RESUMO
Transcatheter mitral valve-in-valve replacement (TMVR) offers a less invasive strategy for managing bioprosthetic mitral valve dysfunction. TMVR positioning is challenging in the setting of a radiolucent bioprosthetic sewing ring. We present 2 cases demonstrating the roles of fluoroscopy and echocardiography in guiding TMVR placement within bioprostheses with radiolucent sewing rings. (Level of Difficulty: Intermediate.).
Assuntos
Valva Aórtica/patologia , Valva Aórtica/cirurgia , Arteriosclerose/etiologia , Bioprótese/efeitos adversos , Endocardite/etiologia , Próteses Valvulares Cardíacas/efeitos adversos , Adulto , Arteriosclerose/patologia , Arteriosclerose/cirurgia , Endocardite/diagnóstico , Humanos , Masculino , Transplante Homólogo/efeitos adversosRESUMO
BACKGROUND: Previous studies have demonstrated the development of impaired systolic function and new segmental wall motion abnormalities following completion of ultraendurance events. Limited information is available on the effect of an endurance event such as a marathon on the left ventricular indices and hemodynamics. METHODS: We examined 45 patients (26 men, 19 women with the average age of 35+/- 8 years) who successfully trained and completed the 2001 Chicago Marathon (26.2 miles). Transthoracic 2-dimensional and Doppler echocardiography (TTE) was preformed prior to the marathon (17+/-10.7 days), immediately following the marathon (71+/-42 minutes), and at follow-up (29+/-12.9 days). RESULTS: Left ventricular end diastolic volumes declined immediately post marathon and returned to baseline at the one-month follow-up. Ejection fraction was maintained and no regional wall motion abnormalities were identified at any time point. Diastolic parameters decreased immediately post marathon but returned to baseline during follow-up principally reflecting a change in volume status. CONCLUSION: Marathon running by a group of well-trained recreational athletes does not result in impairment of left ventricular systolic or diastolic function.