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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 9-year-old patient with known Alagille syndrome presented to our institution with progressive mitral valve regurgitation due to prolapse of the posterior valve leaflet. She underwent successful mitral valve replacement with a mechanical prosthesis 4 years after the initial diagnosis. To the best of our knowledge, an association between mitral valve regurgitation and Alagille syndrome has not been previously described.
Thorac Cardiovasc Surg 2007 Sep
PMID:Rare association of a patient with Alagille syndrome and mitral valve regurgitation. 1772 51

Degenerative mitral valve disease is the most common cause of mitral regurgitation (MR) in developed countries. The most common etiologies of valvular regurgitation are Barlow's disease and fibroelastic deficiency. The mechanism of MR is type II dysfunction (leaflet prolapse) due to chordae elongation or rupture in most patients. Associated annular dilation is a common lesion in almost all patients with chronic MR. By means of segmental valve analysis, isolated posterior leaflet prolapse (P2 segment) is often observed in patients with fibroelastic deficiency, whereas the prolapse of multiple segments or bileaflet prolapse is typically seen in patients with Barlow's disease. In patients with degenerative mitral valve disease and severe MR, reconstructive surgery should be performed before the occurrence of clinical symptoms, atrial fibrillation, pulmonary hypertension, and left ventricular dysfunction or enlargement. The goals of reconstructive surgery are preservation or restoration of normal leaflet motion, creation of a large surface of coaptation, and stabilization of the entire annulus with a remodeling annuloplasty. Today, reconstructive techniques are standardized, reliable, and reproducible, and therefore should be applied systematically to all patients with degenerative valvular disease.
Semin Thorac Cardiovasc Surg 2007
PMID:Principles of reconstructive surgery in degenerative mitral valve disease. 1787 3

Mitral valve repair with Gore-Tex (W.L. Gore & Assoc, Inc, Flagstaff, AZ) neochordae is of increasing interest. In 2000, the loop technique using premeasured Gore-Tex neochordae was introduced by our group. Herein, we report our experience with this technique in minimally invasive mitral valve repair (MVR) for degenerative disease. Between 1999 and 2006, 468 patients (328 men and 140 women) underwent elective MVR using neochordae at our institution. The mean age of the patients was 58 +/- 12.3 years. All patients had significant mitral valve regurgitation, and the mean severity was 3.5 +/- 0.6. Prolapse of the posterior leaflet was diagnosed in 393 patients (84%), and prolapse of the anterior leaflet was diagnosed in 250 patients (53.4%). Mean left ventricular function was 64.8 +/- 12.3%. All patients were operated on with the minimally invasive approach via a right lateral mini-thoracotomy, femoral cannulation for cardiopulmonary bypass, and the transthoracic direct clamp technique. Mean duration of cardiopulmonary bypass was 136 +/- 40 minutes, and mean aortic clamp time was 87 +/- 31 minutes. Gore-Tex neochordae were used in 149 patients (32%) on both leaflets, in 224 patients (47.7%) on the posterior leaflet only, and in 95 patients (20.3%) on the anterior leaflet only. A mean number of 2.7 +/- 1 loops at a mean length of 21 +/- 3.3 mm were used on the A2 segment. On the P2 segment, a mean number of 3.2 +/- 1 loops at a mean length of 14.3 +/- 3.1 mm were applied. The intraoperative course was uneventful in all patients. Early reoperation for bleeding had to be performed in 18 patients (3.9%). Mean duration of hospital stay was 11.9 +/- 13 days. The 30-day mortality rate was 1.5% (7 patients), and 1-year mortality rate was 2.6% (12 patients). MVR with neochordae and the loop technique is an easy and effective treatment for degenerative mitral valve disease. The procedure is reliable and reproducible, leading to low morbidity and mortality. Thus, use of Gore-Tex neochordae has become the standard technique for MVR at our institution.
Semin Thorac Cardiovasc Surg 2007
PMID:Gore-tex chordoplasty in degenerative mitral valve repair. 1787 4

Takotsubo syndrome may be associated with neuromuscular disorders, but has never been described in a patient with mitochondrial disorder. A 75-year-old woman developed muscle cramps, ptosis, fasciculations and slowly progressive weakness and wasting of all four limbs, starting 2.5 years earlier. After exclusion of various differential diagnoses, including non-specific granulomatous myositis, inclusion body myositis, and motor neuron disease, mitochondrial disorder was assumed. Muscle weakness progressed to respiratory insufficiency, requiring mechanical ventilation. Five days after intubation, she developed hypotension, torsades de pointes, ST-segment elevation, and negative T waves. Echocardiography revealed apical ballooning with akinesia of the left ventricular anteroseptal, apical, apicolateral and inferior segments. Coronary angiography was normal, and ventriculography confirmed apical hypokinesia and ballooning. Takotsubo syndrome was diagnosed, resolving completely within 7 weeks under bisoprolol. This case shows that Takotsubo syndrome occurs also in mitochondrial disorder and under mechanical ventilation, and may be triggered by stress from respiratory insufficiency, intubation, pain from tracheostomy, stress from mechanical ventilation, medication, or from the uncertain prognosis.
J Cardiovasc Med (Hagerstown) 2007 Oct
PMID:Apical ballooning (Takotsubo syndrome) in mitochondrial disorder during mechanical ventilation. 1788 29

In mitral valve regurgitation due to anterior leaflet prolapse and other complicated lesions, chordal replacement with expanded polytetrafluoroethylene is widely practiced. The most troublesome aspects of this procedure are the determination of the necessary length of the artificial chorda and the tying of the knot. We describe a simple technique for artificial chordal replacement using an Alfieri stitch, that has been successfully applied to 10 patients with anterior leaflet prolapse.
Asian Cardiovasc Thorac Ann 2007 Dec
PMID:Chordal replacement with temporary Alfieri stitch for anterior leaflet prolapse. 1804 85

Apical hypertrophic cardiomyopathy (AHC) is associated with neurological abnormalities such as transient ischemic attack, stroke, limb-girdle muscular dystrophy, or eosinophilic myositis in single cases. The association of AHC and metabolic myopathy has not been reported. In an 84-year-old woman with long-standing gait disturbance, dementia, Parkinson syndrome, ptosis, ophthalmoparesis, tetraparesis, polyneuropathy, lactacidosis, polyarthralgia, dorsalgia, and osteoporosis, cardiac examination for long-standing anginal chest pain and palpitations, revealed supraventricular and monomorphic ventricular ectopic beats, hypertrophic signs, ST-depression and negative T waves on electrocardiogram (ECG), diastolic dysfunction with impaired relaxation, and AHC on transthoracic echocardiography. AHC was confirmed by cardiac magnetic resonance imaging, which additionally showed a small left ventricular apical aneurysm with a wall-thickness of only 3 mm. The patient was suspected to additionally have a multisystem disease, most likely due to impaired oxidative metabolism. This case shows that AHC may take a mild course and be associated with a number of extracardiac abnormalities.
J Cardiovasc Med (Hagerstown) 2007 Dec
PMID:Apical hypertrophic cardiomyopathy in encephalomyopathy. 1816 25

Percutaneous closure of sedundum atrial septal defects (ASD) has been shown to be safe and effective. Usually crossing the defect is relatively straightforward. Occasionally, with fenestrated ASDs, trying to cross the defect(s) may be challenging. We report the use of a "paralle wire" (0.018 or 0.014 inch wire) technique to maintain access and be able to recross the same defect easily in case of misplacement until just before the device was secured and released. This technique could be used also as a "body wire" for large ASDs with deficient rims to reduce the incidence of device prolapse, and for patent foramen ovale and ventricular septal defect closures. This is a simple and easily reproducible method with the equipment readily available in virtually all catheterization laboratories.
Catheter Cardiovasc Interv 2008 Mar 01
PMID:The parallel wire technique for septal defect closure. 1830 33

We designed a mitral valve repair and successfully performed this repair for a case of broad, asymmetrical prolapse in the middle scallop of the posterior mitral leaflet. The repair procedure consists of making a fan-shaped leaflet by resecting the prolapsed portion in a trapezoid shape with detachment of the leaflet along the annulus and leaflet reapproximation by rotating this fan-shaped leaflet. This technique can utilize more leaflet tissue for filling the gap made by leaflet resection than the quadrangular resection and suture technique. As a result, it helps reduce tension on the suture lines, avoids the need for extensive annular plication, and also avoids leaflet distortion while making it easier to adjust the height of the leaflets that should be reapproximated. The essence of this mitral valve repair exists in the "resecting line of the leaflet," which has not yet been reported.
Gen Thorac Cardiovasc Surg 2008 Mar
PMID:Mitral valve repair for broad, asymmetrical prolapse in the posterior mitral leaflet. 1834 May 15

We report the case of a 52-year-old man who was referred to surgery because of severe mitral and tricuspid regurgitation of Barlow's disease. In particular, the tricuspid valve was a 'four-leaflet valve' due to the presence of a small accessory leaflet between the septal and the posterior leaflets. The valve insufficiency was determined by prolapse of all leaflets (in particular of the anterior and posterior ones) associated with annular dilatation. The patient underwent both mitral and tricuspid valve repair. The tricuspid regurgitation was corrected by stitching together the middle point of the free edges of the tricuspid leaflets producing a 'four-leaflet clover-shaped' valve. Surgical and echocardiographic images of the repaired valve are reported.
J Cardiovasc Med (Hagerstown) 2008 Aug
PMID:'Four-leaflet clover repair' of severe tricuspid valve regurgitation due to complex lesions. 1860 54

Ventricular catheterization in the rat is a widely deployed procedure. Current options allow a one-time catheterization procedure, introducing an error due to the inter-individual variability. Six Fischer rats underwent left ventricular catheterization through the right carotid artery, repeated seven days later via the left carotid artery. We acquired volume and pressure data from each animal during both procedures. Volumes and pressures were plotted to construct pressure-volume loops at the two time-points. The neurological outcome and the gross anatomy of the heart were also evaluated. We did not observe any major behavioral or neurological alteration in any of the animals. We observed a Horner syndrome with palpebral ptosis and enophtalmus in one animal. At the macroscopic evaluation of the explanted hearts, we observed perforation of the left ventricle in one case. This is a safe, easy, and reproducible procedure; it can be performed twice in the same animal with no neurological consequences. It is particularly suitable for longitudinal studies, to minimize the statistical error due to inter-individual variability.
Interact Cardiovasc Thorac Surg 2008 Oct
PMID:New and simplified method for multiple left ventricle catheterizations in small animals. 1880 19


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