Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.919
Filtrar
2.
Int J Cardiovasc Imaging ; 36(1): 23-31, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31388814

RESUMO

While the impairment of left atrial (LA) mechanics in mitral valve disease is well known, the exact onset of reservoir, conduit, and contractile dysfunction in mitral stenosis (MS) and mitral regurgitation (MR) remains unclear. We aimed to clarify the LA deformation mechanics in patients with moderate mitral valve disease. We conducted a prospective observational study of 80 patients with moderate isolated MR, 80 patients with moderate isolated MS, and 64 age-matched controls without mitral valve disease. Strain (ɛ) and strain rate (SR) on speckle tracking echocardiography were assessed as indicators of LA and right atrium (RA) reservoir (ɛsys, SRs), conduit (ɛe, SRe), and contractile (ɛa, SRa) functions. Conventional echocardiographic parameters of the left ventricle (LV) were also assessed. Comparisons were conducted according to mitral valve pathology (MR patients, MS patients, controls). The mean LV ejection fraction, end-diastolic diameter, and global longitudinal strain did not differ across the groups. The pulmonary artery systolic pressure, LA volume indexed to body surface area, and LA mechanics were significantly impaired in mitral valve disease (patients vs controls). While LA ɛ did not vary between MR and MS, MR patients had better LA SRs and SRe but worse SRa (p < 0.01). SRe > - 0.65% had higher specificity for MS, with an area under the curve of 0.85 (p < 0.01). RA mechanics were significantly impaired in mitral valve disease (patients vs controls) but did not vary significantly with disease pathology (MS vs MR). Patients with moderate mitral valve disease exhibit early and pathology-specific changes in the LA deformation mechanics, manifesting mainly as impaired contractile-phase SR in MR and impaired conduit-phase SR in MS. Our findings highlight SR as a potentially useful early marker of LA dysfunction in relation to mitral valve disease.


Assuntos
Função do Átrio Esquerdo , Átrios do Coração/fisiopatologia , Insuficiência da Valva Mitral/fisiopatologia , Estenose da Valva Mitral/fisiopatologia , Valva Mitral/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Diagnóstico Precoce , Feminino , Átrios do Coração/diagnóstico por imagem , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/complicações , Insuficiência da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/complicações , Estenose da Valva Mitral/diagnóstico por imagem , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Função Ventricular Esquerda
3.
J Cardiothorac Surg ; 14(1): 212, 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31805961

RESUMO

BACKGROUND: Myectomy remains the standard surgical treatment of patients with hypertrophic cardiomyopathy (HOCM). New surgical methods developed in the last decades mainly address the mitral valve and are controversial because of their conflicting assumptions. This study assesses the influence of anterior mitral valve leaflet (AML) length and the anterior-posterior diameter of the mitral annulus (MAD) on dynamic left ventricle outflow tract obstruction and mitral regurgitation (MR) after extended myectomy. METHODS: We retrospectively analysed the transthoracic echocardiograms (TTE) of 36 patients. AML length and MAD were obtained from TTE performed before the operation. The greatest maximal left ventricle outflow tract (LVOT) gradient and MR registered in follow-up were analysed. After surgery, patients were divided into two groups; those with moderate or milder MR and/or an LVOT gradient < 30 mmHg (responders), and those with more than moderate MR and/or an LVOT gradient ≥30 mmHg (non-responders). RESULTS: Patients in responders group had significantly longer AML: 32.3 ± 2.3 mm vs 30.0 ± 3.8 mm (p = 0.03) [parasternal long axis view - PLAX view], 25.9 ± 2.3 mm vs 23.5 ± 2.7 mm (p = 0.008) [four chamber view - 4CH view] and larger anterior-posterior mitral annulus diameter 28.1 ± 2.8 mm vs 25.4 ± 3.2 mm (p = 0.011) than those in non-responders group. Among all analysed patients longer anterior mitral leaflet was correlated with lower postoperative LVOT gradient when measured in PLAX view (p = 0.02) and lower degree of MR due to systolic anterior motion (SAM) when measured in 4CH view (p = 0.009). Greater [AML x mitral annulus] ratio correlated with lower postoperative LVOT gradient in both projections: 4CH (p = 0.025), PLAX (p = 0.012). There was significant reduction in NYHA Class after surgery (p = 0.000). There were no significant differences in NYHA class after surgery (p = 0.633) neither in NYHA class reduction (p = 0.475) between patients divided into responders and non-responders group according to echocardiographic parameters. CONCLUSIONS: Patients with a longer AML and a greater diameter of the mitral annulus are less likely to have mitral regurgitation due to residual SAM and increased LVOT gradient after an extended myectomy. Division of patients according to echocardiographic criteria into responders and non-responders was not in concordance with clinical improvement. TRIAL REGISTRATION: Retrospective study. Approved by ethics committee (IK-NPIA-0021-21/1763/19) at 16.01.2019.


Assuntos
Cardiomiopatia Hipertrófica/cirurgia , Valva Mitral/diagnóstico por imagem , Procedimentos Cirúrgicos Cardíacos , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Cardiomiopatia Hipertrófica/patologia , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento
4.
BMC Infect Dis ; 19(1): 1052, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842764

RESUMO

BACKGROUND: The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated associations between bacterial infections and IE manifestations diagnosed by ECHO. METHODS: In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher's exact test was used for comparisons between categorical variables, and student's t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. RESULTS: The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Associations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S. aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). CONCLUSIONS: Associations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.


Assuntos
Endocardite Bacteriana/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Infecções Estreptocócicas/microbiologia , Estreptococos Viridans/isolamento & purificação , Abscesso/microbiologia , Adulto , Idoso , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/microbiologia , Ecocardiografia , Endocardite Bacteriana/sangue , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Feminino , Mortalidade Hospitalar , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/microbiologia , Sistema de Registros , Estudos Retrospectivos , Staphylococcus aureus/genética , Abuso de Substâncias por Via Intravenosa/microbiologia , Suécia , Resultado do Tratamento , Estreptococos Viridans/genética
5.
Tex Heart Inst J ; 46(3): 195-198, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31708702

RESUMO

The MitraClip system can be used to control regurgitant blood flow in patients with mitral regurgitation who cannot tolerate open surgery to replace the mitral valve. Technical limitations make the right femoral vein the standard access point for placing the MitraClip. However, this route is not always suitable. We present the case of an 85-year-old woman in whom we successfully used a left-sided approach for inserting a MitraClip because her right femoral vein was occluded. This apparently novel left femoral approach merits consideration as an option for device insertion when right femoral vein access is precluded.


Assuntos
Cateterismo Cardíaco/métodos , Próteses Valvulares Cardíacas , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Idoso de 80 Anos ou mais , Ecocardiografia , Feminino , Veia Femoral , Fluoroscopia , Implante de Prótese de Valva Cardíaca , Humanos , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/diagnóstico , Resultado do Tratamento
6.
Medicine (Baltimore) ; 98(48): e18169, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770266

RESUMO

INTRODUCTION: Sinus of Valsalva aneurysm (SVA) protruding into the mitral anterior leaflet is an extremely rare clinical condition; herein, we present a case of unruptured noncoronary SVA protruding into the mitral anterior leaflet. PATIENT'S CONCERNS: A 46-year-old male was referred to hospital for exertional dyspnea. DIAGNOSIS: Transthoracic echocardiography (TTE) and coronary computed tomography angiography (CTA) suggested a noncoronary SVA protruding into the mitral anterior leaflet, causing mitral regurgitation and aortic insufficiency. INTERVENTIONS: The aneurysm was resected and the aortic and mitral valves were replaced with mechanical valves via a transaortic approach. OUTCOMES: Postoperative recovery was uneventful. CONCLUSIONS: A rare noncoronary SVA protruding into the mitral anterior leaflet can be diagnosed via TTE and CTA. Transaortic mitral surgery is feasible in patients with a dilated aortic annulus ring and mitral valve diseases.


Assuntos
Aneurisma Aórtico , Insuficiência da Valva Aórtica , Dispneia , Implante de Prótese de Valva Cardíaca/métodos , Insuficiência da Valva Mitral , Valva Mitral , Procedimentos Cirúrgicos Vasculares/métodos , Aneurisma Aórtico/complicações , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/fisiopatologia , Aneurisma Aórtico/cirurgia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/diagnóstico , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/cirurgia , Angiografia por Tomografia Computadorizada/métodos , Dispneia/diagnóstico , Dispneia/etiologia , Dispneia/fisiopatologia , Ecocardiografia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Insuficiência da Valva Mitral/diagnóstico , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/fisiopatologia , Insuficiência da Valva Mitral/cirurgia , Seio Aórtico/diagnóstico por imagem , Seio Aórtico/fisiopatologia , Resultado do Tratamento
8.
Artigo em Inglês | MEDLINE | ID: mdl-31751004

RESUMO

This video tutorial is a guide to transfemoral, transcatheter mitral valve-in-valve implantation using advanced preoperative planning and intraprocedural fusion imaging. We demonstrate mitral valve-in-valve implantation in a patient after surgical bioprosthetic replacement of the mitral valve, with severe restenosis and elevated surgical risk, and we discuss preoperative planning and work-up using advanced imaging software.. The procedure itself is documented in a step-by-step fashion for every important phase of the intervention. Finally, we present the postoperative result after successful implantation and provide a brief discussion of the key points of the case and procedure.


Assuntos
Bioprótese/efeitos adversos , Implante de Prótese de Valva Cardíaca , Cuidados Intraoperatórios/métodos , Estenose da Valva Mitral , Valva Mitral , Reoperação/métodos , Idoso de 80 Anos ou mais , Cateterismo Cardíaco/métodos , Próteses Valvulares Cardíacas/efeitos adversos , Implante de Prótese de Valva Cardíaca/instrumentação , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Estenose da Valva Mitral/diagnóstico , Estenose da Valva Mitral/etiologia , Estenose da Valva Mitral/cirurgia , Falha de Prótese/efeitos adversos , Cirurgia Assistida por Computador , Resultado do Tratamento
9.
J Radiol Case Rep ; 13(1): 1-10, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31565162

RESUMO

Soft-tissue masses or mass-like lesions involving the mitral valve include a wide range of diseases such as tumors, abscesses, vegetations, thrombus and, rarely, caseous calcifications of the mitral annulus. Caseous calcifications of the mitral annulus is a rare variant of mitral annular calcification that is usually asymptomatic and diagnosed incidentally. Echocardiography is the first-choice imaging modality. Cardiac computed tomography is an ideal tool to confirm the presence of calcifications and caseous necrosis. In cases where there is doubt, cardiac magnetic resonance imaging may be used. We present the case of a 62-year-old patient with an intra-cardiac mass diagnosed by echocardiography. Imaging modalities to achieve a correct diagnosis and avoid unnecessary surgical intervention are discussed.


Assuntos
Calcinose/diagnóstico por imagem , Ecocardiografia/métodos , Doenças das Valvas Cardíacas/diagnóstico por imagem , Calcinose/patologia , Feminino , Doenças das Valvas Cardíacas/patologia , Humanos , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem
10.
Dis Markers ; 2019: 7512805, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31583030

RESUMO

Background: The ratio of early mitral inflow velocity to the global diastolic strain rate (E/E'sr) and global longitudinal systolic strain (GLS) of the left ventricle (LV) are emerging indices of diastolic and systolic functions, respectively, for the LV. Their prognostic significance in the prediction of mortality and cardiovascular (CV) outcomes remains underexplored in hemodialysis (HD) patients. Methods: This prospective study included 190 maintenance HD patients. The E/E'sr ratio and GLS were assessed using two-dimensional speckle tracking echocardiography. The clinical outcomes included overall mortality, CV mortality, and major adverse cardiovascular events (MACE). The associations between the E/E'sr ratio, GLS, and clinical outcomes were evaluated using multivariate Cox regression analysis. The incremental values of the E/E'sr ratio and GLS in outcome prediction were assessed by χ 2 changes in Cox models. Results: Over a median follow-up period of 3.7 years, there were 35 overall deaths, 16 CV deaths, and 45 MACE. Impaired diastolic function with a higher E/E'sr ratio was associated with overall mortality (HR, 1.484; 95% CI, 1.201-1.834; p < 0.001), CV mortality (HR, 1.584; 95% CI, 1.058-2.371; p = 0.025), and MACE (HR, 1.205; 95% CI, 1.040-1.397; p = 0.013) in multivariate adjusted Cox analysis. Worsening GLS was associated with overall mortality (HR, 1.276; 95% CI, 1.101-1.480; p = 0.001), CV mortality (HR, 1.513; 95% CI, 1.088-2.104; p = 0.014), and MACE (HR, 1.214; 95% CI, 1.103-1.337; p < 0.001). The E/E'sr ratio and GLS had better outcome prediction than the E to early diastolic mitral annular velocity (E/E') ratio and left ventricular ejection fraction (LVEF). Moreover, adding the E/E'sr ratio and GLS to Cox models containing relevant clinical and conventional echocardiographic parameters improved the prediction of overall mortality (p < 0.001), CV mortality (p < 0.001), and MACE (p < 0.001). Conclusion: The E/E'sr ratio and GLS, as emerging indices of LV diastolic and systolic functions, significantly predict mortality and CV outcomes and outperform conventional echocardiographic parameters in outcome prediction in HD patients.


Assuntos
Diástole , Insuficiência Cardíaca Sistólica/mortalidade , Infarto do Miocárdio/mortalidade , Diálise Renal , Sístole , Disfunção Ventricular Esquerda/mortalidade , Idoso , Biomarcadores/análise , Velocidade do Fluxo Sanguíneo , Ecocardiografia , Feminino , Insuficiência Cardíaca Sistólica/diagnóstico , Insuficiência Cardíaca Sistólica/etiologia , Insuficiência Cardíaca Sistólica/fisiopatologia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/fisiopatologia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/terapia , Volume Sistólico , Disfunção Ventricular Esquerda/complicações , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia
11.
Heart Surg Forum ; 22(5): E390-E395, 2019 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-31596718

RESUMO

BACKGROUND: The development of minimally invasive mitral valve surgery has created the motivation for using this approach in young patients with chronic rheumatic valve disease. We report our recent experience with patients undergoing minimally mitral valve surgery in this group of patients. METHODS: Between July 2014 and June 2018, 142 patients with rheumatic mitral valve dysfunction underwent minimally invasive surgery through a right thoracotomy approach at the University Medical Center of Ho Chi Minh City in Vietnam. Diagnosis was confirmed with transthoracic and transesophageal echocardiography (TTE and TEE). We analyzed the in-hospital and midterm follow-up outcomes of this group. RESULTS: The mean age was 42.6 ± 9.6 years. Sixty patients (42.3%) were male. Sixty-three patients were diagnosed with functional severe tricuspid regurgitation, 29 patients were identified with moderate tricuspid regurgitation, and tricuspid annulus was more than 21 mm/m²). Mitral valve repair was performed in 16 patients (11.3%), and 126 patients underwent mitral valve replacement. Mitral valve repair techniques included annuloplasty, leaflet peeling, and commissurotomy. Thirty-day mortality was 0.7%. Two patients had to be converted to conventional sternotomy, due to left atrial appendage laceration and mitral annular rupture. The overall survival rate was 98.6%. Freedom from reoperation was 97.1%. CONCLUSIONS: In patients with rheumatic valve disease, minimally invasive mitral surgery safely and effectively can be performed with few perioperative complications and good midterm results.


Assuntos
Doenças das Valvas Cardíacas/cirurgia , Valva Mitral/cirurgia , Cardiopatia Reumática/cirurgia , Insuficiência da Valva Tricúspide/cirurgia , Adulto , Conversão para Cirurgia Aberta/estatística & dados numéricos , Ecocardiografia Transesofagiana , Feminino , Doenças das Valvas Cardíacas/diagnóstico por imagem , Implante de Prótese de Valva Cardíaca/estatística & dados numéricos , Humanos , Masculino , Ilustração Médica , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Valva Mitral/diagnóstico por imagem , Valva Mitral/lesões , Cardiopatia Reumática/diagnóstico por imagem , Esternotomia , Taxa de Sobrevida , Toracotomia/métodos , Insuficiência da Valva Tricúspide/diagnóstico
13.
Pediatr Cardiol ; 40(8): 1761-1762, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31506732

RESUMO

We here report a neonate with prenatal echocardiographic diagnosis of tricuspid atresia, with normally related great vessels, and large ventricular septal defect. This diagnosis could be confirmed with echocardiography at birth. An additional double mitral orifice was also seen. This is a very rare association.


Assuntos
Valva Mitral/anormalidades , Atresia Tricúspide/complicações , Ecocardiografia , Feminino , Humanos , Recém-Nascido , Valva Mitral/diagnóstico por imagem , Diagnóstico Pré-Natal , Atresia Tricúspide/diagnóstico
15.
Am J Case Rep ; 20: 1422-1426, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31558692

RESUMO

BACKGROUND Immediate evaluation, diagnosis, and treatment of a patient with infective endocarditis, an infection of the endocardium and/or integral structures found within the heart, is essential to patient survival. CASE REPORT We present the case of a 41-year-old man who was brought to the Emergency Department for altered mental status and fever. He was found to have methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia complicated with severe respiratory failure and metabolic encephalopathy, necessitating intubation and mechanical ventilation. As part of the workup for persistent Staphylococcal bacteremia, 2 transthoracic echocardiograms (TTE) failed to reveal any valvular abnormalities. However, a transesophageal echocardiogram (TEE) detected a 30×30 mm large vegetation on the anterior mitral valve leaflet. Due to the overall size and risk of systemic embolization, and the fact that the patient developed new-onset heart failure, the mitral valve was replaced using an open approach. The patient tolerated the procedure well and was discharged after an extended period of hospitalization. CONCLUSIONS Although the literature emphasizes that the sensitivity of TTE significantly increases when the vegetation size is above 1 cm, it is of utmost importance for clinicians to keep in mind that this is not always true, and clinicians should consider performing a TEE to rule out infective endocarditis whenever a TTE is unable to detect any vegetation in a patient with persistent Staphylococcal bacteremia. This is clearly demonstrated by the present case, in which two TTEs failed to detect a 30×30 mm vegetation.


Assuntos
Ecocardiografia Transesofagiana , Endocardite Bacteriana/diagnóstico por imagem , Valva Mitral/diagnóstico por imagem , Valva Mitral/microbiologia , Adulto , Bacteriemia/diagnóstico , Bacteriemia/microbiologia , Ecocardiografia , Endocardite Bacteriana/patologia , Endocardite Bacteriana/cirurgia , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Valva Mitral/patologia , Valva Mitral/cirurgia , Infecções Estafilocócicas/diagnóstico
16.
J Invasive Cardiol ; 31(9): 260-264, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31478891

RESUMO

OBJECTIVES: Transcatheter aortic valve implantation (TAVI) has become standard therapy for aortic stenosis patients with intermediate or high operative risk. Treatment of patients with pre-existing mechanical mitral valve replacement (MVR) is challenging due to possible interference between the TAVI prosthesis and MVR. We present our single-center experience with this special patient cohort. METHODS: A total of 1960 patients underwent TAVI at our institution between 2009 and March 2018; of these, 16 patients had pre-existing mechanical MVR. Device success and adverse events were analyzed according to the Valve Academic Research Consortium (VARC)-2 criteria. Patients were followed for at least 12 months. RESULTS: Mean patient age was 81.5 ± 4.4 years. The patients had a mean logistic EuroScore of 37.1 ± 13.5% and STS score of 7.1 ± 3.2%. Successful valve deployment was achieved in all patients, peri-interventional stroke rate was 0.0%, and permanent pacemaker was implanted in 2 patients (12.5%). Two patients experienced major complications, with blockage of the MVR disc in 1 patient and annulus rupture in 1 patient. Hence, 30-day mortality was 12.5% and 1-year mortality was 25.0%. CONCLUSION: TAVI in patients with mechanical MVR is challenging and requires careful preparation and choice of TAVI device. Repositionable and retrievable devices seem to be a safer option.


Assuntos
Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Próteses Valvulares Cardíacas , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Substituição da Valva Aórtica Transcateter/métodos , Idoso de 80 Anos ou mais , Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/diagnóstico , Ecocardiografia , Feminino , Seguimentos , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/complicações , Desenho de Prótese , Reoperação , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
17.
J Invasive Cardiol ; 31(9): E274-E276, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31478896

RESUMO

Three-dimensional multiplanar reconstruction was used to diagnose recurrence of mitral regurgitation after MitraClip implantation in a 71-year-old man. Subsequent mitral valve surgery in such a case is high risk, and repeat MitraClip intervention could be feasible but is technically challenging. This imaging series demonstrates that LVAD implantation may be a solution to address MitraClip failure.


Assuntos
Cateterismo Cardíaco/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Coração Auxiliar , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Idoso , Ecocardiografia Tridimensional , Ecocardiografia Transesofagiana , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/diagnóstico
20.
Cardiol Young ; 29(10): 1297-1299, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31475639

RESUMO

There has been great concern with the use of radiofrequency ablation in infants since radiofrequency ablation lesions were shown to have a progressing nature in immature myocardium of animals. In this report, we present a 2-month-old infant with life-threatening medically refractory supraventricular tachycardia. Radiofrequency ablation successfully cured arrhythmia; however, late effects of radiofrequency ablation lesions resulted in a progressive mitral valve perforation requiring surgical repair.


Assuntos
Ablação por Cateter/efeitos adversos , Traumatismos Cardíacos/diagnóstico , Valva Mitral/lesões , Complicações Pós-Operatórias , Taquicardia Supraventricular/cirurgia , Ecocardiografia , Eletrocardiografia , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Humanos , Lactente , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA