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Mitral valve percutaneous intervention

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https://read.qxmd.com/read/30855985/ct-support-of-cardiac-structural-interventions
#1
Michaela M Hell, Stephan Achenbach
Due to its high temporal and isotropic spatial resolution, CT has become firmly established for pre-procedural imaging in the context of structural heart disease interventions. CT allows to very exactly measure dimensions of the target structure, CT can provide information regarding the access route and, as a very valuable addition, volumetric CT data sets can be used to identify fluoroscopic projection angulations to optimally visualize the target structure and place devices. This review provides an overview of current methods and applications of pre-interventional CT to support adult cardiac interventions including transcatheter aortic valve implantation, percutaneous mitral valve intervention, left atrial appendage occlusion and paravalvular leak closure...
March 11, 2019: British Journal of Radiology
https://read.qxmd.com/read/30852836/interventional-treatment-of-mitral-valve-regurgitation-an-alternative-to-surgery
#2
Fabien Praz, Nicolas Brugger, Mohammad Kassar, Lukas Hunziker, Aris Moschovitis, Stefan Stortecky, David Reineke, Thomas Pilgrim, Stephan Windecker
Mitral regurgitation is a highly prevalent condition among elderly patients, affecting almost 10% of the general population aged 75 and older. Left untreated, severe mitral regurgitation results in high mortality and frequent hospitalisation for treatment of heart failure. Surgical treatment remains the first-line therapy for symptomatic, severe mitral regurgitation , especially for patients presenting with a primary aetiology. However, a high proportion of patients with mitral regurgitation are turned down for open-heart surgery, mainly due to advanced age, diminished left ventricular function and comorbidities...
February 25, 2019: Swiss Medical Weekly
https://read.qxmd.com/read/30824479/acute-mitral-regurgitation
#3
REVIEW
Nozomi Watanabe
The diagnosis of acute mitral regurgitation (MR) is often missed or delayed because the clinical presentation is substantially different from that in patients with chronic MR. Management of acute MR depends on the specific aetiology of valve dysfunction and there is a lack of consensus on the optimal therapeutic approach in many patients. In particular, management of secondary MR due to acute ischaemia is challenging because of unique mechanisms of valve incompetence compared with chronic ischaemic MR. Another clinical challenge is management of acute MR due to transient systolic anterior motion of the mitral valve in the acute phase of Takotsubo cardiomyopathy, which commonly resolves within a few weeks...
March 1, 2019: Heart: Official Journal of the British Cardiac Society
https://read.qxmd.com/read/30791961/effects-of-mitraclip-on-cognitive-and-psychological-function-in-heart-failure-patients-the-sicker-the-better
#4
Valentin Terhoeven, Christoph Nikendei, Anna Cranz, Matthias Weisbrod, Nicolas Geis, Philip W Raake, Hugo A Katus, Wolfgang Herzog, Hans-Christoph Friederich, Jobst-Hendrik Schultz, Sven T Pleger
PURPOSE: Cognitive impairment and reduced quality of life is a common condition in patients with heart failure (HF). Percutaneous mitral valve repair using (PMVR) MitraClip (MC) has emerged as a promising interventional tool, reducing all-cause mortality and hospitalization as well as increasing cognitive functioning and quality of life. However, the benefit of HF patients with severely depressed cognitive functioning remains unknown. METHODS: We assessed cognitive functioning (figural memory-FGT, executive function-TOL, TMT B), psychosocial functioning (depression-PHQ-9, quality of life-SF36), and clinical parameters (echocardiography, 6-min walk test distance, and cardiac biomarkers) 1 day before (t0) and 6 weeks after (t1) MC intervention in HF patients (n = 40)...
February 22, 2019: European Journal of Medical Research
https://read.qxmd.com/read/30790414/percutaneous-treatment-of-mitral-regurgitation-in-patients-with-impaired-ventricular-function-impact-of-intracardiac-electronic-devices-from-the-german-transcatheter-mitral-valve-interventions-registry
#5
Giuseppe D'Ancona, Hüseyin Ince, Wolfgang Schillinger, Jochen Senges, Taoufik Ouarrak, Christian Butter, Martin Seifert, Thomas Schau, Edith Lubos, Peter Boekstegers, Ralph Stephan von Bardeleben, Erdal Safak
OBJECTIVES: To identify prevalence/impact of previous implantation of cardiac electronic devices (CEDs), such as cardioverter defibrillator (ICD) and cardiac resynchronization (CRT), in a group of MitraClip (MC) candidates with LVEF < 30%. BACKGROUND: MC therapy is nowadays often considered in patients with depressed left ventricular ejection fraction (LVEF%) and symptomatic severe secondary MR. METHODS: Data from the German Transcatheter Mitral Valve Interventions (TRAMIs) registry were analyzed...
February 21, 2019: Catheterization and Cardiovascular Interventions
https://read.qxmd.com/read/30771213/echocardiographic-guidance-for-transcatheter-mitral-valve-repair-using-edge-to-edge-clip
#6
REVIEW
Edris Aman, Thomas W Smith
Percutaneous intervention for mitral valve disease has been established as an alternative to open surgical repair in high risk and inoperable candidates. Edge-to-edge leaflet plication with Mitraclip (Abbott, Menlo Park, CA, USA) is indicated for primary and secondary mitral valve diseases. Echocardiography provides a better understanding of mitral valve anatomy and allows us to classify and quantify mitral regurgitation. Transesophageal echocardiography is essential in patient screening, intraprocedural guidance, and post-procedure evaluation for patients undergoing edge-to-edge plication with MitraClip...
February 15, 2019: Journal of Echocardiography
https://read.qxmd.com/read/30766003/left-circumflex-artery-injury-postmitral-valve-surgery-single-center-experience
#7
Aysha Husain, Aly Alsanei, Mohammed Tahir, Ziad Dahdouh, Zohair AlHalees, Ali AlMasood
The left circumflex (LCX) artery is located close to the mitral valve (MV), making it susceptible to injury during MV surgery. We are reporting our experience in the diagnosis and management of this complication. We retrospectively reviewed our surgical and coronary angiography databases for patients with documented LCX artery injury during MV surgery between January 2000 and December 2016. The complication was associated with MV replacement (9/1313, 0.7%) but not MV repair (0/393, 0.0%). Eight patients (88...
April 2019: Journal of the Saudi Heart Association
https://read.qxmd.com/read/30704670/impact-of-mitral-stenosis-on-survival-in-patients-undergoing-isolated-transcatheter-aortic-valve-implantation
#8
Anna Sannino, Srinivasa Potluri, Benjamin Pollock, Giovanni Filardo, Ambarish Gopal, Robert C Stoler, Molly Szerlip, Anima Chowdhury, Michael J Mack, Paul A Grayburn
This study was performed to investigate the prevalence and impact on survival of baseline mitral stenosis (MS) in patients who underwent transcatheter aortic valve implantation (TAVI) due to the presence of severe symptomatic aortic stenosis. This retrospective study included 928 consecutive patients with severe, symptomatic aortic stenosis who underwent TAVI in 2 institutions, from January 2012 to August 2016. Mean follow-up was 40.8 ± 13.9 months. Based on the mean mitral gradient (MMG) at baseline, 3 groups were identified: MMG <5 mm Hg (n = 737, 81...
January 25, 2019: American Journal of Cardiology
https://read.qxmd.com/read/30627291/combined-percutaneous-procedure-in-patient-with-lutembacher-syndrome-a-case-report-and-real-world-experience-review
#9
Quang Tan Phan, Hieu Lan Nguyen, Tai Duc Le, WangSoo Lee, HoYoun Won, SeungYong Shin, Saima Sharmin, Truong Quang Nguyen, SangWook Kim
Even cardiac surgery has been accepted as the standard therapy for Lutembacher syndrome, a combination of congenital ostium secundum atrial septal defect (ASD) and acquired mitral valve stenosis (MVS), it also owns many limitations and disadvantages. Therefore, seeking for a less invasive therapy with the same efficacy may be worthwhile. Thanks to the development in technology and experience gaining in cardiovascular intervention, the combination of the two proved effective procedures, including percutaneous MVS treatment using balloon valvuloplasty and percutaneous ASD closure using atrial septal occluders, can be utilized as an attractive alternative therapy for these conditions...
December 2018: Cardiology Research
https://read.qxmd.com/read/30611459/percutaneous-transcatheter-edge-to-edge-mitraclip-technique-a-practical-step-by-step-3-dimensional-transesophageal-echocardiography-guide
#10
REVIEW
Limor Ilan Bushari, Guy S Reeder, Mackram F Eleid, Krishnaswamy Chandrasekaran, Maurice Eriquez-Sarano, Charanjit S Rihal, Joseph F Maalouf
Recent innovations and advancements in 3-dimensional (3D) echocardiography allow for better understanding of anatomic relationships and improve communication with the interventional cardiologist for guidance of catheter-based interventions. The mitral valve lends itself best for imaging with transesophageal echocardiography (TEE). Consequently, the role of 3D TEE in guiding catheter-based mitral interventions has been evolving rapidly. Although several publications have reported on the advantages and role of 3D TEE in guiding one or more of the steps involved in percutaneous mitral valve repair using the MitraClip, none offer a comprehensive and practical user-friendly guide...
January 2019: Mayo Clinic Proceedings
https://read.qxmd.com/read/30595769/acute-papillary-muscle-rupture-immediately-after-st-segment-elevation-acute-myocardial-infarction-a-case-report
#11
Taro Kamada, Masamichi Iwasaki, Wataru Fujimoto, Kentaro Yamashita, Shun Yokota, Daisuke Tsuda, Hiroyuki Yamamoto, Takao Mizuguchi, Takumi Inoue, Hiroshi Okamoto, Susik Kim, Takatoshi Hayashi
A 73-year-old woman in cardiogenic shock was referred to our hospital because of papillary muscle rupture immediately after the onset of acute myocardial infarction (MI). She had undergone emergent percutaneous coronary intervention and mitral valve replacement. Serial creatine kinase and creatine kinase MB levels indicated that she had acute phase MI on arrival. Pathological findings showed coagulative necrosis of the papillary muscle, which was characteristic evidence of the consequence of prolonged ischemia...
December 2018: Journal of Cardiology Cases
https://read.qxmd.com/read/30560603/sociodemographic-clinical-and-patient-reported-outcomes-and-readmission-after-heart-valve-surgery
#12
Britt Borregaard, Jan Sørensen, Ola Ekholm, Jacob E Møller, Lars P Riber, Lars Thrysoee, Charlotte B Thorup, Marianne Vamosi, Anne V Christensen, Trine B Rasmussen, Selina K Berg
BACKGROUND: Readmissions after heart valve surgery represent a significant burden for both the patient and the healthcare system. The study aim was to identify independent predictors of readmission within 180 days after surgery in a population of patients undergoing heart valve surgery. METHODS: Demographic and clinical information was obtained from national registers. Patient-reported outcomes (PROs) including Short Form 12 (SF-12) and EuroQol 5D (EQ-5D) were measured at discharge as part of a national, cross-sectional study (DenHeart)...
January 2018: Journal of Heart Valve Disease
https://read.qxmd.com/read/30554887/profiles-of-hospitalized-patients-with-valvular-heart-disease-experience-of-a-tertiary-center
#13
Ana Fátima Esteves, Dulce Brito, Joana Rigueira, Inês Ricardo, Raquel Pires, Mónica Mendes Pedro, Fátima Veiga, Fausto Pinto
INTRODUCTION: Valvular heart disease (VHD) is increasing worldwide, mostly because of aging. Percutaneous valve intervention is the preferred therapeutic option in high-risk patients. OBJECTIVE: To characterize the profiles of patients with VHD admitted to the cardiology ward at a tertiary referral center. METHODS: On the basis of ICD-9 codes for VHD, the discharge notes of 287 patients hospitalized over a 22-month period were reviewed and analyzed...
December 13, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://read.qxmd.com/read/30553663/proportionate-and-disproportionate-functional-mitral-regurgitation-a-new-conceptual-framework-that-reconciles-the-results-of-the-mitra-fr-and-coapt-trials
#14
REVIEW
Paul A Grayburn, Anna Sannino, Milton Packer
Traditional approaches to the characterization of secondary or functional mitral regurgitation (MR) have largely ignored the critical importance of the left ventricle (LV). We propose that patients with secondary MR represent a heterogenous group, which can be usefully subdivided based on understanding that the effective regurgitant orifice area (EROA) is dependent on left ventricular end-diastolic volume (LVEDV). According to the Gorlin hydraulic orifice equation, patients with heart failure, an LV ejection fraction of 30%, an LVEDV of 220 to 250 ml, and a regurgitant fraction of 50% would be expected to have an EROA of ≈0...
December 6, 2018: JACC. Cardiovascular Imaging
https://read.qxmd.com/read/30549514/repair-of-tricuspid-papillary-muscle-rupture-after-percutaneous-coronary-intervention
#15
Shinji Kanemitsu
Papillary muscle rupture is a rare complication after myocardial infarction and almost all cases occur in the mitral valve papillary muscle. Tricuspid regurgitation development after right ventricular myocardial infarction caused by papillary muscle rupture is extremely rare.  In this video tutorial we present a 70-year-old man with massive tricuspid regurgitation caused by papillary muscle rupture after percutaneous stenting of the right coronary artery. We performed tricuspid valve repair with reimplanted papillary muscle in situ using neither artificial chordae nor a prosthetic valve...
December 6, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30517619/male-female-differences-in-characteristics-and-early-outcomes-of-patients-undergoing-tricuspid-valve-surgery-a-national-cohort-study-in-the-netherlands
#16
Kevin M Veen, Mostafa M Mokhles, Jerry Braun, Michel I M Versteegh, Ad J J C Bogers, Johanna J M Takkenberg
OBJECTIVES: This study aims to explore male-female differences in baseline and procedural characteristics, and outcomes of patients undergoing isolated or concomitant tricuspid valve (TV) surgery. METHODS: All TV procedures registered between 2007 and 2016 in the database of the Netherlands Association for Cardio-Thoracic Surgery were analysed. Logistic regression analyses with interaction terms were used to determine whether sex was associated with hospital mortality...
December 4, 2018: European Journal of Cardio-thoracic Surgery
https://read.qxmd.com/read/30508856/-heart-valve-disease-update-esc-guideline-2017
#17
Hüseyn Ince, Tobias Zeus
Surgical management of patients with aortic valve stenosis is declining and Transcatheter aortic valve implantation (TAVI) is becoming the treatment of choice in many patients. The ESC guideline integrated results of randomized controlled trials in patients with intermediate surgical risk for the first time. TAVI showed good and comparable results to the standard surgical approach.Mitral regurgitation (MR) is a complex disease with good surgical results in primary MR and mixed results in secondary MR. Secondary MR is mainly based on left ventricular disease with subsequent dilatation...
December 2018: Deutsche Medizinische Wochenschrift
https://read.qxmd.com/read/30498690/antiplatelet-therapy-in-valvular-and-structural-heart-disease-interventions
#18
REVIEW
Annunziata Nusca, Edoardo Bressi, Iginio Colaiori, Marco Miglionico, Germano Di Sciascio
Transcatheter interventions for valvular and structural heart diseases are rapidly expanding due to greater operators' experience and development of new generation devices associated with increased procedural safety. They represent the standard strategy for patients with prohibitive risk for open surgery. These procedures are associated with a significant occurrence of both thrombotic and bleeding complications, thus in this setting, even more than in other percutaneous procedures, the balance between thrombotic and bleeding risk is critical...
October 2018: Cardiovascular Diagnosis and Therapy
https://read.qxmd.com/read/30461167/long-term-outcomes-of-melody-valve-in-valve-implantation-for-bioprosthetic-mitral-valve-dysfunction
#19
Timothy A Joseph, Mackram F Eleid, Allison K Cabalka, Joseph F Maalouf, Charanjit S Rihal
OBJECTIVES: This study reports long-term outcomes percutaneous Melody valve (Medtronic, Minneapolis, Minnesota) valve-in-valve therapy in patients with prosthetic valve dysfunction. BACKGROUND: Repeat valve surgery is associated with high morbidity and mortality. Transcatheter mitral valve-in-valve is a promising alternative in patients at high-risk for cardiac surgery. METHODS: We conducted a retrospective cohort analysis of 13 patients who underwent Melody valve-in-valve for bioprosthetic dysfunction from July 2011 to October 2013...
November 20, 2018: Catheterization and Cardiovascular Interventions
https://read.qxmd.com/read/30449876/-aorta-left-main-trunk-interposition-for-adult-anomalous-origin-of-the-left-coronary-artery-from-the-pulmonary-artery-using-a-prosthetic-graft-report-of-a-case
#20
Shota Yamanaka, Tomoya Uchimuro, Suguru Amagaya, Ryogen Yun, Yohei Onga, Chihaya Itou, Daiki Saito, Masayuki Shimizu, Kenji Wada, Takahide Yoshio, Shuichiro Takanashi
A 70-year-old woman with back pain was diagnosed with adult anomalous origin of the left coronary artery from the pulmonary artery [Bland-White-Garland (BWG) syndrome]. Preoperative transthoracic echocardiography showed diffuse hypokinesia of the left ventricle and mild mitral valve regurgitation. Coronary angiography revealed dilatation of both coronary arteries, but no aneurysms. The left coronary ostium was removed as buttons of the pulmonary arterial wall, and a prosthetic graft (8 mm ePTFE graft) was interposed between the ascending aorta and coronary button...
November 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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