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    Aortic Root Surgery in Marfan Syndrome: Medium-Term Outcome in a Single-Center Experience.
    J Heart Valve Dis 2017 Jan;26(1):45-53
    Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA.
    Background: The study aim was to analyze the authors' experience with aortic root surgery in Marfan syndrome (MFS), and to expand the surgical outcome data of patients meeting the Ghent criteria (Marfan registry).

    Methods: Analyses were performed of data acquired from MFS patients (who met the Ghent criteria), including an aortic root surgery and Kaplan-Meier survival.

    Results: Between April 2004 and February 2012, a total of 59 MFS patients (mean age at surgery 36 ± 13 years) underwent 67 operations for aortic root aneurysm (n = 52), aortic valve (AV) regurgitation (n = 15), acute aortic dissection (n = 2), and/or mitral valve (MV) regurgitation resulting from MV prolapse (n = 7). Read More

    Dynamic and quantitative evaluation of degenerative mitral valve disease: a dedicated framework based on cardiac magnetic resonance imaging.
    J Thorac Dis 2017 Apr;9(Suppl 4):S225-S238
    Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy.
    Background: Accurate quantification of mitral valve (MV) morphology and dynamic behavior over the cardiac cycle is crucial to understand the mechanisms of degenerative MV dysfunction and to guide the surgical intervention. Cardiac magnetic resonance (CMR) imaging has progressively been adopted to evaluate MV pathophysiology, although a dedicated framework is required to perform a quantitative assessment of the functional MV anatomy.

    Methods: We investigated MV dynamic behavior in subjects with normal MV anatomy (n=10) and patients referred to surgery due to degenerative MV prolapse, classified as fibro-elastic deficiency (FED, n=9) and Barlow's disease (BD, n=10). Read More

    Mitral Valve Repair for Pure Mitral Regurgitation Followed Years Later by Mitral Valve Replacement for Mitral Stenosis.
    Am J Cardiol 2017 Apr 12. Epub 2017 Apr 12.
    Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas; Division of Cardiology, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas; Department of Pathology, Baylor University Medical Center, Dallas, Texas. Electronic address:
    We describe herein 2 patients who developed severe mitral stenosis (MS) approximately two decades after a mitral valve repair operation for pure mitral regurgitation (MR) secondary to mitral valve prolapse. This report's purpose is to point out that use of a circumferential mitral annular ring during the repair has the potential to produce a transmitral pressure gradient just like that occurring after mitral valve replacement utilizing a mechanical prosthesis or a bioprosthesis in the mitral position. 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

    Common origin of all three coronary arteries from the right sinus of Valsalva - first case study accompanied by mitral valve prolapse and vein anomaly, second case study followed by successful percutaneous coronary intervention of right coronary artery stenosis.
    Kardiochir Torakochirurgia Pol 2017 Mar 31;14(1):66-70. Epub 2017 Mar 31.
    Department of Doctoral Studies, University of Economics, Katowice, Poland.
    Congenital anomalies of the coronary arteries can be divided into two broad categories: those that alter myocardial perfusion and those that do not. In coronary anomalies not altering myocardial perfusion, the coronary arteries originate from the aorta, but their origins are in unusual positions. Although myocardial perfusion is normal, the angiographer may have trouble locating them. 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

    The changing epidemiology and clinical features of infective endocarditis: A retrospective study of 196 episodes in a teaching hospital in China.
    BMC Cardiovasc Disord 2017 May 8;17(1):113. Epub 2017 May 8.
    Department of Infectious Diseases, The First Affiliated Hospital of China Medical University, No. 155 Nanjing Northern Street, Shenyang, Liaoning, 110001, China.
    Background: Infective endocarditis is an uncommon but life-threatening infectious disease. To our knowledge, current investigations of the characteristics of infective endocarditis in our region are scarce. In this study, we aimed to investigate the changes in the epidemiology and clinical features of infective endocarditis. Read More

    Echocardiographic Assessment of Young Male Draft-Eligible Elite Hockey Players Invited to the Medical and Fitness Combine by the National Hockey League.
    Am J Cardiol 2017 Mar 29. Epub 2017 Mar 29.
    Division of Cardiology, St. Michael's Hospital, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address:
    The "athletic heart" is characterized by hypertrophy and dilation of the heart, in addition to functional and electrical remodeling. The aim of this study was to provide reference 2-dimensional (2DE) and 3-dimensional (3DE) echocardiographic measurements in a large database on draft-eligible elite ice hockey players and to determine the frequency of occult cardiac anomalies in this cohort of athletes. In this prospective cohort study, we performed a comprehensive cardiac assessment of the 100 top draft picks selected by the National Hockey League. 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

    Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study.
    Heart 2017 Apr 21. Epub 2017 Apr 21.
    Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden.
    Objective: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking.

    Methods: We used nationwide registers to identify all patients with a first diagnosis of VHD at Swedish hospitals between 2003 and 2010. Age-stratified and sex-stratified incidence of each VHD and adjusted comorbidity profiles were assessed. Read More

    Using cardiovascular imaging modalities to determine cardiac disorders before starting sports activities.
    Turk Kardiyol Dern Ars 2017 Mar;45(2):160-166
    Department of Pediatrics, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
    Objective: We re-examined children who had previously been declared eligible to participate in competitive sports activities for cardiac disorders, using cardiac investigation protocol.

    Methods: Total of 250 children (224 males [89.6%], and 26 females [10. Read More

    P210Long- term outcome of primary mitral valve prolapse: results from a population of 250 patients referred to a tertiary cardiovascular center.
    Eur Heart J Cardiovasc Imaging 2016 Dec;17(suppl_2):ii29-ii37
    Careggi University Hospital (AOUC), cardiovascular diagnostics, Florence, Italy.
    Background: Outcome of Mitral Valve Prolapse (MVP) was controversial for long time. Many studies reported great differences in the incidence of cardiovascular events due, above all, to heterogeneous and small studied populations. Most of theme were also published to late '80 of the last century till early '00. Read More

    Minimally invasive or conventional edge-to-edge repair for severe mitral regurgitation due to bileaflet prolapse in Barlow's disease: does the surgical approach have an impact on the long-term results?†.
    Eur J Cardiothorac Surg 2017 Apr 11. Epub 2017 Apr 11.
    Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
    Objectives: To evaluate whether the adoption of a right minithoracotomy operative approach had an impact on the long-term results of edge-to-edge (EE) repair compared to conventional sternotomy in patients with Barlow's disease and bileaflet prolapse.

    Methods: We assessed the long-term results of 104 patients with Barlow's disease treated with a minimally invasive EE technique. An equal number of patients had a conventional median sternotomy EE repair for the same disease and were used as a control group. Read More

    The effect of mitral valve surgery on ventricular arrhythmia in patients with bileaflet mitral valve prolapse.
    Indian Pacing Electrophysiol J 2016 Nov - Dec;16(6):187-191. Epub 2016 Oct 24.
    Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address:
    Background: Bileaflet mitral valve prolapse (biMVP) is associated with frequent ventricular ectopy (VE) and malignant ventricular arrhythmia. We examined the effect of mitral valve (MV) surgery on VE burden in biMVP patients.

    Methods: We included 32 consecutive patients undergoing MV surgery for mitral regurgitation secondary to biMVP between 1993 and 2012 at Mayo Clinic who had available pre- and post-operative Holter monitoring data. Read More

    Reduction of left ventricular outflow tract obstruction with transcatheter mitral valve repair.
    Echocardiography 2017 Apr;34(4):625-626
    Section of Cardiovascular Medicine, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
    Many patients with severe mitral regurgitation cannot undergo conventional mitral valve surgery due to prohibitive surgical risk and are candidates for transcatheter repair with an edge-to-edge technique. Prior reports suggest efficacy with this approach for mitral regurgitation due to hypertrophic cardiomyopathy with left ventricular outflow obstruction. We present a case report of transcatheter mitral valve repair for posterior leaflet prolapse with concomitant left ventricular outflow tract obstruction due to systolic anterior motion of the mitral valve in the absence of hypertrophic cardiomyopathy. Read More

    Straight Back Syndrome.
    Thorac Surg Clin 2017 May;27(2):133-137
    Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address:
    Straight back syndrome is a rare condition usually associated with mitral valve prolapse and "pseudo-heart disease" caused by a very narrow anterior-posterior chest due to the loss of the normal dorsal curvature of the thoracic spine. More rarely, the narrowed upper chest may compress the trachea causing extrinsic tracheal obstruction. If severe enough, this requires operative repair by effectively opening up the upper chest by a variety of techniques to allow the trachea enough room to avoid compression. Read More

    Long-term results (up to 14 years) of the clover technique for the treatment of complex tricuspid valve regurgitation†.
    Eur J Cardiothorac Surg 2017 Feb 23. Epub 2017 Feb 23.
    Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
    Objectives: To report the long-term results of the clover technique for the treatment of complex forms of tricuspid regurgitation (TR).

    Methods: Ninety-six consecutive patients (mean age 60 ± 16.4, left ventricular ejection fraction 58 ± 8. Read More

    Effects of Surgical Techniques on Long-Term Results in Patients with Degenerative Mitral Valve Bileaflet Prolapse.
    J Heart Valve Dis 2016 Nov;25(6):716-723
    Cardiac Surgery Department, Monaldi Hospital, Second University of Naples, Naples, Italy.
    Background: The study aim was to evaluate the long-term results in patients with degenerative mitral valve bileaflet prolapse (DMVBLP) undergoing mitral valve repair (MVr) or mitral valve replacement (MVR), and to compare the consequences of survival related to each technique.

    Methods: Between 2001 and 2012, a total of 421 patients underwent isolated primary surgery for DMVBLP. MVr was performed in 146 patients (34. Read More

    Identification of Patients Affected by Mitral Valve Prolapse with Severe Regurgitation: A Multivariable Regression Model.
    Oxid Med Cell Longev 2017 2;2017:6838921. Epub 2017 Feb 2.
    Centro Cardiologico Monzino IRCCS, Milan, Italy.
    Background. Mitral valve prolapse (MVP) is the most common cause of severe mitral regurgitation. Besides echocardiography, up to now there are no reliable biomarkers available for the identification of this pathology. Read More

    Effect of Fluoxetine Administration on Clinical and Echocardiographic Findings in Patients with Mitral Valve Prolapse and Generalized Anxiety Disorder: Randomized Clinical Trial.
    Electron Physician 2017 Jan 25;9(1):3483-3491. Epub 2017 Jan 25.
    MD. Cardiologist, Assistant Professor, Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
    Background: Mitral valve prolapse (MVP) is accompanied by mental disorders including anxiety, which has similar presentations as MVP. It is hypothesised that treatment of anxiety might reduce the symptoms of MVP.

    Objective: The aim of this study was to assess the clinical and echocardiographic effects of fluoxetine administration in patients with MVP and anxiety. Read More

    Cardiac arrhythmias in adolescents with mitral valve prolapse and myxomatous degeneration of mitral valve leaflets.
    Wiad Lek 2016;69(6):730-733
    Department Of Clinical Pharmacology Of Kharkiv National Medical University, Kharkiv, Ukraine.
    Introduction: myxomatous degeneration (MD) of valve leaflets and other structures of the valve apparatus and the degree of its severity in particular is of great prognostic significance as this determines the risk of complications development as well as the prognosis. The aim of the paper was to assess heart rhythm and heart conduction disorders in adolescents with primary mitral valve prolapse (MVP) and myxomatous valve degeneration of various degrees.

    Materials And Methods: complete physical examination of 145 adolescents aged 12-16 with MVP was carried out. Read More

    Robotic mitral valve repair for degenerative posterior leaflet prolapse.
    Ann Cardiothorac Surg 2017 Jan;6(1):27-32
    Background: Robotic mitral valve (MV) repair is the least invasive surgical approach to the MV and provides unparalleled access to the valve. We sought to assess technical aspects and clinical outcomes of robotic MV repair for isolated posterior leaflet prolapse by examining the first 623 such cases performed in a tertiary care center.

    Methods: We reviewed the first 623 patients (mean age 56±9. Read More

    The adjustable slipknot technique for implanting neochordae in the repair of mitral valve prolapse.
    Multimed Man Cardiothorac Surg 2016 Dec 6;2016. Epub 2016 Dec 6.
    The adjustable slipknot technique is a novel procedure for implanting neochordae. The neochorda acts like a lasso. The procedure facilitates accurate assessment of the length of the neochordae. Read More

    Evaluation of Prolonged QT Interval: Structural Heart Disease Mimicking Long QT Syndrome.
    Pacing Clin Electrophysiol 2017 Apr 16;40(4):417-424. Epub 2017 Mar 16.
    Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
    Background: In about 20-25% of patients with congenital long QT syndrome (LQTS) a causative pathogenic mutation is not found. The aim of this study was to explore the prevalence of alternative cardiac diagnoses among patients exhibiting prolongation of QT interval with negative genetic testing for LQTS genes.

    Methods: We conducted a retrospective analysis of 239 consecutive patients who were evaluated in the inherited arrhythmia clinic at the Toronto General Hospital between July 2013 and December 2015 for possible LQTS. Read More

    Transapical beating-heart chordae implantation in mitral regurgitation: a new horizon for repairing mitral valve prolapse.
    J Thorac Dis 2016 Dec;8(12):E1665-E1671
    Cardiovascular Department, GVM Care and Research, Maria Eleonora Hospital, Palermo, Italy; ; Department of Surgery and Cancer, University of Palermo, Palermo, Italy.

    Ischemic mitral valve prolapse.
    J Thorac Dis 2016 Dec;8(12):3752-3761
    Department of Cardiovascular Surgery, University Campus Bio-Medico di Roma, Rome, Italy.
    Ischemic mitral prolapse (IMP) is a pathologic entity encountered in about one-third among the patients undergoing surgery for ischemic mitral regurgitation (IMR). IMP is generally the result of a papillary muscle injury consequent to myocardial, but the recent literature is progressively unveiling a more complex pathogenesis. The mechanisms underlying its development regards the impairment of one or more components of the mitral apparatus, which comprises the annulus, the chordae tendineae, the papillary muscle and the left ventricular wall. Read More

    Twist deformation for predicting postoperative left ventricular function in patients with mitral regurgitation: A speckle tracking echocardiography study.
    Echocardiography 2017 Mar 28;34(3):422-428. Epub 2017 Jan 28.
    Kartal Kosuyolu Heart & Research Hospital, Cardiology Clinic, Istanbul, Turkey.
    Purpose: Postoperative LV dysfunction is associated with poor prognosis and increased mortality in patient with mitral regurgitation undergoing surgery. With this study, we aimed to investigate the predictive value of classic and speckle tracking echocardiographic (STE) LV deformational parameters for estimating postoperative LV dysfunction.

    Methods: Fifty-nine asymptomatic patients with severe mitral regurgitation (MR) due to mitral valve prolapse, who had sinus rhythm and LV ejection fraction (EF) ≥50%, were included. Read More

    A systematic review and meta-analysis of chordal replacement versus leaflet resection for isolated posterior mitral valve prolapse.
    J Cardiovasc Surg (Torino) 2017 Jan 25. Epub 2017 Jan 25.
    Division of Cardiology at Columbia University, Mount Sinai Heart Institute, Miami, FL, USA.
    Introduction: Chordal replacement (Chord MVr) for isolated posterior mitral valve prolapse allows for preservation of the native mitral valve apparatus. The potential benefits of this approach, as compared with leaflet resection (Resection), are not clearly defined.

    Evidence Acquisition: A systematic review and meta-analysis was conducted on operative, clinical, and echocardiographic outcomes. Read More

    Coexistence of abnormal systolic motion of mitral valve in a consecutive group of 324 adult Tetralogy of Fallot patients assessed with echocardiography.
    Open Heart 2016 30;3(2):e000518. Epub 2016 Dec 30.
    University of California San Francisco (UCSF) , San Francisco, California , USA.
    Background: The presence of mitral valve prolapse (MVP) in congenital heart disease (CHD) patients is not well described. Tetralogy of Fallot (TOF) is the most common cyanotic CHD associated with overall good long-term survival after palliation. Since MVP is more often identified in adults and TOF patients are now surviving longer, we thus sought to perform this cohort study with a case-control design to (1) determine the prevalence of MVP and systolic displacement of mitral leaflets (SDML) in adult TOF patients, and (2) describe their clinical and imaging characteristics. Read More

    The adjustable slipknot technique for implanting neochordae in the repair of mitral valve prolapse.
    Multimed Man Cardiothorac Surg 2016 Dec 6;2017. Epub 2016 Dec 6.
    The adjustable slipknot technique is a novel procedure for implanting neochordae. The neochorda acts like a lasso. The procedure facilitates accurate assessment of the length of the neochordae. Read More

    Optimal surgical mitral valve repair in Barlow's disease: the concept of functional prolapse.
    Multimed Man Cardiothorac Surg 2016 12 6;2017. Epub 2016 Dec 6.
    Barlow's disease presents the most severe form of degenerative mitral valve disease as it normally affects various valvular structures and segments. We discuss the technical aspects of mitral valve repair in this setting. Furthermore, the concept of "functional prolapse" of the mitral valve is discussed as well as recommendations on when to proceed with surgical correction of anterior leaflet prolapse. 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

    Numerical simulation of mitral valve prolapse considering the effect of left ventricle.
    Math Biosci 2017 Mar 28;285:75-80. Epub 2016 Dec 28.
    Biological Fluid Dynamics Laboratory, Biomedical Egngineering Faculty, Amirkabir University of Technology, Tehran, Iran.
    Heart failure is one of the most important issues that has been investigated in recent research studies. Variations that occur in apparatus of mitral valve, such as chordae tendineaea rupture, can affect the valve function during ventricular contraction and lead to regurgitation from the left ventricle into the left atrium. One method for understanding mitral valve function in such conditions is computational analysis. Read More

    Endovascular Repair of Bilateral Internal Mammary Artery Aneurysms in a Patient with Marfan Syndrome-A Case Report.
    Int J Angiol 2016 Dec 24;25(5):e39-e42. Epub 2014 Jun 24.
    Division of Cardiology, Loyola University Medical Center, Chicago, Illinois.
    Marfan syndrome (MFS) is an autosomal dominant condition that is caused by abnormal synthesis of connective tissue. The syndrome classically affects the ocular, musculoskeletal, and cardiovascular systems. The most common cardiovascular manifestations include mitral valve prolapse/regurgitation and aortic aneurysms at high risk of rupture and dissection. Read More

    A Yellow Papular Eruption on the Arms, Legs, and Neck: A Rare Masquerader.
    Skinmed 2016 1;14(6):465-466. Epub 2016 Dec 1.
    Department of Dermatology, Saint Louis University School of Medicine, St. Louis, MO.
    A 54-year-old Caucasian woman with a medical history of mitral valve prolapse presented with a 5-year history asymptomatic papules. There was no family history of similar lesions. Physical examination revealed >100, 2- to 4-mm, firm, yellow, dermal papules located on the neck, antecubital and popliteal fossae, flexor surface of both forearms, and inner aspect of the thighs (Figure 1). Read More

    Chordal Shortening for Anterior Mitral Leaflet Prolapse and the Maze Procedure for Persistent Atrial Fibrillation.
    J Heart Valve Dis 2016 Jul;25(4):525-526
    Department of Thoracic and Cardiovascular Surgery, Research Institute of Clinical Medicine and Biomedical Research Institute, Chonbuk National University Medical School, Jeonju, Chonbuk, South Korea.
    Letter to the Editor We read with great interest the report by Inoue et al. (Cusp-level chordal shortening for non-rheumatic mitralanterior leaflet prolapse in a patient with persistent atrial fibrillation. J Heart Valve Dis 2015;24:586-589) that described their mitral valve repair technique for anterior leaflet prolapse (ALP) and perioperative adaptive servo-ventilation (ASV) therapy for preventing the recurrence of atrial fibrillation after the maze procedure. Read More

    Off-Pump NeoChord Mitral Valve Repair to Simultaneously Treat Posterior Leaflet Prolapse and Systolic Anterior Motion.
    Ann Thorac Surg 2017 Jan;103(1):e29-e30
    Department of Surgical Sciences, Division of Cardiac Surgery, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
    This case represents the first report of complete elimination of systolic anterior motion by beating-heart implantation of artificial chordae tendineae on a prolapsing and redundant posterior leaflet. Read More

    A Standardized Loop Technique for Mitral Valve Repair.
    Ann Thorac Surg 2017 Jan;103(1):e105-e106
    Department of Cardiac Surgery, Lens Hospital and Ramsay Bois Bernard Private Hospital, Lens, France.
    The loop technique is widely used for mitral valve repair. However, estimation of the correct loops' length remains challenging. We describe a standardized technique with implantation of standardized 15- and 25-mm loops for posterior and anterior mitral prolapses. Read More

    Surgical Treatment of Posterior Mitral Valve Prolapse: Towards 100% Repair.
    J Heart Valve Dis 2015 Nov;24(6):752-759
    Centre of Cardiothoracic Surgery, University Hospital and Faculty of Medicine of Coimbra, Portugal.
    Background: The study aim was to evaluate the immediate and long-term results of surgical treatment of isolated posterior mitral valve leaflet prolapse (PLP), focusing on survival and freedom from recurrent mitral regurgitation (MR).

    Methods: Between January 1998 and December 2012, a total of 492 consecutive patients (375 males, 117 females; mean age 61.8 ± 12. Read More

    Repair of Anterior Mitral Leaflet Prolapse: Comparison of Mid-Term Outcomes with Chordal Transposition and Chordal Replacement Techniques.
    J Heart Valve Dis 2016 Mar;25(2):187-194
    Department of Cardiac Surgery, Montreal Heart Institute, Quebec, Canada.
    Background: The repair of anterior mitral leaflet prolapse is known to be challenging. Hence, the study aim was to compare the mid-term results of anterior leaflet prolapse (ALP) using chordal transposition with results obtained using chordal replacement with expanded polytetrafluoroethylene (ePTFE) sutures.

    Methods: Between 1999 and 2012, a total of 96 consecutive patients (mean age 62 years) with ALP underwent mitral valve repair at the authors' institution. Read More

    Distant Position of Chordae from Coaptation Causes Mitral Regurgitation in Patients with Atrial Fibrillation.
    J Heart Valve Dis 2016 May;25(3):323-331
    Noninvasive Cardiac Laboratory, Cedars-Sinai Heart Institute, Los Angeles, CA, USA. Electronic correspondence:
    Background: The study aim was to investigate the mechanism of mitral regurgitation (MR) in lone atrial fibrillation (AF) patients using three-dimensional (3D) transesophageal echocardiography (TEE).

    Methods: A retrospective analysis was conducted of 64 patients with AF and a normal left ventricle, and without prolapse of the mitral valve. Among these patients, significant MR was not identified in 33 cases (AF+MR- group) but was present in 31 cases (AF+MR+ group). Read More

    Technical aspects of robotic posterior mitral valve leaflet repair.
    Ann Cardiothorac Surg 2016 Nov;5(6):577-581
    Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
    Posterior mitral valve leaflet repair is safe, effective and durable and can be performed through conventional sternotomy or by using minimally invasive thoracoscopic or robotic-assisted approaches. Triangular resection with ventricularization, quadrangular resection with sliding or folding leaflet reconstruction, neochordae implantation and edge-to-edge leaflet repair are different techniques for eliminating the prolapsing mitral leaflet segment and restoring normal leaflet coaptation. Recent studies have demonstrated that minimally invasive approaches are associated with a reduced risk of postoperative complications, shorter hospital stay and improved cosmetic outcomes when compared to conventional sternotomy. Read More

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