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Seminars in Thoracic and Cardiovascular... Mar 2018Congenital mitral valve (MV) dysplasia is a relatively rare and highly complex cardiac disease. We sought to provide a comprehensive analysis of the current surgical... (Review)
Review
Congenital mitral valve (MV) dysplasia is a relatively rare and highly complex cardiac disease. We sought to provide a comprehensive analysis of the current surgical techniques for treating mitral valve insufficiency and the results of mitral valve repair at our institution. Between 1972 and 2017, 104 consecutive patients underwent surgical repair of congenital MV dysplasia-insufficiency at our institution. Among these, 59 patients presented with MV insufficiency (or prevalent MV insufficiency) and were part of the study. There was 1 early (1.7%) and 1 late death (1.7%). Survival at 5, 10 and 20 years was 98%, 98% and 94%, respectively. Eight patients (14%) required MV replacement for residual significant MV insufficiency. Freedom from re-intervention for MV dysfunction at 5, 10 and 20 years were 89%, 84% and 79%, respectively. Surgical techniques for treating mitral valve insufficiency must be tailored for each patient with the main goal of achieving a proper valve function, rather than a "normal" anatomy. The mechanism underlying valve dysfunction in congenital mitral valve insufficiency is multifactorial and requires the application of a variety of surgical techniques in each case.
Topics: Child; Child, Preschool; Humans; Mitral Valve Annuloplasty; Mitral Valve Insufficiency
PubMed: 29425524
DOI: 10.1053/j.pcsu.2017.11.004 -
European Heart Journal Jul 1991Degenerative mitral valve disease has become the major cause of mitral regurgitation in North America; it is incumbent on surgeons to know repair techniques and to... (Review)
Review
Degenerative mitral valve disease has become the major cause of mitral regurgitation in North America; it is incumbent on surgeons to know repair techniques and to document their results. Fortunately, improvements in myocardial protection have been concurrent with the evolution of mitral valve repair in our country. The steep learning curve may be traversed, and the majority of degenerative mitral valves may be successfully repaired. Serial echo Doppler studies provide documentation of successful repair and monitor the patient's progress objectively. Echocardiography also provides a forum for communication between surgeons and cardiologists and, for the first time, the presence and amount of residual mitral regurgitation can be quantitated.
Topics: Echocardiography, Doppler; Follow-Up Studies; Humans; Mitral Valve Insufficiency; Survival Rate
PubMed: 1936020
DOI: 10.1093/eurheartj/12.suppl_b.30 -
Heart Failure Clinics Oct 2018Mitral valve diseases are common causes of congestive heart failure. Chronic primary and secondary (functional) mitral valve regurgitation are the most common reasons.... (Review)
Review
Mitral valve diseases are common causes of congestive heart failure. Chronic primary and secondary (functional) mitral valve regurgitation are the most common reasons. Valve repair for primary mitral regurgitation cures mitral valve disease, whereas in functional regurgitation, mitral valve repair is associated with high failure rates secondary to persistent/progressive ventricular dysfunction and remodeling. Most patients are managed with strict adherence to the valve guidelines. Mitral valve replacement has an increased role in management of functional mitral regurgitation. Surgery for mitral valve disease is indicated in symptomatic patients with severe valve disease and in asymptotic before irreversible ventricular damage occurs.
Topics: Cardiac Surgical Procedures; Heart Failure; Humans; Mitral Valve; Mitral Valve Insufficiency
PubMed: 30266367
DOI: 10.1016/j.hfc.2018.06.006 -
Annual Review of Medicine 1976Mitral valve prolapse is a condition that is being recognized with increased frequency. It is not known whether its incidence is increasing, or whether we are better... (Review)
Review
Mitral valve prolapse is a condition that is being recognized with increased frequency. It is not known whether its incidence is increasing, or whether we are better able to diagnose it today. In the idiopathic or familial variety, the mitral valve pathology is almost always that of myxomatous degeneration. Some authors have suggested the presence of a cardiomyopathy because of significant left ventricular dysfunction in many cases. Idiopathic prolapse occurs predominantly in females, often at a young age, and may be associated with chest pain, dyspnea, fatigue, presyncope, syncope, and/or sudden death. The clinical findings are variable and typically consist of a nonejection click and/or late systolic murmur, heard best at the cardiac apex. Diagnosis can be confirmed by echocardiography and/or ventricular cineangiography, the latter permitting accurate recognition of the anatomy of the prolapsed leaflets. The complications of infective endocarditis, severe mitral insufficiency, and life-threatening ventricular arrhythmias represent the major problems of management. It is important to distinguish the idiopathic form of mitral valve prolapse from that due to coronary artery disease and to realize that mitral valve prolapse may occur in Marfan's syndrome, Turner's syndrome, or in association with secundum atrial septal defect or ruptured chordae tendineae. Typical clicks and/or murmurs have also been described in patients with a history of rheumatic fever and in hypertrophic cardiomyopathy. Although much descriptive knowledge has accumulated over the past 15 years, many unanswered questions remain regarding the idiopathic type of prolapse. What is the nature and cause(s) of myxomatous degeneration? What is the relation of the valve pathology to the left ventricular dysfunction? What is the relation of both of these factors to disabling chest pain, electrocardiographic changes, and life-threatening arrhythmias? Hopefully, answers to these and other important questions regarding mitral valve prolapse will be forthcoming.
Topics: Electrocardiography; Heart Sounds; Humans; Mitral Valve; Mitral Valve Insufficiency; Radiography; Vectorcardiography
PubMed: 779595
DOI: 10.1146/annurev.me.27.020176.001121 -
International Journal of Clinical... Oct 2014In industrially developed countries, moderate or severe mitral valve disease is relatively common and is usually caused by prolapse or is secondary to left ventricular...
In industrially developed countries, moderate or severe mitral valve disease is relatively common and is usually caused by prolapse or is secondary to left ventricular disease. Mitral stenosis (MS), however, is uncommon and usually a sequela of rheumatic fever. This article discusses the natural history of mitral regurgitation and MS and their medical and surgical management.
Topics: Female; Humans; Male; Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Prolapse; Mitral Valve Stenosis
PubMed: 24423132
DOI: 10.1111/ijcp.12321 -
Advances in Experimental Medicine and... 2018Mitral regurgitation (MR) is the most frequent Valvular Heart Disease (VHD) and is an important cause of heart failure. MR can be caused by primary valve abnormality... (Review)
Review
Mitral regurgitation (MR) is the most frequent Valvular Heart Disease (VHD) and is an important cause of heart failure. MR can be caused by primary valve abnormality (Degenerative MR/Primary MR) or it can be secondary to cardiomyopathy (Functional MR/Secondary MR). Medical management alleviates symptoms but does not alter the progression of the disease. Current guidelines recommend surgery for moderate-to-severe (Grade > 3) MR in patients with symptoms or evidence of left ventricular dysfunction. Despite current practice guidelines, the majority of patients with severe MR do not undergo surgery. The reasons include high surgical risk from advanced age or multiple comorbidities, and a lack of clear data supporting valve surgery for secondary MR with LV dysfunction. The recent emergence of percutaneous interventional approaches in treating MR has expanded therapeutic options for patients who are at high risk for conventional Mitral Valve (MV) surgery. In this chapter, we will review the novel advancements in the field of percutaneous MV interventions that could potentially become the standard of care for patients with MR and heart failure.
Topics: Heart Failure; Humans; Mitral Valve; Mitral Valve Insufficiency
PubMed: 29277857
DOI: 10.1007/5584_2017_142 -
Brazilian Journal of Cardiovascular... Aug 2021A rare case of congenital mitral insufficiency characterized by a fenestration in the anterior leaflet of mitral valve is reported. At operation, the mitral valve was...
A rare case of congenital mitral insufficiency characterized by a fenestration in the anterior leaflet of mitral valve is reported. At operation, the mitral valve was successfully repaired by closure of unusual valvular tissue orifice with bovine pericardium and suture of the free edge between A1 and A2 without a ring annuloplasty.
Topics: Heart Defects, Congenital; Humans; Infant, Newborn; Mitral Valve; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Tricuspid Valve
PubMed: 34236785
DOI: 10.21470/1678-9741-2020-0262 -
Italian Heart Journal. Supplement :... May 2002Over the past 15 years, outcome of patients with severe mitral insufficiency is significantly improved. This may be due to concomitant advances in many fields of... (Review)
Review
Over the past 15 years, outcome of patients with severe mitral insufficiency is significantly improved. This may be due to concomitant advances in many fields of medicine such as a more effective diagnosis and left ventricular function monitoring by means of echocardiography, development of useful guidelines and advances in valve reconstruction techniques. We will discuss some aspects of mitral anatomy, pathophysiology, echocardiographic diagnosis and the proper timing for surgical intervention.
Topics: Heart Ventricles; Humans; Mitral Valve Insufficiency; Severity of Illness Index; Ultrasonography
PubMed: 12064187
DOI: No ID Found -
Journal of Cardiac Surgery Oct 2019
Topics: Echocardiography, Three-Dimensional; Humans; Mitral Valve; Mitral Valve Annuloplasty; Mitral Valve Insufficiency
PubMed: 31231842
DOI: 10.1111/jocs.14119 -
Terapevticheskii Arkhiv 1986
Review
Topics: Acute Disease; Chronic Disease; Diagnosis, Differential; Humans; Mitral Valve Insufficiency
PubMed: 3547751
DOI: No ID Found