Search Our Scientific Publications & Authors

J Am Coll Cardiol 2019 Feb;73(6):739-740

J Am Coll Cardiol 2019 Feb;73(6):739

Heart 2019 Feb 12. Epub 2019 Feb 12.

Division of Cardiovascular Medicine, University of California, San Francisco, San Francisco, California, USA.

Objective: Bileaflet mitral valve prolapse (MVP) with either focal or diffuse myocardial fibrosis has been linked to ventricular arrhythmia and/or sudden cardiac arrest. Left ventricular (LV) mechanical dispersion by speckle-tracking echocardiography (STE) is a measure of heterogeneity of ventricular contraction previously associated with myocardial fibrosis. The aim of this study is to determine whether mechanical dispersion can identify MVP at higher arrhythmic risk. Read More

J Cardiovasc Echogr 2018 Oct-Dec;28(4):207-217

Luigi Vanvitelli University, Monaldi Hospital, AORN Ospedali Dei Colli, Naples, Italy.

Mitral valve prolapse is generally a benign condition characterized by fibromyxomatous changes of the mitral leaflet with displacement into the left atrium and late-systolic regurgitation. Although it is an old clinical entity, it still arouses perplexity in diagnosis and clinical management. Complications, such as mitral regurgitation (MR), atrial fibrillation, congestive heart failure, endocarditis, ventricular arrhythmias, and sudden cardiac death (SCD), have been reported. Read More

PLoS One 2019 11;14(2):e0212165. Epub 2019 Feb 11.

Department of Clinical Laboratory, National Hospital Organization Yokohama Medical Center, Yokohama, Kanagawa, Japan.

The mitral valve morphology in patients with pectus excavatum (PE) has not been fully investigated. Thirty-five patients with PE, 46 normal controls, and patients with hypertrophic cardiomyopathy (HCM) who underwent 2 leaflet length measurements of Carpentier classification P2 and A2 using a transthoracic echocardiography were retrospectively investigated. The coaptation lengths and depths, papillary muscle tethering length, and mitral annular diameters were also measured. Read More

World Neurosurg 2019 Feb 7. Epub 2019 Feb 7.

Department of Orthopaedic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China. Electronic address:

Objective: To investigate the incidence of cardiac abnormalities in patients with idiopathic scoliosis and identify risk factors related to cardiac abnormalities.

Methods: A cohort of 531 patients with idiopathic scoliosis requiring surgical treatment in our hospital from March 2009 to August 2017 were recorded. Clinical data including medical records, radiograph, and echocardiogram were collected. Read More

Am J Cardiol 2019 Jan 24. Epub 2019 Jan 24.

The Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center, San Diego, California. Electronic address:

Risk factors predicting progression from low grade to severe mitral regurgitation (MR), which is a guideline criterion for surgical intervention, remain unknown. We hypothesized that abnormalities of cardiac structure and function may predict progression in MR severity. We followed 82 asymptomatic mitral valve prolapse (MVP) patients (65 ± 12 years, 51% men) with mild or moderate MR (36 mild, 46 moderate, mean LVEF: 62%), without significant co-morbidities. Read More

Congenit Heart Dis 2019 Jan 31. Epub 2019 Jan 31.

Department of Pediatrics, Baylor College of Medicine Clinical Center of Excellence, Lilongwe, Malawi.

Background: In asymptomatic children, screening echocardiography has been used to attempt to diagnose rheumatic heart disease (RHD) at an early stage (latent RHD). World Heart Federation guidelines have standardized categorization of "definite," "borderline," or no RHD by echo findings. The progression of RHD diagnosed through echo screening is not known. Read More

Clin Exp Immunol 2019 Jan 29. Epub 2019 Jan 29.

Faculty of Medicine, the University of Queensland, Brisbane, Queensland, Australia.

Lung disease due to nontuberculous mycobacteria (NTM) occurs with disproportionate frequency in postmenopausal women with a unique phenotype and without clinically apparent predisposing factors. Dubbed "Lady Windermere Syndrome", the phenotype includes low body mass index (BMI), tall stature, and higher than normal prevalence of scoliosis, pectus excavatum and mitral valve prolapse. Although the pathomechanism for susceptibility to NTM lung disease in these patients remains uncertain, it is likely to be multifactorial. Read More

Pacing Clin Electrophysiol 2019 Jan 24. Epub 2019 Jan 24.

Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Cleveland, OH, USA.

Background: While there is an association between isolated mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), the baseline characteristics and outcomes of patients with isolated MVP who experience ventricular arrhythmias (VA) and then subsequently undergo catheter ablation and/or implantable cardioverter defibrillator (ICD) implantation are unknown.

Methods: We performed a retrospective review of all patients at the Cleveland Clinic with isolated MVP between 1997-2016 who underwent VA catheter ablation or secondary prevention implantable cardioverter defibrillator (ICD) implantation.

Results: Of 617 screened patients, we identified 43 patients with isolated MVP and significant VA who underwent ICD placement (n = 13, 30%) or catheter ablation (n = 30, 70%). Read More

J Am Coll Cardiol 2019 Jan;73(3):275-277

Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts.

Int J Gen Med 2019 14;12:55-61. Epub 2019 Jan 14.

Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,

Background: Mitral valve prolapse (MVP) is the most common cardiac valvular abnormality in developed countries and it is associated with considerable morbidity and mortality.

Aim Of Work: To study the clinical presentations, risk factors, and echocardiographic features of patients with MVP in Jeddah, Saudi Arabia.

Materials And Methods: A retrospective chart review study was conducted in King Abdulaziz teaching hospital in Jeddah, Saudi Arabia, from 2007 to 2017. Read More

Semin Thorac Cardiovasc Surg 2019 Jan 8. Epub 2019 Jan 8.

The Mitral Laboratory, Yale School of Medicine, New Haven, Connecticut; Section of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut. Electronic address:

Mathematical modeling tries to simplify understanding and proposes a fundamental mechanism that governs the motion and function of a complex biological system such as a mitral valve (MV) motion which represents a dynamic interplay between papillary muscle (PM) position in the context of left ventricular (LV) shape dynamics. Current therapeutic strategies to intervene on the MV may not have exploited these relationships due to lack of understanding of the interactions. We present a MV 3D mathematical model characterized by LV shape dynamics to understand fundamental working principles of ventriculo-papillary-mitral complex. Read More

Ann Cardiothorac Surg 2018 Nov;7(6):812-820

Department of Cardiology, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Transapical off-pump mitral valve repair (MVr) with NeoChord implantation has become widely applied in Europe for patients presenting with severe mitral regurgitation due to leaflet prolapse or flail. The procedure is performed under real-time 2D- and 3D-transesophageal echocardiography (TEE) for both implantation and neochordae tension adjustment allowing real-time monitoring of hemodynamic recovery. Preoperative anatomic and echocardiographic selection criteria, procedure refinement, as well as innovative ex-vivo surgical simulator training have been developed and strategically employed in the past few years, to generate a robust precision-based procedural framework with significantly enhanced operator use, patient safety and clinical outcomes. Read More

Ann Cardiothorac Surg 2018 Nov;7(6):731-740

Heart Valve Clinic, University Hospital of Zürich, University of Zürich, Zürich, Switzerland.

The field of mitral valve disease diagnosis and management is rapidly evolving. New understanding of pathophysiology and improvements in the adoption of sophisticated multimodality imaging modalities have led to early diagnosis and to more complex treatment. The most common cause of mitral regurgitation (MR) in the western world is in the primary alteration of the valve, which leads to degenerative leaflet prolapse due to chordal elongation or rupture and annular dilatation. Read More

Perfusion 2018 Dec 31:267659118820776. Epub 2018 Dec 31.

1 Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Objectives:: To evaluate the impact of concomitant tricuspid valve (TV) repair on the right ventricular (RV) function postoperatively and within the 6 months following degenerative mitral valve (MV) repair.

Methods:: The prospective study included 37 patients (mean age 57.32 ± 2. Read More

Indian Heart J 2018 Nov - Dec;70(6):836-842. Epub 2018 Jan 31.

Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Background: Percutaneous balloon mitral valvuloplasty (PBMV) can be complicated with significant mitral regurgitation (MR). We performed a pilot, prospective study to evaluate the role of three dimensional transesophageal echocardiography (3D-TEE) in the prediction of MR after PBMV through mitral valve quantification (MVQ).

Methods: Between October 2014 and October 2016, 37 patients with rheumatic, moderate-to-severe mitral stenosis, referred to the Cath lab of Bab Alshearia University hospitals for PBMV, were divided into two age and sex matched groups. Read More

Adv Exp Med Biol 2018 ;1085:187-189

Department of Ophthalmology, Columbia University, Edward S. Harkness Eye Institute, NewYork-Presbyterian Hospital, New York, NY, USA.

Pseudoxanthoma elasticum (PXE) is an autosomal recessive multisystem disorder that involves the skin, GI tract, and heart, as well as the eye. It affects approximately 1 in 50,000 people worldwide and is seen twice as frequently in females as in males. Fundus findings include angioid streaks (Fig. Read More

Am J Physiol Heart Circ Physiol 2018 Dec 21. Epub 2018 Dec 21.

Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Japan.

Progressive superior shift of mitral valve (MV) during systole is associated with abnormal papillary muscles (PMs) superior shift in late systolic MV prolapse (MVP). Causal relation on these superior shifts remains unclarified. We hypothesized that MV superior shift is related to augmented MV superiorly pushing force by systolic left ventricular pressure due to MV annular dilatation, which can be corrected by surgical MV plasty, leading to postoperative disappearance of these superior shifts. Read More

J Cardiovasc Electrophysiol 2018 Dec 21. Epub 2018 Dec 21.

Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

Objective: There are scarce comparative data on efficacy and procedural safety between radiofrequency catheter ablation (RFCA) and surgical ablation (SA) combined with mitral valve (MV) surgery for patients with nonparoxysmal atrial fibrillation (AF) and moderate mitral regurgitation (MR).

Methods And Results: This single-center, retrospective, and observational study enrolled 155 consecutive patients with nonparoxysmal AF and moderate MR, of which 98 underwent RFCA and 57 underwent SA combined with MV surgery. Circumferential pulmonary vein ablation, bidirectional block of lines, and disappearance of complex fractionated atrial electrograms were the endpoints of RFCA, while pulmonary vein isolation and left and right atrial incisions were performed in SA. Read More

J Heart Valve Dis 2018 Jan;27(1):114-116

Cardiology Department, Cardiovascular Institute (ICCV), Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.

A patient with ischemic myocardiopathy who had undergone resynchronization therapy was admitted to the authors' institution with progressive dyspnea. Echocardiography demonstrated a left ventricular ejection fraction (LVEF) of 25%, with a massive mitral regurgitation (MR) secondary to anterior leaflet prolapse and posterior leaflet restriction. Despite intensive medical treatment, the patient developed cardiogenic shock and required mechanical ventilation, inotropic support and intra-aortic balloon pumping. Read More

Surg Today 2018 Dec 6. Epub 2018 Dec 6.

Department of Cardiovascular Surgery, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, Japan.

Purpose: To define the outcomes of our original simple chordal replacement technique using ePTFE sutures for mitral regurgitation.

Methods: Between January, 2004 and March, 2014, 38 patients underwent mitral valve repair using our chordal replacement technique for anterior leaflet prolapse. The mitral regurgitation was caused by degenerative disease in 34 patients and infective endocarditis in 4 patients. Read More

J Am Coll Cardiol 2018 Dec;72(23 Pt A):2904-2914

Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York.

There is an increasing awareness of the association between mitral valve prolapse and sudden cardiac death. There are several clinical risk factors associated with an increased risk of mitral valve prolapse-related sudden cardiac death, most of which can be evaluated with noninvasive diagnostic modalities. For example, characteristic changes on the electrocardiogram (T-wave inversions in the inferior leads), complex ventricular ectopy, a spiked configuration of the lateral annular velocities by echocardiography, and evidence of myocardial fibrosis by cardiac magnetic resonance imaging have all been implicated as markers of risk. Read More

J Vet Sci 2019 Jan;20(1):63-71

Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul 05030, Korea.

Genome-wide association study (GWAS) is a powerful tool for identifying the genetic causes of various diseases. This study was conducted to identify genomic variation in Maltese dog genomes associated with degenerative mitral valve disease (DMVD) development and to evaluate the association of each biological condition with DMVD in Maltese dogs. DNA was extracted from blood samples obtained from 48 Maltese dogs (32 with DMVD and 16 controls). Read More

Medicine (Baltimore) 2018 Nov;97(48):e13089

Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital.

Rationale: Infective endocarditis (IE) complicated with obstructive ST elevation myocardial infarction (STEMI) has been reported in the literature and which were mostly related to coronary artery embolism, obstruction, or compression. However, there has been no reported case discussing about IE complicated with nonobstructive STEMI.

Patient Concerns: In this report, we report a 38-year-old female suffering from intermittent fever and was later diagnosed as IE. Read More

Mymensingh Med J 2018 Oct;27(4):894-897

Dr Ranjan Kumar Majumder, Department of Cardiology, Kumudini Women's Medical College, Mirzapur, Tangail, Bangladesh.

Single Atrium is a complex cardiac anomaly and generally a component of certain congenital syndromes. It is extremely rare for SA to be observed as an isolated defect. We report here a 14 year-old male patient with SA with MVP with spontaneously-closed inlet-VSD with polydactyly. Read More

J Am Heart Assoc 2018 Dec;7(23):e010584

1 Department of Cardiology Austin Health University of Melbourne Melbourne Australia.

Background The relationship between mitral valve prolapse ( MVP ) and sudden cardiac death ( SCD ) remains controversial. In this systematic review, we evaluate the relationship between isolated MVP and SCD to better define a potential high-risk subtype. In addition, we determine whether premortem parameters could predict SCD in patients with MVP and the incidence of SCD in MVP . Read More

Expert Rev Cardiovasc Ther 2018 Nov 28. Epub 2018 Nov 28.

a Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust , London , UK.

Introduction: Mitral valve prolapse is a common valve pathology with a spectrum of disease from isolated prolapse to myxomatous, multi-scallop Barlow's disease. The main complications relate to progression of mitral regurgitation, endocarditis, sudden death and stroke. The timing of intervention in patients with asymptomatic severe mitral regurgitation is controversial. Read More

Multimed Man Cardiothorac Surg 2018 Nov 16;2018. Epub 2018 Nov 16.

Department of Cardiac Surgery Medical University of Innsbruck Innsbruck, Austria.

Transcatheter treatment of structural heart disease is becoming an everyday reality for an increasing number of surgeons, and effective training modalities for basic guide-wire skills, catheter handling, and periprocedural imaging are of growing relevance. In this video tutorial we present a beating-heart porcine model used as a high-fidelity training simulator for transcatheter cardiac valve procedures.  We demonstrate a complete transcatheter edge-to-edge mitral valve repair procedure, including periprocedural imaging, clip deployment, and quality control. Read More

Sci Rep 2018 Nov 23;8(1):17306. Epub 2018 Nov 23.

The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.

Mitral valve (MV) dynamics depends on a force balance across the mitral leaflets, the chordae tendineae, the mitral annulus, the papillary muscles and the adjacent ventricular wall. Chordae rupture disrupts the link between the MV and the left ventricle (LV), causing mitral regurgitation (MR), the most common valvular disease. In this study, a fluid-structure interaction (FSI) modeling framework is implemented to investigate the impact of chordae rupture on the left heart (LH) dynamics and severity of MR. Read More

J Thorac Cardiovasc Surg 2018 Oct 17. Epub 2018 Oct 17.

Department of Adult Cardiac Surgery, Hôpital cardiologique Louis Pradel, Lyon Medical School, Bron, France.

Objectives: Complex structure of mitral valve and its central position in the heart limit assessment of mitral function to standardized calculated parameters assessed using medical imaging (echocardiography). Novel techniques, which allow mitral valve repair (MVr) in a beating heart, offer the opportunity for innovative objective assessment in physiologic and pathologic conditions. We report, to our knowledge, the first data of real-time chordal tension measurement during a transapical neochordae implantation. Read More

Psychosomatics 2018 Oct 31. Epub 2018 Oct 31.

The Nathan S. Kline Institute for Psychiatric Research, Clinical Research, NYU Langone Health, Adult Psychiatry, New York, NY.

Background: Although most studies have suggested that mitral valve prolapse (MVP) is more prevalent in patients with panic disorder (PD) than in healthy controls, there is a substantial uncertainty in the rates of MVP across studies.

Objective: To investigate, through systematic review and meta-analysis, the relative risk of MVP in patients with PD compared to controls.

Methods: Embase, Proquest, Pubmed, and Google Scholar electronic databases were searched up to September 2018. Read More

Eur Heart J Cardiovasc Imaging 2018 Nov 15. Epub 2018 Nov 15.

Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN, USA.

Aims: Bicuspid aortic valve (BAV) and mitral valve prolapse (MVP) are common but the prevalence and significance of coexistent conditions are unknown. This study investigated the prevalence, phenotypic expression, and clinical significance of coexistent MVP-BAV.

Methods And Results: Retrospective comparison of MVP-BAV and MVP-tricuspid aortic valve (TAV) prevalence including de novo echocardiographic analysis of all MVP-BAV patients between 2005 and 2015 was performed. Read More

Swiss Med Wkly 2018 11 15;148:w14675. Epub 2018 Nov 15.

, 3010, Bern, SWITZERLAND.

BACKGROUND The term “predisposition” is used as an indication of antimicrobial prophylaxis to prevent infective endocarditis and as a criterion for diagnosing infective endocarditis according to the modified Duke criteria. The criterion for diagnosing infective endocarditis in native valves is not well defined. OBJECTIVES To identify conditions that increase the risk for infective endocarditis in native valves, for the diagnosis of infective endocarditis according to the modified Duke criteria. Read More

Pediatr Cardiol 2018 Nov 11. Epub 2018 Nov 11.

Department of Nursery, Medical University of Gdansk, Gdansk, Poland.

Marfan syndrome (MFS) is a connective tissue disorder characterized by a broad range of clinical manifestations. Cardiovascular involvement is the most life-threatening aspect of the syndrome. Although abnormalities within the cardiovascular system in adults are well documented, there is still a paucity of data regarding manifestation of MFS in childhood. Read More

J Endocr Soc 2018 Nov 17;2(11):1246-1250. Epub 2018 Sep 17.

Division of Endocrine and Diabetes, Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan.

Mitral valve prolapse is a common disorder, but severe mitral regurgitation (MR) as a result of rupture of mitral valve chordae tendineae is a rare manifestation of thyrotoxic heart disease. There are limited reports with respect to the onset of severe MR as a complication of Graves disease. We report a case of a 60-year-old woman with Graves disease and thyroid-associated ophthalmopathy as her past history. Read More

Ann Thorac Surg 2018 Nov 2. Epub 2018 Nov 2.

Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address:

Background: Surgical mitral valve repair is the conventional treatment for severe degenerative mitral regurgitation (MR). MitraClip therapy has emerged as a viable option in high-risk surgical patients. We sought to compare conventional surgery to MitraClip therapy in patients with severe degenerative mitral valve prolapse (MVP) and previous cardiac interventions. Read More

Heart Lung Circ 2018 Oct 17. Epub 2018 Oct 17.

St Andrews War Memorial Hospital, Brisbane, Qld, Australia.

Background: The majority of patients with degenerative mitral regurgitation (DMR) are amenable to reconstructive procedures. There is debate regarding factors that influence long-term durability with respect to repair technique, valve remodelling and progressive myxomatous change.

Methods: A total of 685 patients with DMR underwent mitral valve repair by a single surgeon between 1991 and 2011 with follow-up completed at 31 December 2016. Read More

Int Heart J 2018 Nov 25;59(6):1288-1295. Epub 2018 Oct 25.

Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College.

There is limited information on long-term outcomes of mitral valve repair for mitral regurgitation (MR) caused by different degrees of myxomatous degeneration. The aim of this study was to compare the surgical results of patients with advanced and mild/moderate myxomatous mitral valve degeneration (MVD). We identified 130 patients (25 advanced and 105 mild/moderate MVD patients) who underwent mitral valve repair for MR and were pathologically diagnosed as myxomatous degeneration. Read More

J Thorac Cardiovasc Surg 2018 Sep 25. Epub 2018 Sep 25.

Division of Cardiothoracic Surgery, Structural Heart Research and Innovation Laboratory, Emory University School of Medicine, Atlanta, Ga. Electronic address:

Objective: Repairing a prolapsed mitral valve that involves multiple cusps is procedurally complicated and carries a higher risk of failure when performed with individual neochordae. Inserting multiple neochordae into the papillary muscle, sizing, and aligning them in a manner that can restore coaptation is challenging. A multichordal mitral valve apparatus (MitraPatch) with a single neopapillary muscle section, 4 neochordae with each chord ending in a neoleaflet section, was developed. Read More

Open Heart 2018 15;5(2):e000925. Epub 2018 Oct 15.

Cardiovascular Pathology Unit, St Georges Hospital Medical School, London, UK.

Objective: Mitral valve prolapse is a benign condition, however with occasional reports of sudden cardiac death or out-of-hospital cardiac arrest in the absence of severe mitral regurgitation or coronary artery disease, suggesting the existence of a malignant form. The objective of our study was to contribute to the characterisation of malignant mitral valve prolapse.

Methods: We performed a retrospective analysis of pathology findings in 68 consecutive cases of sudden cardiac death with mitral valve prolapse as lone abnormal finding, reported as cause of death. Read More

Circulation 2018 Aug;138(8):843-845

Cardiac Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences (A.C., E.M., L.B., E.B., A.F.., F.Z., L.B., R.B., G.G.).

Circulation 2018 Sep;138(10):1067-1069

Mayo Clinic, Rochester, MN (M.A.C., S.A., M.A., D.O.H., M.E.-S.).

Structure 2019 Jan 18;27(1):102-112.e4. Epub 2018 Oct 18.

Department of Biological and Environmental Science and Nanoscience Center, University of Jyväskylä, 40014 Jyväskylä, Finland; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; Institute of Biomedicine, University of Turku, 20520 Turku, Finland; Turku Centre for Biotechnology, University of Turku, 20520 Turku, Finland. Electronic address:

Filamin A (FLNa), expressed in endocardial endothelia during fetal valve morphogenesis, is key in cardiac development. Missense mutations in FLNa cause non-syndromic mitral valve dysplasia (FLNA-MVD). Here, we aimed to reveal the currently unknown underlying molecular mechanism behind FLNA-MVD caused by the FLNa P637Q mutation. Read More

J Thorac Cardiovasc Surg 2018 Nov 28;156(5):1856-1866.e3. Epub 2018 May 28.

Department of Biostatistics, University Hospital of Liege, Liege, Belgium.

Objective: Avoiding resection to treat posterior leaflet prolapse has become popular to repair degenerative mitral regurgitation. We never subscribed to such simplification but advocated an alternative approach based on the "respect when you can, resect when you should" concept. The present study reviewed posterior leaflet prolapse in degenerative disease with the aim to expose the 10-year experience with this surgical policy, in particular long-term outcomes such as survival, recurrent/severe mitral regurgitation, and reoperation. Read More

J Cardiothorac Vasc Anesth 2018 Aug 11. Epub 2018 Aug 11.

Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Objective: The use of 3-dimensional (3D) transesophageal echocardiography (TEE) in perioperative evaluation of the mitral valve (MV) is increasing progressively, including the use of 3D MV models for quantitative analysis. However, the use of 3D MV models in clinical practice still is limited by the need for specific training and the long time required for analysis. A new stereoscopic visualization tool (EchoPixel True 3D) allows virtual examination of anatomic structures in the clinical setting, but its accuracy and feasibility for intraoperative use is unknown. Read More

Eur Heart J Cardiovasc Imaging 2018 Oct 15. Epub 2018 Oct 15.

Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 388-1, Seoul, South Korea.

Aims: We compared the diagnostic accuracy of cardiac computed tomography (CT) with that of echocardiography for the detection of mitral valve prolapse (MVP) on a scallop-by-scallop basis, using surgical inspection as a reference standard.

Methods And Results: This retrospective study included 145 patients (mean age 53 years; 94 men) who underwent surgical MVP repair or replacement and preoperative cardiac CT between May 2011 and October 2013. The prolapsed scallop was localized using cardiac CT and echocardiography according to the Carpentier method (anterior leaflet: from lateral to medial A1, A2, A3; posterior leaflet: P1, P2, P3). Read More

Echocardiography 2018 12 15;35(12):2124-2126. Epub 2018 Oct 15.

Department of Anesthesiology, University of Virginia, Charlottesville, Virginia.

Eighty-year-old woman presented for minimally invasive mitral valve repair for severe mitral regurgitation. Intraoperative two-dimensional transesophageal echocardiography (2DTEE) and subsequent three-dimensional transesophageal echocardiography examination showed severe mitral valve regurgitation with a bidirectional jet caused by both P2 segment prolapse and a large cleft within the P2 segment. The preoperative diagnosis of this complex pathology was challenging by 2DTEE, and a 3D examination of the mitral valve was helpful to confirm the presence of a cleft within the prolapsing segment. Read More

Tech Coloproctol 2018 10;22(10):825

Department of General Surgery, Policlinico Tor Vergata di Roma UOC B, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.

Unfortunately, the 2nd affiliation of Shalaby has been missed out in the original publication. Read More