scholarly journals Adult Obstructive Cor Triatriatum with Severe Mitral Regurgitation: A Case Report

2021 ◽  
Vol 24 (3) ◽  
pp. E578-E579
Author(s):  
Tomomi Nakajima ◽  
Dung Van Hung ◽  
Yuji Hiramatsu
Keyword(s):  
Mitral Regurgitation ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Cor Triatriatum ◽  
Severe Mitral Regurgitation ◽  
Mitral Annuloplasty ◽  
Progressive Heart Failure ◽  
Left Ventricular Dilatation ◽  
Annular Dilatation ◽  
Cor Triatriatum Sinister

Adult cor triatriatum sinister associated with severe mitral regurgitation is extremely rare. As these obstructive cor triatriatum feature hemodynamics that mimic mitral stenosis, a pressure load is theoretically generated only on the left atrial proximal chamber, and therefore the left ventricle is less likely to suffer volume loading. Here, we report a surgical case with such rare hemodynamics. A 22-year-old man with obstructive cor triatriatum and severe mitral regurgitation received an anomalous membrane excision and mitral annuloplasty. An abnormal membrane with an orifice 7 mm in size was completely resected while a grossly dilated mitral annulus was repaired via annuloplasty ring. Mitral regurgitation was controlled well, and the postoperative course was uneventful. Even with obstructive cor triatriatum, severe mitral annular dilatation and subsequent left ventricular dilatation may occur, causing the progressive heart failure encountered in this case.

Atrial functional mitral regurgitation: mechanisms and surgical implications

2020 ◽  
Vol 28 (7) ◽  
pp. 421-426
Author(s):  
Yiting Fan ◽  
Song Wan ◽  
Randolph Hung-Leung Wong ◽  
Alex Pui-Wai Lee
Keyword(s):  
Mitral Regurgitation ◽  
Left Ventricular ◽  
Ventricular Dilatation ◽  
Functional Mitral Regurgitation ◽  
Current Evidence ◽  
Disease Entity ◽  
Risk Of Death ◽  
Left Ventricular Dilatation ◽  
Annular Dilatation ◽  
Increased Risk

The term atrial functional mitral regurgitation refers to a newly recognized disease entity in which mitral regurgitation occurs secondary to left atrial disease, without left ventricular dilatation and intrinsic mitral valve disease, typically in the setting of long-standing atrial fibrillation. Recent evidence suggests that atrial functional mitral regurgitation is associated with increased risk of death and heart failure re-hospitalization. The etiology, pathophysiology, and mechanism of atrial functional mitral regurgitation is not completely understood but they should not be regarded as the same as for the conventional type of functional mitral regurgitation secondary to left ventricular dilatation and dysfunction. Mitral annular dilatation, atriogenic leaflet distortion, insufficient leaflet remodeling, and subtle left ventricular dysfunction may play a role in the pathogenesis of atrial functional mitral regurgitation. The therapeutic and surgical considerations of atrial functional mitral regurgitation are different from those of ventricular functional mitral regurgitation. In this review, we assess current evidence regarding this new disease entity and propose a new surgical approach based on up-to-date understanding and experience of this condition.

scholarly journals Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection

2022 ◽  
Vol 8 ◽  
Author(s):  
Johannes H. Jedrzejczyk ◽  
Lisa Carlson Hanse ◽  
Shadi Javadian ◽  
Søren N. Skov ◽  
J. Michael Hasenkam ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Mitral Annulus ◽  
Type I ◽  
Search Term ◽  
Annuloplasty Ring ◽  
Mitral Annuloplasty ◽  
Annular Dilatation ◽  
Specific Morphology ◽  
Leaflet Coaptation ◽  
Flexible Ring

Objectives: To provide an overview that describes the characteristics of a mitral annuloplasty device when treating patients with a specific type of mitral regurgitation according to Carpentier's classification of mitral regurgitation.Methods: Starting with the key search term “mitral valve annuloplasty,” a literature search was performed utilising PubMed, Google Scholar, and Web of Science to identify relevant studies. A systematic approach was used to assess all publications.Results: Mitral annuloplasty rings are traditionally categorised by their mechanical compliance in rigid-, semi-rigid-, and flexible rings. There is a direct correlation between remodelling capabilities and rigidity. Thus, a rigid annuloplasty ring will have the highest remodelling capability, while a flexible ring will have the lowest. Rigid- and semi-rigid rings can furthermore be divided into flat and saddled-shaped rings. Saddle-shaped rings are generally preferred over flat rings since they decrease annular and leaflet stress accumulation and provide superior leaflet coaptation. Finally, mitral annuloplasty rings can either be complete or partial.Conclusions: A downsized rigid- or semi-rigid ring is advantageous when higher remodelling capabilities are required to correct dilation of the mitral annulus, as seen in type I, type IIIa, and type IIIb mitral regurgitation. In type II mitral regurgitation, a normosized flexible ring might be sufficient and allow for a more physiological repair since there is no annular dilatation, which diminishes the need for remodelling capabilities. However, mitral annuloplasty ring selection should always be based on the specific morphology in each patient.

scholarly journals Severe Mitral Regurgitation by Hyperthyroidism in the Absence of Left Ventricular Dilatation

2017 ◽  
Author(s):  
Antonio José Lagoeiro Jorge ◽  
Wolney de Andrade Martins ◽  
Eliza de Almeida Gripp ◽  
Breno Macêdo de Almeida ◽  
Camila Cezário Rocha Paz Figueroa ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Left Ventricular ◽  
Ventricular Dilatation ◽  
Severe Mitral Regurgitation ◽  
Left Ventricular Dilatation

scholarly journals The Story of a Stone Heart – Another Side of Cardiooncology

2019 ◽  
Vol 16 (6) ◽  
pp. 73-75
Author(s):  
Maia Rusu ◽  
Tudor Constantinescu ◽  
Ruxandra Jurcuţ
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Regurgitation ◽  
Systolic Function ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Pericardial Fluid ◽  
Inferior Wall ◽  
Severe Mitral Regurgitation ◽  
Exertional Dyspnea ◽  
Lv Systolic Function

AbstractA 38-year-old man was admitted to our department with moderate exertional dyspnea, fatigue and a syncope during exercise. The medical history revealed: left pulmonary sarcoma at the age of four, treated with radiotherapy, chemotherapy and left total pneumonectomy. At admission, laboratory tests showed high BNP (1426 pg/ml), normal calcium and parathormon levels. The transthoracic echocardiography found normal left ventricular (LV) systolic function with severe calcifications of the papillary muscles, mitral annulus, apical segments of the inferior septum and inferior wall (panel A - arrows; panel D) associated with severe mitral regurgitation (panel B). It also revealed severe tricuspid valve regurgitation, severe pulmonary hypertension (estimated to 120 mmHg, panel C) and small amount of pericardial fluid. A thoracic computed tomography described severe cardiac calcifications (panels E and F, arrow), a hypertrophic right lung herniated in left hemythorax and no other pathological findings in the remnant lung tissue. The pneumological evaluation noted a severe restrictive dysfunction. In this case, pulmonary hypertension was most probably determined by the left cardiac disorders (severe mitral regurgitation postradiotherapy, LV diastolic dysfunction due to severe myocardial and papillary muscle calcifications), most probably related to thoracic radiotherapy during childhood.

scholarly journals A Very Rare Case of Cor Triatriatum with Severe Mitral Regurgitation

2018 ◽  
Vol 6 (5) ◽  
pp. 848-850 ◽  
Author(s):  
Selman Dumani ◽  
Ermal Likaj ◽  
Edlira Ruci ◽  
Ervin Bejko ◽  
Ali Refatllari
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Rare Case ◽  
Congenital Heart ◽  
Cor Triatriatum ◽  
Severe Mitral Regurgitation ◽  
Cor Triatriatum Sinister

BACKGROUND: Cor triatriatum sinister is rare congenital heart disease. It is mainly presented in childhood and often accompanied with other congenital anomalies. The cases with cor triatriatum treated surgically in adults and accompanied with severe mitral regurgitation are very rare.CASE REPORT: We present a case with diagnosed cor triatriatum and severe mitral regurgitation. The diagnose was made by echocardiography. She was a female 25 years that was hospitalised with signs of heart failure NYHA II-III.CONCLUSION: We performed the resection of the membrane in the left atrium and repair of a mitral valve according to Alfieri. The patient did very well after the surgery.

Circular Plication Annuloplasty for Rheumatic Mitral Valve Disease

1997 ◽  
Vol 5 (1) ◽  
pp. 31-34 ◽  
Author(s):  
Mansur Şağban ◽  
Rıza Türköz ◽  
Mert Kestelli ◽  
Gökhan Önem
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Color Doppler ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Polyester Suture ◽  
Annular Dilatation ◽  
The Mean ◽  
Grade 3

Fourteen patients with mitral regurgitation and annular dilatation of rheumatic origin underwent surgery at İzmir State Hospital between May 1991 and January 1995. Number 2 polyester suture was attached around the posterior mitral annulus and circular plication was performed by tightening the suture to obtain a competent mitral valve with the largest possible nonstenotic orifice. Preoperatively all the patients had grade 3 or 4 (mean grade 3.41 ± 0.14) mitral regurgitation diagnosed by color Doppler echocardiography. At follow-up (mean follow-up time 35 ± 6.1 months), echocardiography showed 6 patients had grade 1 mitral regurgitation, 6 patients had grade 2, and 2 patients had no regurgitation (mean grade 1.28 ± 0.19). Postoperatively, the mean mitral valve area was found to be 2.74 ± 0.25 cm2 by pressure half-time echocardiography. The mean left ventricular diastolic diameter was 63 ± 2.9 mm preoperatively and 52 ± 1.7 mm postoperatively ( p < 0.05). The mean gradient across the mitral valve was 5.72 ± 0.78 mm Hg. Success (reduction of mitral regurgitation by at least 2 grades) was 86% at the end of the follow-up period. This annuloplasty technique was found to be a quick and effective method of reducing annular dilatation while maintaining annular flexibility.

Percutaneous Mitral Annuloplasty for Treatment of Functional Mitral Regurgitation

2009 ◽  
Vol 5 (1) ◽  
pp. 67
Author(s):  
Lutz Buellesfeld ◽  
Lazar Mandinov ◽  
Eberhard Grube ◽  
◽  
◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Coronary Sinus ◽  
Standard Of Care ◽  
Mitral Annulus ◽  
Functional Mitral Regurgitation ◽  
Invasive Treatment ◽  
Large Variability ◽  
Mitral Annuloplasty ◽  
Number Of Patients ◽  
Anatomical Relationship

Functional mitral regurgitation affects a substantial proportion of patients with congestive heart failure due to myocardial infarction or dilated cardiomyopathy. Functional mitral regurgitation greatly increases morbidity and mortality. Surgical annuloplasty is the standard of care for symptomatic patients with moderate or severe functional mitral regurgitation; however, a large number of patients are refused surgery. Several percutaneous approaches have been developed to address the need for less invasive treatment of mitral annulus dilatation. Devices using coronary sinus to cinch the mitral annulus are relatively easy to use; however, a number of factors may limit their clinical application, such as suboptimal anatomical relationship between the coronary sinus and mitral annulus, risk of coronary artery compression, large variability in the coronary venous anatomy and conflict with other therapies such as ablation or cardiac resynchronisation. Direct mitral annuloplasty is anticipated to be more effective than the coronary sinus approaches; however, it has yet to prove its safety and efficacy in carefully designed clinical trials. The best candidates and the best timing for each percutaneous mitral annuloplasty therapy, whether direct or indirect, have yet to be identified.

scholarly journals MEGASTRUCTURES IN ISCHEMIC HEART DISEASE. MASSIVE LEFT VENTRICULAR PSEUDOANEURYSM WITH SEVERE MITRAL REGURGITATION

2021 ◽  
Vol 77 (18) ◽  
pp. 2581
Author(s):  
Andrea Teira Calderon ◽  
Adrián Margarida ◽  
Ignacio Santiago ◽  
Indira Cabrera ◽  
Sofia Gonzalez Lizarbe ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Ischemic Heart Disease ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Severe Mitral Regurgitation ◽  
Left Ventricular Pseudoaneurysm
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