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    Reversible thrombotic mitral valve stenosis after transcatheter mitral valve replacement (TMVR): Is life-long anticoagulation therapy necessary?
    J Card Surg 2017 Feb 21. Epub 2017 Feb 21.
    Medical Faculty of the Slovak Medical University, National Institute of Cardiovascular Diseases, Clinic of Cardiac Surgery, Bratislava, Slovakia.
    We describe a case of reversible thrombotic mitral valve stenosis following a valve-in-ring transcatheter mitral valve replacement. Life-long oral anticoagulation in patients who underwent transcatheter mitral valve replacement might be beneficial. Read More

    Repeated Prosthetic Mitral Valve Thrombosis in Fluke Infection Induced Hypereosinophilic Syndrome.
    Ann Thorac Surg 2017 Mar;103(3):e259-e260
    Department of Cardiothoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address:
    A 43-year-old female patient with mitral valve stenosis and hypereosinophilia on admission received mechanical mitral valve replacement. During the 2 years after the first surgery, the patient underwent two mitral valve revision operations for repeated prosthetic mitral valve thrombosis. During the 2-year period, the patient's absolute eosinophil count was found elevated repeatedly. Read More

    Role of Myocardial Collagen in Severe Aortic Stenosis With Preserved Ejection Fraction and Symptoms of Heart Failure.
    Rev Esp Cardiol (Engl Ed) 2017 Feb 16. Epub 2017 Feb 16.
    Servicio de Cardiología, Hospital Universitario Donostia, Universidad del País Vasco, San Sebastián, Guipúzcoa, Spain; Área de Enfermedades Sistémicas, Instituto de Investigación Biodonostia, San Sebastián, Guipúzcoa, Spain. Electronic address:
    Introduction And Objectives: We investigated the anatomical localization, biomechanical properties, and molecular phenotype of myocardial collagen tissue in 40 patients with severe aortic stenosis with preserved ejection fraction and symptoms of heart failure.

    Methods: Two transmural biopsies were taken from the left ventricular free wall. Mysial and nonmysial regions of the collagen network were analyzed. Read More

    Infective endocarditis causing mitral valve stenosis - a rare but deadly complication: a case report.
    J Med Case Rep 2017 Feb 17;11(1):44. Epub 2017 Feb 17.
    Cardiology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN, 55415, USA.
    Background: Infective endocarditis rarely causes mitral valve stenosis. When present, it has the potential to cause severe hemodynamic decompensation and death. There are only 15 reported cases in the literature of mitral prosthetic valve bacterial endocarditis causing stenosis by obstruction. Read More

    Robotic trans-atrial and trans-mitral ventricular septal resection.
    Ann Cardiothorac Surg 2017 Jan;6(1):54-59
    Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University & Vidant Medical Center, Greenville, North Carolina, USA.
    Localized ventricular septal hypertrophy, also known as idiopathic hypertrophic subaortic stenosis or idiopathic hypertrophic subaortic septal obstruction (IHSS), can create severe ventricular outflow obstruction. This often results in a high sub-aortic pressure gradient with potentially lethal symptoms. In 1960, Braunwald described the hemodynamic characteristics of IHSS, and thereafter, Morrow developed a trans-aortic approach to resect a large part of the ventricular septum, enlarging the outflow tract. Read More

    Cor triatriatum sinistrum: presentation of syncope and atrial tachycardia.
    BMJ Case Rep 2017 Feb 14;2017. Epub 2017 Feb 14.
    Papworth Hospital NHS Foundation Trust, Cambridge, UK.
    We present a rather unusual cause for syncope associated with atrial tachycardia. A man aged 39 years presented with an episode of syncope and narrow complex tachycardia. Further investigations, including transoesophageal echocardiography, identified cor triatriatum sinistrum (CTS), a rare congenital abnormality characterised by the atrium being divided by a fibrous membrane. Read More

    Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Disease Other Than Significant Mitral Stenosis and Mechanical Valves: A Meta-Analysis.
    Circulation 2017 Feb;135(7):714-716
    From Division of Cardiovascular Medicine, University of Michigan, Ann Arbor (K.C.S.); and Division of Health Care Policy and Research, Department of Health Sciences Research (X.Y.) and Division of Cardiovascular Diseases (B.J.G., P.A.N.), Mayo Clinic, Rochester, MN.

    Congenital uni-leaflet mitral valve with severe stenosis: A case report with literature review.
    Echocardiography 2017 Feb 9. Epub 2017 Feb 9.
    Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China.
    Numerical abnormalities of mitral leaflets is a special entity in congenital mitral malformations. Previously reported cases of uni-leaflet mitral valve were primarily related to absence or dysplasia of certain leaflets. We present a case here with mitral leaflets that were not divided into anterior and posterior as usual, but developed as an integral structure instead, which is different from previously documented cases of uni-leaflet mitral valves. Read More

    Massive left atrial calcification: a case report and review of the literature.
    Gen Thorac Cardiovasc Surg 2017 Feb 7. Epub 2017 Feb 7.
    Division of Cardiothoracic Surgery, Warren Alpert School of Medicine, Brown University, Rhode Island, USA.
    Left atrial (LA) calcification is mostly observed in patients with rheumatic mitral valve (MV) diseases who underwent surgical treatment. We report a case of LA calcification in a 69-year-old woman presented with dyspnea and cyanosis. Admission electrocardiogram showed atrial fibrillation and biventricular hypertrophy. Read More

    IgG4-positive cell infiltration in various cardiovascular disorders - results from histopathological analysis of surgical samples.
    BMC Cardiovasc Disord 2017 Feb 3;17(1):52. Epub 2017 Feb 3.
    Department of Cardiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka, 569-8686, Japan.
    Background: The diagnosis of Immunoglobulin G4 (IgG4)-related disease (IgG4-RD), in general, depends on serum IgG4 concentrations and histopathological findings; therefore, diagnosis of IgG4-RD in cardiovascular organs/tissues is often difficult owing to the risk of tissue sampling.

    Methods: Prevalence of IgG4-positive lymphoplasmacytic infiltration in 103 consecutive cardiovascular surgical samples from 98 patients with various cardiovascular diseases was analyzed immunohistochemically.

    Results: The diagnoses of the enrolled patients included aortic aneurysm (abdominal, n = 8; thoracic, n = 9); aortic dissection (n = 20); aortic stenosis (n = 24), aortic regurgitation (n = 10), and mitral stenosis/regurgitation (n = 17). Read More

    Usefulness of the MrWALLETS Scoring System to Predict First Diagnosed Atrial Fibrillation in Patients With Ischemic Stroke.
    Am J Cardiol 2017 Jan 5. Epub 2017 Jan 5.
    Stroke Unit, Medical Department of Continuity of Care and Disability, S.Orsola-Malpighi Hospital, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
    Some cryptogenic strokes are caused by undetected paroxysmal atrial fibrillation (AF) and could benefit from oral anticoagulation. In this study, we searched for echocardiographic parameters associated with first diagnosed AF, to form a scoring system for the identification of patients with AF. We examined 571 patients with ischemic stroke (72. Read More

    Heart disease in East Timor : cross-sectional analysis of 474 patients attending Timor-Leste's first cardiology service.
    Intern Med J 2017 Feb 1. Epub 2017 Feb 1.
    East Timor Hearts Fund.
    Background: East Timor is a developing country and close neighbour of Australia. The prevalence of cardiac disease is unknown.

    Aims: To describe the prevalence and patterns of cardiac disease in patients attending the first cardiology service of Timor-Leste. Read More

    Impact of Mitral Annular Displacement on Left Ventricular Diastolic Function Improvement After Transcatheter Aortic Valve Implantation.
    Circ J 2017 Jan 27. Epub 2017 Jan 27.
    Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center.
    Background: The clinical significance of left ventricular (LV) diastolic function (DF) improvement after transcatheter aortic valve implantation (TAVI) is not fully elucidated. We sought to investigate the long-term clinical and hemodynamic effects of post-TAVI DF improvement and to identify its determinants.Methods and Results:Clinical and serial echocardiographic data before and after TAVI were retrospectively reviewed together with measurement of mitral annular displacement (MAD) representing longitudinal myocardial function in 98 patients with severe aortic stenosis and ejection fraction >55%. Read More

    Cohort profile: prevalence of valvular heart disease in community patients with suspected heart failure in UK.
    BMJ Open 2017 Jan 27;7(1):e012240. Epub 2017 Jan 27.
    Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust, London, UK.
    Purpose: The aim of this study was to evaluate the proportion of suspected heart failure patients with significant valvular heart disease. Early diagnosis of valve disease is essential as delay can limit treatment and negatively affect prognosis for undiagnosed patients. The prevalence of unsuspected valve disease in the community is uncertain. Read More

    Advanced imaging in valvular heart disease.
    Nat Rev Cardiol 2017 Jan 27. Epub 2017 Jan 27.
    Department of Cardiology, Heart and Lung Center, Leiden University Medical Center, Leiden, Albinusdreef 2, 2300 RC Leiden, Netherlands.
    Although echocardiography remains the mainstay imaging technique for the evaluation of patients with valvular heart disease (VHD), innovations in noninvasive imaging in the past few years have provided new insights into the pathophysiology and quantification of VHD, early detection of left ventricular (LV) dysfunction, and advanced prognostic assessment. The severity grading of valve dysfunction has been refined with the use of Doppler echocardiography, cardiac magnetic resonance (CMR), and CT imaging. LV ejection fraction remains an important criterion when deciding whether patients should be referred for surgery. Read More

    Rheumatic Heart Disease and Myxomatous Degeneration: Differences and Similarities of Valve Damage Resulting from Autoimmune Reactions and Matrix Disorganization.
    PLoS One 2017 25;12(1):e0170191. Epub 2017 Jan 25.
    Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
    Autoimmune inflammatory reactions leading to rheumatic fever (RF) and rheumatic heart disease (RHD) result from untreated Streptococcus pyogenes throat infections in individuals who exhibit genetic susceptibility. Immune effector mechanisms have been described that lead to heart tissue damage culminating in mitral and aortic valve dysfunctions. In myxomatous valve degeneration (MXD), the mitral valve is also damaged due to non-inflammatory mechanisms. Read More

    Characteristics, aetiological spectrum and management of valvular heart disease in a Tunisian cardiovascular centre.
    Arch Cardiovasc Dis 2017 Jan 20. Epub 2017 Jan 20.
    Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia.
    Background: Valvular heart diseases occur frequently in Tunisia, but no precise statistics are available.

    Aim: To analyse the characteristics of patients with abnormal valvular structure and function, and to identify the aetiological spectrum, treatment and outcomes of valvular heart disease in a single cardiovascular centre in Tunisia.

    Methods: This retrospective study included patients with abnormal valvular structure and function, who were screened by transthoracic echocardiography at a single cardiology department between January 2010 and December 2013. Read More

    Triple valve surgery through a less invasive approach: early and mid-term results.
    Interact Cardiovasc Thorac Surg 2017 Jan 22. Epub 2017 Jan 22.
    Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany.
    Objectives: A partial upper sternotomy has become established as a less invasive approach mainly for single and double valve surgery. This report evaluates the clinical outcomes of triple valve surgery performed through a partial upper sternotomy.

    Methods: We reviewed the medical records of 37 consecutive patients (28 men, 76%) who underwent triple valve surgery through a partial upper sternotomy between 2005 and 2015. Read More

    Simultaneous transfemoral aortic and transseptal mitral valve replacement utilising SAPIEN 3 valves in native aortic and mitral valves.
    EuroIntervention 2017 Jan;12(13):1649-1652
    University of Iowa Carver College of Medicine, Iowa City, IA, USA.
    Aims: Concomitant severe calcific aortic and mitral stenosis is a relatively uncommon but very challenging valvular heart disease to manage. We sought to evaluate the feasibility of a fully percutaneous approach to replace both stenotic native mitral and aortic valves using SAPIEN 3 valves.

    Methods And Results: An 87-year-old woman with chronic kidney disease stage 3, pul-monary hypertension, chronic obstructive pulmonary disease, a permanent pacemaker, and atrial fibrillation was referred with Class III heart failure symptoms. Read More

    First successful transcatheter double valve replacement from a transapical access and nine-month follow-up.
    EuroIntervention 2017 Jan;12(13):1645-1648
    Department of Cardiac Surgery, University of Ulm, Ulm, Germany.
    Aims: While TAVI is the treatment of choice in patients with aortic stenosis considered inoperable or at high risk, interventional replacement of the mitral valve is still in the preclinical or early clinical phase. Our aim was to report on the first transcatheter double valve replacement into native valves from a transapical access.

    Methods And Results: A 67-year-old, highly symptomatic female patient considered inoperable due to severe calcification of the mitral annulus and comorbidities was scheduled for transcatheter double valve replacement by the local Heart Team. Read More

    Echocardiographic assessment of long-term hemodynamic characteristics of mechanical mitral valve prostheses with different mitral valvular diseases.
    Australas Phys Eng Sci Med 2017 Jan 19. Epub 2017 Jan 19.
    Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610000, People's Republic of China.
    Mitral stenosis (MS) and mitral insufficiency (MI) have different pre-operative hemodynamic characteristics. However, it is unclear if there are differences in long-term echocardiographic characteristics of MS and MI patients after mechanical mitral valve replacement. This study is to compare long-term echocardiographic results of mechanical mitral valve prostheses between MS and MI patients. Read More

    Right Atrial Clot Formation Early after Percutaneous Mitral Balloon Valvuloplasty.
    Case Rep Med 2016 25;2016:3058015. Epub 2016 Dec 25.
    Department of Cardiology, Health Sciences University Samsun Training and Research Hospital, Samsun, Turkey.
    Mitral balloon valvuloplasty which has been used for the treatment of rheumatic mitral stenosis (MS) for several decades can cause serious complications. Herein, we presented right atrial clot formation early after percutaneous mitral balloon valvuloplasty which was treated successfully with unfractioned heparin infusion. Read More

    Simplified mitral valve repair in pediatric patients with connective tissue disorders.
    J Thorac Cardiovasc Surg 2017 Feb 23;153(2):399-403. Epub 2016 Sep 23.
    Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.
    Background: In pediatric patients with connective tissue disorders (CTDs), early cardiac presentation often involves severe mitral regurgitation (MR) associated with severe bileaflet prolapse and, less frequently, aortic root enlargement. We adopted a simplified repair to address MR and prevent systolic anterior motion (SAM) in this unique group of patients.

    Materials And Methods: Retrospective review of clinical and echocardiographic data of all pediatric patients (age < 18 years) with CTD and MR undergoing simplified repair at 3 institutions (2000-2014). Read More

    The change in NT-Pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study.
    Rom J Intern Med 2017 Jan 18. Epub 2017 Jan 18.
    Background: The change in the level of NT-Pro-BNP (N-terminal Pro-Brain Natriuretic Peptide) is now considered as a reflection of the hemodynamic alterations and its circulatory reductions reported early after successful PTMC (percutaneous transvenous mitral commissurotomy). The present study aims to assess the change in the level of NT-Pro BNP following PTMC in patients with mitral stenosis and also to determine the association between circulatory NT-Pro BNP reduction and post-PTMC echocardiography parameters.

    Methods: Twenty five symptomatic consecutive patients with severe MS undergoing elective PTMC were prospectively enrolled. Read More

    Accessory Mitral Valve Leaflet Causing Severe Left Ventricular Outflow Tract Obstruction in a Preterm Neonate with a Partial Atrioventricular Septal Defect.
    Tex Heart Inst J 2016 Dec 1;43(6):543-545. Epub 2016 Dec 1.
    Atrioventricular septal defects represent a class of congenital cardiac malformations that vary in presentation and management strategy depending upon the severity of the particular lesions present. We present the case of a premature neonate who had a partial atrioventricular septal defect and an accessory mitral (or left atrioventricular) valve leaflet. The latter caused severe left ventricular outflow tract obstruction and severely depressed left ventricular function. Read More

    Primary Percutaneous Coronary Intervention Followed by Valve Surgery for Acute Coronary Syndrome at Left Main Trunk Complicated With Severe Aortic Stenosis.
    Int Heart J 2017 Feb 17;58(1):125-130. Epub 2017 Jan 17.
    Department of Cardiology, Kyoto First Red Cross Hospital.
    An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function. Read More

    [Outcome comparison of different therapy procedures in surgical high-risk elderly patients with severe aortic stenosis].
    Zhonghua Xin Xue Guan Bing Za Zhi 2017 Jan;45(1):13-18
    Department of Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
    Objective: To compare the outcome of surgical high-risk elderly patients with severe aortic stenosis(SAS) treated by different therapy procedures, including transcatheter aortic valve implantation(TAVI), surgical aortic valve replacement(SAVR), and drug therapy. Methods: We retrospectively analyzed the clinical data of 242 surgical high-risk elderly (age ≥65 years old) SAS patients hospitalized in Fuwai Hospital between September 2012 and June 2015. According to the treatment method, patients were divided into TAVI group (81 cases), SAVR group (59 cases) and drug therapy group (102 cases). Read More

    Left atrial appendage mass: is it always a thrombus?
    Kardiochir Torakochirurgia Pol 2016 Dec 30;13(4):359-360. Epub 2016 Dec 30.
    Department of Cardiovascular Surgery, Gulhane School of Medicine, Ankara, Turkey.
    Myxoma is the most common benign tumor of the heart, but it is very rare for it to originate from the left atrial appendage. Distinguishing between a mass, a thrombus, and a tumor in the body of the left atrium with preoperative transthoracic or transesophageal echocardiography is very difficult, even more so in patients with mitral valve disease and chronic atrial fibrillation. A 50-year-old male patient was admitted for surgery with the diagnosis of mitral stenosis and chronic atrial fibrillation. Read More

    Integrated imaging of echocardiography and computed tomography to grade mitral regurgitation severity in patients undergoing transcatheter aortic valve implantation.
    Eur Heart J 2017 Jan 10. Epub 2017 Jan 10.
    Department of Cardiology, Heart Lung Centre, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
    Aims: Quantitative mitral regurgitation (MR) grading remains challenging. This study evaluated the concept of integrating echocardiography and computed tomography for grading MR severity. Specifically, an integrated parameter was developed that combines the true cross-sectional mitral regurgitant orifice area (ROA) assessed with multi-detector row computed tomography (MDCT) with flow data from echocardiography. Read More

    Rapidly progressive mitral valve stenosis in patients with acromelic dysplasia.
    Cardiol Young 2017 Jan 12:1-4. Epub 2017 Jan 12.
    1New York Presbyterian - Morgan Stanley Children's Hospital of New York,Columbia University Medical Center,Division of Pediatric Cardiology,New York,New York,United States of America.
    Acromelic dysplasias are a group of skeletal dysplasias characterised by short-limbed short stature with other distinctive phenotypic features including small hands and feet and stiff joints. Geleophysic dysplasia is an acromelic dysplasia that is associated with characteristic facial features, progressive cardiac valvular thickening, and tracheal stenosis. Owing to overlapping clinical features with other types of short-limbed skeletal dysplasias, it is important to make a precise diagnosis as they have different cardiac morbidity and mortality. Read More

    Acute effect of treatment of mitral stenosis on left atrium function.
    Ann Card Anaesth 2017 Jan-Mar;20(1):42-44
    Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
    Aim: Peak atrial longitudinal strain (PALS) is used to evaluate left atrium (LA) function in patients with mitral stenosis (MS), before and after percutaneous transmitral commissurotomy (PTMC) and mitral valve replacement (MVR).

    Methods: Patients with severe symptomatic MS, who were referred to our echocardiographic laboratory for a diagnostic examination before cardiac surgery or PTMC from October of 2014 to October of 2015, were included in the study.

    Result: The peak systolic global LA strain improved post-PTMC (P < 0. Read More

    Mitral valve resistance determines hemodynamic consequences of severe rheumatic mitral stenosis and immediate outcomes of percutaneous valvuloplasty.
    Echocardiography 2017 Jan 10. Epub 2017 Jan 10.
    Department of Cardiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
    Introduction: The mitral valve area (MVA) poorly reflects the hemodynamic status of (MS). In this study, we compared the MVA with mitral valve resistance (MVR) with regard to the determination of hemodynamic consequences of MS and the immediate outcomes of percutaneous balloon mitral valvuloplasty (PBMV).

    Methods: In a prospective study, 36 patients with severe rheumatic MS with left ventricular ejection fraction (LVEF) >50% were evaluated. Read More

    Mitral stenosis due to dynamic clip-leaflet interaction during the MitraClip procedure: Case report and review of current knowledge.
    Cardiovasc Revasc Med 2016 Dec 22. Epub 2016 Dec 22.
    Division of Cardiovascular Medicine, University of California Davis Medical Center, Sacramento, CA. Electronic address:
    The goal of MitraClip therapy is to achieve mitral regurgitation reduction without iatrogenic creation of clinically significant MS. In some series, up to 35% of patients are left with mild MS. There are many contributors to the final transmitral gradient achieved in patients undergoing MitraClip therapy. Read More

    Cardiovascular Abnormalities in Egyptian Children with Mucopolysaccharidoses.
    J Clin Diagn Res 2016 Nov 1;10(11):SC05-SC08. Epub 2016 Nov 1.
    Researcher, Department of Paediatrics, National Research Center , Cairo, Egypt .
    Introduction: The Mucopolysaccharidoses (MPS) are rare inherited metabolic disorders. They are characterized by the progressive systemic deposition of Glycosaminoglycans (GAGs). GAGs accumulate in the myocardium and the cardiac valves. Read More

    TH-CD-206-07: Determination of Patient-Specific Myocardial Mass at Risk Using Computed Tomography Angiography.
    Med Phys 2016 Jun;43(6):3884
    University of California, Irvine, CA.
    Purpose: To evaluate the accuracy of a patient-specific coronary perfusion territory assignment algorithm that uses CT angiography (CTA) and a minimum-cost-path approach to assign coronary perfusion territories on a voxel-by-voxel basis for determination of myocardial mass at risk.

    Methods: Intravenous (IV) contrast (370 mg/mL iodine, 25 mL, 7 mL/s) was injected centrally into five swine (35-45 kg) and CTA was performed using a 320-slice CT scanner at 100 kVp and 200 mA. Additionally, a 4F catheter was advanced into the left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) and contrast (30 mg/mL iodine, 10 mL, 1. Read More

    Repair of Parachute and Hammock Valve in Infants and Children: Early and Late Outcomes.
    Semin Thorac Cardiovasc Surg 2016 Summer;28(2):448-459. Epub 2016 Apr 27.
    Trauma Surgery Centre Berlin, Berlin Germany.
    Parachute and hammock valves in children remain one of the most challenging congenital malformations to correct. We report our institutional experience with valve-preserving repair techniques and the early and late surgical outcomes in parachute and hammock valves in infants and children. From January 1990-June 2014, 20 infants and children with parachute (n = 12, median age = 2. Read More

    The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights from 2016.
    J Cardiothorac Vasc Anesth 2016 Oct 14. Epub 2016 Oct 14.
    Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address:

    Evidence of subannular and left ventricular morphological differences in patients with bicuspid versus tricuspid aortic valve stenosis: magnetic resonance imaging-based analysis.
    Interact Cardiovasc Thorac Surg 2016 Dec 31. Epub 2016 Dec 31.
    Department of Cardiac Surgery, Central Hospital Bad Berka, Bad Berka, Germany.
    Objectives: Prospective analysis of left ventricular (LV) morphological/functional parameters in patients with bicuspid versus tricuspid aortic valve (TAV) stenosis undergoing aortic valve replacement (AVR) surgery.

    Methods: A total of 190 consecutive patients with BAV (n = 154) and TAV stenosis (n = 36) (mean age 61 ± 8 years, 65% male) underwent AVR ± concomitant aortic surgery from January 2012 through May 2015. All patients underwent preoperative cardiac magnetic resonance imaging in order to evaluate: (i) left ventricular outflow tract (LVOT) dimensions, (ii) length of anterior mitral leaflet (AML), (iii) end-systolic and end-diastolic LV wall thickness, (iv) LV area, (v) LV end-systolic and end-diastolic diameters (LVESD, LVEDD), (vi) LV end-diastolic and end-systolic volumes (LVEDV, LVESV) and (vii) maximal diameter of aortic root. Read More

    Concomitant mitral annular calcification and severe aortic stenosis: prevalence, characteristics and outcome following transcatheter aortic valve replacement.
    Eur Heart J 2016 Dec 30. Epub 2016 Dec 30.
    The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
    Aims: Calcified aortic stenosis (AS) and mitral annular calcification (MAC) have certain similar etiology and pathophysiological mechanisms. MAC is frequently encountered in pre-procedural computed tomography (CT) imaging of patients that undergo transcatheter aortic valve replacement (TAVR), but its prognostic implications for these patients have not been thoroughly investigated. This study sought to evaluate the prevalence of MAC among patients with severe AS and to assess the clinical implications of MAC on these patients during and following TAVR. Read More

    Rheumatic Heart Disease Predisposing to Embolic Myocardial Infarction: A Multimodality Imaging Approach.
    Int J Angiol 2016 Dec 23;25(5):e4-e7. Epub 2013 Jul 23.
    Operative Unit of Cardiology and Cardiac Intensive Care Unit, Aurelia Hospital, Rome, Italy.
    We report a clinical case of a 45-year-old male with a diagnosis of inferior myocardial infarction and previous history of rheumatic fever during his childhood. Coronary angiography demonstrated normal coronary arteries. Transthoracic echocardiogram showed hypokinetic left ventricular inferolateral wall and mitral stenosis; furthermore, speckle tracking analysis revealed reduction of global longitudinal strain involving the inferior wall. Read More

    Rapid-Deployment Aortic Valve Replacement after Previous Mechanical Valve Implantation.
    Thorac Cardiovasc Surg Rep 2016 Dec 4;5(1):24-26. Epub 2016 Apr 4.
    Department of Cardiothoracic Surgery, Ruhr University Hospital Bergmannsheil - Bochum, North Rhine-Westphalia, Germany.
    Recent studies report a reproducible reduction of myocardial ischemic and cardiopulmonary bypass times along with excellent hemodynamics and low rates of paravalvular leakage for rapid-deployment valves. A 68-year-old female patient with aortic stenosis and a mechanical mitral valve which was implanted in 2006 received rapid-deployment aortic valve replacement. The procedure could be performed with a cross-clamp time of 45 minutes and a cardiopulmonary bypass time of 60 minutes. Read More

    Mitral Valve Diverticulum Presenting with Severe Mitral Stenosis: Case Report.
    J Heart Valve Dis 2016 Jul;25(4):515-518
    Wiltshire Cardiac Centre, Great Western Hospital, Swindon, UK. Electronic correspondence:
    The case is presented of a non-infectious anterior mitral valve leaflet diverticulum, which appeared as symptomatic mitral stenosis. Unlike previous reports, there was no histological myxomatous degeneration of the valve. To the authors' knowledge, this is the first time a mitral valve diverticulum resulting in severe mitral stenosis has been reported in the literature. Read More

    Suture Forces for Closure of Transapical Transcatheter Aortic Valve Replacement: A Mathematical Model.
    J Heart Valve Dis 2016 Jul;25(4):424-429
    Department of Surgery, University of California San Francisco and San Francisco VA Medical Centers, San Francisco, CA, USA. Electronic correspondence:
    Background: Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of severe aortic stenosis in intermediate, high-risk, and inoperable patients. TAVR has multiple access routes, including transfemoral (TF), transapical (TA), direct aortic (DA), axillary, transcarotid, and transcaval. The most commonly applied algorithm is a TF-first approach, where only when patients are unsuitable for TF are alternatives such as TA considered. Read More

    Mitral Valve Replacement With Sapien 3 Transcatheter Valve in Severe Mitral Annular Calcification.
    Ann Thorac Surg 2017 Jan;103(1):e57-e59
    Department of Cardiovascular Surgery, Morristown Medical Center, Morristown, New Jersey.
    Transcatheter valve implantation in the mitral position with severe calcific mitral stenosis has been described in patients who are at an increased risk for conventional mitral valve surgical procedures. We report the direct deployment of the Sapien 3 valve in the mitral position with severe mitral annular calcification through a sternotomy in an arrested heart in two cases. Read More

    Direct oral anticoagulant use in nonvalvular atrial fibrillation with valvular heart disease: a systematic review.
    Clin Cardiol 2016 Dec 22. Epub 2016 Dec 22.
    Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Methodist University Hospital, Memphis, Tennessee.
    Direct oral anticoagulants (DOACs) are indicated for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), which, according to the American College of Cardiology/American Heart Association/Heart Rhythm Society atrial fibrillation (AF) guidelines, excludes patients with rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair. However, the data regarding use of DOACs in AF patients with other types of valvular heart disease (VHD) are unclear. We aimed to summarize and evaluate the literature regarding the safety and efficacy of DOAC use in NVAF patients with other types of VHD. Read More

    Transcatheter implantation of aortic valve prostheses into degenerated mitral valve bioprostheses and failed annuloplasty rings: outcomes according to access route and Mitral Valve Academic Research Consortium (MVARC) criteria.
    EuroIntervention 2016 Dec;12(12):1520-1526
    Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
    Aims: The study sought to assess outcomes of transcatheter mitral valve-in-valve implantation (TMVIV) for degenerated bioprostheses and transcatheter mitral valve-in-ring implantation (TMVIR) for failed annuloplasty rings according to access route and the Mitral Valve Academic Research Consortium (MVARC) criteria.

    Methods And Results: Twenty-four patients (72±13 years; eight men [33%]) underwent TMVIV (n=14) or TMVIR (n=10) for mitral regurgitation (MR; n=17) or stenosis (n=7) using balloon-expandable bioprostheses. Transapical (TA) access was chosen in 13, and transseptal (TS) access in 11 patients. Read More

    Annuloplasty Ring Size Determines Exercise-Induced Mitral Stenosis Severity after Valve Repair.
    J Heart Valve Dis 2015 Nov;24(6):744-751
    Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
    Background: Patients are occasionally encountered with high mitral pressure gradients after mitral valve repair for degenerative mitral regurgitation (MR), despite the use of a 'truesized' ring based on the anterior leaflet dimension. The study aim was to assess these patients at rest and during exercise, using echocardiography.

    Methods: Sixty-seven patients who underwent mitral repair for degenerative disease using a semi-rigid, complete annuloplasty ring were assessed. Read More

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