Image-based fluid dynamics analysis of left ventricle outflow tract pressure gradient after deployment transcatheter mitral valve

2017 ◽  
Author(s):  
Yousef Alharbi ◽  
Nigel H. Lovell ◽  
James Otton ◽  
David Muller ◽  
Amr Al Abed ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Pressure Gradient ◽  
Outflow Tract ◽  
Dynamics Analysis

scholarly journals P2579Patient-specific LV fluid dynamics analysis to guide percutaneous mitral valve implantation

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
Y Alharbi ◽  
J Otton ◽  
D Muller ◽  
N H Lovell ◽  
A Al Abed ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Mitral Valve ◽  
Dynamics Analysis ◽  
Valve Implantation

scholarly journals Anterior mitral leaflet length and mitral annulus diameter impact the echocardiographic outcome after isolated myectomy

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Mateusz Kuć ◽  
Magdalena Kumor ◽  
Mariusz Kłopotowski ◽  
Maciej Dąbrowski ◽  
Natalia Kopyłowska-Kuć ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Nyha Class ◽  
Mitral Annulus ◽  
Outflow Tract ◽  
Mitral Leaflet ◽  
Anterior Mitral Leaflet ◽  
Anterior Posterior ◽  
Annulus Diameter

Abstract Background Myectomy remains the standard surgical treatment of patients with hypertrophic cardiomyopathy (HOCM). New surgical methods developed in the last decades mainly address the mitral valve and are controversial because of their conflicting assumptions. This study assesses the influence of anterior mitral valve leaflet (AML) length and the anterior-posterior diameter of the mitral annulus (MAD) on dynamic left ventricle outflow tract obstruction and mitral regurgitation (MR) after extended myectomy. Methods We retrospectively analysed the transthoracic echocardiograms (TTE) of 36 patients. AML length and MAD were obtained from TTE performed before the operation. The greatest maximal left ventricle outflow tract (LVOT) gradient and MR registered in follow-up were analysed. After surgery, patients were divided into two groups; those with moderate or milder MR and/or an LVOT gradient < 30 mmHg (responders), and those with more than moderate MR and/or an LVOT gradient ≥30 mmHg (non-responders). Results Patients in responders group had significantly longer AML: 32.3 ± 2.3 mm vs 30.0 ± 3.8 mm (p = 0.03) [parasternal long axis view – PLAX view], 25.9 ± 2.3 mm vs 23.5 ± 2.7 mm (p = 0.008) [four chamber view - 4CH view] and larger anterior-posterior mitral annulus diameter 28.1 ± 2.8 mm vs 25.4 ± 3.2 mm (p = 0.011) than those in non-responders group. Among all analysed patients longer anterior mitral leaflet was correlated with lower postoperative LVOT gradient when measured in PLAX view (p = 0.02) and lower degree of MR due to systolic anterior motion (SAM) when measured in 4CH view (p = 0.009). Greater [AML x mitral annulus] ratio correlated with lower postoperative LVOT gradient in both projections: 4CH (p = 0.025), PLAX (p = 0.012). There was significant reduction in NYHA Class after surgery (p = 0.000). There were no significant differences in NYHA class after surgery (p = 0.633) neither in NYHA class reduction (p = 0.475) between patients divided into responders and non-responders group according to echocardiographic parameters. Conclusions Patients with a longer AML and a greater diameter of the mitral annulus are less likely to have mitral regurgitation due to residual SAM and increased LVOT gradient after an extended myectomy. Division of patients according to echocardiographic criteria into responders and non-responders was not in concordance with clinical improvement. Trial registration Retrospective study. Approved by ethics committee (IK-NPIA-0021-21/1763/19) at 16.01.2019.

scholarly journals Corevalve Evolut R implantation to treat severe left ventricle outflow tract obstruction following mitral valve-in-ring: first-in-man report

2015 ◽  
Vol 37 (3) ◽  
pp. 317-317 ◽  
Author(s):  
Maurizio Taramasso ◽  
Fabian Nietlispach ◽  
Markus Schmid ◽  
Francesco Maisano
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Outflow Tract

scholarly journals Pseudoaneurysm of mitro-aortic intervalvular fibrosa during the course of mitral valve endocarditis with aorto-left ventricle outflow tract fistula

2012 ◽  
Vol 24 (3) ◽  
pp. 201-204 ◽  
Author(s):  
A. Fazlinezhad ◽  
H. Fatehi ◽  
S. Tabaee ◽  
M. Alavi ◽  
L. Hoseini ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Outflow Tract ◽  
Tract Fistula

scholarly journals Subaortinė stenozė ir dviburio vožtuvo anoma-lijos: chirurginio gydymo ypatumai

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Daina Liekienė ◽  
Virgilijus Lebetkevičius ◽  
Virgilijus Tarutis ◽  
Rimantas Karalius ◽  
Rita Sudikienė ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Subaortic Stenosis ◽  
Left Ventricular Outflow ◽  
Vilnius University

Daina Liekienė1, Virgilijus Lebetkevičius1, Virgilijus Tarutis2, Rimantas Karalius1, Rita Sudikienė2, Kęstutis Lankutis2, Giedrė Nogienė1, Alicija Dranenkienė1, Vytautas Sirvydis11 Vilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Subaortinės stenozės diagnozė apima didelį spektrą anatominių pakitimų – nuo paprastos membranos iki fibroraumeninio tunelio. Straipsnyje aprašoma reta subaortinė stenozė, sukelta dviburio vožtuvo priekinės burės ir papilinio raumens anomalijos. Trys pacientai, operuoti dėl subaortinės stenozės, sukeltos dviburio vožtuvo anomalijos, dviem atlikta dviburio vožtuvo plastika ir kairiojo skilvelio infundibulinės dalies raumenų rezekcija. Vienam ligoniui atliktas mitralinio vožtuvo (MV) protezavimas ir kairiojo skilvelio infundibulinės dalies raumenų rezekcija.Dviburį vožtuvą išsaugančias operacijas dažniau pavyksta padaryti, kai dviburio vožtuvo yda yra antrinė liga. Dviburio vožtuvo plastika galima rečiau, jei anomalaus dviburio vožtuvo audiniai siaurina kairiojo skilvelio infundibulinę dalį. Pagrindiniai žodžiai: subaortinė stenozė, dviburio vožtuvo anomalija, kairiojo skilvelio išvarymo trakto obstrukcija Subaortic stenosis and mitral valve anomaly: surgical treatment aspects Daina Liekienė1, Virgilijus Lebetkevičius1, Virgilijus Tarutis2, Rimantas Karalius1, Rita Sudikienė2, Kęstutis Lankutis2, Giedrė Nogienė1, Alicija Dranenkienė1, Vytautas Sirvydis11 Vilnius University, Cardiac Surgery Centre, Santariškių str. 2, LT-08661 Vilnius, Lithuania2 Vilnius University Hospital „Santariškių klinikos“, Cardiac Surgery Centre,Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] The diagnosis of subaortic stenosis contains a broad spectrum of anatomical changes varying from discrete membrane to fibromuscular tunnel. We review a rare subaortic stenosis caused by anomaly of mitral valve anterior leaflet and papillary muscle. We review three patients who underwent surgery because of subaortic stenosis caused by anomalous mitral valve. Two patients underwent mitral valve plastic and resection of the left ventricular outflow tract muscles. One patient underwent mitral valve replacement and resection of the left ventricular outflow tract muscles.Valve preserving operations are more easy to perform when mitral valve disease is a comorbidity. Mitral valvoplasty is more complicated to perform when the mass of anomalous mitral valve obstructs the outflow tract of the left ventricle. Key words: subaortic stenosis, anomalous mitral valve, left ventricle outflow tract obstruction

Primary Cardiac Synovial Sarcoma Originating from the Mitral Valve Causing Left Ventricular Outflow Tract Obstruction

2015 ◽  
Vol 18 (3) ◽  
pp. 112 ◽  
Author(s):  
Altin Veshti ◽  
Edvin Mihal Prifti ◽  
Majlinda Ikonomi
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Synovial Sarcoma ◽  
Surgical Excision ◽  
Radical Resection ◽  
Ventricular Outflow Tract ◽  
Small Mass ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Cardiac Synovial Sarcoma

An 11-year-old boy was admitted due to different episodes of syncope and convulsion. Echocardiogram revealed a mass of 2 × 4 cm originating from the mitral subvalvular apparatus and more precisely from the antero-lateral papillary muscle, protruding in the left ventricle outflow tract causing intermittent obstruction. The patient underwent surgical excision of the left sided mass. Pathology confirmed the diagnosis of primary synovial sarcoma. At 6 months after the operation a small mass in the left ventricle of 1 × 1 cm was detected. The patient underwent reoperation consisting in radical resection of the subvalvular apparatus and mitral valve replacement. Histology confirmed that the mass was a cardiac synovial sarcoma. At 1 year after surgery the patient is doing well.

Extended Myectomy for Hypertrophic Obstructive Cardiomyopathy

2012 ◽  
Vol 15 (5) ◽  
pp. 251
Author(s):  
Changqing Gao ◽  
Chonglei Ren ◽  
Cangsong Xiao ◽  
Yang Wu ◽  
Gang Wang ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Surgical Procedures ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Systolic Anterior Motion ◽  
Anterior Leaflet ◽  
Septal Myectomy ◽  
The Mean

<p><b>Background:</b> The purpose of this study was to summarize our experience of extended ventricular septal myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM).</p><p><b>Methods:</b> Thirty-eight patients (26 men, 12 women) with HOCM underwent extended ventricular septal myectomy. The mean age was 36.3 years (range, 18-64 years). Diagnosis was made by echocardiography. The mean (mean � SE) systolic gradient between the left ventricle (LV) and the aorta was 89.3 � 31.1 mm Hg (range, 50-184 mm Hg) according to echocardiographic assessments before the operations. Moderate or severe systolic anterior motion (SAM) of the anterior leaflet of the mitral valve was found in 38 cases, and mitral regurgitation was present in 29 cases. Extended ventricular septal myectomy was performed in all 38 cases. The results of the surgical procedures were evaluated intraoperatively with transesophageal echocardiography (TEE) and with transthoracic echocardiography (TTE) at 1 to 2 weeks after the operation. All patients were followed up with TTE after their operation.</p><p><b>Results:</b> All patients were discharged without complications. The TEE evaluations showed that the mean systolic gradient between the LV and the aorta decreased from 94.8 � 35.6 mm Hg preoperatively to 13.6 � 10.8 mm Hg postoperatively (<i>P</i> = .0000) and that the mean thickness of the ventricular septum decreased from 28.3 � 7.9 mm to 11.8 � 3.2 mm (<i>P</i> = .0000). Mitral regurgitation and SAM were significantly reduced or eliminated. During the follow-up, all patients promptly became completely asymptomatic or complained of mild effort dyspnea only, and syncope was abolished. TTE examinations showed that the postoperative pressure gradient either remained the same or diminished.</p><p><b>Conclusions:</b> Extended ventricular septal myectomy is mostly an effective method for patients with HOCM, and good surgical exposure and thorough excision of the hypertrophic septum are of paramount importance for a successful surgery.</p>

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