Prediction of Symptom Status following Mitral Valve Replacement for Mitral Regurgitation by Preoperative Echocardiographic Measurement of the End-Systolic Stress to End-Systolic Volume Ratio

1987 ◽  
Vol 1 (6) ◽  
pp. 321-328 ◽  
Author(s):  
Jessica Furer ◽  
Clare Hochreiter ◽  
Nathaniel W. Niles ◽  
Richard B. Devereux ◽  
Paul Kligfield ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Volume Ratio ◽  
Systolic Volume ◽  
Echocardiographic Measurement ◽  
End Systolic Volume ◽  
Symptom Status

scholarly journals Remodeling of the left heart in patients with rheumatic mitral valve disease after mitral valve replacement with preservation of subvalvular structures

2020 ◽  
Vol 4 (Issue 2) ◽  
pp. 40
Author(s):  
Dinara Toktosunova ◽  
Murat Djundubaev ◽  
Elmira Seytahunova ◽  
Irina Akhmedova
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Case Histories ◽  
Systolic Volume ◽  
Replacement Surgery ◽  
End Systolic Volume ◽  
Valve Replacement Surgery

Objectives: to evaluate the advantage of preserving the subvalvular structures of the mitral valve from both leaflets compared with the preservation of the subvalvular structures only from the posterior valve during mitral valve replacement surgery (MVR). Methods: A retrospective analysis of case histories of 41 patients with isolated rheumatic lesions of the mitral valve who underwent MVR, which were divided into 2 groups: with complete preservation of subvalvular structures (n = 24) and preservation of only the posterior leaflet (n = 17), was performed. Results: In the group with complete preservation of the chordal-papillary apparatus, there was a significant decrease in the end-systolic volume (p<0.05) and a slight increase in the ejection fraction of the left ventricle in the immediate postoperative period compared with the group with the preservation of the chordal-papillary apparatus only from the posterior cusp, where end-systolic volume decreased slightly (p&qt;0.05) and the ejection fraction of the left ventricle remained at the same levels. Conclusion: Our preliminary results of the study indicate better remodeling and optimization of the geometry of the left ventricle when assessing the closest postoperative parameters in a group of patients with preservation of chordo-papillary structures of both leaflets, both the anterior and the posterior leaflets.

Randomized Trial of Partial Versus Complete Chordal Preservation Methods of Mitral Valve Replacement

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Kwok L. Yun ◽  
Colleen F. Sintek ◽  
D. Craig Miller ◽  
Gregg T. Schuyler ◽  
Alden D. Fletcher ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Ejection Fraction ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Wall Stress ◽  
Posterior Leaflet ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
Fractional Shortening

Background —The merits of retaining the subvalvular apparatus during mitral valve replacement for chronic mitral regurgitation have been demonstrated in numerous clinical and laboratory investigations. In this preliminary report, we analyzed the early effects of complete versus partial chordal preservation on left ventricular mechanics. Methods and Results —Fifty patients undergoing isolated surgical correction of mitral insufficiency were prospectively randomized to either total or partial chordal-sparing mitral valve replacement. Of the first 19 patients studied, 8 had preservation of the posterior leaflet only, and 11 had complete preservation of all chordal structures. A comparison group consisted of 6 patients who had primary mitral valve repair. Echocardiography was performed preoperatively and at discharge from the hospital to determine dimensions, wall stress, and ejection fraction. Preservation of the posterior leaflet only resulted in a reduction in end-diastolic volume, an increase in end-systolic volume ( P =0.058), a rising trend in end-systolic stress, a decrease in long-axis fractional shortening, and a fall in ejection fraction from 0.68±0.16 to 0.46±0.19 ( P =0.001). Although patients who had preservation of all chordal structures also had decreased end-diastolic volume, long-axis fractional shortening, and ejection fraction (0.60±0.13 to 0.52±0.07, P =0.01), end-systolic stress fell and end-systolic volume decreased instead of increased. Compared with the posterior leaflet preservation group, those in the group with completely preserved chordal structures had a larger decline in end-diastolic volume and smaller decreases in long-axis fractional shortening and ejection fraction. Changes in end-systolic volume and stress were also statistically different between the 2 cohorts. No differences were detected between the group with total preserved chordal structures and the mitral repair group in any of the measured parameters. Conclusions —Compared with posterior chordal preservation only, complete retention of the subvalvular apparatus during mitral valve replacement resulted in improved ejection performance and smaller chamber volumes due to reduced systolic wall stress. These hemodynamic advantages are comparable to those observed with primary mitral reconstruction.

Surgery for Degenerative Mitral Regurgitation Valve Repair v. Valve Replacement with Chordal Preservation

1994 ◽  
Vol 2 (2) ◽  
pp. 90-94
Author(s):  
Masaharu Shigenobu ◽  
Shunji Sano
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Valve Repair ◽  
Repair Group

This study compares mitral valve repair and mitral valve replacement with chordal preservation for chronic mitral regurgitation due to myxomatous degeneration with special reference to left ventricular function. Twenty-six patients underwent complete preoperative and 2 years later postoperative echocardiography study. Thirteen patients underwent mitral valve replacement associated with preservation of chordae tendineae and papillary muscles, and 13 patients had mitral valve repair. There were no statistically significant differences between the 2 groups for clinical findings, hemodynamic profiles, or left ventricular function compared prior to surgery. After correcting mitral regurgitation, increase in cardiac index was significant for the repair group. Left ventricular end-diastolic volume decreased in both groups. Left ventricular end-systolic volume significantly decreased in the repair group, but remained unchanged in the replacement group. Both ejection fraction and mean left ventricular circumferential fiber shortening velocity (mVcf) decreased in the replacement group, but significantly increased in the repair group 2 years after surgery. These findings suggest valve replacement with chordal preservation shows less improvement in ventricular systolic function late after surgery compared with mitral valve repair.

scholarly journals A Giant Left Atrium due to Rheumatic Mitral Regurgitation, Outcome after Left Atrial Reduction Surgey with Mitral Valve Replacement

2018 ◽  
Vol 14 (1) ◽  
pp. 42-44
Author(s):  
Istiaq Ahmed ◽  
Sorower Hossain ◽  
Ankan Kumar Paul
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Atrium ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Quick Recovery ◽  
Replacement Surgery ◽  
Atrial Size ◽  
Giant Left Atrium

A trans-thoracic echocardiography and chest radiograph of a 26 year old lady diagnosed as rheumatic mitral regurgitation with atrial fibrillation revealed a giant left atrium of 10.9 cm size with symptoms of dyspnoea and palpitation. The patient was treated with left atrial size reduction along with mitral valve replacement surgery and showed an excellent and quick recovery with total disappearance of symptoms and restoration of sinus rhythm only within few days.University Heart Journal Vol. 14, No. 1, Jan 2018; 42-44

Combined Mitral Valve Replacement and Pericardiectomy in a Patient with Mitral Regurgitation and Constrictive Pericarditis

1994 ◽  
Vol 2 (2) ◽  
pp. 109-110
Author(s):  
Nainar Madhu Sankar ◽  
Premanand Ponoth ◽  
Krishna Sivaprakasha ◽  
John Bapoo Kotail Jacob ◽  
Vellayikodath Velayudhan Bashi ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Postoperative Period ◽  
Constrictive Pericarditis ◽  
Inotropic Support ◽  
Surgical Correction

We present the case of a patient with chronic constrictive pericarditis and significant mitral regurgitation who successfully underwent combined pericardiectomy and mitral valve replacement. The need for early surgical correction is stressed. Prolonged ventilatory and inotropic support was required in the postoperative period.

scholarly journals Mitral Valve Replacement and Remodeling of the Left Ventricle in Dilated Cardiomyopathy with Mitral Regurgitation: Initial Results

2002 ◽  
Vol 78 (2) ◽  
Author(s):  
Luiz Boro Puig ◽  
Fábio Antonio Gaiotto ◽  
José de Lima Oliveira Júnior ◽  
Mirian Magalhães Pardi ◽  
Fernando Bacal ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Initial Results
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