1
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Endo Y, Shimamura Y, Niinami H. Mitral Valve Regurgitation in Klippel-Feil Syndrome With Related Thoracic Deformity. Tex Heart Inst J 2024; 51:e238282. [PMID: 38665003 DOI: 10.14503/thij-23-8282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
Klippel-Feil syndrome, characterized by congenital fusion of any 2 or more cervical vertebrae, is a rare disorder in which skeletal and other organ system-related abnormalities have been reported. This article reports a case of mitral valve regurgitation in a patient with Klippel-Feil syndrome and related thoracic deformity who underwent mitral valvuloplasty. Postoperatively, the mitral valve regurgitation disappeared, and there has been no recurrence for 3 years. This case highlights mitral valvuloplasty via median sternotomy as an excellent treatment for mitral valve regurgitation in a patient with thoracic deformity related to Klippel-Feil syndrome.
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Affiliation(s)
- Yuki Endo
- Department of Cardiovascular Surgery, Saitama City Hospital, Saitama City, Saitama, Japan
- Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Yoshiei Shimamura
- Department of Cardiovascular Surgery, Saitama City Hospital, Saitama City, Saitama, Japan
| | - Hiroshi Niinami
- Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, Tokyo, Japan
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2
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Farhat B, Bordeu I, Jagla B, Ibrahim S, Stefanovic S, Blanc H, Loulier K, Simons BD, Beaurepaire E, Livet J, Pucéat M. Understanding the cell fate and behavior of progenitors at the origin of the mouse cardiac mitral valve. Dev Cell 2024; 59:339-350.e4. [PMID: 38198889 DOI: 10.1016/j.devcel.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/08/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024]
Abstract
Congenital heart malformations include mitral valve defects, which remain largely unexplained. During embryogenesis, a restricted population of endocardial cells within the atrioventricular canal undergoes an endothelial-to-mesenchymal transition to give rise to mitral valvular cells. However, the identity and fate decisions of these progenitors as well as the behavior and distribution of their derivatives in valve leaflets remain unknown. We used single-cell RNA sequencing (scRNA-seq) of genetically labeled endocardial cells and microdissected mouse embryonic and postnatal mitral valves to characterize the developmental road. We defined the metabolic processes underlying the specification of the progenitors and their contributions to subtypes of valvular cells. Using retrospective multicolor clonal analysis, we describe specific modes of growth and behavior of endocardial cell-derived clones, which build up, in a proper manner, functional valve leaflets. Our data identify how both genetic and metabolic mechanisms specifically drive the fate of a subset of endocardial cells toward their distinct clonal contribution to the formation of the valve.
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Affiliation(s)
- Batoul Farhat
- INSERM U1251/Aix-Marseille Université, Marseille 13885, France
| | - Ignacio Bordeu
- Department of Applied Mathematics and Theoretical Physics, Centre for Mathematical Sciences, Wilberforce Road, Cambridge CB3 0WA, UK; Wellcome Trust/Cancer Research UK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge CB2 1QN, UK; Departamento de Física, Facultad de Ciencias Físicas y Matemáticas, Universidad de Chile, Santiago 9160000, Chile
| | - Bernd Jagla
- Pasteur Institute UtechS CB & Hub de Bioinformatique et Biostatistiques, C3BI, Paris, France
| | - Stéphanie Ibrahim
- C2VN Aix-Marseille Université, INSERM 1263, INRAE 1260, Marseille 13885, France
| | - Sonia Stefanovic
- C2VN Aix-Marseille Université, INSERM 1263, INRAE 1260, Marseille 13885, France
| | - Hugo Blanc
- Laboratory for Optics and Biosciences, Ecole Polytechnique, CNRS, INSERM, IP Paris, Palaiseau 91120, France
| | - Karine Loulier
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris 75012, France
| | - Benjamin D Simons
- Department of Applied Mathematics and Theoretical Physics, Centre for Mathematical Sciences, Wilberforce Road, Cambridge CB3 0WA, UK; Wellcome Trust/Cancer Research UK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge CB2 1QN, UK; Wellcome Trust-Medical Research Council Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge CB2 A0W, UK
| | - Emmanuel Beaurepaire
- Laboratory for Optics and Biosciences, Ecole Polytechnique, CNRS, INSERM, IP Paris, Palaiseau 91120, France
| | - Jean Livet
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris 75012, France
| | - Michel Pucéat
- INSERM U1251/Aix-Marseille Université, Marseille 13885, France.
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Abu-Hilal LH, Njoum Y, Barghouthi DI, Khatib H, Mtour S, Adwan B. An Undiagnosed Shone Complex in a 52-Year-Old Female: A Case Report. J Investig Med High Impact Case Rep 2024; 12:23247096231218636. [PMID: 38288715 PMCID: PMC10829487 DOI: 10.1177/23247096231218636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/08/2023] [Accepted: 11/18/2023] [Indexed: 02/01/2024] Open
Abstract
Shone complex (SC) is a rare congenital heart disease characterized by four obstructive anomalies, including parachute mitral valve (PMV), left atrial supra-valvular ring, subaortic stenosis, and coarctation of the aorta. Typically, SC manifests early in life. However, we encountered a 52-year-old female with a history of hypertension diagnosed at 26 years and left-sided weakness poststroke. She presented with worsening dyspnea and palpitations, prompting a thorough investigation. Echocardiography revealed a heavily calcified bicuspid aortic valve with severe aortic stenosis and parachute mitral valve with severe mitral stenosis and preserved ejection fraction, raising suspicions regarding the presence of SC. Cardiac catheterization, aortic-angiography, and noncontrast chest computed tomography (CT) revealed abrupt occlusion of the postductal aorta, giving a picture of aortic coarctation with well-established collateral vessels including prominent right and left internal mammary arteries. So, she was diagnosed with an incomplete SC at the age of 52. Shone complex is a rare congenital heart disease that typically presents in early childhood, but late presentations due to misdiagnosis or incomplete work up are possible. This case emphasizes the rarity of late presentations of SC and highlights the importance of early diagnosis and intervention to improve outcomes. An incomplete SC should be considered in adult patients presenting with left-sided obstructive lesions.
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Affiliation(s)
| | | | | | - Hasan Khatib
- Al-Makassed Charitable Hospital, Jerusalem, Palestine
| | - Sameer Mtour
- Al-Makassed Charitable Hospital, Jerusalem, Palestine
| | - Bilal Adwan
- Al-Makassed Charitable Hospital, Jerusalem, Palestine
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4
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Uygur B, Turkmen I, Erturk M. Combination of an extremely rare and a common congenital valvular anomalies: Accessory mitral valve chordae from left atrium and bicuspid aortic valve. Echocardiography 2024; 41:e15710. [PMID: 37922245 DOI: 10.1111/echo.15710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/09/2023] [Accepted: 10/20/2023] [Indexed: 11/05/2023] Open
Abstract
Accessory chordae tendineae is an extremely rare anomaly. In this case report, we described a 61-year-old female patient newly diagnosed with the combination of an accessory mitral valve chordae extending from left atrium which is an extremely rare congenital anomaly and a bicuspid aortic valve. In our patient, three-dimensional echocardiography showed incremental value over two-dimensional echocardiography in the assessment of the exact localization and the extend of accessory chordea.
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Affiliation(s)
- Begum Uygur
- Cardiology Department, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Irem Turkmen
- Cardiology Department, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Erturk
- Cardiology Department, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Nalawade D, Malani SK, Chigullapalli S, Chaudhary P. Role of 3D transoesophageal echocardiography in correct diagnosis of congenital isolated double orifice mitral valve in a young adult misdiagnosed as rheumatic heart disease. BMJ Case Rep 2023; 16:e258918. [PMID: 38114299 DOI: 10.1136/bcr-2023-258918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Double orifice mitral valve (DOMV) is an extremely rare congenital anomaly of the mitral valve (MV) wherein the MV orifice divides into two separate orifices by an accessory fibrous band.Isolated DOMV is a rarity and is often discovered incidentally. It may be associated with other congenital conditions wherein it is identified in early childhood. Its prevalence and prognostic relevance in adulthood remain unclear. DOMV patients may be asymptomatic or have symptoms due to mitral stenosis or regurgitation. We present a case of an asymptomatic young adult initially diagnosed with rheumatic mitral stenosis. However, after a thorough echocardiographic assessment, including three-dimensional transesophageal echocardiography, the accurate diagnosis of DOMV was made.
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Affiliation(s)
- Digvijay Nalawade
- Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pimpri-Chinchwad, Pune, Maharashtra, India
| | - Susheel Kumar Malani
- Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pimpri-Chinchwad, Pune, Maharashtra, India
| | - Sridevi Chigullapalli
- Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pimpri-Chinchwad, Pune, Maharashtra, India
| | - Prakash Chaudhary
- Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pimpri-Chinchwad, Pune, Maharashtra, India
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Galindo-Hayashi JM, Villarreal EG, Sanchez-Félix ER. Accessory mitral valve tissue: a differential diagnosis of an obstructive mass on the left ventricular outflow tract. Cardiol Young 2023; 33:2661-2663. [PMID: 37721025 DOI: 10.1017/s1047951123003293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Accessory mitral valve tissue is a rare congenital cardiac anomaly that is typically discovered incidentally during echocardiographic evaluation prompted by an asymptomatic murmur. This pathology has characteristic echocardiographic elements and is usually associated with other CHD. The decision to perform surgical resection depends on factors such as the degree of obstruction, presence of symptoms, presence of other CHDs, and risk of thrombosis. The researchers hereby present a case of an asymptomatic paediatric patient with accessory mitral valve tissue that produced left ventricular outflow tract obstruction.
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Affiliation(s)
- José M Galindo-Hayashi
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, NL, Mexico
| | - Enrique G Villarreal
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, NL, Mexico
| | - Ely R Sanchez-Félix
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Merida, YUC, Mexico
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7
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Anderson RH, Spicer DE, Crucean A. Which Phenotypes Should We Include in the Hypoplastic Left Heart Syndrome? World J Pediatr Congenit Heart Surg 2023; 14:738-740. [PMID: 37738500 PMCID: PMC10631272 DOI: 10.1177/21501351231181313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/18/2023] [Indexed: 09/24/2023]
Abstract
The recent special issue of the World Journal for Pediatric and Congenital Heart Surgery devoted to hypoplastic left heart syndrome, and its related anomalies, contained significant information of great clinical relevance. Very little attention, however, was devoted to the integrity of ventricular septum as providing a criterion to distinguish between the phenotypes to be included within the syndrome, as opposed to the related anomalies. In this commentary, we summarize the evidence in support of the notion that the phenotypes to be included within the syndrome can be interpreted on the basis of an acquired disease of fetal life. We suggest that it is the integrity of the ventricular septum that provided the major criterion for the distinction between the lesions making up the syndrome and the related anomalies. The subsets of lesions to be included within the syndrome can then be recognized in terms of the time, subsequent to the closure of the embryonic interventricular communication, at which the left ventricle ceased its growth relative to the remainder of the cardiac components. On this basis, it is possible to recognize the combinations of aortic and mitral atresia, mitral stenosis with aortic atresia, combined mitral and aortic stenosis, and hypoplasia of the left ventricle with commensurate hypoplasia of the aortic and mitral valves; the latter combination now recognized as the hypoplastic left heart complex.
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Affiliation(s)
| | - Diane E. Spicer
- Heart Institute, Johns Hopkins All Children's Hospital, St. Petersberg, FL, USA
| | - Adrian Crucean
- Department of Paediatric Cardiac Surgery, Birmingham Women's and Children's Hospital, Birmingham, UK
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Sugiyama K, Matsuyama K, Ogino H. Redo mitral valve replacement in an adult with severe pulmonary hypertension resulting from structural valve deterioration and left ventricular outflow tract obstruction and a history of atrioventricular septal defect repair: a case report. J Cardiothorac Surg 2023; 18:270. [PMID: 37794522 PMCID: PMC10552387 DOI: 10.1186/s13019-023-02371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Pulmonary hypertension (PH)-associated with left heart disease (Nice PH classification group II) improves when the latter is treated; however, the treatment of PH concomitant with group I PH due to congenital heart disease is difficult, and the optimal pharmacotherapy is controversial. Intervention strategies for the left-sided atrioventricular valve in partial atrioventricular septal defect (AVSD) are problematic. CASE PRESENTATION A 37-year-old woman who had undergone patch closure for a partial AVSD and mitral valve replacement with a rather large bioprosthesis at the juxta-annular position for mitral regurgitation 12 years earlier was referred to our institute because of severe PH. Echocardiography revealed calcification resulting in severe stenosis of the bioprosthesis and protrusion of its stent post into the left ventricular outflow tract; therefore, redo mitral valve replacement at the supra-annular position was performed using a mechanical valve. Combined group I and II PH gradually improved with meticulous postoperative medical management. CONCLUSIONS Severe PH due to stent post protrusion and structural valve deterioration in AVSD was successfully treated with redo mitral valve replacement. The present case was complicated with group I and II PH, for which medical therapy in conjunction with surgical treatment yielded an optimal therapeutic effect.
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Affiliation(s)
- Kayo Sugiyama
- Department of Cardiac Surgery, Aichi Medical University Hospital, Nagakute, Japan
| | - Katsuhiko Matsuyama
- Department of Cardiac Surgery, Aichi Medical University Hospital, Nagakute, Japan
| | - Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
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9
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Simsek B, Ozyuksel A, Saygi M. A rare coexistence: Hammock mitral valve and aortopulmonary window. Cardiol Young 2023; 33:1787-1789. [PMID: 37092647 DOI: 10.1017/s1047951123000914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Congenital mitral stenosis is a broad-spectrum pathology in which blood flow to the left ventricle is obstructed both functionally and anatomically. Hammock mitral valve, also known as anomalous mitral arcade, is a rare congenital anomaly particularly in infants and children. Hammock mitral valve may not be suitable for repair regarding the advanced dysplastic mitral valve structure. Aortopulmonary window is an unusual cardiac anomaly which is defined as a communication between the main pulmonary artery and the ascending aorta. As a result of the excessive left-to-right shunt, early intervention and surgical closure deemed mandatory to avoid development of severe pulmonary hypertension and its consequences. All patients with an aortopulmonary window necessitates prompt repair immediately. In this brief report, mitral valve replacement with a mechanical valve and repair of aortopulmonary window with a Dacron patch were performed simultaneously in a 5-month-old patient with a hammock mitral valve and accompanying aortopulmonary window.
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Affiliation(s)
- Baran Simsek
- Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Turkey
| | - Arda Ozyuksel
- Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Turkey
- Department of Cardiovascular Surgery, Biruni University School of Medicine, Istanbul, Turkey
| | - Murat Saygi
- Department of Pediatric Cardiology, Medicana International Hospital, Istanbul, Turkey
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10
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Ghosh S, Halder V, Mittal A, Mishra A, Haranal M, Aggarwal P, Singh H, Barwad P, Naganur S, Thingnam SKS. Surgical outcomes of double-orifice mitral valve repair in patients with atrioventricular canal defects: a systematic review and meta-analysis. Cardiol Young 2023; 33:1506-1516. [PMID: 37518865 DOI: 10.1017/s1047951123002664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
INTRODUCTION Double-orifice mitral valve or left atrioventricular valve is a rare congenital cardiac anomaly that may be associated with an atrioventricular septal defect. The surgical management of double-orifice mitral valve/double-orifice left atrioventricular valve with atrioventricular septal defect is highly challenging with acceptable clinical outcomes. This meta-analysis is aimed to evaluate the surgical outcomes of double-orifice mitral valve/double-orifice left atrioventricular valve repair in patients with atrioventricular septal defect. METHODS AND RESULTS A total of eight studies were retrieved from the literature by searching through PubMed, Google Scholar, Embase, and Cochrane databases. Using Bayesian hierarchical models, we estimated the pooled proportion of incidence of double-orifice mitral valve/double-orifice left atrioventricular valve with atrioventricular septal defect as 4.88% in patients who underwent surgical repair (7 studies; 3295 patients; 95% credible interval [CI] 4.2-5.7%). As compared to pre-operative regurgitation, the pooled proportions of post-operative regurgitation were significantly low in patients with moderate status: 5.1 versus 26.39% and severe status: 5.7 versus 29.38% [8 studies; 171 patients]. Moreover, the heterogeneity test revealed consistency in the data (p < 0.05). Lastly, the pooled estimated proportions of early and late mortality following surgical interventions were low, that is, 5 and 7.4%, respectively. CONCLUSION The surgical management of moderate to severe regurgitation showed corrective benefits post-operatively and was associated with low incidence of early mortality and re-operation.
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Affiliation(s)
| | | | | | - Amit Mishra
- Department of CTVS, PGIMER, Chandigarh, India
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11
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Kaneko T, Miyazaki S, Koike T, Murata A, Morimoto R, Hirose K, Takamura K, Endo D, Amano A, Minamino T. Atypical Shone's Complex Diagnosed at 70 Years Old: Presenting with Double-orifice Mitral Valve, Bicuspid Aortic Valve, and Aortic Coarctation. Intern Med 2022; 61:1367-1370. [PMID: 34670894 PMCID: PMC9152849 DOI: 10.2169/internalmedicine.8176-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Atypical Shone's complex is a rare congenital anomaly involving a left-sided obstructive lesion of two or three cardiovascular levels. A 70-year-old man with dyspnea on exertion was diagnosed with severe aortic stenosis (AS) with a bicuspid valve, complicated by severe aortic coarctation (CoA) and a double-orifice mitral valve. He underwent surgery for AS and CoA in one session. It is important to search for complicated malformations, even in cases of bicuspid aortic valve found in old age.
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Affiliation(s)
- Tomohiro Kaneko
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Sakiko Miyazaki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Takuma Koike
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Azusa Murata
- Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Japan
| | - Ryoko Morimoto
- Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Japan
| | - Kuniaki Hirose
- Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Japan
| | - Kazuhisa Takamura
- Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Japan
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University School of Medicine, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University School of Medicine, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Japan
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12
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Wang L, Fang L, Li Y, Xie M, Zhang L. OUP accepted manuscript. Eur Heart J Cardiovasc Imaging 2022; 23:e263. [PMID: 35134832 DOI: 10.1093/ehjci/jeac025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lufang Wang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Lingyun Fang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yuman Li
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Mingxing Xie
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Li Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
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13
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Mandeş L, Roşca M, Ciupercă D, Popescu BA. The role of echocardiography for diagnosis and prognostic stratification in hypertrophic cardiomyopathy. J Echocardiogr 2020; 18:137-148. [PMID: 32301048 PMCID: PMC7473965 DOI: 10.1007/s12574-020-00467-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/01/2020] [Accepted: 03/10/2020] [Indexed: 12/15/2022]
Abstract
Hypertrophic cardiomyopathy (HCM) is the most frequent cardiac disease with genetic substrate, affecting about 0.2-0.5% of the population. While most of the patients with HCM have a relatively good prognosis, some are at increased risk of adverse events. Identifying such patients at risk is important for optimal treatment and follow-up. While clinical and electrocardiographic information plays an important role, echocardiography remains the cornerstone in assessing patients with HCM. In this review, we discuss the role of echocardiography in diagnosing HCM, the key features that differentiate HCM from other diseases and the use of echocardiography for risk stratification in this setting (risk of sudden cardiac death, heart failure, atrial fibrillation and stroke). The use of modern echocardiographic techniques (deformation imaging, 3D echocardiography) refines the diagnosis and prognostic assessment of patients with HCM. The echocardiographic data need to be integrated with clinical data and other information, including cardiac magnetic resonance, especially in challenging cases or when there is incomplete information, for the optimal management of these patients.
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Affiliation(s)
- Leonard Mandeş
- University of Medicine and Pharmacy "Carol Davila", Euroecolab, Bucharest, Romania
- Emergency Institute for Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Şos. Fundeni 258, Sector 2, 022328, Bucharest, Romania
| | - Monica Roşca
- University of Medicine and Pharmacy "Carol Davila", Euroecolab, Bucharest, Romania
- Emergency Institute for Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Şos. Fundeni 258, Sector 2, 022328, Bucharest, Romania
| | - Daniela Ciupercă
- University of Medicine and Pharmacy "Carol Davila", Euroecolab, Bucharest, Romania
| | - Bogdan A Popescu
- University of Medicine and Pharmacy "Carol Davila", Euroecolab, Bucharest, Romania.
- Emergency Institute for Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Şos. Fundeni 258, Sector 2, 022328, Bucharest, Romania.
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14
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Jain CC, Warnes CA, Egbe AC, Cetta F, DuBrock HM, Connolly HM, Miranda WR. Hemodynamics in Adults With the Shone Complex. Am J Cardiol 2020; 130:137-142. [PMID: 32703525 DOI: 10.1016/j.amjcard.2020.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/31/2020] [Accepted: 06/05/2020] [Indexed: 12/11/2022]
Abstract
Patients with Shone complex (SC) have multiple left-sided obstructive lesions and thus are at risk for left ventricular (LV) remodeling, LV diastolic dysfunction and pulmonary hypertension. Yet, to date, there has been no description of hemodynamics in adults with SC. Retrospective chart review of 25 patients with SC who underwent cardiac catheterization at Mayo Clinic, MN between 2002 and 2019 was performed. SC was defined as multiple left-sided obstructive lesions in the presence of an anatomically abnormal mitral valve. Median age was 32 years (22.5, 42) and 15 patients (60%) were female. The majority of patients (84%) had history of coarctation of the aorta, 10 (40%) had subaortic stenosis, 11 (44%) had prior aortic valve replacement, and 10 (40%) had prior mitral valve replacement. Structural disease at the time of catheterization which warranted intervention within the next year was present in 13 patients (52%). The mean LV end-diastolic pressure was 21.3 ± 9.0 mm Hg (>15 mm Hg in 71%), pulmonary artery peak systolic pressure was 55.4 ± 13.4 mm Hg, and the pulmonary artery mean pressure was 37.0 ± 9.4 mm Hg (>20 mm Hg in 96%). During a mean follow-up of 8.3 ± 4.4 years, there were 7 deaths (28%) and 3 additional patients (12%) underwent cardiac transplantation. In conclusion, adults with SC who underwent catheterization showed significant left-sided heart and pulmonary vascular remodeling. Elevated LV end-diastolic pressure and pulmonary artery pressures were highly prevalent. There were high mortality and cardiac transplant rates in our cohort.
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Affiliation(s)
- C Charles Jain
- Department of Cardiovascular Medicine, Mayo Clinic, Minnesota
| | - Carole A Warnes
- Department of Cardiovascular Medicine, Mayo Clinic, Minnesota
| | | | - Frank Cetta
- Department of Cardiovascular Medicine, Mayo Clinic, Minnesota; Department of Pediatric and Adolescent Medicine/Division of Pediatric Cardiology, Mayo Clinic, Minnesota
| | - Hilary M DuBrock
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
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15
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Cohen J, Levasseur S, Simpson L, Miller R, Freud L. Fetal cardiac findings and hemodynamic changes associated with severe lower urinary tract obstruction in utero. Ultrasound Obstet Gynecol 2019; 54:780-785. [PMID: 30908816 DOI: 10.1002/uog.20271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 03/12/2019] [Accepted: 03/19/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To describe fetal echocardiographic findings associated with lower urinary tract obstruction (LUTO) and to compare anatomic and hemodynamic measurements between fetuses with LUTO and gestational age (GA)-matched controls, with an emphasis on quantitative indices of diastolic function and cardiac output. METHODS This was a retrospective cohort study of fetuses diagnosed with severe LUTO with giant bladder, which underwent at least one fetal echocardiogram at our center between January 2005 and June 2018. Fetuses with major congenital heart disease were excluded. Control fetuses did not have any structural or functional abnormalities and were GA-matched to the LUTO fetuses based on the time of the first fetal echocardiogram. Cardiac anatomy and hemodynamic measurements were compared between fetuses with LUTO and controls. In infants with LUTO, serial fetal and postnatal echocardiographic data were assessed, when available, and clinical outcomes were reviewed. RESULTS Twenty-six fetuses with LUTO and at least one fetal echocardiogram available were identified, one of which was excluded due to hypoplastic left heart syndrome, leaving 25 LUTO fetuses in the final cohort. The mean GA at the first fetal echocardiogram was 25.4 ± 5.1 weeks in the LUTO group and 25.3 ± 5.0 weeks in the control group. Common findings in fetuses with LUTO included cardiomegaly (40%), pericardial effusion (44%), right ventricular (RV) hypertrophy (64%) and left ventricular (LV) hypertrophy (48%). Compared with GA-matched controls, LUTO fetuses had lower ascending aorta Z-score (-0.10 ± 0.94 vs -0.93 ± 1.03; P = 0.02) and aortic isthmus Z-score (-0.14 ± 0.86 vs -1.62 ± 1.11; P < 0.001), shorter mitral valve inflow time indexed to cardiac cycle length (0.46 ± 0.04 vs 0.41 ± 0.06; P = 0.002), and worse (increased) LV myocardial performance index (0.39 ± 0.03 vs 0.44 ± 0.04; P < 0.001). In addition, the ratio of RV to LV cardiac index was higher in LUTO fetuses compared with controls (1.62 ± 0.13 vs 1.33 ± 0.11; P < 0.001). Of the 25 LUTO pregnancies, two were lost to follow-up, three underwent elective termination of pregnancy and three ended in intrauterine fetal demise. Four (16%) patients had mildly hypoplastic left-heart structures, comprising two with aortic arch hypoplasia and two with mitral and aortic stenosis. CONCLUSION In addition to presenting with cardiomegaly, pericardial effusion and ventricular hypertrophy, fetuses with LUTO demonstrate LV diastolic dysfunction and appear to redistribute cardiac output as compared to control fetuses, which may contribute to the development of left-heart hypoplasia. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- J Cohen
- Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - S Levasseur
- Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - L Simpson
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - R Miller
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - L Freud
- Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY, USA
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Affiliation(s)
- Yaron D Barac
- The Division of Cardiovascular and Thoracic Surgery at Duke University Medical Center, Durham, NC, USA
| | - Donald D Glower
- The Division of Cardiovascular and Thoracic Surgery at Duke University Medical Center, Durham, NC, USA.
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17
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Sinha M, Pandey NN, Sharma A, Parashar N, Rajagopal R, Kumar S. Left ventricular outflow tract obstruction by thickened anterior mitral valve leaflet in a patient with tetralogy of Fallot. J Cardiovasc Comput Tomogr 2019; 14:e113-e114. [PMID: 31439446 DOI: 10.1016/j.jcct.2019.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/07/2019] [Accepted: 07/21/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Mumun Sinha
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Niraj Nirmal Pandey
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Arun Sharma
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Nitin Parashar
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Rengarajan Rajagopal
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Sanjeev Kumar
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India.
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18
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Al-Atta A, Khan H, Sosin M. Accessory Mitral Valve Tissue Causing Features Of Left Ventricular Outflow Tract Obstruction-A Case Report And Updated Literature Review. J Ayub Med Coll Abbottabad 2019; 31:276-278. [PMID: 31094131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Accessory mitral valve tissue is a rare congenital anomaly that is commonly incidentally diagnosed. When symptomatic, it tends to present with features of left ventricular outflow (LVOT) obstruction in about two thirds of cases. It is also commonly associated with other congenital anomalies, notably ventricular septal defects. Transthoracic echocardiography is a very useful diagnostic test to make a diagnosis and its widespread use will increase detection of this condition. We are presenting a case of a 29-year-old lady who presented with breathlessness in the third trimester of pregnancy and was subsequently found to have evidence of accessory mitral valve tissue on echocardiography.
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19
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Ikeno Y, Yokawa K, Henmi S, Nakai H, Yamanaka K, Inoue T, Tanaka H, Tanaka H, Hirata K, Okita Y. A successful report of mitral valve repair for parachute-like mitral valve in adult. Gen Thorac Cardiovasc Surg 2018; 68:287-289. [PMID: 30565035 DOI: 10.1007/s11748-018-1047-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 11/28/2018] [Indexed: 11/26/2022]
Abstract
A 65 year-old man was diagnosed with congestive heart failure secondary to severe mitral regurgitation resulting from a parachute-like asymmetrical mitral valve. We performed mitral annuloplasty and triangular resection of the thick tissue. The postoperative course was uneventful with no recurrence of mitral regurgitation.
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Affiliation(s)
- Yuki Ikeno
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, 650-0017, Kobe, Japan.
| | - Koki Yokawa
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, 650-0017, Kobe, Japan
| | - Soichiro Henmi
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, 650-0017, Kobe, Japan
| | - Hidekazu Nakai
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, 650-0017, Kobe, Japan
| | - Katsuhiro Yamanaka
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, 650-0017, Kobe, Japan
| | - Takeshi Inoue
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, 650-0017, Kobe, Japan
| | | | - Hiroshi Tanaka
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, 650-0017, Kobe, Japan
| | | | - Yutaka Okita
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, 650-0017, Kobe, Japan
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20
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Groarke JD, Galazka PZ, Cirino AL, Lakdawala NK, Thune JJ, Bundgaard H, Orav EJ, Levine RA, Ho CY. Intrinsic mitral valve alterations in hypertrophic cardiomyopathy sarcomere mutation carriers. Eur Heart J Cardiovasc Imaging 2018; 19:1109-1116. [PMID: 30052928 PMCID: PMC6148328 DOI: 10.1093/ehjci/jey095] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/29/2018] [Accepted: 06/21/2018] [Indexed: 11/13/2022] Open
Abstract
Aims Mitral valve (MV) abnormalities are recognized features of hypertrophic cardiomyopathy (HCM), and there is preliminary evidence suggesting they are intrinsic phenotypic manifestations of sarcomere mutations, present in mutation carriers without left ventricular (LV) hypertrophy (subclinical HCM). However, further study is required to characterize the nature of these changes and their functional impact. Thus, we performed comprehensive echocardiographic analysis of MV structure and function on a genotyped population. Methods and results MV and papillary muscle echocardiographic parameters were measured in 192 genotyped individuals, including 50 overt HCM, 79 subclinical HCM, and 63 mutation-negative, healthy relatives as normal controls. Compared to controls, subclinical HCM subjects had elongated anterior MV leaflets relative to LV end-diastolic volume index (0.57 ± 0.02 vs. 0.51 ± 0.02 mm/mL/m2, P = 0.013) and anteriorly displaced papillary muscles [decreased papillary-septal separation (31.1 ± 0.7 vs. 34.2 ± 0.9 mm, P = 0.004) and relative antero-posterior position ratio of the papillary muscles (0.67 ± 0.01 vs. 0.71 ± 0.01, P = 0.011]. Similar findings were identified comparing overt HCM to controls. These MV changes were associated with an increased prevalence of systolic anterior motion (SAM) of the MV amongst subclinical HCM subjects. Conclusions Sarcomere mutations are associated with primary abnormalities of the MV apparatus, specifically excess anterior leaflet length relative to LV cavity size and anterior displacement of the papillary muscles; both features predisposing to SAM. These abnormalities appear to be early phenotypic consequences of sarcomere mutations, observed in mutation carriers with normal LV wall thickness.
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Affiliation(s)
- John D Groarke
- Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, USA
| | - Patrycja Z Galazka
- Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, USA
| | - Allison L Cirino
- Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, USA
| | - Neal K Lakdawala
- Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, USA
| | - Jens J Thune
- Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Bispebjerg Bakke 23, Denmark
| | - Henning Bundgaard
- The Unit for Inherited Cardiac Diseases, The Heart Center, Rigshospitalet, Copenhagen Health Science Partners, Copenhagen University, Blegdamsvej 9, Denmark
| | - E John Orav
- Division of General Medicine, Brigham and Women’s Hospital, Boston, 75 Francis Street, MA USA
| | - Robert A Levine
- Cardiology Division, Massachusetts General Hospital, 32 Fruit Street, Boston, MA, USA
| | - Carolyn Y Ho
- Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, USA
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21
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D'Amore A, Luketich SK, Raffa GM, Olia S, Menallo G, Mazzola A, D'Accardi F, Grunberg T, Gu X, Pilato M, Kameneva MV, Badhwar V, Wagner WR. Heart valve scaffold fabrication: Bioinspired control of macro-scale morphology, mechanics and micro-structure. Biomaterials 2018; 150:25-37. [PMID: 29031049 PMCID: PMC5988585 DOI: 10.1016/j.biomaterials.2017.10.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/19/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
Abstract
Valvular heart disease is currently treated with mechanical valves, which benefit from longevity, but are burdened by chronic anticoagulation therapy, or with bioprosthetic valves, which have reduced thromboembolic risk, but limited durability. Tissue engineered heart valves have been proposed to resolve these issues by implanting a scaffold that is replaced by endogenous growth, leaving autologous, functional leaflets that would putatively eliminate the need for anticoagulation and avoid calcification. Despite the diversity in fabrication strategies and encouraging results in large animal models, control over engineered valve structure-function remains at best partial. This study aimed to overcome these limitations by introducing double component deposition (DCD), an electrodeposition technique that employs multi-phase electrodes to dictate valve macro and microstructure and resultant function. Results in this report demonstrate the capacity of the DCD method to simultaneously control scaffold macro-scale morphology, mechanics and microstructure while producing fully assembled stent-less multi-leaflet valves composed of microscopic fibers. DCD engineered valve characterization included: leaflet thickness, biaxial properties, bending properties, and quantitative structural analysis of multi-photon and scanning electron micrographs. Quasi-static ex-vivo valve coaptation testing and dynamic organ level functional assessment in a pressure pulse duplicating device demonstrated appropriate acute valve functionality.
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Affiliation(s)
- Antonio D'Amore
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Fondazione RiMED, Italy; Dipartimento innovazione industriale e digitale (DIIT), Università di Palermo, Italy
| | - Samuel K Luketich
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Giuseppe M Raffa
- Istituto mediterraneo trapianti e terapie ad alta specializzazione (ISMETT), UPMC, Italy
| | - Salim Olia
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Artificial Heart Program, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Giorgio Menallo
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Antonino Mazzola
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Dipartimento innovazione industriale e digitale (DIIT), Università di Palermo, Italy
| | - Flavio D'Accardi
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Dipartimento innovazione industriale e digitale (DIIT), Università di Palermo, Italy
| | - Tamir Grunberg
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; ORT Braude College of Engineering, Israel
| | - Xinzhu Gu
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michele Pilato
- Istituto mediterraneo trapianti e terapie ad alta specializzazione (ISMETT), UPMC, Italy
| | - Marina V Kameneva
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vinay Badhwar
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Dep. of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA
| | - William R Wagner
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
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22
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Rodríguez-Santamarta M, Estévez-Loureiro R, Benito-González T, Gualis J, Garrote C, Pérez de Prado A, Fernández-Vázquez F. Trileaflet Mitral Valve Treated with the MitraClip® System. J Heart Valve Dis 2017; 26:589-591. [PMID: 29762929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 79-year-old woman with a history of ischemic dilated cardiomyopathy, severely depressed left ventricular ejection fraction and significant mitral regurgitation (MR) was admitted to the authors´ institution for percutaneous mitral valve repair. Transesophageal echocardiography (TEE) revealed the presence of a posterior mitral cleft at the P2 level, causing a trileaflet mitral valve that contributed significantly to the regurgitant jet. The procedure was performed under general anesthesia and guided by real-time three-dimensional TEE. Three MitraClip® devices (Abbott Vascular, Santa Clara, CA, USA) were implanted, which reduced the MR to grade 1+.
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Affiliation(s)
- Miguel Rodríguez-Santamarta
- Departamento de Cardiología, Complejo Asistencial Universitario de León, León, Spain. Electronic correspondence:
| | | | - Tomás Benito-González
- Departamento de Cardiología, Complejo Asistencial Universitario de León, León, Spain
| | - Javier Gualis
- Departamento de Cardiología, Complejo Asistencial Universitario de León, León, Spain
| | - Carmen Garrote
- Departamento de Cardiología, Complejo Asistencial Universitario de León, León, Spain
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23
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De Rosa R, Schranz D, Vasa-Nicotera M, Assmus B, Risteski P, Moritz A, Zeiher AM, Fichtlscherer S. Percutaneous Therapy of a Stenotic Parachute Mitral Valve Previously Treated by Surgery. J Heart Valve Dis 2017; 26:488-491. [PMID: 29302951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Parachute mitral valve (PMV) is a congenital heart anomaly which consists of a unifocal attachment of the mitral valve chordae into a single or dominant papillary muscle. This morphological anomaly determines the impairment of mitral leaflet motion, resulting in different grades of mitral stenosis. Due to its frequent association with other congenital cardiac defects requiring surgical correction, the therapy of a relevant stenotic PMV is usually represented by surgical commissurotomy. Herein is reported the case of a PMV treated by surgery in infancy, which showed a severe restenosis after 34 years and was successfully treated by percutaneous valvuloplasty with the additional creation of a restrictive atrial communication.
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Affiliation(s)
- Roberta De Rosa
- Division of Cardiology, Department of Medicine III, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany. Electronic correspondence:
| | - Dietmar Schranz
- Hessisches Kinderherzzentrum and Pediatric Heart Center, Justus-Liebig University, Giessen, Germany
| | - Mariuca Vasa-Nicotera
- Division of Cardiology, Department of Medicine III, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Birgit Assmus
- Division of Cardiology, Department of Medicine III, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Petar Risteski
- Division of Thoracic and Cardiovascular Surgery, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Anton Moritz
- Division of Thoracic and Cardiovascular Surgery, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Andreas M Zeiher
- Division of Cardiology, Department of Medicine III, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Stephan Fichtlscherer
- Division of Cardiology, Department of Medicine III, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
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24
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Khalpey Z, Rawashdeh B, Kazui T, Lick S. Bileaflet Foldoplasty in Barlows Disease. J Heart Valve Dis 2017; 26:355-357. [PMID: 29092123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Mitral valve repair is a feasible and preferable option for the treatment of Barlow's disease. Complex valve repair techniques, in contrast, often lead to increased cross-clamp times and low cardiac output syndrome. A simple, fast, and reproducible foldoplasty technique to reduce anterior and posterior mitral leaflet heights may improve coaptation and reduce mitral regurgitation. Accordingly, herein are described minimally invasive, successful trans-septal and robotic approaches for a bileaflet foldoplasty technique in two patients with Barlow's disease.
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Affiliation(s)
- Zain Khalpey
- Banner University Medical Center - Tucson, Tucson, AZ, USA
- University of Arizona, Department of Surgery, Division of Cardiothoracic Surgery, Tucson, AZ, USA. Electronic correspondence:
| | - Badi Rawashdeh
- Emory University, Department of Cardiac Surgery, Atlanta, GA, USA
| | - Toshinobu Kazui
- Banner University Medical Center - Tucson, Tucson, AZ, USA
- University of Arizona, Department of Surgery, Division of Cardiothoracic Surgery, Tucson, AZ, USA
| | - Scott Lick
- Banner University Medical Center - Tucson, Tucson, AZ, USA
- University of Arizona, Department of Surgery, Division of Cardiothoracic Surgery, Tucson, AZ, USA
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25
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Sivri S, Bastug S, Can Guney M, Alsancak Y, Ozdemir E, Bozkurt E. Quadricuspid Aortic Valve Associated with Aortic Regurgitation, Mitral Regurgitation, and Aortic Dilatation. J Heart Valve Dis 2017; 26:243-246. [PMID: 28820561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The quadricuspid aortic valve (QAV) is a very uncommon congenital malformation with an estimated incidence of 0.003% to 0.043% of all congenital heart diseases. Combinations of QAV with several different congenital malformations have been described. The case is reported of a type A QAV associated with moderate aortic regurgitation, mild mitral regurgitation, and ascending aorta dilatation. This interesting case was referred for close follow up.
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Affiliation(s)
- Serkan Sivri
- Ahi Evran University Education and Research Hospital, Division of Cardiology, Kırşehir, Turkey. Electronic correspondence:
| | - Serdal Bastug
- Atatürk Education and Research Hospital, Division of Cardiology, Ankara, Turkey
| | - Murat Can Guney
- Yıldırım Beyazıt University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Yakup Alsancak
- Atatürk Education and Research Hospital, Division of Cardiology, Ankara, Turkey
| | - Elcin Ozdemir
- Yıldırım Beyazıt University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Engin Bozkurt
- Yıldırım Beyazıt University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey
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26
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Wilkes JK, Fraser CD, Seery TJ. 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 2017; 43:543-545. [PMID: 28100980 DOI: 10.14503/thij-15-5675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
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. We found only one other report of this atrioventricular valve abnormality in association with atrioventricular septal defect. To our knowledge, our patient (at a body weight of 1,800 g) is the smallest to survive corrective surgery of an accessory mitral valve leaflet with severe left ventricular outflow tract obstruction. In addition to our patient's case, we discuss the relevant medical literature.
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Misumi I, Nagao A, Iwamoto K, Honda T, Ishii M, Ueyama H, Maeda Y, Ishizaki M, Kurisaki R, Okazaki T, Yamashita T, Fujimoto A, Honda Y. Acute Multiple Cerebral Infarction in a Patient with an Accessory Mitral Valve. Intern Med 2017; 56:153-155. [PMID: 28090044 PMCID: PMC5337459 DOI: 10.2169/internalmedicine.56.7649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A 96-year-old woman developed hemiparesis 2 weeks after orthopedic surgery. Magnetic resonance imaging revealed multiple cerebral infarctions in the bilateral hemisphere. Transthoracic echocardiography revealed a mobile structure attached to the anterior mitral leaflet that protruded toward the left ventricular outflow tract. The structure was identified as an accessory mitral valve. Doppler echocardiography showed that there was no significant left ventricular outflow obstruction. This is a rare case of a silent accessory mitral valve that was detected after multiple cerebral infarctions.
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Affiliation(s)
- Ikuo Misumi
- Department of Cardiology, Kumamoto Saisyunsou Hospital, Japan
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Abstract
Double-orifice mitral valve is a rare congenital anomaly. Although it is more frequently associated with other cardiac abnormalities, it may occur as an isolated lesion. There are 2 forms of myocardial noncompaction: isolated and nonisolated myocardial noncompaction. Nonisolated myocardial noncompactions are occasionally reported postnatally in association with congenital heart anomalies such as ventricular septal defect, pulmonic stenosis, and atrial septal defect. To our knowledge, this is the first case presentation reporting a double-orifice mitral valve associated with nonisolated myocardial noncompaction.
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Affiliation(s)
- Sevket Gorgulu
- Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Department, Istanbul, Turkey.
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29
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Mohan JC, Shukla M, Mohan V, Sethi A. Spectrum of congenital mitral valve abnormalities associated with solitary undifferentiated papillary muscle in adults. Indian Heart J 2016; 68:639-645. [PMID: 27773402 PMCID: PMC5079137 DOI: 10.1016/j.ihj.2015.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/18/2015] [Accepted: 12/21/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Congenital anomaly wherein the mitral valve leaflets are directly attached to the papillary muscle(s) (PM) with or without short under-developed chords is rarely reported in adults. Patients with two PMs with an intervening fibrous bridge have also been included under this head in previous studies. METHODS Echocardiography enables accurate evaluation of the morphology and function of valve leaflets, chordae tendineae, and PM. This report describes a series of six patients aged 56-84 years who had abnormal mitral valve with a large solitary and anomalously inserted PM seen over a period of 3 years. Only those patients who had a single pillar or bridge-like PM and either absent tendinous chords or small under-developed chords were included in the analysis. RESULTS Among 9600 consecutive echocardiograms performed, six patients met the criteria of an abnormal mitral valve with solitary large PM. Two patients underwent mitral valve replacement with partial excision of the PM wherein echocardiographic observations were confirmed. The patients were previously followed with the diagnosis of hypertrophic cardiomyopathy (3) and rheumatic mitral valve disease (3). Multi-planar reconstruction of 3D echocardiographic images provided incremental value in assessing the detailed patho-anatomy of PMs in these cases. CONCLUSION In adult patients, a high index of suspicion is required to detect congenital mitral stenosis/regurgitation with large solitary PM (resembling a parachute mitral valve) which may masquerade as hypertrophic cardiomyopathy or rheumatic mitral valve disease.
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Affiliation(s)
- Jagdish C Mohan
- Fortis Institute of Cardiac Sciences, Fortis Hospital, Shalimar Bagh, New Delhi 110088, India.
| | - Madhu Shukla
- Fortis Institute of Cardiac Sciences, Fortis Hospital, Shalimar Bagh, New Delhi 110088, India
| | - Vishwas Mohan
- Fortis Institute of Cardiac Sciences, Fortis Hospital, Shalimar Bagh, New Delhi 110088, India
| | - Arvind Sethi
- Fortis Institute of Cardiac Sciences, Fortis Hospital, Shalimar Bagh, New Delhi 110088, India
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30
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Osovska NY, Kuzminova NV, Knyazkova II. Cardiac arrhythmias in adolescents with mitral valve prolapse and myxomatous degeneration of mitral valve leaflets. Wiad Lek 2016; 69:730-733. [PMID: 28214804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
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. Patients were divided into four groups according to the degree of myxomatous degeneration (MD): group 1 - 29 patients without MD; group 2 - 43 patients with MD and 3-4 mm leaflets thickness; group 3 - patients with MD and 5-6 mm leaflets thickness; group 4 - patients with MD and 7-8 mm leaflets thickness. Our own methods used to determine the degree of MD are presented in the paper. RESULTS in general, significant increase in the total number of both ventricular and supraventricular arrhythmias was observed in all patients with myxomatous degeneration when compared with the group of patients with no MD. While in patients from group 2 the number of ventricular premature beats was 6.5 times higher than in group 1, it was 10 times higher in group 3 and 20 times higher in group 4. The same significant changes (p < 0.05) were seen in extrasystoles in Lown's grading (increase from grade I to grade IV), the episodes of ventricular tachycardia (VT) and their number, mean heart rate as well as maximal duration of ventricular tachycardia episodes. CONCLUSIONS thus, the presence of MD of mitral valve leaflets in MVP and its degree of severity in particular, were found to be the major risk factor in arrhythmia development.
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Affiliation(s)
- N Y Osovska
- Department Of Internal Therapy №1 Of Vinnitsa National Pirogov Memorial Medical University, Vinnitsa, Ukraine, e-mail:
| | - N V Kuzminova
- Department Of Internal Therapy №1 Of Vinnitsa National Pirogov Memorial Medical University, Vinnitsa, Ukraine
| | - I I Knyazkova
- Department Of Clinical Pharmacology Of Kharkiv National Medical University, Kharkiv, Ukraine
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31
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Vistarini N, Belaidi M, Desjardins G, Pellerin M. Parachute Mitral Valve. Can J Cardiol 2015; 32:1261.e5-1261.e6. [PMID: 27568105 DOI: 10.1016/j.cjca.2015.10.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 11/17/2022] Open
Affiliation(s)
- Nicola Vistarini
- Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Canada; Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Pavia University School of Medicine, Pavia, Italy
| | - Mustapha Belaidi
- Department of Anesthesia, Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | - Georges Desjardins
- Department of Anesthesia, Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | - Michel Pellerin
- Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Canada.
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32
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Segreto A, De Salvatore S, Chiusaroli A, Bizzarri F, Van Wyk C, Congiu S. Double-Orifice Mitral Valve in an Eight-Year-Old Boy. J Heart Valve Dis 2015; 24:522-524. [PMID: 26897828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The case is described of an eight-year-old boy who required an operation for moderate mitral regurgitation due to a double-orifice mitral valve (DOMV). The DOMV, which was clearly demonstrated by transthoracic echocardiography, had a central fibrous bridge. Mitral valve repair using a 5/0 Prolene suture placed at the level of the superior commissure of each hole to stabilize the valve, and ring annuloplasty with Edwards Physio ring, was successfully performed. Intraoperative real-time transesophageal echocardiography showed the repaired DOMV to be without regurgitation or stenosis.
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33
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Yamaguchi S. Reply: To PMID 25193197. Ann Thorac Surg 2015; 99:2254. [PMID: 26046896 DOI: 10.1016/j.athoracsur.2015.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 12/20/2014] [Accepted: 01/05/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Shojiro Yamaguchi
- Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Takara-machi 13-1, Kanazawa, Japan 920-8641.
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34
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Affiliation(s)
- Samet Yilmaz
- Turkey Yuksek Ihtisas Education and Research Hospital, 06100, Sihhiye, Ankara, Turkey.
| | - Süleyman Kalayci
- Turkey Yuksek Ihtisas Education and Research Hospital, 06100, Sihhiye, Ankara, Turkey.
| | - Zehra Gölbaşi
- Turkey Yuksek Ihtisas Education and Research Hospital, 06100, Sihhiye, Ankara, Turkey.
| | - Omac Tüfekcioglu
- Turkey Yuksek Ihtisas Education and Research Hospital, 06100, Sihhiye, Ankara, Turkey.
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35
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Li D, Lin K, An Q, Feng Y. Surgical treatment following transcatheter intervention in an adult patient with supravalvar mitral ring, large patent ductus arteriosus and severe pulmonary hypertension. Int J Cardiol 2014; 177:146-8. [PMID: 25499363 DOI: 10.1016/j.ijcard.2014.09.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 08/26/2014] [Accepted: 09/16/2014] [Indexed: 02/05/2023]
Affiliation(s)
- Dongxu Li
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Sichuan, People's Republic of China
| | - Ke Lin
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Sichuan, People's Republic of China.
| | - Qi An
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Sichuan, People's Republic of China
| | - Yuan Feng
- Department of Cardiology, West China Hospital, Sichuan University, Sichuan, People's Republic of China.
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36
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Meenakshi K, Chidambaram S, Dhandapani VE, Rameshwar R. A Rare Association of Parachute Mitral Valve with Double Outlet Right Ventricle and Severe Pulmonary Hypertension in an Adult. J Assoc Physicians India 2014; 62:50-52. [PMID: 26281483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Congenital mitral stenosis (MS) is a rare congenital cardiac malformation and the obstruction to the flow across the mitral valve can be caused by supramitral ring, commissural fusion, short chordae, anomalous mitral arcade, anomalous position of the papillary muscles and the so-called'parachute mitral valve'. We describe here the case of a 47 year old male diagnosed to have a double outlet right ventricle (DORV), subaortic ventricular septal defect (VSD) with no pulmonary stenosis, severe pulmonary hypertension and congenital MS due to parachute mitral valve.
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37
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Donmez E, Seker T, Icen YK, Elbasan Z, Gur M, Cayli M. Incidental asymptomatic accessory mitral valve: a differential diagnosis for intracardiac mass. ACTA MEDICA PORT 2014; 27:779-82. [PMID: 25641295 DOI: 10.20344/amp.5006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 09/19/2014] [Indexed: 11/20/2022]
Abstract
Accessory mitral valve is a rare entity which is commonly detected in children. It might present as a cause for left ventricular outflow obstruction, aortic regurgitation or a source for thromboembolic event. Diagnosis is based on echocardiographic findings, transesophageally when possible. Usually treatment is not required however treatment decisions are based on associated abnormalities and symptoms. Our aim is to report a case which was referred to our clinic as a suspected intracardiac mass.
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Affiliation(s)
- Esra Donmez
- Department of Cardiology. Adana Numune Research and Training Hospital. Istanbul. Turkey
| | - Taner Seker
- Department of Cardiology. Adana Numune Research and Training Hospital. Istanbul. Turkey
| | - Yahya Kemal Icen
- Department of Cardiology. Adana Numune Research and Training Hospital. Istanbul. Turkey
| | - Zafer Elbasan
- Department of Cardiology. Adana Numune Research and Training Hospital. Istanbul. Turkey
| | - Mustafa Gur
- Department of Cardiology. Adana Numune Research and Training Hospital. Istanbul. Turkey
| | - Murat Cayli
- Department of Cardiology. Adana Numune Research and Training Hospital. Istanbul. Turkey
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38
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Abstract
In industrially developed countries, moderate or severe mitral valve disease is relatively common and is usually caused by prolapse or is secondary to left ventricular disease. Mitral stenosis (MS), however, is uncommon and usually a sequela of rheumatic fever. This article discusses the natural history of mitral regurgitation and MS and their medical and surgical management.
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Affiliation(s)
- R Ray
- Cardiothoracic Centre, Guy's and St Thomas' Hospitals, London, UK
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39
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Mochizuki Y, Tanaka H, Fukuda Y, Hirata KI. An uncommon case of isolated parachute-like asymmetric mitral valve in an adult. J Heart Valve Dis 2014; 23:651-653. [PMID: 25799716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 31-year-old asymptomatic male was referred to hospital for an examination of right bundle brunch block. Both, transthoracic and transesophageal echocardiography revealed normal left ventricular function, and two different-sized papillary muscles; the anterolateral muscle was more pronounced, with almost major chordae tendineae inserted into this dominant muscle, whereas the immature, flat posteromedial papillary muscle had very short chordae tendineae and was located higher in the left ventricle, inserted directly into the mitral annulus. The mitral valve orifice was eccentrically located at the lateral side, but no significant mitral stenosis or regurgitation was observed. No other congenital heart anomalies were identified. Thus, the final diagnosis was isolated parachute-like asymmetric mitral valve (PLAMV), without any other congenital heart anomalies. The patient was followed up closely with periodic echocardiographic examinations. Parachute mitral valve is a rare congenital cardiac defect characterized by focalized attachment of the chordae tendineae of both leaflets to a single papillary muscle. In contrast to true parachute mitral valve, PLAMV has two separate papillary muscles, one of which is more pronounced and into which all chordae are inserted. PLAMV was highly associated with other congenital heart anomalies, and the involved dominant muscle was most frequently a posteromedial papillary muscle. Isolated PLAMV in an adult is even more rare, while the presence of an immature posteromedial papillary muscle--as in the present case--is extremely rare.
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40
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Homadanchi A, Abdullayeva A, Goebel B, Lichtenauer M. [Another smile of the mitral valve]. MMW Fortschr Med 2014; 156:5. [PMID: 25022071 DOI: 10.1007/s15006-014-3132-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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41
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Rajesh GN, Sajeer K, Nair A, Sajeev CG, Krishnan MN. Hammock mitral valve: a rare cause of congenital mitral regurgitation--a case report. Indian Heart J 2014; 66:370-1. [PMID: 24973848 PMCID: PMC4121745 DOI: 10.1016/j.ihj.2014.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 01/09/2014] [Accepted: 03/23/2014] [Indexed: 10/25/2022] Open
Abstract
Hammock valve, also known as anomalous mitral arcade is a rare mechanism for congenital mitral insufficiency. We report a case of a two-week-old neonate who presented with features of heart failure and an apical systolic murmur. Echocardiogram showed severe mitral regurgitation and abnormal mitral valve with direct attachment of mitral leaflets to papillary muscle without intervening chordae tendinae, typical of hammock valve. Heart failure was controlled with ionotrpes and diuretics. The literature on the hammock mitral valve is reviewed.
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Affiliation(s)
- Gopalan Nair Rajesh
- Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala 673008, India.
| | | | - Anishkumar Nair
- Senior Resident, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India
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42
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Ayoub C, Ranasinghe I, Yiannikas J. Successful negative inotropic treatment of acute left ventricular outflow tract obstruction by elongated mitral valve leaflet. J Clin Ultrasound 2014; 42:245-248. [PMID: 24115147 DOI: 10.1002/jcu.22094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 06/19/2013] [Accepted: 08/08/2013] [Indexed: 06/02/2023]
Abstract
Elongated anterior mitral valve leaflet (EAMVL) has not been reported to cause left ventricular outflow tract obstruction (LVOTO) in the absence of left ventricular hypertrophy. We report the case of an elderly male patient who presented with acute heart failure and severe mitral regurgitation in the setting of dehydration. Echocardiography revealed acute LVOTO secondary to EAMVL. The patient was ineligible for surgery and was treated with negative inotropic agents, which ensured resolution of heart failure and marked improvement in the degree of LVOTO. This case demonstrates that, under certain circumstances, EAMVL without associated left ventricular hypertrophy may produce hemodynamic compromise that can be successfully treated medically.
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Affiliation(s)
- Chadi Ayoub
- Department of Cardiology, The University of Sydney, Level 3 West, Concord Repatriation General Hospital. Hospital Road, Sydney, NSW 2139, Australia
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43
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Zhang J, Sun F, Ren W, Xiao Y, Zhan Y. Hypoplasia of the posterior mitral leaflet concurrent with a supravalvular mitral ring: a rare cause of congenital mitral stenosis. J Ultrasound Med 2014; 33:736-738. [PMID: 24658957 DOI: 10.7863/ultra.33.4.736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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44
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Liu X, He Y, Zhang Y, Li Z. Mitral valve dysplasia syndrome. J Ultrasound Med 2014; 33:358-359. [PMID: 24449742 DOI: 10.7863/ultra.33.2.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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45
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46
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Kharwar RB, Sharma A, Sethi R, Narain VS. Double orifice mitral valve with bicuspid aortic valve: evaluation by three-dimensional echocardiography. J Am Coll Cardiol 2013; 63:e1. [PMID: 24184247 DOI: 10.1016/j.jacc.2013.08.1646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 08/13/2013] [Indexed: 11/19/2022]
Affiliation(s)
| | - Akhil Sharma
- Department of Cardiology, King George's Medical University, Lucknow, India
| | - Rishi Sethi
- Department of Cardiology, King George's Medical University, Lucknow, India
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47
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Rowin EJ, Maron BJ, Lesser JR, Rastegar H, Maron MS. Papillary muscle insertion directly into the anterior mitral leaflet in hypertrophic cardiomyopathy, its identification and cause of outflow obstruction by cardiac magnetic resonance imaging, and its surgical management. Am J Cardiol 2013; 111:1677-9. [PMID: 23499271 DOI: 10.1016/j.amjcard.2013.01.340] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 01/24/2013] [Accepted: 01/24/2013] [Indexed: 11/19/2022]
Abstract
This case presents an uncommon but important mechanism of muscular left ventricular outflow obstruction in hypertrophic cardiomyopathy due to anomalous and direct papillary muscle insertion into the anterior mitral leaflet, a finding reliably identified clinically by cardiac magnetic resonance imaging. The identification of this left ventricular outflow tract morphology is important before invasive ventricular septal reduction therapy because it dictates a specific surgical strategy. These findings further support the role of cardiac magnetic resonance imaging in the early evaluation of hypertrophic cardiomyopathy patients.
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Affiliation(s)
- Ethan J Rowin
- Hypertrophic Cardiomyopathy Center, Division of Cardiology, Tufts Medical Center, Boston, Massachusetts, USA
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48
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Işılak Z, Deveci OS, Yalçın M, Incedayı M. Coexistence of accessory mitral papillary muscle and ventricular septal defect. Anadolu Kardiyol Derg 2013; 13:E15-E16. [PMID: 23443868 DOI: 10.5152/akd.2013.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Zafer Işılak
- Department of Cardiology, Gülhane Military Medical Academy, Haydarpaşa Hospital, İstanbul, Turkey.
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49
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Teo LLS, Hia CPP, Ling LH, Quek SC. Isolated cleft mitral valve with severe regurgitation resulting in a left inferior pulmonary vein varix diagnosed from cardiovascular magnetic resonance imaging. Pediatr Cardiol 2013; 34:1055-6. [PMID: 23143311 DOI: 10.1007/s00246-012-0573-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 10/11/2012] [Indexed: 11/25/2022]
Abstract
Isolated cleft mitral valve (ICMV) is a rare entity not known to be related to pulmonary atresia with ventricular septal defect (PA-VSD). This report describes the use of cardiovascular magnetic resonance (CMR) imaging to diagnose ICMV in a patient with repaired PA-VSD who presented with incidental severe mitral regurgitation (MR) on follow-up echocardiography. An associated pulmonary varix secondary to the severe MR also was shown by CMR.
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Affiliation(s)
- Lynette L S Teo
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
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50
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Dzemeshkevich AS, Raskin VV, Malikova MS, Frolova IV, Korolev SV, Akchurin RS, Dzemeshkevich SL. [The mitral valve dysplasia in adults: the choice of surgical tactics]. Khirurgiia (Mosk) 2013:40-44. [PMID: 23503382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Early and long-term results of hereditary mitral valve dysplasia surgical treatment were obtained in 203 patients. All patients were divided in 2 groups: 73 (36%) patients after valve-preserving operations and 130 patients after universal chorda-preserving valve prosthetics. The choice of treatment modality depended on the type of anatomical changes and overall surgical volume. Hospital lethality rate was 2.46%. Surgery led to satisfactory functional results, thus, 83.3% of the operated patients have I-II NYHA functional class. Analysis of the own experience allowed to mark out factors, contraindicating the durable plastic mitral valve.
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