Search results for "Mitral"

Papillary muscle relocation and mitral annuloplasty in ischemic mitral valve regurgitation: midterm results.

2014

Objectives The surgical approach for ischemic mitral regurgitation remains unclear. Many studies are in favor of adding the subvalvular procedure to mitral annuloplasty to reduce recurrent mitral regurgitation. This study reports the clinical and echocardiographic outcomes of papillary muscle relocation combined with mitral annuloplasty.Methods From 2003, 115 patients with severe ischemic mitral regurgitation who underwent papillary muscle relocation plus nonrestrictive mitral annuloplasty and coronary artery bypass grafting were retrospective analyzed. Patients' mean age was 52 ± 12.8 years, New York Heart Association class III or IV was 71%, and preoperative left ventricular ejection frac…

Identification of abscess formation in native-valve infective endocarditis using transesophageal echocardiography: implications for surgical treatmen…

1991

The object of the study was to follow patients with endocarditis-associated abscesses in order to evaluate the clinical outcome with and without surgical intervention. Transesophageal echocardiography successfully displayed the location and extent of abscess cavities in 14 patients (group A) with aortic valve endocarditis. The infective process was limited to the perivalvular tissue in two, extended into the ascending aorta in six, and included the interventricular septum, the right ventricular outflow tract, interatrial septum, and/or mitral valve annulus in six patients. The complication rate was significantly higher in group A than in group B, which consisted of 27 patients with proven s…

The Neochord Procedure After Failed Surgical Mitral Valve Repair.

2021

Surgical mitral valve reintervention is associated with significant morbidity and mortality, and repeat repair is not always feasible. We examine the clinical outcomes of the NeoChord procedure after failed conventional mitral valve repair. A total of 312 patients were treated with the NeoChord repair procedure between January 2014 and December 2018 at 5 European centers. Clinical and echocardiographic data were reviewed to identify patients who had a prior surgical mitral valve repair procedure. The primary endpoint (Patient Success) was a composite of placement of at least 2 neochordae and end-procedure mitral valve regurgitation (MR) ≤ mild, freedom from death, stroke, structural or func…

T-shaped Transseptal Approach for Mitral Valve Surgery.

2020

AbstractWe present a T-shaped transseptal approach for mitral valve surgery that makes adequate exposure possible under challenging anatomic and surgical circumstances, hence eliminating the need for forceful retraction on potentially fragile tissues. Particularly suited for patients with complex mitral pathology, it also facilitates juxta-annular transseptal right atrial anchoring, especially in cases of endocarditic anterior mitral annular destruction.

Mitral valve annuloplasty and papillary muscle relocation oriented by 3-dimensional transesophageal echocardiography for severe functional mitral reg…

2012

Objective The study of the mitral valve apparatus and its modifications during functional mitral regurgitation (FMR) is better revealed by 3-dimensional (3D) transesophageal echocardiography (TOE). To plan mitral valve repair by annuloplasty and papillary muscle (PPM) relocation, we proposed a valve repair procedure oriented by the new main features obtained by real-time 3D TOE reconstruction of the mitral valve apparatus. Methods Since January 2008, 25 patients with severe FMR before mitral valve repair were examined. Mean coaptation depth and mean tenting area were 1.3 ± 0.2 cm and 3.2 ± 0.5 cm 2 , respectively. Intraoperative 2D and 3D TOE were performed, followed by a 3D offline reconst…

Transapical beating-heart chordae implantation in mitral regurgitation: a new horizon for repairing mitral valve prolapse

2016

Mitral regurgitation (MR) is increasingly prevalent in western countries despite reduced incidence of rheumatic disease (1,2). MR results from several heterogeneous conditions, including disorders of the valve leaflets, mitral annulus, chordae tendineae, papillary muscles and left ventricle (LV). MR causes are roughly classified as primary (i.e. organic/structural) or secondary (i.e. functional/non-structural) (3).

POINT: Efficacy of adding mitral valve restrictive annuloplasty to coronary artery bypass grafting in patients with moderate ischemic mitral valve re…

2009

ObjectiveSurgical management of moderate chronic ischemic mitral valve regurgitation is still debated. The aim of this study was to evaluate the effect of adding mitral valve repair to coronary artery bypass grafting on clinical outcomes and left ventricular remodeling in patients who underwent coronary artery bypass grafting alone versus coronary artery bypass grafting plus mitral valve repair in a randomized trial.MethodsBetween February 2003 and May 2007, 102 patients were eligible for this study and were randomly assigned to one of 2 groups by means of card allocation: coronary artery bypass grafting plus mitral valve repair (CABG plus MVR group; 48 patients, 47%) or coronary artery byp…

Evolution Of Moderate Chronic Ischemic Mitral Regurgitation In Patients Underwent Only Coronary Artery Surgery: Clinical And Echocardiographic Follow…

2008

Management of moderate chronic ischemic mitral valve regurgitation (oIMR) is still debated. Several authors favouring surgical treatment in combining with coronary artery bypass grafting (CABG) while others suggested conservative approach. However, evolution of moderate oIMR after only CABG is still unclear. Aim of this study was to evaluate prospectively, at rest and under exercise condition, the clinical outcomes and echocardiographic results of patients with moderate cIMR underwent onlv CABG.

2017

Background Percutaneous edge‐to‐edge mitral valve repair ( PMVR ) has become an established treatment option for mitral regurgitation in patients not eligible for surgical repair. Currently, most procedures are performed under general anesthesia ( GA ). An increasing number of centers, however, are performing the procedure under deep sedation ( DS ). Here, we compared patients undergoing PMVR with GA or DS . Methods and Results A total of 271 consecutive patients underwent PMVR at our institution between May 2014 and December 2016. Seventy‐two procedures were performed under GA and 199 procedures under DS . We observed that in the DS group, doses of propofol (743±228 mg for GA versus 369±2…

Diagnosis of papillary muscle rupture after acute myocardial infarction by transthoracic and transesophageal echocardiography.

1993

The sensitivity of transthoracic echocardiography to visualize the structural abnormality of papillary muscle rupture (PMR) after acute myocardial infarction can be anticipated to average about 50%; therefore, we evaluated five patients exhibiting the condition with both transthoracic and transesophageal echocardiography. The use of the two imaging techniques resulted in the fact that no instance of PMR was missed. Using transthoracic echocardiography in two patients and transesophageal echocardiography in four, the ruptured papillary muscle was visualized directly. Mitral insufficiency as an indirect sign was observed in all patients. In one patient the papillary muscle rupture developed i…