery was ultimately performed in 265 patients, involving valve repair in 240 patients (90.6%) and valve replacement in 25 patients (mechanical: n = 18, bioprosthesis: n = 7). Forty patients (15.1%) underwent concomitant coronary bypass surgery and 7 had a Maze procedure. As expected, patients who underwent surgery after diagnosis versus those who remained medically managed, had larger RVol (89 ± 37 ml vs. 43 ± 32 ml, p , 0.001) and LA index (63 ± 25 ml/m2vs. 46 ± 23 ml/m2, p , 0.001). During total follow-up (including pre- and post-operative period), 80 patients died (survival: 85 ± 1.8% 5 years after diagnosis), and 26 patients died after mitral surgery (survival: 91 ± 2.0% 5 years after surgery). New onset AF occurred in 26 patients and heart failure in 15 patients. There was no difference in post-operative outcome after stratification by pre-operative LA index ≥60 or ,60 ml/m2(5-year post-operative mortality: 9.1 ± 2.0% vs. 8.7 ± 2.8%, p = 0.98; and cardiovascular events: ...
Mitral Incompetence, Mitral regurgitation (MR),mitral insufficiency, Aetiology of Mitral Incompetence,Examination and Treatment for Mitral Incompetence
450 patients with , 70% stenosis in ≥1 epicardial coronary artery (75% men, median age 63 years, median LV ejection fraction (EF) 22 %, median ESVi 106ml, median scar % of 29% ) underwent delayed hyperenhancement-MRI (Siemens 1.5-T scanner, Erlangen, Germany) between 2002-2006. CMR evaluation included long and short axis assessment of LV and RV function on balanced steady state free precession images along with assessment of LV and RV myocardial scar (on phase-sensitive inversion recovery DHE-CMR sequence ~ 10-20 minutes after injection of 0.2 mmol/kg of Gadolinium dimenglumine). Scar was identified as regions of interest , 2 SD above normal myocardium. Cox proportional hazards survival modeling, using a primary end-point of all-cause mortality, was used to risk-adjust comparisons. MR severity was determined by echocardiography and assessed by width of the vena contracta. Cox proportional hazards survival modeling, using a primary end-point of all-cause mortality, was used to risk-adjust ...
In the studies, 327 of 351 patients completed 12 months of follow-up. Patients were elderly (76 ± 11 years), with 70% having functional MR and 60% having prior cardiac surgery. The mitral valve device reduced MR to ≤2+ in 86% of patients at discharge (n = 325; p < 0.0001). Major adverse events at 30 days included death in 4.8%, myocardial infarction in 1.1%, and stroke in 2.6%. At 12 months, MR was ≤2+ in 84% of patients (n = 225; p < 0.0001). From baseline to 12 months, left ventricular (LV) end-diastolic volume improved from 161 ± 56 ml to 143 ± 53 ml (n = 203; p < 0.0001), and LV end-systolic volume improved from 87 ± 47 ml to 79 ± 44 ml (n = 202; p < 0.0001). New York Heart Association functional class improved from 82% in class III/IV at baseline to 83% in class I/II at 12 months (n = 234; p < 0.0001). The 36-item Short Form Health Survey physical and mental quality-of-life scores improved from baseline to 12 months (n = 191; p < 0.0001). The annual hospitalization rate for heart ...
Background: In heart failure (HF) patients the severity of mitral regurgitation (MR) at rest has a well established prognostic value and its increase during exercise further adds to an increased risk. Our goal was to define the relationship between the degree of exercise MR severity with cardiopulmonary and echocardiographic related phenotypes in a cohort of HF patients. Methods: 71 HF reduced ejection fraction patients (mean age 67±11; male 72%; ischemic etiology 61%; NYHA class I, II, III and IV 13%, 36%, 39% and 12%, mean ejection fraction 33±9%) underwent cardiopulmonary exercise test (CPET) on tiltable cycle-ergometer combined with echocardiography at rest and during exercise. The population was divided into two groups according to the degree of functional peak MR: no to mild/moderate MR (no MR, MR1+ and MR2+) vs moderate/severe MR (MR3+ and MR4+). Results: A good correlation (ρ coefficient= 0.49) was found between the degree of dynamic MR and PASP at peak exercise. Despite similar ...
A combination of left ventricular volumetric quantification and phase-contrast imaging performed at level of ascending aorta, however, allows accurate and reproducible assessment of mitral regurgitation. In the presence of regurgitation, the difference in cardiac output between the left ventricle and ascending aorta yields the regurgitation volume. Regurgitation fraction is calculated by normalizing the regurgitation volume to the left ventricular stroke volume. Use of regurgitation fraction should be recommended as this parameter has the advantage to be relatively insensitive to concomitant other valve abnormalities. Regurgitation fraction limits for mitral and aortic regurgitations have been estimated by using cardiac MRI: mild ≤ 15%; moderate 16-25%; moderate-severe 26-48%; severe , 48%.. ...
BACKGROUND: Ischemic mitral regurgitation (iMR) predisposes to right ventricular (RV) pressure and volume overload, providing a nidus for RV dysfunction (RVDYS) and non-ischemic fibrosis (NIF). Echocardiography (echo) is widely used to assess iMR, but performance of different indices as markers of RVDYS and NIF is unknown. METHODS: iMR patients prospectively underwent echo and cardiac magnetic resonance (CMR) within 72 hours. Echo quantified iMR, assessed conventional RV indices (TAPSE, RV-S, fractional area change [FAC]), and strain via speckle tracking in apical 4-chamber (global longitudinal strain [RV-GLS]) and parasternal long axis orientation (transverse strain ...
BACKGROUND Studies assessing ischemic mitral regurgitation (IMR) comprised of heterogeneous population and evaluated IMR in the subacute setting. The incidence of early IMR in the setting of primary PCI,
Among patients with multivessel coronary artery disease and at least moderate mitral regurgitation, CABG plus mitral valve repair improved functional capacity at 1 year. This strategy also improved LV reverse remodeling, mitral regurgitation, and BNP levels. CABG plus mitral valve repair required longer bypass time, greater volume of blood transfusion, longer intubation times, and longer hospital stay. Therefore, future studies are needed to determine the impact of this added surgical technique on clinical outcomes.. ...
This thesis deals with the estimation of blood flow in the heart and larger vessels where control-volume methods are applied using ultrasound Doppler technique. In particular two control-volume techniques were investigated: The proximal isovelocity surface area method, (PISA) and the Surface Integration of Velocity Vectors method, (SIVV).. For PISA, computational fluid dynamics, (CFD) was used for non-stationary flow and non-planar circular geometries where special emphasis was given to the influence from the angle of the valvular leaflets on the proximal surface area. The CFD results were compared with ultrasound measurements, in an in-vitro model with controlled geometry and flow characteristics. Three different valvular geometries were used: planar, reversed cone and funnel. In these idealised CFD and experimental models it was found that there is support to use the hemispherical PISA approach for the geometries investigated provided that the flow is not to high in the reversed cone and ...
A 69-year-old woman developed acute pulmonary edema and severe mitral regurgitation (MR) 2 days following an uncomplicated AV nodal (AVN) ablation and insertion of VVI pacemaker for chronic atrial fibrillation. There was no history of significant mit
How Is Mitral Valve Regurgitation Diagnosed? - The signs doctors might see include elevated pressure in neck veins and sound in the base of the lungs, says Nayab...
OBJECTIVES We sought to analyze several new hemodynamic characteristics which address the interplay of left atrial (LA) and left ventricular (LV) pressures, as well as to re-analyze several other V wave characteristics employed in the determination of mitral regurgitation (MR) severity in order to determine which, if any, had adequate correlation with grade of MR for clinical utility. BACKGROUND Invasive assessment of mitral regurgitation includes analysis of intracardiac pressures and LV angiography. The V wave, when obtained from the pulmonary capillary wedge position (PCWP), and its various characteristics are believed to be of limited value for prediction of MR severity. METHOD We analyzed the transeptal pressure tracings of patients with various degrees of MR. Several relationships from the simultaneous pressure-time curves of the LA and LV were defined. Biplane left ventricular angiography was used to grade MR. Correlation between each parameter and MR grade was determined by calculating a
A method and device (157) for reducing mitral regurgitation. An elongated body is positioned in a coronary sinus of a patient in a vicinity of a heart mitral valve posterior leaflet (39). The body is adapted to straighten a natural curvature of at least a portion of the coronary sinus in the vicinity of the posterior leaflet to move a posterior annulus (33) anteriorly, which in turn moves the posterior leaflet (39) anteriorly, thereby to improve leaflet coaptation.
Learn more about Mitral Regurgitation at Sky Ridge Medical Center DefinitionCausesRisk FactorsSymptomsDiagnosisTreatmentPreventionrevision ...
TY - JOUR. T1 - Reduction in mitral regurgitation during therapy guided by measured filling pressures in the ESCAPE trial. AU - Palardy, Maryse. AU - Stevenson, Lynne W.. AU - Tasissa, Gudaye. AU - Hamilton, Michele A.. AU - Bourge, Robert C.. AU - DiSalvo, Thomas G.. AU - Elkayam, Uri. AU - Hill, James A.. AU - Reimold, Sharon C.. PY - 2009/5/1. Y1 - 2009/5/1. N2 - Background-Dynamic mitral regurgitation (MR) contributes to decompensation in chronic dilated heart failure. Reduction of MR was the primary physiological end point in the ESCAPE trial, which compared acute therapy guided by jugular venous pressure, edema, and weight (CLIN) with therapy guided additionally by pulmonary artery catheters (PAC) toward pulmonary wedge pressure ≤15 and right atrial pressure ≤8 mm Hg. Methods and Results-Patients were randomized to PAC or CLIN during hospitalization with chronic heart failure and mean left ventricular ejection fraction 20%, and at least 1 symptom and 1 sign of congestion. MR and mitral ...
The German Heart Centre Munich (DHM), part of Munich University of Technology, is one of the worldʼs leading and most modern specialist centres for the treatment of cardiovascular disease in adults and children. Founded in 1974, the DHM was one of Europeʼs first heart centres and has provided the impetus for numerous medical developments since then. An early milestone was the first successful heart transplant in Germany, which took place on 7 May 1981. Professor Rüdiger Lange has been Director of the Department of Cardiovascular Surgery at the DHM since 1999. He has overseen the development of minimally invasive surgery, the worldʼs first totally endoscopic mitral valve reconstruction using the Da Vinci telemanipulator and the earliest example worldwide of the implantation of a catheter-supported CoreValve aortic valve via the apex of the heart and aorta.. Progress and change in heart surgery. Just ten years ago, the standard procedure for most patients was still open heart surgery, ...
BACKGROUND:. MR causes volume overload and hemodynamic burden on the left ventricle. Initial compensatory mechanisms may fail, leading to increased severity. Patients who have had repair of an atrioventricular septal defect (AVSD) are selected for this study as they have a relatively high incidence of moderate MR and their regurgitant orifice is mobile and dynamic, contributing to the likelihood that they might respond to medical therapy.. DESIGN NARRATIVE:. This is a randomized, double-blind, placebo-controlled trial of ACE-I therapy in children less than 18 years of age with at least moderate MR who are at least 6 months postoperative from repair of an AVSD. A non-randomized Observational Phase enrolled 181 children who were less than 6 months postoperative from repair of an AVSD, who were then evaluated at 6 months for trial eligibility. ...
Hi, Im a 48 years old, female who...15 years ago was diagnosed with MVP by a cardiologist. Yet, a recent echocardiogram report states nothing about MVP but does mention that there is mild regur...
The Cardiothoracic Surgical Trials Network is reporting results for the first time from a clinical trial of patients who have a complication of coronary heart disease known as moderate ischemic mitral regurgitation. Study findings were presented today at the American Heart Associations Scientific Sessions 2014 and published simultaneously in the New England Journal of Medicine.
The trial was a randomised, prospective, non-blinded, multi-institutional study of patients undergoing surgery for severe ischaemic mitral regurgitation with or without coronary revascularisation," Dr Acker reported. A total of 251 patients were recruited, with approximately half undergoing mitral valve repair and half undergoing replacement. While there was no difference in efficacy or main safety outcomes, there was a difference in the percentage of patients experiencing a recurrence of IMR - 32.6% in the repair group versus 2.3% in the replacement group (p,0.001).. ...
Sometimes in the heart blood flows back in to the left atrium because the valve doesnt work properly which is called mitral regurgitation.