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    The flaws in the detail of an observational study on transcatheter aortic valve implantation versus surgical aortic valve replacement in intermediate-risks patients.
    Eur J Cardiothorac Surg 2017 Jun;51(6):1031-1035
    Department of Cardiac Surgery, IRCCS Policlinico S. Donato, Milan, Italy.
    The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results. The study by Thourani and colleagues showed several major methodological concerns: suboptimal methods in propensity score analysis with evident misspecification of the propensity scores (PS; no adjustment for the most significantly different covariates: left ventricular ejection fraction, moderate-severe mitral regurgitation and associated procedures); use of PS quintiles rather than matching; inference on not-adjusted Kaplan-Meier curves, although the authors correctly claimed for the need of balancing score adjusting for confounding factors in order to have unbiased estimates of the treatment effect; evidence of poor fit; lack of data on valve-related death. Read More

    Functional Implication of Mitral Annular Disjunction in Mitral Valve Prolapse: A Quantitative Dynamic 3D Echocardiographic Study.
    JACC Cardiovasc Imaging 2017 May 11. Epub 2017 May 11.
    Cardiology Department, Renji Hospital, Medical College of Shanghai Jiao Tong University, Shanghai, China.
    Objectives: This study aimed to assess the hypothesis that mitral annular disjunction (MAD) is associated with abnormal annular dynamics due to decoupling of annular-ventricular function.

    Background: MAD, defined as a separation between the atrial wall-mitral valve (MV) junction and left ventricular (LV) attachment, is a structural abnormality occurring in MV prolapse (MVP). Few data exist on the 3-dimensional (3D) geometry of MAD and its functional implication. Read More

    Three Cases of Aneurysmatic Coronary Fistulas Associated With Mitral Valve Insufficiency.
    Ann Thorac Surg 2017 Jun;103(6):e505-e507
    Cardiovascular Department, Centro Cuore, Policlinico di Monza, Alessandria, Italy.
    We report three cases of coronary fistula aneurysm associated with mitral valve insufficiency. The patients were referred to our cardiovascular department because of exertional dyspnea. Echocardiography showed severe mitral valve insufficiency resulting from leaflet flail or prolapse and normal left ventricular function. Read More

    Resolution of Mitral Regurgitation With Left Ventricular Assist Device Support.
    Ann Thorac Surg 2017 May 17. Epub 2017 May 17.
    Division of Cardiothoracic Transplantation and Circulatory Support, Texas Heart Institute, Baylor College of Medicine, Houston, Texas.
    Background: Cardiac valve disease is common in patients with end-stage heart failure undergoing left ventricular assist device implantation (LVAD). The aim of this study was to determine if preoperative mitral regurgitation (MR) affects outcomes and hemodynamics in patients after LVAD implantation.

    Methods: From March 2006 through May 2015, 238 consecutive patients underwent LVAD implantation. Read More

    Mechanism of atrial functional mitral regurgitation in patients with atrial fibrillation: A study using three-dimensional transesophageal echocardiography.
    J Cardiol 2017 May 17. Epub 2017 May 17.
    Department of Cardiology, Nishinomiya-Watanabe Cardiovascular Center, Nishinomiya, Japan.
    Background: Functional mitral regurgitation (MR) can occur in patients with atrial fibrillation (AF) despite having preserved left ventricular (LV) systolic function. This MR is known as atrial functional MR. The aim of this study was to clarify the mechanism of atrial functional MR using real-time three-dimensional transesophageal echocardiography (3DTEE). Read More

    Amyloidosis - a rare cause of refractory heart failure in a young female.
    Rom J Morphol Embryol 2017 ;58(1):201-206
    Department of Ophthalmology, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania;
    Cardiac amyloidosis may occur in any type of systemic amyloidosis. The clinical picture is often characterized by restrictive cardiomyopathy. We report the case of a 41-year-old female patient admitted to the Department of Cardiology with clinical signs of right heart failure: congested jugular veins, hepatomegaly, peripheral edema, ascites associated with atrial fibrillation, low values of arterial blood pressure and oliguria. Read More

    Surgical repair of partial atrioventricular septal defect.
    Pak J Med Sci 2017 Mar-Apr;33(2):285-289
    Muhammad Shuaib, FCPS, Registrar, Paediatric Cardiac Surgery, CPE Institute of Cardiology, Multan, Pakistan.
    Objective: To review the results of surgical correction of partial atrioventricular septal defect and associated cardiac comorbidities.

    Methods: Retrospective case analysis of electronic database of department of paediatrics cardiac surgery, CPEIC, Multan was done. Forty consecutive patients operated for partial atrioventricular septal defect repair from September 2011 to October 2016 were included. Read More

    The reduction of central sleep apnoea severity in the left lateral position is not due to an improvement in cardiac haemodynamics in patients with chronic heart failure.
    Sleep Med 2017 Jun 18;34:30-32. Epub 2017 Mar 18.
    Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri SpA SB, Montescano (PV), Italy.
    Objective: The severity of central sleep apnoea (CSA), a common comorbidity in patients with chronic heart failure (CHF) and reduced ejection fraction, markedly decreases from the supine to the lateral sleeping position, with no difference between the left and right positions. The mechanisms responsible for this beneficial effect have not yet been elucidated.

    Methods: We tested the hypothesis that CSA attenuation in the left lateral position is due, at least in part, to an improvement in cardiac haemodynamics. Read More

    Role of mitral valve repair in active infective endocarditis: long term results.
    J Cardiothorac Surg 2017 May 18;12(1):29. Epub 2017 May 18.
    Cardiochirurgia, AOU Careggi Firenze, Florence, Italy.
    Background: Although mitral valve repair is at present the technique of choice in mitral regurgitation (MR) due to degenerative valve disease, long term results in patients with active mitral infective endocarditis (IE) are still under evaluation.

    Methods: In the study were included 34 consecutive patients (22 males; mean age, 60 years; range 32-84 years) referred to our institution between January 1, 2005 to December 31, 2011 who were treated with valve repair for mitral valve (MV) active infective endocarditis. Eighteen patients underwent isolated MV repair. Read More

    Outcomes and Prognostic Factors for Adult Patients With Congenital Heart Disease Undergoing Primary or Reoperative Systemic Atrioventricular Valve Surgery.
    World J Pediatr Congenit Heart Surg 2017 May;8(3):346-353
    1 Division of Cardiac, Thoracic, and Vascular Surgery, Section of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital, New York Presbyterian, Columbia University Medical Center, New York, NY, USA.
    Background: Adults with congenital heart disease (ACHD) undergoing systemic atrioventricular valve (SAVV) surgery are a complex, understudied population. We assessed midterm outcomes and prognostic factors in ACHD undergoing SAVV surgery.

    Methods: We performed retrospective evaluation of ACHD undergoing SAVV surgery from January 2005 to February 2016: 14 (33%) patients with congenital mitral valve stenosis/regurgitation, 15 (35%) with atrioventricular septal defect (AVSD), and 14 (33%) with congenitally corrected transposition of the great arteries (ccTGA) with systemic tricuspid valve regurgitation. Read More

    Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA).
    J Vis Exp 2017 Apr 24(122). Epub 2017 Apr 24.
    Institute of Veterinary Physiology and Zurich Center of Integrative Human Physiology (ZIHP), University of Zurich.
    Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ischemia and infarction in children. If left untreated, it results in a 90% mortality rate in the first year of life. In patients who survive to the adulthood, the coronary steal phenomenon and retrograde left-sided coronary flow provide a substrate for chronic subendocardial ischemia, which may lead to left ventricular dysfunction, ischemic mitral regurgitation, malignant ventricular arrhythmias, and sudden cardiac death. Read More

    Gerbode defect and multivalvular dysfunction: Complex complications in adult congenital heart disease.
    Echocardiography 2017 May 18. Epub 2017 May 18.
    Cardiology Department, Leiria Hospital Center, Leiria, Portugal.
    We report a clinical case of a 40-year-old male with surgically corrected congenital heart disease (CHD) 10 years earlier: closure of ostium primum, mitral annuloplasty, and aortic valve and root surgery. The patient was admitted with acute heart failure. Transesophageal echocardiography (TEE) revealed a dysmorphic and severely incompetent aortic valve, a partial tear of the mitral valve cleft repair and annuloplasty ring dehiscence. Read More

    Cardiogenic Shock, Acute Severe Mitral Regurgitation and Complete Heart Block After Cavo-Tricuspid Isthmus Atrial Flutter Ablation.
    Cardiol Res 2017 Apr 3;8(2):63-67. Epub 2017 May 3.
    Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
    Radiofrequency (RF) ablation is the first-line management of cavo-tricuspid isthmus dependent atrial flutter. It has been performed with 95% success rate. Adverse events are very rare. Read More

    A retrospective analysis of mitral valve pathology in the setting of bicuspid aortic valves.
    Echo Res Pract 2017 May 17. Epub 2017 May 17.
    A van Rensburg, Department of Medicine, Division of Cardiology, Tygerberg Academic Hospital, Cape Town, South Africa.
    The therapeutic implications of bicuspid aortic valve associations have come under scrutiny in the transcatheter aortic valve implantation era. We evaluate the spectrum of mitral valve disease in patients with bicuspid aortic valves to determine the need for closer echocardiographic scrutiny/follow-up of the mitral valve. A retrospective analysis of echocardiograms done at a referral hospital over five years was conducted in patients with bicuspid aortic valves with special attention to congenital abnormalities of the mitral valve. Read More

    When Cardioversion May Be Complicated.
    Isr Med Assoc J 2017 May;19(5):282-288
    Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    Background: In recent years cardioversion of atrial fibrillation has become a routine procedure, enabling symptomatic functional improvement in most cases. However, some patients develop complications after cardioversion. Identifying these individuals is an important step toward improving patient outcome. Read More

    Mechanism and Immediate Outcome of Significant Mitral Regurgitation Following Balloon Mitral Valvuloplasty with JOMIVA Balloon.
    J Clin Diagn Res 2017 Mar 1;11(3):OC01-OC04. Epub 2017 Mar 1.
    Clinical Pharmacist, Department of Cardiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
    Introduction: Balloon Mitral Valvuloplasty (BMV) with inoue balloon is the most common technique being followed worldwide. Over the wire BMV is a modified technique with Joseph Mitral Valvuloplasty (JOMIVA) balloon and is being followed in certain centres. We hypothesized that, the incidence and mechanism of Mitral Regurgitation (MR) is likely to be different from that of inoue balloon. Read More

    Global longitudinal strain predicts outcome after MitraClip implantation for secondary mitral regurgitation.
    J Cardiovasc Med (Hagerstown) 2017 May 13. Epub 2017 May 13.
    aDepartment of Cardiology, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy bDepartment of Cardiology, University of Liège Hospital, GIGA-Cardiovascular Sciences, Liège, Belgium cGruppo Villa Maria Care and Research, E.S. Health Science Foundation, Lugo, Romagna dDivision UTIC, Sant'Ottone Frangipane, Ariano Irpino, Avellino, Italy.
    Aim: The aim of this study was to assess preoperative determinants, prevalence, and prognostic impact of left ventricular (LV) reverse remodeling (LVRR) in patients with secondary mitral regurgitation (SMR), undergoing MitraClip implantation (MCi).

    Methods: From March 2012 to January 2015, a total of 41 consecutive patients with moderate-to-severe SMR treated successfully with MCi were enrolled. All patients underwent clinical and echocardiographic follow-up after MCi. Read More

    Transcatheter paravalvular leak closure and hemolysis - a prospective registry.
    Arch Med Sci 2017 Apr 13;13(3):575-584. Epub 2016 Jun 13.
    3 Department of Cardiology, Medical University of Silesia, Katowice, Poland.
    Introduction: Paravalvular leak (PVL) related to a surgical prosthetic valve may be associated with clinically significant hemolysis. The influence of transcatheter PVL closure (TPVLC) on hemolysis remains uncertain.

    Material And Methods: The prospective registry included patients undergoing TPVLC due to PVL-related heart failure and/or hemolysis. Read More

    Dynamic Transcatheter Mitral Valve Repair: a New Concept to treat Functional Mitral Regurgitation using an Adjustable Spacer.
    EuroIntervention 2017 May 16. Epub 2017 May 16.
    Department of Cardiothoracic Surgery, King's College Hospital London, United Kingdom.
    We report about the first-in-man implantation of the Mitra-SpacerTM (Cardiosolutions Inc., West Bridgewater, MA/USA). It was implanted transapically. Read More

    Transcatheter mitral valve interventions for mitral regurgitation, with special focus on MitraClip: The position of Spanish, Portuguese and Italian interventional societies.
    Int J Cardiol 2017 May 9. Epub 2017 May 9.
    Department of Cardiology, Reina Sofia Hospital, University of Cordoba (IMIBIC), Spain.
    Mitral regurgitation is a common valvular heart disease and its prevalence is expected to increase with population ageing. In the recent years we have witnessed the evolution of several transcatheter devices to correct mitral regurgitation in patients at high-risk for surgery. Most of the evidence of the safety and efficacy of this new therapy comes from MitraClip studies. Read More

    Mitral Regurgitation Grading in the Operating Room: A Systematic Review and Meta-analysis Comparing Preoperative and Intraoperative Assessments During Cardiac Surgery.
    J Cardiothorac Vasc Anesth 2017 Feb 13. Epub 2017 Feb 13.
    Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
    Objective: To assess differences in mitral regurgitation (MR) grade between the preoperative and the intraoperative evaluations.

    Design: Systematic review and meta-analysis of 6 observational studies found from MEDLINE and EMBASE.

    Setting: Cardiac surgery. Read More

    United Kingdom: coronary and structural heart interventions from 2010 to 2015.
    EuroIntervention 2017 05;13(Z):Z83-Z88
    Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham, United Kingdom.
    In the United Kingdom, a clinical data set is completed for every patient undergoing coronary intervention and certain structural interventions, and sent to central servers in the National Institute for Cardiovascular Outcomes Research (NICOR) on behalf of the British Cardiovascular Intervention Society (BCIS). These data are linked to the national mortality register. In addition, data are obtained about the structure of healthcare provision using an annual survey. Read More

    Exercise stress echocardiography in hypertrophic cardiomyopathy.
    J Echocardiogr 2017 May 13. Epub 2017 May 13.
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
    In this review, we make a comprehensive summary of exercise stress echocardiography in hypertrophic cardiomyopathy (HCM) and practical tips used in our hospital. The main objective of performing exercise stress echocardiography in patients with HCM is to evaluate left ventricular outflow tract obstruction, mitral regurgitation, left ventricular asynergy, and diastolic function during exercise. There are limitations to the explanations that can be provided for exertional symptoms when resting echocardiography is performed in patients with HCM. Read More

    Tricuspid annuloplasty versus a conservative approach in patients with functional tricuspid regurgitation undergoing left-sided heart valve surgery: A study-level meta-analysis.
    Int J Cardiol 2017 May 5. Epub 2017 May 5.
    Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy. Electronic address:
    Background: Tricuspid valve (TV) repair at the time of left-sided valve surgery is indicated in patients with either severe functional tricuspid regurgitation (TR) or mild-to-moderate TR with coexistent tricuspid annular dilation or right heart failure. We assessed the benefits of a concomitant TV repair strategy during left-sided surgical valve interventions, focusing on mortality and echocardiographic TR-related outcomes.

    Methods: A meta-analysis was performed of studies reporting outcomes of patients who underwent left-sided (mitral and/or aortic) valve surgery with or without concomitant TV repair. Read More

    Mitral arcade: A rare case presenting with fatigue and cough.
    Echocardiography 2017 May 12. Epub 2017 May 12.
    Department of Pediatric Cardiology, SBU Suleymaniye Obstetrics and Children Training and Research Hospital, Istanbul, Turkey.
    An 11-year-old girl was admitted to pediatric emergency unit with complaints of fatigue and cough. The patient had no previous complaints. There was no history of rheumatic heart disease. Read More

    Quantification of mitral regurgitation during percutaneous mitral valve repair: added value of simultaneous hemodynamic and 3D echocardiographic assessment.
    Int J Cardiovasc Imaging 2017 May 11. Epub 2017 May 11.
    Divisions of Cardiology, Angiology, Pneumology, and Intensive Medical Care, Department of Internal Medicine 1, Friedrich-Schiller-University of Jena, Erlanger Allee 101, 07740, Jena, Germany.
    The objective of this study was to investigate the usefulness of intraprocedural hemodynamic monitoring for MR evaluation during pMRV. Assessment of mitral regurgitation (MR) during percutaneous mitral valve repair (pMVR) procedure is challenging. 3D color Doppler allows exact quantification of MR, but is technically demanding. Read More

    [Surgical Experience of Infective Aneurysm of Brachial Artery Complicated with Infective Mitral Valve Endocarditis].
    Kyobu Geka 2017 May;70(5):348-351
    Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.
    We report a rare case of aneurysmal formation of the left brachial artery complicated with infective endocarditis of the mitral valve. A 67-year-old man was referred to our institution for further examination of pulsatile mass at the left upper extremity. Computed tomography showed a left brachial arterial aneurysm with a diameter of 4 cm and gradual expansion of the aneurysm was also recognized. Read More

    [Echocardiographic assessment of mitral regurgitation in the perspective of valve repair].
    G Ital Cardiol (Rome) 2017 Apr;18(4):270-285
    Cattedra di Cardiologia e LTTA Centre, Azienda Ospedaliero-Universitaria di Ferrara - Maria Cecilia Hospital, GVM Care & Research, E.S. Health Science Foundation, Cotignola (RA).
    Echocardiography is the most used imaging technique for the study of patients with mitral regurgitation because of its wide distribution, non-invasiveness and ability to provide diagnostic, functional, hemodynamic and prognostic evaluations. Also, echocardiography can provide essential information on surgical and percutaneous reparability of the regurgitant valve and can guide the surgical and interventional indications relative to valve repair. However, the echocardiographic study is not always appropriately performed in clinical practice and based on a surgery perspective. Read More

    Worsening of mitral valve regurgitation after radiofrequency catheter ablation of ventricular arrhythmia originating from a left ventricular papillary muscle.
    HeartRhythm Case Rep 2017 Apr 10;3(4):215-218. Epub 2017 Feb 10.
    Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.

    Severe ischemic cardiomyopathy with mechanical complications: Still a surgical disease.
    Int J Cardiol 2017 May 6. Epub 2017 May 6.
    L'Aquila University, L'Aquila, Italy.
    Background: Surgical treatment of ischemic cardiomyopathy (ICM) with mechanical complications has been limited in favor of suboptimal treatments because of the perception of poor outcome.

    Methods And Results: From May 2009 till June 2014 115 patients with severe ICM (ejection fraction, EF, ≤25%) and mechanical complications were operated on. Median EF was 24% (19, 24), mean end-systolic volume index (ESVi) was 86±27ml/m(2) and all patients had an MR grade of 2 or more. Read More

    Adaptive Servo-Ventilation Treatment Increases Stroke Volume in Stable Systolic Heart Failure Patients With Low Tricuspid Annular Plane Systolic Excursion.
    Int Heart J 2017 May 8. Epub 2017 May 8.
    Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo College of Medicine.
    We hypothesized that the effects of adaptive servo-ventilation (ASV) therapy were influenced by right-sided heart performance. This study aimed to clarify the interaction between the effects of ASV and right-sided heart performance in patients with stable heart failure (HF) with reduced ejection fraction (HFrEF).Twenty-six stable HF inpatients (left ventricular ejection fraction < 0. Read More

    Transcatheter aortic valve insertion after previous mitral valve operation.
    J Thorac Cardiovasc Surg 2017 Apr 4. Epub 2017 Apr 4.
    Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.
    Objective: There are limited data on transcatheter aortic valve insertion after previous mitral valve operation. To better understand the associated procedural risks, we reviewed our single-center experience.

    Methods: We retrospectively reviewed the records of 772 consecutive patients who received transcatheter aortic valve insertion from November 2008 through August 2016. Read More

    Von Willebrand Factor as a Novel Player in Valvular Heart Disease: From Bench to Valve Replacement.
    Angiology 2017 Jan 1:3319717708070. Epub 2017 Jan 1.
    1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy.
    von Willebrand Factor (vWF) is a well-known mediator of hemostasis and vascular inflammation. Its dynamic modulation in the bloodstream, according to hemodynamic conditions, makes it an appealing biomarker in patients with valvular heart disease (VHD). Recent studies highlight the close connection between vWF and VHD, with possible implications in the pathogenesis of VHD, promoting valve aging and calcification or favoring the development of infective endocarditis. Read More

    Quantitation of valve regurgitation severity by three-dimensional vena contracta area is superior to flow convergence method of quantitation on transesophageal echocardiography.
    Echocardiography 2017 May 7. Epub 2017 May 7.
    Echocardiography Laboratory, Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, USA.
    Background: Quantitation of regurgitation severity using the proximal isovelocity acceleration (PISA) method to calculate effective regurgitant orifice (ERO) area has limitations. Measurement of three-dimensional (3D) vena contracta area (VCA) accurately grades mitral regurgitation (MR) severity on transthoracic echocardiography (TTE).

    Methods: We evaluated 3D VCA quantitation of regurgitant jet severity using 3D transesophageal echocardiography (TEE) in 110 native mitral, aortic, and tricuspid valves and six prosthetic valves in patients with at least mild valvular regurgitation. Read More

    Implantation of CARILLON(®) Mitral Contour System with transvenous left ventricular lead in place.
    Clin Res Cardiol 2017 May 5. Epub 2017 May 5.
    Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
    Background: Cardiac resynchronisation therapy (CRT) is an established treatment option for chronic heart failure patients with left bundle branch block. Although a concomitant functional mitral regurgitation is often reduced by CRT, many patients need additional mitral valve repair. Placing a CARILLON(®) Mitral Contour System (CMCS) over a transvenous CRT lead is currently not recommended, since both of them are implanted in the coronary sinus (CS). Read More

    [Malignant bileaflet mitral valve prolapse syndrome in otherwise idiopathic ventricular fibrillation].
    Herzschrittmacherther Elektrophysiol 2017 May 5. Epub 2017 May 5.
    Klinik für Kardiologie & Rhythmologie, Agaplesion Diakonie Kliniken Kassel, Kassel, Deutschland.
    A 32-year-old, otherwise healthy woman was admitted after successful out-of-hospital resuscitation due to ventricular fibrillation. Established cardiac, pulmonary, metabolic, and toxicological causes were excluded. However, persisting (biphasic) negative T waves in the inferior ECG leads and premature ventricular contractions (PVC) were noted. Read More

    Traditional Cardiovascular Risk Factors and Their Relation to Future Surgery for Valvular Heart Disease or Ascending Aortic Disease: A Case-Referent Study.
    J Am Heart Assoc 2017 May 5;6(5). Epub 2017 May 5.
    Department of Public Health and Clinical Medicine, Cardiology, Umeå University, Umeå, Sweden
    Background: Risk factors for developing heart valve and ascending aortic disease are based mainly on retrospective data. To elucidate these factors in a prospective manner, we have performed a nested case-referent study using data from large, population-based surveys.

    Methods And Results: A total of 777 patients operated for heart valve disease or disease of the ascending aorta had previously participated in population-based health surveys in Northern Sweden. Read More

    Helcococcus kunzii prosthetic valve endocarditis secondary to lower extremity cellulitis.
    BMJ Case Rep 2017 May 3;2017. Epub 2017 May 3.
    Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
    An 88-year-old man with history of bioprosthetic aortic valve replacement was hospitalised with fever, chills, malaise and right lower extremity cellulitis. Laboratory investigations revealed leucocytosis and blood cultures grew Helcococcus kunzii Although transoesophageal echocardiography was negative for endocarditis, the patient was treated with 4 week of intravenous ceftriaxone. However, he was readmitted 6 weeks later with symptoms of fever, chills and hypoxia in setting of recurrent H. Read More

    Management of Nonagenarian Patients With Severe Aortic Stenosis: The Role of Comorbidity.
    Heart Lung Circ 2017 Apr 12. Epub 2017 Apr 12.
    Hospital General Universitario Gregorio Marañón, Madrid, Spain; Universidad Complutense, Universidad Europea, Madrid, Spain.
    Background: The number of nonagenarian patients with aortic stenosis will likely increase due to the ageing population. We assessed the clinical characteristics, management, and outcomes of nonagenarian patients with severe aortic stenosis.

    Methods: A total of 177 (117 females and 60 males) consecutive nonagenarian patients from two large contemporary registries were included in this study. Read More

    Transcatheter Aortic Valve Implantation Within Degenerated Aortic Surgical Bioprostheses: PARTNER 2 Valve-in-Valve Registry.
    J Am Coll Cardiol 2017 May;69(18):2253-2262
    Structural Heart and Valve Center, Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center, New York, New York.
    Background: Early experience with transcatheter aortic valve replacement (TAVR) within failed bioprosthetic surgical aortic valves has shown that valve-in-valve (VIV) TAVR is a feasible therapeutic option with acceptable acute procedural results.

    Objectives: The authors examined 30-day and 1-year outcomes in a large cohort of high-risk patients undergoing VIV TAVR.

    Methods: Patients with symptomatic degeneration of surgical aortic bioprostheses at high risk (≥50% major morbidity or mortality) for reoperative surgery were prospectively enrolled in the multicenter PARTNER (Placement of Aortic Transcatheter Valves) 2 VIV trial and continued access registries. Read More

    Elevated Mitral Valve Pressure Gradient After MitraClip Implantation Deteriorates Long-Term Outcome in Patients With Severe Mitral Regurgitation and Severe Heart Failure.
    JACC Cardiovasc Interv 2017 May;10(9):931-939
    Heart Center Brandenburg in Bernau, Fontane University Brandenburg, Bernau, Germany.
    Objectives: This single-center study was performed to analyze the effect of an increased transvalvular gradient after the MitraClip (MC) (Abbott Laboratories, Abbott Park, Illinois) procedure on patient outcome during follow-up.

    Background: Percutaneous transcatheter repair of the mitral valve with the MC device has been established as a novel technique for patients with severe mitral regurgitation and high surgical risk. This study investigated the influence of an increased pressure gradient after MC implantation on the long-term outcome of patients. Read More

    The ordeal of left atrioventricular valve replacement in children under 1 year of age†.
    Interact Cardiovasc Thorac Surg 2017 May 2. Epub 2017 May 2.
    Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, VIC, Australia.
    Objectives: This study reviews the outcomes of children under 1 year of age who had left atrioventricular valve (LAVV) replacement (LAVVR) in one centre and explores the benefits of an innovative approach for LAVVR in very small patients.

    Methods: Thirteen consecutive patients operated for LAVV replacement between 1997 and 2016 were reviewed retrospectively. Indication for surgery was regurgitation in 7, stenosis in 5 and both stenosis and regurgitation in 1. Read More

    Ongoing and future directions in percutaneous treatment of mitral regurgitation.
    Expert Rev Cardiovasc Ther 2017 May 19:1-6. Epub 2017 May 19.
    a University Heart Center Zürich , Zürich , Switzerland.
    Introduction: Mitral regurgitation (MR) is one of the major valvular disease. Although surgical mitral valve (MV) repair is the standard of care for patients with severe MR, an unmet need exists in the management of patients with severe symptomatic MR and high surgical risk. Transcatheter MV therapies are alternative treatment option in such patients with moderate to severe and symptomatic MR. Read More

    Long or redundant leaflet complicating transcatheter mitral valve replacement: Case vignettes that advocate for removal or reduction of the anterior mitral leaflet.
    Catheter Cardiovasc Interv 2017 May 4. Epub 2017 May 4.
    Division of Cardiology, Emory University School of Medicine, Structural Heart and Valve Center, Atlanta, Georgia.
    Transcatheter mitral valve replacement (TMVR) procedures can be an alternative to surgical valve replacement for high surgical risk patients with bioprosthetic mitral valves, annuloplasty rings, or severe mitral annular calcification (MAC). TMVR can trigger acute left ventricular outflow tract (LVOT) obstruction from permanent displacement of the native anterior mitral leaflet toward the left ventricular septum, more often among patients undergoing valve-in-ring and valve-in-MAC procedures. Although acute LVOT obstruction is well described in the literature, there are important additional complications of TMVR related to the length and/or redundancy of the anterior mitral valve that have been recognized after mitral valve surgery and have not been previously reported in the setting of TMVR. Read More

    A Ruptured Mitral Valve Aneurysm as Complication of a Bicuspid Aortic Valve Endocarditis.
    J Cardiovasc Echogr 2017 Jan-Mar;27(1):23-25
    Depatment of Emergency, Cardiology Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Marche Region, Italy.
    We present a case of a ruptured mitral valve (MV) aneurysm as a complication of a bicuspid aortic valve (BAV) endocarditis. It is about a young 35-year-old man, admitted to Cardiology Unit because of unexpected heart failure picture. We found a BAV endocarditis complicated by anterior MV-anterior leaflet aneurysm formation and subsequent severe MV regurgitation caused by aneurysm perforation. Read More

    Incidental Finding of an Isolated Double-orifice Mitral Valve in an Asymptomatic Man.
    J Cardiovasc Echogr 2016 Jul-Sep;26(3):100-103
    Department of Cardio-thoracic and Vascular Medicine, University Hospital of Pisa, Pisa, Italy.
    Double-orifice mitral valve (DOMV) is a very rare congenital anomaly that usually presents as mitral regurgitation. We present the case of a 39-year-old asymptomatic, healthy man with no previous medical history who was affected by isolated complete bridge type DOMV, incidentally detected by two-dimensional echocardiographic examination in the parasternal short-axis view. The mitral valve of the patient was normally functioning without any other coexistent cardiac abnormalities. Read More

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