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1

Loop, F. D., D. M. Cosgrove e W. J. Stewart. "Mitral valve repair for mitral insufficiency". European Heart Journal 12, suppl B (2 luglio 1991): 30–33. http://dx.doi.org/10.1093/eurheartj/12.suppl_b.30.

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2

REUL, R., e L. COHN. "Mitral valve reconstruction for mitral insufficiency". Progress in Cardiovascular Diseases 39, n. 6 (maggio 1997): 567–99. http://dx.doi.org/10.1016/s0033-0620(97)80015-1.

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3

Hausmann, Harald, Henrik Siniawski, Holger Hotz, Joseph Hofmeister, Tito Chavez, Gerard Schmidt e Roland Hetzer. "Mitral Valve Reconstruction and Mitral Valve Replacement for Ischemic Mitral Insufficiency". Journal of Cardiac Surgery 12, n. 1 (gennaio 1997): 8–14. http://dx.doi.org/10.1111/j.1540-8191.1997.tb00082.x.

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4

Hendren, William G., James J. Nemec, Bruce W. Lytle, Floyd D. Loop, Paul C. Taylor, Robert W. Stewart e Delos M. Cosgrove. "Mitral valve repair for ischemic mitral insufficiency". Annals of Thoracic Surgery 52, n. 6 (dicembre 1991): 1246–52. http://dx.doi.org/10.1016/0003-4975(91)90008-e.

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5

Lin, Jeffrey C., e Richard A. Ott. "Acute Traumatic Mitral Valve Insufficiency". Journal of Trauma: Injury, Infection, and Critical Care 47, n. 1 (luglio 1999): 165–68. http://dx.doi.org/10.1097/00005373-199907000-00035.

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6

Cheng, Tsung O. "Valve Repair for Mitral Insufficiency". Annals of Thoracic Surgery 44, n. 3 (settembre 1987): 330. http://dx.doi.org/10.1016/s0003-4975(10)62093-0.

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7

Cooley, Denton A. "Valve Repair for Mitral Insufficiency". Annals of Thoracic Surgery 44, n. 3 (settembre 1987): 330. http://dx.doi.org/10.1016/s0003-4975(10)62094-2.

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8

Hetzer, Roland, e Eva Maria Delmo Walter. "Repair of Congenital Mitral Valve Insufficiency". Operative Techniques in Thoracic and Cardiovascular Surgery 15, n. 4 (2010): 260–72. http://dx.doi.org/10.1053/j.optechstcvs.2010.09.003.

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9

Chabchoub, Souhir, Sofienne Mansouri e Ridha B. Salah. "Diagnosis of mitral insufficiency using impedance cardiography technique ICG". Journal of Electrical Bioimpedance 7, n. 1 (8 agosto 2019): 28–34. http://dx.doi.org/10.5617/jeb.2872.

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Abstract Impedance cardiography (ICG) is a non-invasive tool for assessing the hemodynamic parameters. It has been used for diagnosing several cardiovascular diseases, such as heart failure, cardio-myopathy, and valvular diseases. Particularly, the valvular heart disease is characterized by the damage in one of the four heart valves: the mitral, aortic, tricuspid or pulmonary valves. The mitral valve insufficiency and the aortic valve stenos are the most frequent valve diseases in the world. In this paper, we propose to diagnosis the mitral valve insufficiency using the impedance cardiography technique. The study group consisted of 40 subjects (20 control subjects and 20 patients with mitral insufficiency). A parameter “I” is calculated from the impedance cardiogram waveform and it is used to differentiate control subjects from patients with mitral insufficiency. The parameter “I” was related significantly to the abnormalities of the impedance cardiogram waveform. For patients with mitral insufficiency, “I” was higher than for the healthy subjects with a difference ratio of 89% (p<0.001). To improve the diagnosis, we determined the stroke volume, cardiac output, and other hemodynamic parameters for the two groups of subjects. Finally, we concluded that we could identify, easily, patients with mitral insufficiency based on the abnormalities of the impedance cardiogram tracings and a characteristic parameter “I”.
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10

Galloway, A. C., S. B. Colvin, F. G. Baumann, S. Harty e F. C. Spencer. "Current concepts of mitral valve reconstruction for mitral insufficiency." Circulation 78, n. 5 (novembre 1988): 1087–98. http://dx.doi.org/10.1161/01.cir.78.5.1087.

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11

Krause, Albert H., J. Edward Okies, John C. Bigelow, U. Scott Page, Mark T. Metzdorff, Neal W. Salomon e Ronald W. Schutz. "Early experience with mitral valve reconstruction for mitral insufficiency". American Journal of Surgery 161, n. 5 (maggio 1991): 563–66. http://dx.doi.org/10.1016/0002-9610(91)90900-x.

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12

Mahmudov, Rashad. "MODERN PRINCIPLES OF DIAGNOSIS AND SURGICAL TREATMENT OF ISCHEMIC MITRAL INSUFFICIENCY". BULLETIN OF SURGERY IN KAZAKHSTAN, n. IV (1 ottobre 2021): 011–15. http://dx.doi.org/10.35805/bsk2021iv011.

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The purpose of the study is to evaluate and analyze the results of surgical treatment of patients with ischemic mitral insufficiency. Material and methods. The results of the examination and surgical treatment of 35 patients with ischemic mitral insufficiency are analyzed. In the operative period, in order to identify the degree of mitral insufficiency and the valvular apparatus, an echocardiography was performed, where the diameter of the fibrous ring, the interpapillary distance, the annulopapillary distance, the area of the cusp tension, and the depth of the coaptation of the valves were determined. Results. A preoperative examination proved the presence of mitral valve insufficiency with regurgitation of varying degrees. 15 patients underwent myocardial revascularization, 20 patients underwent myocardial revascularization + various options for correction of ischemic mitral insufficiency. After the operation, a significant improvement in the spatial-geometric correlation of the LV and mitral valve by reducing the tension forces acting on the valves and in the group of patients undergoing myocardial revascularization + various options for the correction of ischemic mitral insufficiency as the elimination of regurgitation. Conclusion. In patients with ischemic heart disease after echocardiographic studies, having determined the degree of mitral insufficiency with its moderate and severe degree, it is necessary to have a surgical correction of the mitral valve in its apparatus; the use of myocardial revascularization + various options for the correction of ischemic mitral insufficiency gives more tantalizing results than isolated myocardial revascularization.
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13

Kadiroğulları, Ersin, Ömer Faruk Çiçek, Serkan Mola, Emre Yaşar, İbrahim Erkengel, Adnan Yalçınkaya, Eren Günertem et al. "Comparison of Anterior Mitral Leaflet Repair Techniques with and without the Use of Chordal Replacement in Patients with Degenerative Mitral Valve Insufficiency". Heart Surgery Forum 22, n. 3 (24 maggio 2019): E234—E240. http://dx.doi.org/10.1532/hsf.2317.

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Background: The aim of our study was to compare the outcome of patients who underwent mitral valve anterior leaflet repair with and without chordal replacement for degenerative mitral valve insufficiency. Methods: This study was conducted at our center between May 2006 and May 2013. The study included 125 patients with degenerative mitral valve insufficiency (64 males, 61 females; mean age 47 years, age range 16-78 years) who underwent mitral valve repair with anterior leaflet procedures. The patients were divided into 2 groups. Group A consisted of 56 patients with chordal replacement, and group B consisted of 69 patients with other repair techniques performed. Results: No significant difference was determined between the 2 groups in mortality, recurrence, and reoperation rates. The mortality rate was 3.6% in group A and 1.4% in group B. During the follow-up period, 3 patients were reoperated on (mitral valve replacement) because of severe mitral valve insufficiency. Two of these patients were from group A (3.6%), and the other was from group B (1.4%). One patient in group A underwent intraoperative mitral valve replacement after unsuccessful chordal replacement. Fifty patients (89.3%) in group A and 65 patients (94.2%) in group B exhibited no or mild recurrence of mitral valve insufficiency. Conclusion: Mitral valve repair in patients with degenerative mitral valve insufficiency resulting from anterior leaflet pathology is a safe procedure because of its durability and good long-term results. Despite the difficulty of the chordal replacement procedure, it may be used as an alternative technique for anterior mitral valve leaflet repair.
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14

Shaikh, Abubakr, Mohsin Alam e Surendra P. Garg. "Increased Mitral Valve Insufficiency during Precordial “Whoop”". Chest 93, n. 1 (gennaio 1988): 209–10. http://dx.doi.org/10.1378/chest.93.1.209.

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15

Cheng, Tsung O. "Increased Mitral Valve Insufficiency During Precordial Whoop". Chest 94, n. 1 (luglio 1988): 221. http://dx.doi.org/10.1378/chest.94.1.221b.

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16

Kimbrell, Brian, Timothy Degner, Paul Glatleider e Harry Applebaum. "Pulmonary sequestration presenting as mitral valve insufficiency". Journal of Pediatric Surgery 33, n. 11 (novembre 1998): 1648–50. http://dx.doi.org/10.1016/s0022-3468(98)90600-5.

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17

Ulas, Mahmut Mustafa, Sabit Sinan Kocabeyoglu, Ali Umit Yener, Kerim Cagli e Mustafa Pac. "Mitral Valve Replacement in “Complex” Mitral Insufficiency: An Unusual Case of an Isolated Hammock Mitral Valve". Journal of Cardiac Surgery 24, n. 2 (marzo 2009): 141–42. http://dx.doi.org/10.1111/j.1540-8191.2008.00731.x.

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18

Nazarov, V. M., A. V. Afanasev e I. I. Demin. "Mitral valve repair in Barlow disease". Patologiya krovoobrashcheniya i kardiokhirurgiya 18, n. 1 (10 ottobre 2015): 70. http://dx.doi.org/10.21688/1681-3472-2014-1-70-73.

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Abstract (sommario):
A mitral valve prolapse nowadays is the most common cause of mitral insufficiency in the western countries and is associated with high morbidity and mortality. In the last decades repairing the mitral valve has become the operation of choice for treatment of the mitral valve prolapse, thus enabling to improve the geometry and function of the left ventricle and long-term survival. Literature related to mitral valve repair in patients with Barlow disease is reviewed.
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19

Stojanovic, Ivan, Ljiljana Jovovic, Milan Vukovic, Ljiljana Trkulja e Zeljko Bojovic. "Posterior cusp enlargement in mitral valve reconstructive surgery for restrictive valve insufficiency: Case report". Srpski arhiv za celokupno lekarstvo 135, n. 9-10 (2007): 562–65. http://dx.doi.org/10.2298/sarh0710562s.

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Introduction According to Carpentier classification, group III of mitral insufficiency is caused by the restrictive motion of the mitral valve. A rheumatic process and a coronary disease are the main causes. It is very important to examine the valve precisely, to define deformities and aetiology in order to make such a valve functional. In rheumatic disease, fibrosis and degeneration deform the entire mitral apparatus. A surgical principle is to re-establish mobility and pliability of the apparatus taking care of the functional anatomy at the same time. Cusp enlargement, chordal mobilization and ring remodeling are just some of the numerous surgical techniques that could be performed in these patients. Case outlineA 55-year old female patient was admitted to hospital with severe mitral regurgitaion. She belonged to NYHA, functional stage 2. Echocardiography revealed that both cusps, mostly posterior, were of reduced size and mobility, resulting in grade 3 regurgitation. We performed posterior cusp enlargement by using autologous pericardium treated in 0.6% of glutaraldehyde solution. Annulus remodeling was done using size 27 flexible Duran ring. Control echocardiography found trivial regurgitation. The patient was discharged on 12th postoperative day in sinus rhythm. Conclusion Surgical reconstruction of the rheumatic mitral valve back to the functional state is a demanding procedure, which, however, provides certain benefit for the successfully treated patient.
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20

Rudenko, S. A. "The Effect of Concomitant Tricuspid Valve Regurgitation on the Condition of Patients with Ischemic Mitral Insufficiency". Ukrainian journal of cardiovascular surgery, n. 4 (41) (16 dicembre 2020): 26–29. http://dx.doi.org/10.30702/ujcvs/20.4112/063026-029/036.

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Ischemic mitral regurgitation is one of the most difficult and complex problems of surgical treatment of coronary heart disease and drug therapy of this group of patients. Mitral regurgitation in coronary heart disease negatively affects the survival of patients. The combination of ischemic mitral regurgitation and tricuspid valve insufficiency significantly worsens the prognosis in this category of patients. The aim. To study the effect of concomitant tricuspid insufficiency on the condition of patients with ischemic mitral regurgitation. Material and methods. From January 2012 to December 2019, 292 patients with ischemic mitral insufficiency underwent surgical intervention at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine. Results and discussion. Almost half of the patients (48.0%) who applied to the Institute and had severe tricuspid valve regurgitation already had a history of moderate right atrial hypertrophy. In the expressed backflow on the tricuspid valve these blockades occur much more often than in the absence of insufficiency of the tricuspid valve (p<0.01). The occurrence of ventricular and atrial extrasystoles is also not reliably linked to the level of tricuspid valve regurgitation. Examining the results of surgical treatment of patients with mitral regurgitation of ischemic origin revealed positive correlation between the effect of tricuspid valve regurgitation and postoperative mortality. Examining the results of surgical treatment of patients with mitral regurgitation of ischemic origin revealed positive correlation between the effect of tricuspid valve regurgitation and postoperative mortality. Conclusions. Concomitant tricuspid insufficiency in mitral regurgitation of ischemic origin significantly affects clinical condition of patients and their quality of life. The results of surgical treatment of patients with ischemic mitral regurgitation also depend on the degree of preoperative tricuspid valve regurgitation.
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21

Kim, Sang Ik, Sang Joon Oh e Kook Yang Park. "A Clinical Study of Mitral Valve Repair for the Treatment of Mitral Valve Insufficiency". Korean Circulation Journal 31, n. 12 (2001): 1240. http://dx.doi.org/10.4070/kcj.2001.31.12.1240.

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22

Ivanov, Igor, Jadranka Dejanovic, Biljana Radisic, Dejan Ivanov e Josip Cikos. "Mitral valve prolapse". Medical review 55, n. 1-2 (2002): 60–62. http://dx.doi.org/10.2298/mpns0202060i.

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Mitral valve prolapse (MVP) is a common finding in everyday clinical practice. However, despite simple diagnostics, clinicians remain interested in it due to its undetermined prevalence, various etiology, clinical features and echocardiographic findings. Etiology and prevalence MVP exists as a primary condition and is commonly associated with tissue diseases of familial origin. It is more common in people with asthenic constitution and congenital thoracic abnormalities. Secondary etiology occurs in rheumatic processes on mitral valve, hypertrophic cardiomyopathy and ischemic heart disease. The prevalence varies between 0.33-17%. Diagnosis and complications Clinical manifestations are different and in most patients asymptomatic. The diagnosis is established by anamnesis, physical examination, M-mode and 2-dimensional transthoracic and transesophageal echocardiography, left ventriculography and direct histopathologic investigation of mitral apparatus. Although MVP is a benign condition, there are certain complications such as infective endocarditis, severe mitral regurgitation, heart failure, cerebral and coronary embolism events arrhythmias and sudden death. Complications mostly occur in patients with heart murmurs and mitral insufficiency in contrast to patients with cusps.
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23

Villanueva, Claudia, Matthew Doyle e Sheen Peeceeyen. "Anomalous anterior mitral leaflet chordae – rare cause of mitral valve insufficiency". Heart, Lung and Circulation 24 (2015): e50. http://dx.doi.org/10.1016/j.hlc.2014.12.104.

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24

Zeeshan, Ahmad, Mojun Zhu e John Elefteriades. "Immediate Improvement in Severe Mitral Regurgitation After Aortic Valve Replacement for Severe Aortic Insufficiency". AORTA 04, n. 03 (giugno 2016): 91–94. http://dx.doi.org/10.12945/j.aorta.2016.15.035.

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AbstractA 57-year-old male with ascending aortic aneurysm, severe aortic regurgitation, and severe mitral regurgitation (MR) underwent ascending aortic replacement and aortic valve replacement. MR in this patient with normal mitral valve morphology was considered secondary to aortic valve incompetency. Consequently, a surgical approach to restore aortic valve function was adopted with successful MR resolution. This case report demonstrates the possibility of reversing early functional mitral regurgitation without surgically approaching the mitral valve.
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25

Vida, Vladimiro L., Lorenza Zanotto, Massimiliano Carrozzini, Massimo A. Padalino e Giovanni Stellin. "Repair Techniques for Mitral Valve Insufficiency in Children". Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 21 (marzo 2018): 41–45. http://dx.doi.org/10.1053/j.pcsu.2017.11.004.

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26

Stojanovic, Ivan, Milan Vukovic, Vojislava Neskovic, Milan Babic, Miroljub Zlatanovic e Zeljko Bojovic. "Reconstructive surgery of idiopathic hypertrophic cardiomyopathy, systolic anterior motion and severe mitral regurgitation". Srpski arhiv za celokupno lekarstvo 132, n. 7-8 (2004): 254–57. http://dx.doi.org/10.2298/sarh0408254s.

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Hypertrophie obstructive cardiomyopathy (HOCM) is an idiopathic disease frequently associated with systolic anterior motion (SAM). The anterior leaflet of mitral valve is sucked by Ventury effect into the left ventricle outflow tract making subaortic stenosis more severe and producing mitral insufficiency at the same time. Septal myectomy along with mitral valve replacement has been the treatment of choice for a long time. An understanding of pathoanatomy and hemodynamics of the disease has opened possibility for total reconstructive treatment of both subaortic stenosis and mitral insufficiency in such patients. This is a case report of 50-year-old male with severe subaortic stenosis (136/70 mmHg) due to HOCM and SAM along with grade IV mitral insufficiency. Septal myectomy was performed. Mitral insufficiency was managed by reducing the height of posterior cusp along with remodeling of mitral annulus by Carpentier-Classic ring. In that way, subaortic obstruction was reduced to 30.9/10 mmHg while mitral insufficiency was lowered to negligible level. The patient was discharged from hospital with sinus rhythm eight days after the surgery.
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27

Kadyrova, M. V., N. N. Askerova, Yu A. Stepanova, N. V. Zhemerov, E. S. Malyshenko, V. A. Popov e A. Sh Revishvili. "Possibilities of Echocardiography at the Stages of Surgical Treatment of the Patient with the Mitral Valve Posterior Leaflet Prolapse Resulted in Mitral Insufficiency and Atrial Fibrillation (A Case Report)". Medical Visualization, n. 2 (28 aprile 2017): 103–13. http://dx.doi.org/10.24835/1607-0763-2017-2-103-113.

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The mitral valve prolapse is characterized by the degeneration of the valve leaflets, accompanied by their thickening, increasing surface area and flexibility. The mitral valves leaflets bulge (prolapse) beyond the plane of the atrioventricular ring into the left atrium during ventricular systole and lose the ability to close tightly, leading to the mitral regurgitation. Acute chord rupture of the mitral valve posterior leaflet is a rare but important cause of severe mitral regurgitation and the development of acute or progressive chronic heart failure. Acute mitral insufficiency, accompanied by hemodynamic disorders, requires an urgent valve plastic surgery or valve prosthetics. The mitral valve plastic surgery gives a number of undeniable advantages over prosthetics, providing the best hemodynamic parameters, saving the patient from lifelong receiving of anticoagulant drugs. Detailed qualified echocardiographic evaluation of all structures of the mitral valve (fibrous ring, MV leaflets by segments, overlapping structures, structure of the chordal apparatus, papillary muscles) provides the necessary information for the mitral valve reconstructive plastic surgery with the choice of the method that is most optimal for a certain patient at the preoperative stage. We report herein a clinical observation of the patient with a diagnosis: acquired heart disease, the mitral valve posterior leaflet prolapse with mitral insufficiency Grade 3. Chronic heart failure IIA. II FC. Atrial fibrillation. The patient underwent multicomponent mitral valve reconstruction with the creation of a neochord and the fibrous ring plastic on the duplicate of a PTFE strip (soft support ring), pairwise isolation of the pulmonary vein entrance and right cavotricuspid isthmus.
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28

Sharifulin, R. M., A. V. Bogachev-­Prokofiev, I. Yu Zhuravleva, T. P. Timchenko, S. I. Zheleznev e A. M. Karaskov. "The results of transcatheter mitral valve replacement". Russian Journal of Cardiology, n. 11 (6 dicembre 2018): 137–44. http://dx.doi.org/10.15829/1560-4071-2018-11-137-144.

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Abstract (sommario):
Mitral insufficiency is one of the most common valvular pathology. In almost half of the patients, standard mitral valve replacement using extracorporeal circulation cannot be used due to the high risk of complications. In recent years, for this category of patients a method for transcatheter mitral valve replacement has been proposed. Now it is known about a few transcatheter prostheses for implantation into the native mitral valve that are at the stage of preclinical or clinical trials. This article analyzes the results of the clinical use of prostheses for transcatheter mitral valve replacement.
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Minami, Tomoyuki, Kiyotaka Imoto, Shin-ichi Suzuki, Keiji Uchida, Norihisa Karube, Koichiro Date, Motohiko Goda, Toshiki Hatsune e Munetaka Masuda. "A Patient Who Underwent Mitral Annuloplasty for Mitral-Valve Insufficiency due to Calcification of the Mitral-Valve Annulus". Japanese Journal of Cardiovascular Surgery 36, n. 6 (2007): 333–36. http://dx.doi.org/10.4326/jjcvs.36.333.

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Malik, Albahi, Aneeqa Saif, Awsse Al-Ani e Christopher Haas. "Murmur on top of the head: bioprosthetic mitral valve insufficiency". BMJ Case Reports 14, n. 10 (ottobre 2021): e245117. http://dx.doi.org/10.1136/bcr-2021-245117.

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Abstract (sommario):
In 1961, K Merendino ‘in pure curiosity’, while tracking the murmur of mitral regurgitation, placed his stethoscope ‘on the vertex of the head’, and ultimately led to a medical curiosity and exam finding that not only bears his name, but awes medical learners at all stages of their careers. Merendino and colleagues collected seven such cases of the ‘Murmur on Top of the Head’ building on the work of others who provided a detailed description of mitral regurgitation and noted murmur radiation to the neck and cervical/lumbosacral spine. The majority of patients suffered from rheumatic heart disease or subacute bacterial endocarditis in native heart valves. Here, we report on a case of the ‘Murmur on Top of the Head’ and provide the reader/listener with a direct recording of the ‘Merendino murmur’ (as well as its spinal correlate) in an elderly woman with a bioprosthetic mitral valve.
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Heyse, A. "Mitral Insufficiency with Congenital Double-Orifice Mitral Valve in an Elderly Patient". European Journal of Echocardiography 4, n. 4 (dicembre 2003): 334–35. http://dx.doi.org/10.1016/s1525-2167(03)00016-7.

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Tanaka, Hiroshi, Kenji Okada, Teruo Yamshita, Keitaro Nakagiri, Masamichi Matsumori e Yutaka Okita. "Accessory mitral valve causing left ventricular outflow tract obstruction and mitral insufficiency". Journal of Thoracic and Cardiovascular Surgery 132, n. 1 (luglio 2006): 160–61. http://dx.doi.org/10.1016/j.jtcvs.2006.01.062.

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33

Kalangos, Afksendiyos, Ingrid Oberhansli, Gregory Khatchatourian, Beat Friedli e Bernard Faidutti. "Multiple-leaflet mitral valve as a rare cause of congenital mitral insufficiency". Annals of Thoracic Surgery 63, n. 5 (maggio 1997): 1452–55. http://dx.doi.org/10.1016/s0003-4975(97)00108-2.

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Congiu, Stefano, Miguel Josa, Xavier Freixa, Manuel Azqueta, Carlos Mestres e Jaime Mulet. "Mitral insufficiency with a double-orifice mitral valve in an adult patient". Journal of Thoracic and Cardiovascular Surgery 134, n. 1 (luglio 2007): 250–51. http://dx.doi.org/10.1016/j.jtcvs.2006.11.074.

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35

Elsharkawy, Ihab, Hosam Sayed, Mahmoud Elwakeel e Ahmed Lamloom. "Mitral Valve Repair in Children with Mitral Insufficiency Using Single Simple Technique". Egyptian Journal of Hospital Medicine 90, n. 1 (1 gennaio 2023): 84–87. http://dx.doi.org/10.21608/ejhm.2023.279201.

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36

Ma, Jianrui, Tong Tan, Xiaohua Li, Jiaoyang Li, Zhen Zhang e Haiyun Yuan. "Mitral Valve Replacement Adopting Chimney Technique in Mitral Insufficiency And Extensive Mitral Annular Calcification: A Case Report". Heart Surgery Forum 25, n. 5 (12 ottobre 2022): E718—E720. http://dx.doi.org/10.1532/hsf.5015.

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Abstract (sommario):
Extensive and serious mitral annular calcification represents a troublesome obstacle in intracardiac mitral valve replacement due to time-consuming requirements and the potential of decalcification-associated complications. We report the case of a high-risk patient with extremely severe mitral insufficiency and difficult-to-debride annular calcification who received mitral replacement using a chimney technique. This approach enabled not only the minimization of mitral calcification debridement but also the reduction of surgery time. Consequently, the surgery was successful with a great postoperative outcome. Thus, this technique is a safe and feasible option to deal with intractable mitral annular calcification during mitral valve surgery.
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Vörös, Károly, Viktória Szilvási, Ferenc Manczur, Ákos Máthé, Jenő Reiczigel, Ingo Nolte e Stephan Hungerbühler. "Occurrence of mitral valve insufficiency in clinically healthy Beagle dogs". Acta Veterinaria Hungarica 63, n. 4 (dicembre 2015): 458–71. http://dx.doi.org/10.1556/004.2015.043.

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Chronic degenerative valve disease (CDVD) is the most common cardiac disease in dogs, usually resulting in mitral valve insufficiency (MVI). The goal of this study was to investigate the occurrence of MVI in clinically healthy Beagle populations. A total of 79 adult healthy Beagles (41 females and 38 males; age: 5.6 ± 2.7 years, range 1.4 to 11.7 years) were examined. The diagnosis of MVI was based on the detection of a systolic murmur heard above the mitral valve, and was confirmed by colour flow Doppler (CFD) echocardiography. Systolic mitral valve murmurs were detected in 20/79 dogs (25.3%), of them 11 males and 9 females with no statistically significant gender difference (P = 0.6059). The strength of the murmur on the semi-quantitative 0/6 scale yielded intensity grade 1/6 in 10 dogs, grade 2/6 in 4 dogs, and grade 3/6 in 6 dogs. Mild to moderate MVI was detected by CFD in all these 20 dogs with systolic murmurs. Of them, 17 dogs had mild and 3 demonstrated moderate MVI, showing 10–30% and 30–50% regurgitant jets compared to the size of the left atrium, respectively. The age of dogs with MVI was 7.1 ± 2.3 years, which was significantly different from that of dogs without MVI (5.1 ± 2.7 years, P = 0.0029). No significant differences in body weight (P = 0.1724) were found between dogs with MVI (13.8 ± 2.8 kg) and those without MVI (12.8 ± 3.0 kg). Mitral valve disease causing MVI is relatively common in Beagle dogs, just like in other small breed dogs reported in the literature.
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38

Dnistryanska, A. P., Yu Konovalenko, N. A. Godlevskaya, N. G. Burtyak e L. S. Baida. "Comparative assessment of fetal blood flow and cardiac system status of pregnant women with mitral valve pathology". Reports of Vinnytsia National Medical University 23, n. 4 (30 dicembre 2019): 645–51. http://dx.doi.org/10.31393/reports-vnmedical-2019-23(4)-15.

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Annotation. The aim of this work is to analyze the course of pregnancy in women with mitral pathology, the task is to identify preclinical criteria for worsening cardiovascular pathology that can lead to the development of complications of pregnancy and functioning of the fetal CVS, to evaluate the effectiveness of preventive measures. The article presents the analysis of changes in ultrasound characteristics of fetoplacental blood flow in women with mitral valve prolapse and mitral valve insufficiency, as well as cardiovascular status in these women. Statistical processing was performed by calculating Student coefficients (+) using the Microsoft Excel PC program. Doppler examination of fetal umbilical cord blood flow during pregnancy was studied. The correlation between the level of maternal blood flow compensation and pathological changes in the fetoplacental complex was established. As a result of our work, the prevalence of the disease was estimated. As of 2018, it was found that of the total number of extragenital pathology in 1676 pregnant women with CVSD; respectively for 2017 — 1699, for 2016 — 1925, 2015 — 1857 in the region. Of these, 331 (2018), 313 (2017), 326 (2016), 306 (2015) had mitral valve defects, including prolapse. A retrospective assessment of pregnancy and childbirth indicates the possibility of complications of pregnancy and childbirth. In the group of patients with mitral valve prolapse and mitral valve insufficiency, compared to the control group, they did not show significant changes in the dynamics of the Doppler metrics of cardiovascular pathology, which indicates the compensation of the cardiovascular system against the background of changes in the valve. At the same time, the tendency to decrease of CF in women with mitral valve prolapse and insufficiency of the mitral valve against the background of increasing pregnancy is revealed, indicates a violation of CVD adaptation to changes inherent in pregnancy, which provoke hemic and hemodynamic changes in the body, which will cause pregnancy and fetal status. FPC status in women with mitral valve prolapse and mitral valve insufficiency worsens in the third trimester of pregnancy, especially indicators such as the ratio of systolic volume ratio (SVR) to diastolic volume ratio (DVR) and IR. The administration of 40 mg of ƅ-blockers for a 2-week period improved the FPC, was safe and effective.
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39

Rudenko, S. A., A. V. Rudenko, Yu V. Kaschenko e V. P. Zakharova. "Surgical treatment of the ischemic heart disease with lowered contractility of left ventricle and mitral valve insufficiency". Klinicheskaia khirurgiia 87, n. 9-10 (29 ottobre 2020): 22–26. http://dx.doi.org/10.26779/2522-1396.2020.9-10.22.

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Objective. To determine the impact of the mitral valve insufficiency in patients, suffering ischemic heart disease with lowered contractility of left ventricle and methods of its treatment. Materials and methods. During 01.01.2015-31.12.2018 yrs period in the Amosov National Institute of Cardiovascular Surgery there were conducted 2267 consecutive operations of coronary shunting, of them 190 (8.4%) - in patients, suffering the ischemic heart disease with lowered contractility of left ventricle. Reduction of the output fraction of left ventricle down to 35% and lower have served as criterion of inclusion of the patients into the Group. There were 170 (89.5%) men and 20 (10.5%) women. The patients’ age have constituted 29 - 83 yrs old, (61.1 ± 8.9) yrs old at average. Results. In 47.9% of the patients the lowering of the left ventricle contractility after myocardial infarction was followed by occurrence of regurgitation on a mitral valve. At the same time it was noted, that the regurgitation value have had correlated with degree of the left ventricle contractility lowered: in reduction of values of the left ventricle output fracture down to 25% and lower a moderate regurgitation on a mitral valve was registered up to 2 times, a significant one - in 2.5 times, and the pronounced one - in 1.5 times more frequently, than in values of the left ventricle output fracture, exceeding 25%. Occurrence of a mitral insufficiency in 18.7% patients was caused by direct damage of valvular apparatus, while in 81.3% patients the consequences of the heart cavities were present in disorder of contractile function of myocardium. Presence of postinfarction mitral insufficiency enhances the risk of an acute cardiac insufficiency in 1.7 times and necessitates intraoperative correction in values of the regurgitation fraction over 30%. Conclusion. The own data obtained witness, that noncorrected mitral insufficiency in the ischemic heart disease worsens significantly the postoperative period course after performance of coronary shunting, enhancing rate of an acute cardiac, respiratory and renal insufficiency. Thus, taking into account a negative impact of concomitant mitral valve insufficiency on efficacy of surgical interventions in the lowered contractility of left ventricle the need emerges to perform complex reconstructive intervention in patients, suffering ischemic heart disease with lowered contractility of left ventricle.
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40

Gümüş, Hüseyin. "Beating heart mitral valve redo surgery in a patient with low ejection fraction and a stuck mitral valve". Cardiovascular Perfusion and Nursing 1, n. 1 (5 gennaio 2022): 8–9. http://dx.doi.org/10.5606/e-cvpn.2022.119.

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Mitral valve redo surgery is a high-risk intervention in particularly patients with low ejection fraction. In these cases, if the absence of aortic insufficiency is documented, beating heart surgery is possible via right thoracotomy in the Trendelenburg position. However, venous drainage, cardiopulmonary bypass temperature, electrolyte balance, and cerebral monitorization are the key considerations for the perfusionist. Herein, we discuss the perfusion standards of mitral valve redo surgery in a patient with low ejection fraction and a stuck mitral valve.
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41

Menjura, Sandra Rocio Rivera, Lia G. Moyano Rivas, Camila Parraguez Gamboa, Cristobal Balmaceda, Juan P. Peralta e Luis Rocha. "Mitral Valve Disease in Thyroid Storm". Journal of the Endocrine Society 5, Supplement_1 (1 maggio 2021): A941—A942. http://dx.doi.org/10.1210/jendso/bvab048.1924.

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Abstract Introduction: The cardiovascular effects that thyroid gland causes are widely studied. In fact, there is a known correlation between Graves’ Disease and mitral valve damage. We present the case of a patient admitted with thyroid storm and heart failure associated with severe structural damage of the mitral valve papillary muscle. Case Report: 24 year old woman with hyperthyroidism diagnosed 12 years ago, treated irregularly with thiamazole and propranolol, leaving treatment a year ago, presents dyspnea, class III functional capacity, diarrhea and logic dysphagia of a month of evolution. Heart rate over 170 bpm, respiratory rate 48 rpm and blood pressure 143/84 mmHg. Physical exam positive for exophthalmos, grade III goiter, crackles in both lung bases, pretibial myxedema and fulfilling criteria for a thyroid storm (65 points in Burch-Wartofsky Point Scale). First Lab Results: TSH&lt;0.005µU/mL, free T4&gt;7.7ng/dl and TRAB 37.8UI/L. Chest ray: Global cardiomegaly and pulmonary edema. EKG: Narrow complex supraventricular tachycardia. Thyroid ultrasound: Intrathoracic goiter. Transesophageal echocardiogram: Severe mitral insufficiency (Carpentier Type I and IIIB), right cavities and left ventricular enlargement, preserved right ventricular function and severe pulmonary hypertension (PSAP 71-76 mmHg). First treated with thiamazole, hydrocortisone IV, cholestyramine and sedation, falling time after into ventilatory failure and developing delirium, requiring invasive mechanical ventilation. Tested positive for COVID- 19. Starts preparation with Lugol and undergoes Total Thyroidectomy. After surgery develops severe hypocalcemia secondary to transitory hypoparathyroidism. During hospitalization presents multiple infections including pneumonia (Pseudomonas Aeruginosa), lung aspergillosis, bacteriuria (Enteroccocus Faecium) and candiduria (Candida Albicans and Glabrata), each one treated with multiple antibiotics and vasoactive drugs. Once stable, mitral valve replacement is realized, after which, the patient progresses favorably being discharged with programmed ambulatory controls. Conclusion: We report a case of a patient who was presented with positive thyroid storm criteria associated with heart failure and severe mitral valve insufficiency. The case gets complicated as multiple infections take place, including COVID-19. Fortunately, because of the early and aggressive multidisciplinary management, the patient evolved favorably, overcoming the life-threatening conditions she went through. Key Words: Thyroid storm, mitral valve insufficiency, heart failure. Bibliography: Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007 Oct 9;116(15):1725-35. doi: 10.1161/CIRCULATIONAHA.106.678326. Erratum in: Circulation. 2008 Jan 22;117(3):e18. PMID: 17923583.
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42

Skopin, I. I., I. V. Slivneva, M. S. Latyshev, D. V. Murysova, T. V. Asatryan, N. O. Sokolskaya, A. V. Vavilov e N. O. Toporkov. "Assessment of the predictors of persistence/progression of functional mitral insufficiency in patients undergoing the interventional treatment of aortic valve diseases". Patologiya krovoobrashcheniya i kardiokhirurgiya 23, n. 2 (15 ottobre 2019): 9. http://dx.doi.org/10.21688/1681-3472-2019-2-9-19.

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<p>Mitral insufficiency usually accompanies numerous aortic valve diseases. At present, concomitant pronounced mitral regurgitation remains a fairly urgent problem in the transcatheter treatment of aortic valve diseases. During the postoperative period of transcatheter aortic valve replacement, mitral insufficiency tends to decrease in majority of the patients; however, in certain patients, mitral insufficiency persists as well as progresses, highlighting the advantages of this approach over open two-valve surgery. This article presents an analysis of research devoted to functional mitral insufficiency in patients undergoing the interventional treatment of aortic valve diseases. This study included high-risk patients (according to the STS scale of operational risk ≥8%), representing an older age group with a broad spectrum of comorbid pathologies. Some cases were categorised as the New York Heart Association functional class IV, presented with pronounced systolic dysfunction of the left ventricle or were considered inoperable. Based on the systematic review of eight studies, predictors of potential mitral insufficiency progression were identified, and treatment algorithms for this category of patients were studied for the interventional treatment of aortic valve disease. The intervention aims to optimise long-term prognosis, both in open surgery and minimally invasive interventions. The results of the present study will help improve immediate and long-term postoperative outcomes of the interventional treatment of aortic valve diseases. Determining the prognostic development of mitral regurgitation will help select the best management tactics for this complex group of patients, thereby improving treatment outcomes and long-term prognosis of both open surgery and minimally invasive interventions.</p><p>Received 26 June 2019. Revised 23 August 2019. Accepted 26 August 2019.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>
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43

Kanazawa, H. "Result of surgical treatment of infantile mitral valve insufficiency." Japanese Journal of Cardiovascular Surgery 18, n. 4 (1989): 603–5. http://dx.doi.org/10.4326/jjcvs.18.603.

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44

Pelletier, L. C. "Valve replacement with bioprostheses for non-ischaemic mitral insufficiency". European Heart Journal 12, suppl B (2 luglio 1991): 44–47. http://dx.doi.org/10.1093/eurheartj/12.suppl_b.44.

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45

Glazun, L. O., e E. P. Shcherbataya. "Ultrasound assessment of the morphology and severity of mitral insufficiency". Public health of the Far East Peer-reviewed scientific and practical journal 92, n. 2 (27 giugno 2022): 14–23. http://dx.doi.org/10.33454/1728-1261-2022-2-14-23.

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The article describes in detail the mechanisms of anatomical and functional changes in the mitral valve that cause its insufficiency. Modern recommendations on diagnostic criteria and assessment of the severity of mitral regurgitation are given. Attention is drawn to the need for an integrated approach to diagnosis, integrating data on morphological changes in the valve, Doppler criteria and the degree of hemodynamic disorders
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46

Onan, Burak, Unal Aydin, Zeynep Kahraman, Korhan Erkanli e Ihsan Bakir. "Robot-Assisted Mitral Valve Repair with Posterior Leaflet Extension for Rheumatic Disease". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 12, n. 1 (gennaio 2017): 60–63. http://dx.doi.org/10.1097/imi.0000000000000335.

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Mitral valve repair has been one of the widely used applications of robotic surgery. Patients with rheumatic mitral disease usually present at an early age with thickening, retraction, or fusion of the leaflets and subvalvular apparatus. Robotic mitral repair can be feasible among this group of patients, rather than replacement. Herein, we describe a young woman who presented with rheumatic mitral valve insufficiency. A complex mitral repair with posterior leaflet extension with an autologous pericardial patch was successfully conducted using robot assistance.
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47

Buklas, Dimitrios, Massimo Massetti, Eric Saloux, Eugenio Neri, Olivier LePage, Calin Ivascau, Gerard Babatasi e Andre Khayat. "A Complex Mitral Valve Reconstruction: A Case Report". Heart Surgery Forum 6, n. 2 (2 febbraio 2005): 27. http://dx.doi.org/10.1532/hsf.648.

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Several techniques are currently in use for mitral valve reconstruction. We report a mitral repair case in which the use of a combination of different surgical techniques resulted in the necessary correction. A 47-year-old woman underwent surgical intervention to treat severe mitral valve insufficiency due to A1/A2/A3 and P2 prolapsed valve tissue. A combination of quadrangular resection, sliding leaflet, single chordal transposition, "flip-over" leaflet, and ring annuloplasty techniques were applied, and postsurgical correct valve function was documented by results of a left ventricular saline filling test and transesophageal echocardiography control. Complex mitral valve repairing techniques can be combined to reestablish valvular function.
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48

Sarioglu, C. Tayyar, Yasemin Turkekul, Ahmet Arnaz, Emrah Sisli, Yusuf Kenan Yalcinbas e Ayse Sarioglu. "Surgical Repair of Congenital Left Atrial Aneurysm and Mitral Valve Insufficiency in a Four-Year-Old Child". World Journal for Pediatric and Congenital Heart Surgery 9, n. 3 (12 dicembre 2016): 357–59. http://dx.doi.org/10.1177/2150135116678416.

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Left atrial aneurysm is an extremely rare anomaly, which can be associated with supraventricular arrhythmia, compression of coronary arteries, intracardiac thrombus, life-threatening systemic embolization, pulmonary venous obstruction, mitral valve insufficiency, and congestive heart failure. Herein, we report a four-year-old boy who had a giant aneurysm of the left atrium and severe mitral regurgitation. The aneurysm and mitral valve cleft causing severe mitral regurgitation were successfully repaired.
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49

Schlömicher, Markus, Matthias Bechtel, Zulfugar Taghiyev, Yazan Al-Jabery, Peter Lukas Haldenwang, Vadim Moustafine e Justus Thomas Strauch. "The Use of Rapid Deployment Valves in Combined Aortic and Mitral Valve Surgery". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 12, n. 3 (maggio 2017): 201–6. http://dx.doi.org/10.1097/imi.0000000000000373.

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Objective Patients undergoing multiple valve surgery represent a high-risk group who could potentially benefit from a reduction of cross-clamp and cardiopulmonary bypass times because prolonged bypass and cross-clamp times are considered independent risk factors for increased morbidity and mortality after cardiac surgery. Methods Between July 2013 and November 2014, 16 patients underwent rapid deployment aortic valve replacement with the EDWARDS INTUITY valve system in the setting of concomitant mitral disease. Fifteen patients showed mitral regurgitation, whereas one patient had severe mitral stenosis. Fourteen patients received mitral valve repair and two patients received biological mitral valve replacement. Tricuspid valve repair was performed additionally in two patients. The mean ± SD age was 72.8 ± 8.4 years, and the mean ± SD logistic EuroSCORE II is 8.7% ± 3.4%. Results Within a 30-day perioperative period, no patient was lost (n = 0). The mean ± SD follow-up time was 11 ± 2 months. At 1 year, the overall survival was 81% (n = 13). A mean ± SD transaortic gradient of 10.7 ± 2.3 mm Hg and a mean ± SD effective orifice area of 1.7 ± 0.3 cm2 were measured echocardiographically. No higher-grade paravalvular leak (aortic insufficiency > 1+) occurred. Eight patients (61%) had no residual mitral regurgitation, four patients (30%) showed trivial regurgitation (1/4), and one patient (7.3%) had moderate mitral regurgitation (2/4). No interference of the subannular stent frame with the reconstructed valve or the biological mitral prosthesis was seen. Conclusions Rapid deployment aortic valve replacement with the EDWARDS INTUITY valve system in combined aortic and mitral valve surgery can be performed safely with reproducible results. One-year follow-up data of this small series shows encouraging results potentially justifying the extension of the indication for rapid deployment valves to patients with concomitant mitral disease. Especially elderly patients undergoing multiple valve surgery may benefit from a reduction of cardiopulmonary bypass and myocardial ischemic times.
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50

Ziyatdinov, D. Zh, A. V. Mikhailov, Yu S. Alueva e E. M. Idov. "Functional tricuspid valve insufficiency and right ventricular dysfunction after mitral valve replacement". Kardiologiya i serdechno-sosudistaya khirurgiya 8, n. 1 (2015): 84. http://dx.doi.org/10.17116/kardio20158184-87.

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