scholarly journals Left ventricular outflow tract area after percutaneous transseptal transcatheter mitral valve implantation: A three‐dimensional transesophageal echocardiography study

2021 ◽  
Author(s):  
Atsushi Hayashi ◽  
Hiroki Ikenaga ◽  
Takafumi Nagaura ◽  
Jun Yoshida ◽  
Goki Uno ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Transesophageal Echocardiography ◽  
Left Ventricular Outflow Tract ◽  
Three Dimensional ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Outflow ◽  
Valve Implantation

scholarly journals Left Ventricular Outflow Tract Area After Percutaneous Transseptal Transcatheter Mitral Valve Implantation; A Three-dimensional Transesophageal Echocardiography Study

2021 ◽  
Author(s):  
atsushi hayashi ◽  
hiroki ikenaga ◽  
takafumi nagaura ◽  
Jun Yoshida ◽  
Florian Rader ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Transesophageal Echocardiography ◽  
Left Ventricular Outflow Tract ◽  
Strong Association ◽  
Multivariable Analysis ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Outflow ◽  
Valve Implantation

Background: Left ventricular (LV) outflow tract (LVOT) obstruction increases mortality in patients undergoing transcatheter mitral valve implantation (TMVI) in degenerated bioprostheses, annuloplasty rings, and native mitral valves. We aimed to evaluate the left ventricular outflow tract area after TMVI using 3-diensional (3D) transesophageal echocardiography (TEE) and to investigate the pre-procedural cardiac geometry affects the LVOT area after TMVI. Methods: We retrospectively reviewed echocardiography data in 43 patients who had TMVI. A change in pressure gradient across LVOT from before to after TMVI (∆PG) and post-procedure 3D cross sectional area (CSA) at the level of the most distal portion of the mitral valve stent that was closest to the LV apex were assessed as evidence of LVOT narrowing. Results: TMVI with the use of balloon-expandable valve system was performed for 24 bioprostheses, 7 annuloplasty rings, and 12 native valves. Compared to patients without increase in LVOT gradient (∆PG <10 mmHg; n=33), patients with increase in LVOT gradient (∆PG ≥10 mmHg; n=10) had smaller LV end-systolic volume (LVESV), greater LV ejection fraction (LVEF) and smaller aorto-mitral (AM) angle. CSA at the valve stent distal edge showed strong association with ∆PG (r=-0.68, P<0.0001). Only small AM angle was associated with small CSA at the valve stent ventricular edge on multivariable analysis, independent of LVESV and LVEF. Conclusion: Pre-procedural AM angle as well as LVESV and LVEF were associated with LVOT narrowing in patients undergoing transcatheter mitral valve-in-valve, valve-in-ring, and valve-in-native valve implantation. These data may be useful for preprocedural planning.

scholarly journals Dynamic left ventricular outflow tract obstruction in Takotsubo cardiomyopathy resulting in cardiogenic shock

2021 ◽  
Vol 14 (3) ◽  
pp. e240010
Author(s):  
Paulina M Conradi ◽  
Ramon B van Loon ◽  
M Louis Handoko
Keyword(s):  
Mitral Valve ◽  
Cardiogenic Shock ◽  
Left Ventricular Outflow Tract ◽  
Apical Ballooning ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Systolic Anterior Motion ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow

We report a case of a 73-year-old female patient, who was admitted to the coronary care unit due to chest pain, malaise and near syncope. During physical examination, the patient was hypotensive and there were signs of left-sided heart failure and a loud systolic murmur. Echocardiogram showed apical ballooning with dynamic left ventricular outflow tract obstruction, based on systolic anterior motion of the mitral valve with important mitral valve regurgitation. In the acute setting, the cardiogenic shock was treated cautiously with fluid resuscitation and intravenous metoprolol, resulting in direct stabilisation of her haemodynamic condition. As a codiagnosis, there was a significant stenosis of left anterior descending artery, which was treated successfully by percutaneous coronary intervention with drug eluting stents. During follow-up, left ventricular function normalised, and the left ventricular outflow tract obstruction, systolic anterior motion of mitral valve and related mitral regurgitation all resolved.

Critical Left Ventricular Outflow Tract Obstruction Due to Accessory Mitral Valve Tissue

2000 ◽  
Vol 17 (2) ◽  
pp. 177-180 ◽  
Author(s):  
RAFFAELE CALABRO ◽  
GIUSEPPE SANTORO ◽  
CARLO PISACANE ◽  
BERARDO SARUBBI ◽  
GABRIELLA FARINA ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Valve Tissue ◽  
Left Ventricular Outflow ◽  
Accessory Mitral Valve Tissue
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