• Title/Summary/Keyword: Mitral regurgitation

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Mitral Valve Repair for Mitral Regurgitation (승모판막폐쇄부전에 대한 승모판막재건술)

  • 최세영;유영선;박기성;최대융;박창권;이광숙
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.221-225
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    • 1998
  • From February 1996 to May 1997, 18 patients underwent mitral valve repair for mitral regurgitation. There were 9 male and 9 female patients aged from 19 to 68 years(mean, 53). Thirteen patients were in New York Heart Association(NYHA) class III and IV. The cause of mitral regurgitation was degenerative in 12 patients, rheumatic in 5 patients and infective in 1 patient. Fifteen patients were in Carpentier's functional classification II, 2 patients in Carpentier's class III and 1 patient in Carpentier's class I. Surgical procedures included prosthetic ring annuloplasty(16 cases), rectangular resection of posterior leaflet(15 cases), chordal shortening(5 cases), triangular resection of anterior leaflet(2 cases), commissurotomy(2 cases), partial transposition of posterior leaflet(1 case). These procedures were combined in most patients. There was no operative death. These patients have been followed from 1 to 15 months, mean of 6.7 months. There was one late death resulted from low cardiac output following mitral valve replacement. The function of the repaired valve in other 17 patients has remained satisfactory during the observed interval. We consider that mitral valve repair is highly satisfactory in patients with mitral regurgitation.

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Vegetative Mitral Valvular Regurgitation Caused by Infective Endocarditis in a Maltese Dog (말티스견의 감염성 심내막염에 의한 우상성 이첨판 역류증)

  • Choi, Ran;Nam, So-Jeong;Moon, Hyeong-Sun;Lee, Seung-Gon;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.25 no.2
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    • pp.106-111
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    • 2008
  • A 3-year-old intact female Maltese dog (2.5 kg of body weight) with the primary complaint of sudden onset of heart murmur, depression and anorexia was referred to the Veterinary Teaching Hospital of Kangwon National University. The dog was febrile with marked leukocytosis and left apical VI/VI holosystolic murmurs. The electrocardiogram implied the left ventricular enlargement. Diagnostic imaging studies revealed left atrial and ventricular dilation, severe vegetations on mitral valvular cusps with concurrent mitral regurgitation. Based on findings from clinical and diagnostic investigation, the case was diagnosed as vegetative mitral valvular regurgitation caused by infective endocarditis. The dog was successfully treated with broad spectrum antibiotics, diuretics, angiotensin converting enzyme inhibitor and antithrombotics.

Long term resuls of De Vega tricuspid annuloplasty (삼첨판 성형술 [De Vega 술식]의 원격 성적에 대한 고찰)

  • 김병열
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.827-832
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    • 1993
  • From Jan 1982 through Dec.1991, thirty-three DeVega`s tricuspid annuloplasties were performed in association with mitral and combined mitral and aortic valve disease. Preoperatively,all of the patients were in NYHA functional class III or IV.There were one early death and 4 patients died during follow up period of 18 to 138 months [ mean follow up : 67.3 months ]. Nine patients required reoperation because of biological mitral valve failure at 4.7 to 11 years after tricuspid annuloplasty[TAP]. Among these patients,2 cases needed for reoperation of TAP due to loosening of suture material. Twenty four [86%] of the survivors were in NYHA functional class I or II after TAP.The actuarial survival rate for the TAP was 74% at 138 months. Rt atrial pressure of 9 reoperation cases were significantly decreased [P<0.05] compared with initial Rt.atrial pressure [ Mean period; 93.6 months].Doppler echocardiographic studies for tricuspid regurgitation were performed in 15 cases after TAP [Mean period: 42.3 months].These results showed significantly reduced [P<0.01] tricuspid annulus diameter and tricuspid regurgitation distance [ P<0.05 ].Our surgical experience that the DeVega`s TAP is a simple,safe,effective procedure and resulted in good hemodynamic improvement with moderate to severe functional tricuspid regurgitation.

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In-Vitro Model Design of Mitral Valve Regurgitation and Comparative Study of Quantification between PISA and 4D flow MRI (승모판 역류 In-Vitro 모델을 활용한 초음파 및 4D flow MRI 기반 혈류 정량화 비교연구)

  • Juyeon Lee;Minseong Kwon;Hyungkyu Huh
    • Journal of the Korean Society of Visualization
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    • v.22 no.1
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    • pp.40-48
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    • 2024
  • This study presents an in-vitro model designed to simulate mitral valve regurgitation, aiming to compare the quantification results between Proximal Isovelocity Surface Area(PISA) and 4D Flow MRI on both fixed and valve annulus tracking(VAT) views. The in-vitro model replicates the dynamic conditions of the mitral valve in a pulsatile environment, utilizing a piston pump set at 60 bpm. Through systematic experiments and analysis, the study evaluates the accuracy and effectiveness of PISA and 4D Flow MRI in assessing regurgitation severity, considering both fixed and valve annulus tracking. The displacement length measured in echo closely resembled that of optical measurements, making it advantageous for structural analysis. VAT-4D flow MRI exhibited the smallest deviation from actual flow rate values, establishing it as most accurate method for quantitative regurgitation assessment.

Postoperative Transesophageal Echocardiographic Evaluation in Patients with Cardiac Valve Replacement (경식도 심초음파 검사를 이용한 판막대치술 환자의 평가)

  • 조건현
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.265-270
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    • 1991
  • Since advent of the prosthetic cardiac valve replacement, much efforts for accurate assessing value function in-vivo have been attempted. To evaluate the postoperative functional and morphological status of the replaced cardiac valve prosthesis, 33 patients with valve replacement were studied by transthoracic and transesophageal 2-dimensional echocardiac imaging as well as by color Doppler flow velocity imaging. Twenty four patients had mitral valve replacement. 6 patients had aortic valve replacement and 3 patients had both mitral and aortic valve replacement. There were 34 mechanical and 2 biological prosthesis. Comparing to transthoracic echocardiography, transesophageal approach showed transvalvular regurgitant jet flow amid the prosthetic mitral valve ring during. systole and much clear visualization of cardiac chamber behind prosthesis which could give shadowing effect to ultrasound beam. According to the quantitative grading by the length and area of mitral regurgitant flow, 24 out of 27 mitral valves revealed mild degree regurgitation considered as physiological after prosthetic bileaflet valve replacement and the other 3 valves including 2 biological prosthesis had moderate degree regurgitation which was regarded as pathologic one. 2 cases of left atrial thromboses and 1 case of paravalvular leakage which were not visible by transthoracic approach were identified by transesophageal echocardiography in patients with mitral valve replacement and patients with aortic valve replacement respectively. We conclude that in patients with prosthetic mitral valve replacement, transesophageal 2-dimensional imaging with color Doppler can suggest reliable information beyond that available from the transthoracic access even though it gives patient some discomfort to proceed.

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Severe Mitral Regurgitation due to Traumatic Anterolateral Papillary Muscle Rupture: A Case Report

  • Lee, Chul Ho;Kwon, Oh Choon;Lee, Sub;Jang, Jae Seok
    • Journal of Chest Surgery
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    • v.45 no.6
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    • pp.401-403
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    • 2012
  • A 29-year-old man was admitted for abrupt dyspnea and hemoptysis. An echocardiogram revealed severe mitral regurgitation due to papillary muscle rupture for which an emergency mitral valve replacement operation was performed 4 days after admission. Herein, we report our experience with this case along with a review of the literature.

Preoperative Extracorporeal Membrane Oxygenation for Severe Ischemic Mitral Regurgitation - 2 case reports -

  • Kim, Tae-Sik;Na, Chan-Young;Baek, Jong-Hyun;Kim, Jae-Hyun;Oh, Sam-Sae
    • Journal of Chest Surgery
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    • v.44 no.3
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    • pp.236-239
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    • 2011
  • Indication for extracorporeal membrane oxygenation (ECMO) has been extended as the experience of ECMO in various clinical settings accumulates and the outcome after ECMO installation improves. We report two cases of successful mitral valve surgery for severe ischemic mitral regurgitation in patients on ECMO support for cardiogenic shock which developed upon coronary angiography.

Single-Suture Neochorda-Folding Plasty for Mitral Regurgitation

  • Park, Jong Myung;Je, Hyung Gon;Lee, Sang Kwon
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.70-72
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    • 2016
  • The single-suture neochorda-folding plasty technique is a modification of existing mitral valve repair techniques. In the authors' experience, its simplicity, reliability, and versatility make it a useful technique for mitral valve repair, especially when a minimally invasive approach is used.

Operative Treatment of Mitral Valve Regurgitation Due to Chordal Rupture and/or Papillary Muscle Rupture (건삭 파열 및 유두근 파열로 인한 승모판 판막 폐쇄부전의 외과적 치험)

  • 김시호;방정희;우종수
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.401-409
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    • 2004
  • Background: As the rupture of chordae and/or papillary muscle became the main cause of mitral valve regurgitation, mitral reconstructive surgery has a very important role. In this regard, we analyzed the clinical result and postoperative early result of operative treatment performed in our hospital, Material and Method: For this analysis, forty nine patients (male 26, female 23, mean age 49.0$\pm$16.5) who underwent mitral valve operation caused by the rupture of chordae and/or papillary muscle from August 1991 to April 2002 were reviewed. Among forty nine patients, twenty two (44.9%) received mital valve reconstruction and twenty seven (59.2%) received mitral valve replacement. Result: As to the pathological etiology of rupture of mitral and papillary muscle, twenty five cases (51.0%) were nonspecific degeneration, eleven cases (22.4%) were myxomatous degeneration, seven cases (14.3%) were subacute bacterial endocarditis. Three patients suffered mortality after operation (6.1%) and valve replacement was performed again on one patient because of remnant mitral insufficiency after valve reconstruction. The 5-year survival rate after operation for the entire mitral valve regurgitation patients was 81 .4%. We have also compared and analyzed the operation results of a group of patients who underwent valve reconstruction and the other group of patients who underwent valve replacement from thirty six patients who had suffered from mitral valve regurgitation caused by degenerative disease. The mortalities were 0% and 14.3%, respectively and the 5-year survival rates were 90.2% and 64.3%, respectively, but there were no statistical significance. Conclusion: The most common pathological etiology of mitral valve regurgitation caused by rupture of chordae and/or papillary muscle was nonspecific degeneration, In case of degenerative disease is the cause of mitral valve regurgitation, valve reconstruction showed better long-term effects in many respects and better operation results compared to valve replacement.

Severe Mitral Regurgitation Due to Coronary Vasospasm, Confirmed by Ergonovine Echocardiography (에르고노빈 심초음파로 확진된 승모판 폐쇄부전을 유발한 혈관연축 1예)

  • Cha, Jung-Joon;Kyung, Chan Hee;Cho, Jang Ho;Kim, Yong Hoon;Kim, Haewon;Lee, Sung-Joo;Rim, Se-Joong;Choi, Eui-Young
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.120-123
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    • 2013
  • The common causes of organic mitral regurgitation (MR) include mitral valve prolapse (MVP) syndrome, rheumatic heart disease, and endocarditis. MR also occurs secondary to dilated cardiomyopathy and coronary artery disease. In acute severe MR, the hemodynamic overload often cannot be tolerated, and mitral valve repair or replacement must be performed immediately. We report herein a case of severe MR due to coronary vasospasm that was confirmed via ergonovine echocardiography in a 70-year-old man. He was scheduled to undergo mitral valve surgery, but it did not push through and he was put on medical therapy.