scholarly journals Primary Cardiac Sarcoma Remission after Surgery: 5-Years Follow-up: Case Report

2018 ◽  
Vol 21 (5) ◽  
pp. E401-E403 ◽  
Author(s):  
Melike Elif Teker ◽  
Önder Teskin
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Radical Resection ◽  
Patient Specific ◽  
Anterior Leaflet ◽  
Full Remission ◽  
Primary Cardiac Sarcoma

Background: Primary cardiac sarcoma is a rare and atypical clinical entity. We present a patient with long-term remission after primary cardiac sarcoma resection. Case Report: A 42-year-old previously healthy female presented to the emergency department after an effort-induced 30-minute episode of chest pain and extreme shortness of breath. Physical examination upon admission was remarkable for a pulse of 99/minute; blood pressure was 101/73 mmHg. Transthoracic echocardiography showed a mass measuring 5.5 × 5.6 cm extending from the left septum to the mitral valve anterior leaflet. A multilobulated broad-based 5.5 × 5.6 × 4 cm3 mass invading a large portion of the left septum to the mitral valve anterior leaflet was completely excised in the open heart surgery. Chemotherapy regimen (paclitaxel 175 mg/m2/day on day 1, every 21 days) was started after operation. Full remission was provided. Metastasis and recurrence have not been observed for 5 years of follow-up by PET. We observed during 5 years and used a PET. And the finally we did not see metastasis at the 5 years of follow-up. Conclusions: We strongly recommend that a patient-specific multidisciplinary approach involving radical resection, chemotherapy, and radiation therapy in these cases results in patient survival and a significant improvement in quality of life. We also think that it is necessary to perform MRI to exclude other illnesses that are considered to be a myxoma.

scholarly journals Early results of a real-world series with two transapical transcatheter mitral valve replacement devices

2020 ◽  
Author(s):  
S. Ludwig ◽  
D. Kalbacher ◽  
N. Schofer ◽  
A. Schäfer ◽  
B. Koell ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Functional Improvement ◽  
Study Cohort ◽  
Early Results ◽  
Transcatheter Mitral Valve Replacement

Abstract Aims Transcatheter mitral valve replacement (TMVR) with dedicated devices promises to fill the treatment gap between open-heart surgery and edge-to-edge repair for patients with severe mitral regurgitation (MR). We herein present a single-centre experience of a TMVR series with two transapical devices. Methods and results A total of 11 patients were treated with the Tendyne™ (N = 7) or the Tiara™ TMVR systems (N = 4) from 2016 to 2020 either as compassionate-use procedures or as commercial implants. Clinical and echocardiographic data were collected at baseline, discharge and follow-up and are presented in accordance with the Mitral Valve Academic Research Consortium (MVARC) definitions. The study cohort [age 77 years (73, 84); 27.3% male] presented with primary (N = 4), secondary (N = 5) or mixed (N = 2) MR etiology. Patients were symptomatic (all NYHA III/IV) and at high surgical risk [logEuroSCORE II 8.1% (4.0, 17.4)]. Rates of impaired RV function (72.7%), severe pulmonary hypertension (27.3%), moderate or severe tricuspid regurgitation (63.6%) and prior aortic valve replacement (63.6%) were high. Severe mitral annulus calcification was present in two patients. Technical success was achieved in all patients. In 90.9% (N = 10) MR was completely eliminated (i.e. no or trace MR). Procedural and 30-day mortality were 0.0%. At follow-up NYHA class was I/II in the majority of patients. Overall mortality after 3 and 6 months was 10.0% and 22.2%. Conclusions TMVR was performed successfully in these selected patients with complete elimination of MR in the majority of patients. Short-term mortality was low and most patients experienced persisting functional improvement. Graphic abstract

Spirometric Changes following Open-Heart Surgery on Rheumatic Mitral Valves

1998 ◽  
Vol 6 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Abha Chandra ◽  
Shashi Srivastava ◽  
Dronamraju Dilip
Keyword(s):  
Mitral Valve ◽  
Lung Function ◽  
Vital Capacity ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Cardiothoracic Ratio ◽  
The Mean

Evaluation of pulmonary function by spirometry in adult patients undergoing cardiac surgery is a simple test to assess pulmonary reserve that has important implications in the operative morbidity. Pulmonary function was studied preoperatively, before discharge, and at the 3-month follow-up in 22 randomly selected patients who underwent open-heart surgery for rheumatic mitral valve disease (2 reconstructions, 20 replacements). The mean preoperative cardiothoracic ratio was 0.58. Lung function was found to be impaired preoperatively in all 22 patients and the majority suffered from restrictive lung disease. Better preoperative lung function was seen in nonsmokers, patients with a cardiothoracic ratio of less than 0.50, and those with a normal pulmonary artery pressure. After mitral valve surgery, the mean pulmonary artery pressure was 20.6 ± 2.9 mm Hg, the mean mitral valve pressure gradient was 3.6 ± 2.4 mm Hg, and the mean cardiothoracic ratio was 0.52 ± 0.09. A significant deterioration was seen in the predischarge spirometric values of forced vital capacity, forced expiratory volume in one second, peak expiratory flow rate, flow rate at 25% to 75% of expired vital capacity, and maximum volume ventilation. The deterioration was greater in smokers and those who had prolonged cardiopulmonary bypass (more than 80 minutes). No correlation was found with ventilation because all patients were electively ventilated overnight. There was an overall improvement in spirometric parameters at the 3-month follow-up although the values remained lower than predicted. Spirometry was found to be useful for assessing lung function in patients undergoing mitral valve surgery and we recommended it as a routine test.

scholarly journals Transcatheter Self-expandable Aortic Valve (Portico) Implantation in a Patient with Previous Mitral Valve Replacement: A Case Report

2019 ◽  
Author(s):  
Ahmet Korkmaz ◽  
Havva Tuğba Gürsoy ◽  
Mehmet İleri ◽  
Özgül Uçar Elalmış ◽  
Ümit Güray
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Severe Aortic Stenosis ◽  
Open Heart Surgery ◽  
Mitral Valve Surgery ◽  
Transcatheter Aortic Valve

Transcatheter aortic valve implantation (TAVI) has shown favorable outcomes in patients with severe symptomatic aortic valve stenosis who are at high surgical risk or who are unsuitable candidates for open-heart surgery. However, concerns exist over treating patients who have undergone previous mitral valve surgery due to the potential interference between the mitral prosthetic valve or ring and the TAVI device. In this case report, we present a case in which a patient with symptomatic severe aortic stenosis and previous mechanical mitral valve replacement was successfully treated with TAVI using a Portico valve, which is under-researched.   J Teh Univ Heart Ctr 2019;14(2):85-89   This paper should be cited as: Korkmaz A, Gürsoy HT, İleri M, Uçar Elalmış Ö, Güray Ü. Transcatheter Self-expandable Aortic Valve (Portico) Implantation in a Patient with Previous Mitral Valve Replacement: A Case Report. J Teh Univ Heart Ctr 2019;14(2):85-89.

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>

scholarly journals Neuropsychomotor development before and after open-heart surgery in infants

2009 ◽  
Vol 67 (2b) ◽  
pp. 457-462 ◽  
Author(s):  
Taís Sica da Rocha ◽  
Ana Guardiola ◽  
Jefferson Pedro Piva ◽  
Cláudia Pires Ricachinevski ◽  
Aldemir Nogueira
Keyword(s):  
Heart Surgery ◽  
Intensive Care Unit Discharge ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Neurodevelopmental Outcomes ◽  
Early Improvement ◽  
Before And After ◽  
Neurological Exam ◽  
Brazilian Studies

There are few Brazilian studies on neuropsychomotor follow-up after open-heart surgery with circulatory bypass in infants. Twenthy infants had neurodevelopmental outcomes (neurological exam and Denver II test) assessed before open-heart surgery, after intensive care unit discharge and 3-6 months after hospital discharge. Heart lesions consisted of septal defects in 11 cases (55%). The mean circulatory bypass time was 67 ± 23.6 minutes. Fifteen infants had altered neurological examination and also neurodevelopment delay before surgery. After 6 months it was observed normalization in 6 infants. When Denver II test indexes were analysed, it was observed an improvement in all domains except personal-social. Although those infants were in risk of new neurological findings, an early improvement on neuropsychomotor indexes were seen.

scholarly journals Long-term outcome of endocardial-only versus combined endocardial-epicardial homogenization of the scar for treatment of ventricular tachycardia in patients with ischemic cardiomyopathy

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Mohanty ◽  
C Trivedi ◽  
D G Della Rocca ◽  
C Gianni ◽  
B MacDonald ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ischemic Cardiomyopathy ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Long Term Outcome ◽  
Obstructive Sleep ◽  
Number Of Patients ◽  
Group 2 ◽  
Group 1

Abstract Introduction We investigated the ablation success of scar homogenization with combined (epicardial + endocardial) versus endocardial-only approach for ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) at 5 years of follow-up. Method Consecutive ICM patients undergoing VT ablation at our center were classified into group 1: endocardial scar homogenization and group 2: endocardial +epicardial scar homogenization. Patients with previous open heart surgery were excluded. All patients underwent bipolar substrate mapping with standard scar settings defined as normal tissue &gt;1.5 mV and severe scar &lt;0.5 mV. Non-inducibility of monomorphic VT was the procedural endpoint in both groups. Patients were followed up twice a year for 5 years with implantable device interrogations. Results A total of 361 (Group 1: 291 and group 2: 70) patients were included in the study (mean age: 67 years, male: 88.4%). At 5 years, significantly higher number of patients from group 2 remained arrhythmia-free (figure 1). Of those patients, 87 (45%) and 51 (89%) from group 1 and 2 respectively were off-anti-arrhythmic drugs (AAD) (p&lt;0.001). After adjusting for age, gender, hypertension, diabetes, and obstructive sleep apnea, scar homogenization using endo-epicardial approach was associated with 51% less recurrence compared to the endocardial ablation strategy (Hazard Ratio: 0.49, 95% CI: 0.27–0.89, p: 0.02). Conclusion In this series of patients with ischemic cardiomyopathy and VT, endo-epicardial scar homogenization was associated with a lower need for AAD and a significantly lower recurrence rate at 5-years of follow-up compared to the endocardial ablation alone. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

scholarly journals Influence of biomarkers level during follow-up when operating under cardiopulmonary bypass

2015 ◽  
Vol 18 (3) ◽  
pp. 39
Author(s):  
Yu. I. Petrishchev ◽  
A. L. Levit ◽  
I. N. Leyderman
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Plasma Levels ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Cardiac Surgeons ◽  
The Given ◽  
The Relationship

Systemic inflammatory response was first determined in 1980 and cardiac surgeons turned to it in 1996. At present, there are a lot of publications on this issue, however, the extent of operation and duration of CPB are considered in clinical practice as crucial indicators of severity of patient's condition following cardiac surgery. In our study we tried to look at this problem from a different perspective and draw a parallel between the severity of patient's condition resulting from operational trauma and CPB. We included 48 patients who under-went cardiac surgery under CPB. Plasma levels of procalcitonin (PCT), lactate and interleukin-6 were investigated before the operation, after CPB and at 24 hours. Also revealed was the relationship between the plasma levels of IL-6, lactate and PCT (r = 0.53; p = 0.000 in both cases). The level of PCT at the 3rd stage was found to relate to the duration of CPB (r = 0.4; p = 0.005), ALV (r = 0.44; p = 0.001) and length of stay at ICU (r = 0.53; p = 0.000). We didn't manage to find any relationship between the length of stay at ICU and the duration of CPB. Correlation between the PCT plasma level and the duration of intensive care indicates the importance of dynamics of the given biomarker for early prediction of follow-up course after open-heart surgery.

scholarly journals Mitral valve disease and open heart surgery in osteogenesis imperfecta tarda.

Heart ◽  
1973 ◽  
Vol 35 (1) ◽  
pp. 103-106 ◽  
Author(s):  
S J Wood ◽  
J Thomas ◽  
M V Braimbridge
Keyword(s):  
Mitral Valve ◽  
Osteogenesis Imperfecta ◽  
Mitral Valve Disease ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Valve Disease ◽  
Open Heart
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