33,364 results match your criteria Mitral Regurgitation


Outcomes of open mitral valve replacement versus Transcatheter mitral valve repair; insight from the National Inpatient Sample Database.

Int J Cardiol Heart Vasc 2020 Jun 28;28:100540. Epub 2020 May 28.

Detroit Medical Center, DMC Heart Hospital, Detroit, MI, USA.

Background: Transcatheter mitral valve repair and replacement (TMVR) is a minimally invasive alternative to conventional open-heart mitral valve replacement (OMVR). The present study aims to compare the burden, demographics, cost, and complications of TMVR and OMVR.

Methods: The United States National Inpatient Sample (US-NIS) for the year 2017 was queried to identify all cases of TMVR and OMVR. Read More

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http://dx.doi.org/10.1016/j.ijcha.2020.100540DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262433PMC

Vasopressin in Patients with Septic Shock and Dynamic Left Ventricular Outflow Tract Obstruction.

Cardiovasc Drugs Ther 2020 Jun 2. Epub 2020 Jun 2.

Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Unit of Anaesthesia and Intensive Care Fondazione Policlinico San Matteo, IRCCS, University of Pavia, Pavia, Italy.

Purpose: Left ventricular outflow tract obstruction (LVOTO) is a relatively uncommon but severe condition that may lead to hemodynamic impairment. It can be elicited by morphological (left ventricular hypertrophy, sigmoid septum, prominent papillary muscle, prolonged anterior mitral valve leaflet) and functional (hypovolemia, low afterload, hypercontractility, catecholamines) factors. We sought to determine the incidence of the most severe form of LVOTO in septic shock patients and describe the therapeutic effects of vasopressin. Read More

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http://dx.doi.org/10.1007/s10557-020-06998-8DOI Listing

Clinical Impact of Valvular Heart Disease in Elderly Patients Admitted for Acute Coronary Syndrome: Insights From the Elderly-ACS 2 Study.

Can J Cardiol 2019 Nov 21. Epub 2019 Nov 21.

Department of Cardiology, Multimedica IRCSS, Milan, Italy.

Background: Elderly patients are under-represented in clinical trials and registries, and a gap of evidence exists for clinical decision making in the setting of acute coronary syndromes (ACS). We aimed to assess the prevalence and independent prognostic impact of valvular heart disease (VHD) diagnosed during the index hospitalization on clinical outcomes among elderly patients with ACS. Included VHDs were moderate-to-severe mitral regurgitation (MR), moderate-to-severe aortic stenosis (AS), or both combined. Read More

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http://dx.doi.org/10.1016/j.cjca.2019.11.014DOI Listing
November 2019

Characteristics and Outcomes of Patients Who Are Denied From a Percutaneous Edge-to-Edge Mitral Valve Repair After Being Referred to a Transcatheter Mitral Valve Program: Impact of a Dedicated Multidisciplinary Mitral Heart Team Approach.

J Invasive Cardiol 2020 Jun;32(6):E151-E157

Quebec Heart and Lung Institute, 2725 Chemin Sainte-Foy, Québec, Quebec, Canada G1V 4G5.

Background: Many patients referred for a MitraClip intervention are finally refused for this intervention, and data are very scarce on their outcomes. Our study sought to determine the characteristics and outcomes of patients who are referred to a mitral valve clinic and are finally denied from a percutaneous mitral edge-to-edge repair.

Methods: A total of 210 patients referred to our clinic for severe mitral regurgitation were retrospectively analyzed. Read More

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Evaluation of Effectiveness and Safety of Transcatheter Mitral Valve Repair Under Moderate Conscious Sedation.

J Invasive Cardiol 2020 Jun;32(6):206-210

11800 Carmel Creek Road, San Diego, CA 92130 USA.

Background: Transcatheter mitral valve repair (TMVR) using the MitraClip system (Abbott Vascular) has become a world-wide, well-established therapeutic alternative to symptomatic patients with severe mitral regurgitation (MR) and prohibitive surgical risk. Currently, TMVRs are performed under general anesthesia. Herein, we aimed to present the effectiveness and safety of TMVR under moderate conscious sedation (MCS). Read More

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Mitral valve perforation during transcatheter aortic valve replacement.

Asian Cardiovasc Thorac Ann 2020 Jun 1:218492320930842. Epub 2020 Jun 1.

Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.

An 86-year-old female with severe aortic valve stenosis underwent transcatheter aortic valve replacement. A balloon-expandable valve was used, guided by a double-stiff guidewire that successfully straightened the aorta. During valve placement, the balloon shifted. Read More

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http://dx.doi.org/10.1177/0218492320930842DOI Listing

Diastology: 2020-A practical guide.

Authors:
Sherif F Nagueh

Echocardiography 2020 Jun 1. Epub 2020 Jun 1.

Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.

Left ventricular (LV) diastolic function can be most conveniently assessed by echocardiography which provides reliable assessments of LV structure and function. Most patients with structural heart disease have variable degrees of myocardial dysfunction. LV structural changes as pathologic hypertrophy and systolic functional abnormalities as depressed LV long-axis systolic function are associated with diastolic dysfunction. Read More

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http://dx.doi.org/10.1111/echo.14742DOI Listing

Hemodynamics of an Iatrogenic Atrial Septal Defect (IASD) after MitraClip Implantation.

Eur J Clin Invest 2020 May 31:e13295. Epub 2020 May 31.

Innere Medizin III, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Background: The MitraClip procedure requires transseptal access of the left atrium with a 24 F guiding sheath. We evaluated invasively whether a MitraClip induced iatrogenic atrial septal defect (IASD) leads to development of a relevant interatrial shunt and right ventricular overload.

Methods: A total of 69 patients who underwent a MitraClip procedure due to a severe mitral valve regurgitation (MVR) were included in the observational, retrospective cohort study. Read More

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http://dx.doi.org/10.1111/eci.13295DOI Listing

Transcatheter mitral valve repair with MitraClip for severe mitral regurgitation and cardiogenic shock during the COVID-19 pandemic.

Cardiovasc Revasc Med 2020 May 23. Epub 2020 May 23.

Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin St., Suite 1901, Houston, TX 77030, USA. Electronic address:

Transcatheter mitral valve repair with MitraClip (Abbott) is largely an elective procedure. The ongoing coronavirus disease 2019 (COVID-19) pandemic has posed challenges to health care systems; in many cases elective interventions have been curtailed. Patients with severe mitral regurgitation (MR) and cardiogenic shock are high-risk surgical candidates and at risk of a poor outcome without intervention. Read More

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http://dx.doi.org/10.1016/j.carrev.2020.05.030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244416PMC

Tricuspid valve geometry in patients with functional tricuspid regurgitation: A three-dimensional echocardiographic study.

Echocardiography 2020 May 29. Epub 2020 May 29.

Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Introduction: Tricuspid valve (TV) has a complex anatomy causing some difficulties in echocardiographic evaluation. In this study, we sought to assess the geometry of TV in patients with functional tricuspid regurgitation (TR) by the implementation of 2- and 3-dimennsional (2D and 3D) echocardiography.

Methods: In a case-control study, the geometrical features of TV were evaluated in forty patients with functional TR using echocardiographic examinations, and those data compared with twenty-five age- and sex-matched healthy individuals. Read More

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http://dx.doi.org/10.1111/echo.14747DOI Listing

Impact of COAPT trial exclusion criteria in real-world patients undergoing transcatheter mitral valve repair.

Int J Cardiol 2020 May 26. Epub 2020 May 26.

University of Cologne, Faculty of Medicine and University Hospital Cologne, Department III of Internal Medicine, Heart Center, Germany.

Background: The generalizability of the COAPT trial results on the benefit of TMVR in patients with secondary mitral regurgitation is unclear.

Methods: Functional and long-term clinical outcome were examined in 122 consecutive patients with secondary mitral regurgitation and reduced ejection fraction undergoing TMVR. "COAPT-like" patients were defined according to principal COAPT inclusion/exclusion criteria if all of the following was fulfilled: symptomatic mitral regurgitation grade 3+ or more according to American guidelines; left ventricular ejection fraction ≥20%, left ventricular end-systolic dimension ≤70 mm, estimated pulmonary artery systolic pressure ≤70 mmHg, mitral valve orifice area ≥4 cm, no prior mitral valve procedure, no right sided congestive heart failure, no COPD requiring home oxygen therapy and NYHA class less than IVb. Read More

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http://dx.doi.org/10.1016/j.ijcard.2020.05.061DOI Listing

Clinical Impact of Preprocedural Moderate or Severe Mitral Regurgitation on Outcomes After Transcatheter Aortic Valve Replacement.

Can J Cardiol 2019 Dec 31. Epub 2019 Dec 31.

Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.

Background: The influence of improved mitral regurgitation (MR) on the outcomes of transcatheter aortic valve replacement (TAVR) is unknown. Our aim was to determine the impact of significant preprocedural MR and the improvement of MR after TAVR.

Methods: A population of 1587 patients from the Optimized Catheter Valvular Intervention Transcatheter Aortic Valve Implantation (OCEAN-TAVI) registry were evaluated. Read More

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http://dx.doi.org/10.1016/j.cjca.2019.12.022DOI Listing
December 2019

Acute myocarditis following varicella zoster infection in an immunocompetent adolescent: An uncommon complication.

Arch Argent Pediatr 2020 Jun;118(3):e284-e287

Department of Pediatric Cardiology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ziraat Mah, Ankara, Turkey.

Myocarditis is a serious complication of varicella zoster virus infection. A 15 year-old boy was admitted to the Emergency Department for chest pain, tachycardia and hypotension. An electrocardiogram showed sinus tachyicardia. Read More

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http://dx.doi.org/10.5546/aap.2020.eng.e284DOI Listing

Perspectives on surgical treatment of mitral valve disease.

Authors:
Tirone E David

Asian Cardiovasc Thorac Ann 2020 May 29:218492320930846. Epub 2020 May 29.

Division of Cardiovascular Surgery of Peter Munk Cardiac Centre at Toronto General Hospital and the University of Toronto, Toronto, Ontario, Canada.

A sound knowledge of the functional anatomy of the mitral valve and the alterations caused by different diseases is indispensable for surgeons treating patients with mitral valve disease. Rheumatic mitral valve disease remains the most common heart valvular disorder in developing countries, whereas mitral regurgitation due myxomatous degeneration of the valve is the most common in developed countries. The mitral valve should be repaired whenever possible, as long as the outcome is predictably better than that of replacement. Read More

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http://dx.doi.org/10.1177/0218492320930846DOI Listing

Impact of mitral regurgitation on cardiovascular hospitalization and death in newly diagnosed heart failure patients.

ESC Heart Fail 2020 May 29. Epub 2020 May 29.

Edwards Lifesciences, Irvine, CA, 92614, USA.

Aims: Heart failure (HF) carries a poor prognosis, and the impact of concomitant mitral regurgitation (MR) is not well understood. This analysis aimed to estimate the incremental effect of MR in patients newly diagnosed with HF.

Methods And Results: Data from the IBM® MarketScan® Research Databases were analysed. Read More

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http://dx.doi.org/10.1002/ehf2.12653DOI Listing

Impact of right ventricular impairment on morbidity and mortality in takotsubo syndrome-a meta-analysis of observational trials.

Heart Fail Rev 2020 May 28. Epub 2020 May 28.

Department of Cardiology, University of Iowa Health Care, Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA.

The impact of right ventricular impairment (RVI) on the morbidity and mortality of patients with Takotsubo syndrome (TTS) is well-debated. We conducted a meta-analysis to evaluate the mortality and morbidity risk associated with RVI compared with those without RVI in patients with TTS. A comprehensive search was performed in PubMed and Embase from inception to April 19, 2019. Read More

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http://dx.doi.org/10.1007/s10741-020-09981-5DOI Listing

MitraClip as bridging strategy for heart transplantation in Chagas cardiomyopathy: a case report.

Eur Heart J Case Rep 2020 Feb 18;4(1):1-5. Epub 2020 Jan 18.

Division of Cardiology, Department of Heart Failure and Transplantation, Fundación Cardioinfantil, Universidad El Bosque, Calle 163A # 13B-60, Bogotá, Colombia.

Background: Patients with end-stage heart failure, suffering from severe pulmonary hypertension (PH) and elevated pulmonary vascular resistance, are not eligible for heart transplant due to high mortality risk and primary graft dysfunction. Severe PH may be favoured by functional severe mitral regurgitation, which is present in many cardiopathies like end-stage Chagasic cardiomyopathy.

Case Summary: We present a case of a young man with end-stage heart failure secondary to Chagas cardiomyopathy with severe functional mitral regurgitation (FMR) and severe PH. Read More

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http://dx.doi.org/10.1093/ehjcr/ytz238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245051PMC
February 2020

Hemodynamic Effects of Sacubitril-Valsartan in Heart Failure with Reduced-Ejection Fraction: Are All Doses Created Equal?

J Heart Lung Transplant 2020 Apr 30;39(4S):S53. Epub 2020 Mar 30.

Cardiovascular Department, University of Bologna, Bologna, Italy.

Purpose: Paradigm HF trial showed that Sacubitril/Valsartan (LCZ696) 97/103 mg bid reduces the risk of death and hospitalizations for heart failure (HF). We tested the hypothesis that this clinical benefit is reflected by changes in hemodynamic profile in a population of patients (pts) affected by advanced HF.

Methods: Among pts included in our prospective HF Registry, we enrolled those who underwent two right heart catheterizations (RHC) and started LCZ696 in between, from May 2017 to April 2019. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.1236DOI Listing

Outcomes of Left Ventricular Assist Device Implantation with Mitral Regurgitation with and without Concomitant Mitral Operation.

J Heart Lung Transplant 2020 Apr 30;39(4S):S441-S442. Epub 2020 Mar 30.

Center for Outcomes Research & Evaluation and Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT.

Purpose: The clinical impact of mitral valve procedures (MVP) at time of left ventricular assist device (LVAD) is not well understood. We examined the association of MVP, according to severity of MR, with long term survival and quality of life metrics.

Methods: Continuous-flow LVAD recipients with MR from the 2008-2017 INTERMACS registry were included in the analysis. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.251DOI Listing

Prognostic Impact of Functional Mitral Regurgitation at the Time of Left Ventricular Assist Device Implantation.

J Heart Lung Transplant 2020 Apr 30;39(4S):S429. Epub 2020 Mar 30.

Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany.

Purpose: Due to LV remodeling functional mitral regurgitation (FMR) is a common feature of heart failure resulting in an impaired outcome. Nevertheless, the prognostic impact of uncorrected FMR at the time of LVAD implantation remains controversial.

Methods: Between 2015 and 2018 77 consecutive patients underwent continuous-flow LVAD implantation at our institution. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.221DOI Listing

The Hole of Hope: Balloon Atrial Septostomy for Left Ventricle Unloading during VA ECMO.

J Heart Lung Transplant 2020 Apr 30;39(4S):S420-S421. Epub 2020 Mar 30.

CIBERCV, U. Complutense, Cardiology, Hospital 12 de Octubre, Madrid, Spain.

Purpose: Veno arterial extracorporeal membrane oxygenation (VA-ECMO) is an established rescue therapy for cardiogenic shock (CS). However, the increase in left ventricle (LV) afterload associated with inappropriate LV unloading remains an unsolved problem. Balloon atrial septostomy (BAS) is an inexpensive effective with low complication rates. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.199DOI Listing

The Hemodynamic Impact of Mitral Regurgitation on Aortic Insufficiency in the LVAD-Supported Heart.

J Heart Lung Transplant 2020 Apr 30;39(4S):S416-S417. Epub 2020 Mar 30.

Bioengineering, San Diego State University, San Diego, CA.

Purpose: Aortic valve incompetence (AI) is a serious complication that develops in 20% of LVAD patients within 12 months of implantation. Many LVAD patients with AI also develop mitral regurgitation (MR). Our goal in this study was to measure systemic flow (Qsys) and LVAD flow (Q) during AI, MR and AI+MR. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.188DOI Listing

Change in Mitral Valve Geometry after Left Ventricular Assist Device Implantation in Patients with Functional Mitral Regurgitation.

J Heart Lung Transplant 2020 Apr 30;39(4S):S405-S406. Epub 2020 Mar 30.

Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, NY.

Purpose: Previous studies have shown remarkable decrease in severity of functional mitral regurgitation (FMR) after left ventricular assist device (LVAD) implantation with mechanical unloading. This study aimed to identify the change of FMR and mitral geometry in LVAD patients.

Methods: We retrospectively reviewed all patients who underwent LVAD implantation and had significant FMR without mitral valve procedure between January 2010 and December 2017. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.156DOI Listing

Persistent Mitral Regurgitation after Left Ventricular Assist Device: A Clinical Conundrum.

J Heart Lung Transplant 2020 Apr 30;39(4S):S402. Epub 2020 Mar 30.

Cardiovascular Disease / Advanced Heart Failure, University of Alabama at Birmingham, Birmingham, AL.

Purpose: Persistent mitral valve regurgitation (MR) after continuous flow left ventricular assist device implantation (cfLVAD) is associated with pulmonary hypertension and right ventricular (RV) failure with variable effects on survival across published studies. The aim of this study is to determine the incidence and predictors of persistent MR at 6-month follow up after cfLVAD implantation and its impact on survival, hemodynamics, RV function and morbidity.

Methods: Retrospective review of all adult cfLVAD recipients from January 2012 to June 2017 at a single tertiary university hospital. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.145DOI Listing

Predictors of Late Tricuspid Regurgitation in Patients with Left Ventricular Assist Devices.

J Heart Lung Transplant 2020 Apr 30;39(4S):S401. Epub 2020 Mar 30.

Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.

Purpose: Moderate and severe tricuspid regurgitation (TR) at the time of LVAD-Implantation is associated with poor survival. Therefore the benefit of Tricuspid repair at the time of LVAD implantation is subject of intensive discussion. The aim of this study was to evaluate predictors of moderate to severe and severe TR (ms-sTR) 6 months after Implantation. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.143DOI Listing

Validation of Non-Invasive RAMP-Testing for HeartMate 3.

J Heart Lung Transplant 2020 Apr 30;39(4S):S340. Epub 2020 Mar 30.

Karolinska Institutet, Stockholm, Sweden.

Purpose: RAMP-testing in the postoperative period can be used to optimize LVAD speed for optimal left ventricular unloading, cardiac output, right ventricular function, and LV-RV interactions. We tested the hypotheses that a non-invasive echocardiographic RAMP-test post HM3 implantation improves LV unloading immediately after and 1-3 months after as compared to before the test. We also tested a secondary hypothesis that RPM adjustments during echocardiography-guided RAMP-testing does not worsen RV function immediately after and 1-3 months after. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.378DOI Listing

ACE Inhibitor Use is Associated with Reduction in Gastrointestinal Bleeding Events in CF-LVAD Patients.

J Heart Lung Transplant 2020 Apr 30;39(4S):S28. Epub 2020 Mar 30.

Cardiology/Cardiac Surgery, Massachusetts General Hospital, Boston, MA.

Purpose: Gastrointestinal bleeding (GIB) remains a vexing issue in patients supported with continuous-flow LVADs (CF-LVAD). GIB is associated with hospital readmissions, need for procedures, and blood transfusions. Recent literature has suggested association between angiotensin II antagonism and formation of AVMs in CF-LVAD patients. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.1171DOI Listing

Case Report: Percutaneous Mitral Valve Repair in a Patient with Fontan Repair for a Single Functional Ventricle.

J Heart Lung Transplant 2020 Apr 30;39(4S):S239. Epub 2020 Mar 30.

Penn State Medical Center, Hershey, PA.

Purpose: Mitral regurgitation (MR) can complicate congenital heart disease, particularly when secondary to left ventricular dysfunction and mitral annular dilation. Significant MR is associated with substantial morbidity and mortality in patients with reduced LV systolic function, with recent studies demonstrating that percutaneous mitral valve repair can significantly reduce hospitalizations and all-cause mortality.

Methods: A 31 year-old man was referred to our Advanced Valve center for evaluation and management of significant MR. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.909DOI Listing

Papillary Muscle Viability Correlates with Changes of Functional Mitral Regurgitation in Patients with Non-Ischemic Dilated Cardiomyopathy.

J Heart Lung Transplant 2020 Apr 30;39(4S):S236. Epub 2020 Mar 30.

Advanced Heart Failure and Transplantation Center, UMC Ljubljana, Ljubljana, Slovenia.

Purpose: Functional mitral regurgitation (FMR) in non-ischemic cardiomyopathy (NICM) may be partly related to the dysfunction of subvalvular apparatus. Thus, we sought to investigate the correlation between papillary muscle viability and FMR changes in NICM.

Methods: Of 35 patients with NICM (LVEF<40%, NHYA III) undergoing repeated CD34 cell transplantation we enrolled 30 patients (86%) who presented with ≥1+ grade FMR. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.900DOI Listing

Characteristics Associated with Improved Pulmonary Vascular Resistance Following LVAD Surgery.

J Heart Lung Transplant 2020 Apr 30;39(4S):S139. Epub 2020 Mar 30.

Cardiology, Tufts Medical Center, Cambridge, MA.

Purpose: LVAD therapy improves pulmonary vascular resistance (PVR) in patients with heart failure, but the patient characteristics associated with PVR reduction are unknown.

Methods: Primary continuous-flow LVAD recipients in the INTERMACS registry with implant PVR ≥3 Wood units (WU) and at least one reported postoperative PVR were included. Post-implant PVR was modeled as a function of 29 covariates using multivariable linear mixed effects modeling. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.1053DOI Listing

Prognostication of Residual Mitral Regurgitation or Aortic Insufficiency after Invasive Hemodynamic Ramp Optimization.

J Heart Lung Transplant 2020 Apr 30;39(4S):S117. Epub 2020 Mar 30.

Cardiovascular Disease, University of Chicago Medical Center, Chicago, IL.

Purpose: LVAD speed optimization via invasive ramp studies have been shown to reduce LVAD related morbidity. Many LVAD implanting centers use non-invasive echocardiographic (TTE) ramp studies for optimization and use mitral (MR) and aortic insufficiency (AI) severity as surrogates for unloading and optimization. We examined the prognostic value of residual MR and AI after invasive hemodynamic optimization. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.994DOI Listing

Morphologic and Functional Changes after LVAD Implantation in Patients with Preoperative Severe Mitral Regurgitation.

J Heart Lung Transplant 2020 Apr 30;39(4S):S116. Epub 2020 Mar 30.

Cardiac Surgery, University of Michigan-Ann Arbor, Ann Arbor, MI.

Purpose: Examined cardiac changes after continuous flow left ventricular assist device (cfLVAD) implantation in patients with preop severe mitral regurgitation (MR).

Methods: From 2003-2017, 134 patients with severe MR had cfVLAD implant without mitral valve (MV) intervention. We assessed echocardiographic (echo) features pre-cfLVAD, early post-cfLVAD, and the last available echo. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.993DOI Listing

Impact of Residual Secondary Mitral Regurgitation on Clinical Outcomes after LVAD Implantation: An Analysis from the MOMENTUM 3 Pivotal Trial and Continuous Access Protocol Study.

J Heart Lung Transplant 2020 Apr 30;39(4S):S116. Epub 2020 Mar 30.

Brigham and Women's Hospital, Boston, MA.

Objectives: Secondary mitral regurgitation (MR), not amenable to percutaneous or surgical repair, is common in advanced heart failure patients considered for LVAD implantation. Single center analyses have suggested variable frequency of persistent MR after LVAD implantation and consequent pulmonary hypertension, worse right heart function and more readmissions. The contemporary impact of newer devices such as the HeartMate 3 (HM3) on amelioration of MR post-LVAD implant remains uncertain. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.992DOI Listing

The Clinical Importance of Functional Mitral Regurgitation and Atrial Fibrillation in Patients with Left Ventricular Assist Device.

J Heart Lung Transplant 2020 Apr 30;39(4S):S115-S116. Epub 2020 Mar 30.

Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, NY.

Purpose: Functional mitral regurgitation (FMR) and atrial fibrillation (AF) are common in patients undergoing left ventricular assist device (LVAD) implantation. However, the impact of FMR and AF on clinical outcomes is uncertain. The aim of this study is to investigate the prognostic significance of FMR and AF in patients with LVAD. Read More

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http://dx.doi.org/10.1016/j.healun.2020.01.991DOI Listing

Predictors of functional improvement in the short term after MitraClip implantation in patients with secondary mitral regurgitation.

PLoS One 2020 28;15(5):e0232817. Epub 2020 May 28.

Department of Internal Medicine I, Klinikum St. Marien, Amberg, Germany.

Background And Objectives: MitraClip implantation is an established therapy for secondary mitral regurgitation (MR) in high-risk patients and has shown to improve several important outcome parameters such as functional capacity. Patient selection is both challenging and crucial for achieving therapeutic success. This study investigated baseline predictors of functional improvement as it was quantified by the six-minute walk distance (6MWD) after transcatheter mitral valve repair. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232817PLOS

Moderate to severe ischemic mitral regurgitation: More data to guide the choice. Why not consider the use of subvalvular repair?

Cardiol J 2020 ;27(2):220-222

Department of Cardiac Surgery, Center Cardiologique du Nord, Saint-Denis, Paris, France.

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http://dx.doi.org/10.5603/CJ.2020.0051DOI Listing
January 2020

Subannular repair for moderate to severe ischemic mitral regurgitation: Still a long way to go. Authors' reply.

Cardiol J 2020 ;27(2):223-224

SunState Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.

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http://dx.doi.org/10.5603/CJ.2020.0052DOI Listing
January 2020

Submitral Aneurysm: A Rare Cause of Severe Mitral Regurgitation.

J Cardiovasc Imaging 2020 May 27. Epub 2020 May 27.

Department of Cardiology, Jaipur Heart Institute, Jaipur, India.

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http://dx.doi.org/10.4250/jcvi.2019.0131DOI Listing

Redo MitraClip for Late Recurrent Severe Mitral Regurgitation: Case Report and Literature Review.

CJC Open 2020 May 15;2(3):179-185. Epub 2020 Feb 15.

Structural Heart Program, Prairie Heart Institute, St. John's Hospital, Springfield, Illinois, USA.

Transcatheter mitral valve repair using the MitraClip (Abbott Vascular, Santa Clara, CA) is a reasonable option for the treatment of patients with severe symptomatic degenerative mitral regurgitation (MR) who are at prohibitive surgical risk. The occurrence of recurrent severe MR after initial successful MitraClip repair is uncommon. Data are sparse on the management of recurrent severe MR after initial successful repair using the MitraClip. Read More

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http://dx.doi.org/10.1016/j.cjco.2020.01.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242512PMC

Contemporary Management of Secondary Mitral Regurgitation.

Eur Cardiol 2020 Feb 12;15:e22. Epub 2020 May 12.

Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine Nashville, TN, US.

Secondary mitral regurgitation (SMR) is a common occurrence in patients with heart failure with reduced ejection fraction. Moderate-severe or severe SMR is associated with increased mortality and hospitalisations from heart failure. Medical and cardiac resynchronisation therapies have been the only treatments proven to improve prognosis in this patient population. Read More

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http://dx.doi.org/10.15420/ecr.2019.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236019PMC
February 2020

The use of MitraClip in secondary mitral regurgitation and heart failure.

Cardiovasc Revasc Med 2020 May 19. Epub 2020 May 19.

Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA.

Secondary (also known as functional) mitral regurgitation (MR) has increased substantially over the last several decades due to an increase in the prevalence of dilated cardiomyopathy (ischemic and non-ischemic). Mortality and morbidity in patients with dilated cardiomyopathy is much greater when associated with MR as compared to without MR. MR will result in further left ventricular (LV) volume overload, LV dilation, and pupillary muscle displacement resulting in deterioration of the severity of MR leading to a vicious cycle. Read More

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http://dx.doi.org/10.1016/j.carrev.2020.05.015DOI Listing

A rare case of brain abscess caused by Actinomyces meyeri.

BMC Infect Dis 2020 May 27;20(1):378. Epub 2020 May 27.

Division of Infectious Disease, East Carolina University Brody School of Medicine, Greenville, NC, USA.

Background: Brain abscesses are the rare and most severe form of actinomycosis, which usually manifests as abscesses of the occipital or parietal lobe due to direct expansion from an adjacent area, the oral cavity. In the medical literature, there are only a few reported cases of brain abscess caused by Actinomyces meyeri. In this report, we present a 35-year-old male patient who experienced an insidious headache and left-sided weakness and was diagnosed with an Actinomyces meyeri brain abscess. Read More

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http://dx.doi.org/10.1186/s12879-020-05100-9DOI Listing

Percutaneous valve repair of functional mitral regurgitation: aiming at optimal and durable results.

Eur J Heart Fail 2020 May 27. Epub 2020 May 27.

Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.

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http://dx.doi.org/10.1002/ejhf.1850DOI Listing

Does the Presence of Significant Mitral Regurgitation prior to Transcatheter Aortic Valve Implantation for Aortic Stenosis Impact Mortality? - Meta-Analysis and Systematic Review.

Cardiology 2020 May 27:1-11. Epub 2020 May 27.

Division of Cardiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.

Background: Mitral regurgitation (MR) is commonly encountered in patients with severe aortic stenosis (AS). However, its independent impact on mortality in patients undergoing transcatheter aortic valve implantation (TAVI) has not been established.

Methods: We performed a systematic search for studies reporting characteristics and outcome of patients with and without significant MR and/or adjusted mortality associated with MR post-TAVI. Read More

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http://dx.doi.org/10.1159/000506624DOI Listing

Hybrid Positron Emission Tomography/Magnetic Resonance Imaging in Arrhythmic Mitral Valve Prolapse.

JAMA Cardiol 2020 May 27. Epub 2020 May 27.

The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York.

Importance: Myocardial replacement fibrosis has been reported to occur in one-third of patients with mitral valve prolapse (MVP) and significant mitral regurgitation (MR). However, it remains unknown whether there are detectable changes in myocardial metabolism suggestive of inflammation or ischemia that accompany the development of fibrosis.

Objectives: To characterize the burden and distribution of fluorine 18-labeled (18F) fluorodeoxyglucose (FDG) uptake and late gadolinium enhancement (LGE) in patients with degenerative MVP and ventricular ectopy. Read More

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http://dx.doi.org/10.1001/jamacardio.2020.1555DOI Listing

Transcatheter closure of paravalvular leaks: short and medium-term outcomes.

Arch Cardiol Mex 2020 ;90(2):122-129

Departamento de Cardiología Intervencionista, Instituto Nacional de Cardiología Ignacio Chávez. Ciudad de México, México.

Background: Paravalvular leak is a frequent and important complication after surgical valvular replacement that can cause heart failure, hemolytic anemia and is associated with poor clinical outcomes. Surgical reoperation has been the standard treatment, but it is associated with high morbidity and mortality. Transcatheter closure is a therapeutic alternative. Read More

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http://dx.doi.org/10.24875/ACM.19000169DOI Listing
January 2020

Left bundle branch area. A new site for physiological pacing: a pilot study.

Heart Vessels 2020 May 27. Epub 2020 May 27.

B.M Birla Heart Research Centre, Kolkata, India.

Chronic RV pacing may lead to pacing induced cardiomyopathy in some patients and results in a higher risk of development of LV systolic dysfunction, heart failure, mitral regurgitation and atrial fibrillation. His bundle pacing emerged as the most physiologic form of ventricular pacing. However, wide adoption of this technique in routine clinical practice is limited by higher capture thresholds at implant sometimes, lower R wave amplitudes, atrial over sensing and increased risk for late rise in pacing thresholds (resulting in the need for lead revisions). Read More

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http://dx.doi.org/10.1007/s00380-020-01623-yDOI Listing

A Comprehensive Engineering Analysis of Left Heart Dynamics After MitraClip in a Functional Mitral Regurgitation Patient.

Front Physiol 2020 7;11:432. Epub 2020 May 7.

Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States.

Percutaneous edge-to-edge mitral valve (MV) repair using MitraClip has been recently established as a treatment option for patients with heart failure and functional mitral regurgitation (MR), which significantly expands the number of patients that can be treated with this device. This study aimed to quantify the morphologic, hemodynamic and structural changes, and evaluate the biomechanical interaction between the MitraClip and the left heart (LH) complex of a heart failure patient with functional MR using a fluid-structure interaction (FSI) modeling framework. MitraClip implantation using lateral, central and double clip positions, as well as combined annuloplasty procedures were simulated in a patient-specific LH model that integrates detailed anatomic structures, incorporates age- and gender-matched non-linear elastic material properties, and accounts for mitral chordae tethering. Read More

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http://dx.doi.org/10.3389/fphys.2020.00432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221026PMC

Functional mitral regurgitation and cardiac resynchronization therapy in the "era" of trans-catheter interventions: Is it time to move from a staged strategy to a tailored therapy?

Int J Cardiol 2020 Mar 28. Epub 2020 Mar 28.

Heart Valve Clinic, University Hospital of Zurich, Ramistrasse 100, 8091 Zurich, Switzerland.

Cardiac resynchronization therapy (CRT) has been associated to left ventricle (LV) remodelling, reduction of functional mitral regurgitation (FMR) and clinical improvement in patients with heart failure and reduced ejection fraction (HFrEF). The prevalence of significant FMR in patients with LV dyssynchrony that are candidate to CRT is up to 40%. Current approach in patients with FMR undergoing CRT consists of re-evaluation of the amount of FMR following a waiting period of at least 3 months after the implant. Read More

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http://dx.doi.org/10.1016/j.ijcard.2020.03.071DOI Listing