Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mobile masses within the left atrial cavity are commonly caused by organized thrombi or left atrial myxoma. The use of transesophageal echocardiography has provided means for differentiation between the 2 conditions. We report a case of a left atrial mass in a female patient who presented with mitral stenosis and atrial fibrillation, and was diagnosed by transthoracic echocardiography (TTE). The mass appeared freely mobile but did not prolapse between the mitral leaflets due to the tightly stenosed valve orifice. In the presence of mitral stenosis, atrial fibrillation and dilated left atrium, the appearance of the mass was in keeping with mobile thrombus. Consequently, the patient was referred for surgical treatment and the mass removed through left atriotomy. Microscopic examination revealed a highly organized thrombus. We conclude that TTE is still a reliable tool in the diagnosis of large mobile atrial thrombi; TEE is needed when differentiation from atrial myxoma is difficult.
 ...
PMID:Floating left atrial mass in a patient with mitral stenosis. 1612 33

Three-dimensional echocardiography offers great promise for improving the understanding of the mitral valve anatomy, function, and pathology. It may have important implications for medical or surgical management of different mitral valve disease. In this article we provide an overview of the three-dimensional anatomy of the mitral valve. Based on the studies using three-dimensional echocardiography we describe the topography of the mitral valve, its nonplanarity as well as dynamics of the mitral annulus. Furthermore, we review the use of three-dimensional echocardiography in the evaluation of different mitral valve disease. Three-dimensional echocardiography has become a new clinical standard in the assessment of the severity of mitral stenosis by means of accurate mitral valve area measurement. Also, unconventional indices, like the geometry and mitral valve volume may be assessed by three-dimensional echocardiography. It is a very suitable technique for monitoring the efficacy and complications of percutaneous mitral valvuloplasty. Three-dimensional echocardiography allows accurate identification and quantification of prolapse of individual segments of the mitral valve leaflets. Three-dimensional color flow imaging makes echocardiography an accurate method also in the assessment of mitral regurgitation severity. Finally, we outline three-dimensional echocardiography as a potentially useful guide for a surgeon, particularly in mitral valve repair.
 ...
PMID:Three-dimensional echocardiography in mitral valve disease. 1629 31

Between January 1988 and December 2003, 898 patients with rheumatic heart disease (mean age 22.4+/-10.1 years) underwent mitral valve (MV) repair. Five hundred and sixty-five patients (63%) had pre-operative atrial fibrillation. Six hundred and ten (68%) patients were in NYHA class III or IV. Four hundred and twelve (45.9%) had pure mitral regurgitation (MR) and 486 (54.1%) had mixed mitral stenosis and MR. The pathology was leaflet prolapse (n=270, 30%), annular dilatation (n=717, 79.8%) and calcification (n=39, 4.3%). Reparative procedures included annuloplasty (n=793, 88%), commissurotomy (n=530, 59%), chordal shortening (n=225, 25%), cusp excision/plication (n=41, 4.5%), cuspal thinning (n=325, 36%), cleft suture (n=142, 16%), decalcification (n=30, 3.3%), chordal transfer (n=13, 1.4%), and neo chordae construction (n=3, 0.3%). Early mortality was 32 (3.6%). Follow-up ranged from 6 to 180 months (mean 62.7+/-31.8 months) and was 96% complete. Six hundred and twenty-one patients (69%) had no, or trivial, or mild MV. Two hundred and seventy-seven of the 866 survivors had MR which was moderate in 153 (18%) and severe in 124 (14%) patients. Thirty-five patients underwent re-operation. There were 21 late deaths (2.4%). Actuarial and re-operation-free survival at 10 years were 92+/-1.1% and 81+/-5.2%, respectively. Freedom from moderate or severe MR was 32+/-3.9%. MV repair in the rheumatic population is feasible with acceptable long-term results.
 ...
PMID:Results of mitral valve repair in rheumatic mitral regurgitation. 1767 May 93

Atrial myxoma is the most common primary cardiac tumor. Its clinical presentation spreads from asymptomatic incidental mass to serious life-threatening cardiovascular complications. We report the case of a 44-year-old man with evening fever and worsening dyspnea in the last weeks, admitted to our hospital for acute pulmonary edema. The cardiac auscultation was very suspicious for mitral valve stenosis, but the echocardiography revealed a huge atrial mass with a diastolic prolapse into mitral valve orifice causing an extremely high transmitral gradient pressure. Awareness of this uncommon acute presentation of atrial myxoma is necessary for timely diagnosis and prompt surgical intervention.
 ...
PMID:Acute pulmonary edema caused by a giant atrial myxoma. 2376 77

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.
...
PMID:Mitral valve disease. 2442 32

We present an eight year-old girl who required an operation for moderate mitral insufficiency associated with partial atrioventricular septal defect. Echocardiography disclosed an ostium primum atrial septal defect and double-orifice mitral valve with moderate mitral regurgitation secondary to a cleft in the anterior leaflet and prolapse of the anterior leaflet. Intraoperative inspection revealed that the chordae from each orifice were attached to a single papillary muscle which resulted in a unique double-orifice mitral valve. Mitral valve repair using chordal shortening and cleft closure was successfully performed. Postoperative echocardiography observed trivial MR and no mitral stenosis.
...
PMID:Mitral valve repair for double-orifice mitral valve. 2519 58

I surveyed our echocardiographic database of the years between 1998 and 2012 for congenital abnormalities of the mitral valve in patients over 14 years. A total of 249 patients with mitral valve abnormalities were identified. Abnormalities included clefts in the mitral valve in 58 patients, double orifice of the mitral valve in 19, mitral stenosis with two papillary muscles in 72, and mitral stenosis with one papillary muscle in 51 patients. Supravalvar rings were found in 35 patients with a single papillary muscle, and mitral stenoses with two papillary muscles were found in 22 patients. Mitral prolapse occurred in 44 patients and mitral valvar straddle in five patients. The patients were evaluated by all modalities of ultrasound available over the course of time. Although some lesions were isolated, there were many lesions in which more than one mitral deformity presented in the same patient. The patients are presented showing anatomical correlation with autopsy specimens, some of which came from the patients in this series, and others matched to show correlative anatomy. These lesions remain rare as a group and continue to have high morbidity and mortality.
...
PMID:Echocardiography of congenital mitral valve disorders: echocardiographic-morphological comparisons. 2564 77

Mitral regurgitation secondary to accessory mitral valve (MV) chordae of the left atrium is an extremely rare congenital disease. A 85-year-old female (NYHA I-II) was hospitalized for investigations. An echocardiogram showed calcification of the MV with mild stenosis and moderate regurgitation. Transesophageal three-dimensional echocardiogram revealed a band-like structure extending from the distal third of the anterior wall of the left atrium to the MV. This accessory chordae determined severe systolic regurgitation and mild mitral stenosis. The patient was referred for consideration of cardiac surgery but was refused for comorbidities and anatomy. Usually aberrant chordae determinant valvulopathies are detected and treated at a much younger age. The delay of the symptoms could be explained in our case with the progressive growth and dilatation of the left atrium causing traction of the aberrant chord resulting in an increase in the leaflet prolapse and regurgitation.
 ...
PMID:A late presentation of congenital cardiac anomaly: Accessory chordae from the left atrium causing severe mitral regurgitation. 2956 66

Patients diagnosed with ocular myasthenia gravis (MG) and mitral valve disease represent a significant perioperative management problem, especially for the anaesthesiologist, due to complex inter-actions between the disease, drugs to treat the disease, and anaesthetic agents, such as neuromuscu-lar blocking agents (NMBAs). This paper describes the successful management of a 31-year-old female with mitral valve stenosis and ocular MG who was diagnosed with MG 4 years prior to the indication for cardiac surgery. Preoperatively, the patient was under treatment with Pyridostigmine and Prednisone. Mitral valve replacement and full thymectomy were performed, under general anaesthesia, using Fentanyl, Sevoflurane and low doses of non-depolarising NMBAs. The postoperative course was uneventful, the patient was extubated at 6 hours postoperatively, in-tensive care unit stay was 48 hours, and the patient was discharged after 6 days without any compli-cations. After 3 months, at the follow-up examination, the patient's ocular symptoms (eyelid ptosis) disappeared.
 ...
PMID:Mitral Valve Replacement with Thymectomy in a Patient with Ocular Myasthenia Gravis: Case Report. 3159 8

Cardiac myxoma is a benign neoplasm composed of stellate to plump, cytologically bland mesenchymal cells set in a myxoid stroma. Although benign, as they can lead to severe complications, they are often removed surgically. A 39-year-old female presented with a chief complaint of generalized fatigue. Patient had a history of a large 7cm x 2.5cm left atrial myxoma resected at the age of 32 years after she presented with symptoms of dyspnea on exertion. The dyspnea was due to prolapse of the mass through the mitral valve during diastole, leading to functional severe mitral stenosis. The mass was resected with clear margins confirmed on biopsy. On physical examination, heart rate was regular with no murmurs. No signs of congestive heart failure were noted. A 2D echo revealed a mobile structure in the left atrium along with mild mitral regurgitation. Cardiac MRI showed a 21mm x 9mm well defined, pedunculated, mobile mass in the left atrium arising from inter-atrial septum. The mass was hyperintense on T2 weighted images with patchy delayed hyper-enhancement consistent with recurrence of a myxoma. The patient underwent a repeat median sternotomy with the removal of left atrial mass and repair of atrial septum with hemashield patch. The mass was sent for pathological evaluation confirming the diagnosis of recurrent myxoma. On genetic testing, patient tested negative for mutations in PRKAR1A gene (mutated in up to 60%-80% cases with Carney complex), MEN1, RET and sarcoma (TP53) genes. Cardiac myxomas are rare primary benign tumors of the heart with a small recurrence rate. Follow-up studies have rarely reported recurrences after complete resection. However, in our case not only did the patient have the sporadic form of myxoma with recurrence, but it also occurred within three years of the previous resection despite complete removal with clear margins.
 ...
PMID:Sporadic Form of Recurrent Atrial Myxoma: The Blob Strikes Back. 3294 60


<< Previous 1 2 3 4