Limited donor availability for orthotopic cardiac transplantation has led surgeons to develop surgical alternatives to treat congestive heart failure as a result of ischemic cardiomyopathy. Coronary revascularization plays a clear role in patients with ischemic cardiomyopathy, substantial viable myocardium subtended by coronary stenoses, and presence of anginal symptoms. It is ...

OBJECTIVES: To delineate the cardiac magnetic resonance (MR) appearances of cardiovascular disease (CVD) in patients with systemic lupus erythematosus (SLE), in comparison with transthoracic echocardiographs. METHODS: Cardiac MR was performed on 22 patients with SLE-11 with previous CVD and 11 matched controls-using late gadolinium contrast enhancement (LGE) to identify areas ...

BACKGROUND AND AIM OF THE STUDY: Ischemic mitral regurgitation is present in a substantial proportion of patients presenting for coronary revascularization. Although patients with even mild to moderate ischemic mitral regurgitation (IMR) have a poorer long-term outcome, mitral valve repair in these cases can be unreliable due to the posterior ...

BACKGROUND: Abnormal positioning and size of the mitral valve contribute to the systolic anterior motion and mitral-septal contact that are important components of obstructive hypertrophic cardiomyopathy (HCM). The RPR repair (resection of the septum, plication of the anterior leaflet, and release of papillary muscle attachments) addresses all aspects of this ...

Dilated cardiomyopathy is often complicated by severe mitral regurgitation (MR) caused by dilation of the annulus. Heart transplantation remains the ultimate treatment when heart failure fails to respond to medical treatment. Mitral annuloplasty for severe MR in dilated or ischemic cardiomyopathy may delay or replace the need for heart transplantation. ...

The coronary venous system is routinely targeted during electrophysiological measurements or cardiac resynchronization therapy. However, several novel interventional techniques require coronary venous catheterization and visualization as well as transvenous delivery of devices and/or therapeutic agents. Recent reports suggest the possibility of a transvenous approach for the interventional treatment of refractory ...

OBJECTIVE: Congestive heart failure complicating aortic regurgitation is poorly described, and predictive roles of quantitative versus traditional (symptoms or low ejection fraction) surgical markers are unclear. METHODS: We prospectively enrolled 287 patients with aortic regurgitation (age, 61 +/- 17 years; 68% male) in whom we performed quantitative Doppler echocardiographic analysis ...

Reoperation rates to correct left atrioventricular valve regurgitation after primary repair of atrioventricular canal defects remain relatively high. The causes of valvular regurgitation are likely multifactorial, and simple cleft closure is often insufficient to prevent recurrence. To elucidate the mechanisms leading to regurgitation, we conducted hemodynamic studies using isolated native ...

Mitral valve regurgitation is a common valvular problem, particularly in developing nations. It causes significant morbidity and mortality, especially if the severity of valve regurgitation is underestimated. Echocardiography plays a significant role in the diagnoses, serial follow-up and management of patients with valvular heart disease. However, precise quantitation of the ...

We determined the pattern and severity of valvular involvement in 100 Sudanese patients with rheumatic heart disease (RHD) in 2 centres in Khartoum in 2003. All the patients underwent history taking, physical examination and Doppler echocardiography. The commonest lesions were mitral regurgitation (84%) and aortic regurgitation (40%). Mitral stenosis alone ...

BACKGROUND: Ischemic mitral regurgitation (IMR) has an adverse prognosis, but survival characteristics and management are controversial. This study reviewed a 20-year series of IMR patients managed with multiple approaches to assess and refine surgical strategies. METHODS: Patients having surgery for primary coronary disease from 1986 to 2006 were divided into ...

Chronic ischemic mitral regurgitation is associated with mitral annular dilatation in the septal-lateral dimension and flattening of the annular 3-dimensional saddle shape. To examine whether these perturbations are caused by the ischemic insult, mitral regurgitation, or both, we investigated the effects of pure mitral regurgitation (low pressure volume overload) on ...

Non-compaction of the ventricular myocardium (NCVM) is an under-diagnosed cardiomyopathy. Patients diagnosed with NCVM at the King Abdulaziz Cardiac Centre, Riyadh, KSA from January 2000 to July 2004 and at the Sudan Heart Centre from August 2004 to July 2007 were included. Fifty-two patients with NCVM were identified (22 per ...

The effects of erythropoietin administration on mitral regurgitation in patients with congestive heart failure have not yet been examined. After 2 months, erythropoietin treatment results in a significant reduction in left ventricular volumes and mitral regurgitation severity and improves hemodynamics.

BACKGROUND: A medical treatment that decreases the likelihood of left ventricular (LV) dysfunction or symptoms would benefit patients with moderate to severe degenerative mitral regurgitation. The aim of this pilot study was to determine the short-term effects of a beta-blocker on mitral regurgitant volume and LV work in these patients. ...

OBJECTIVE: This study investigated the early and late results of restrictive mitral valve (MV) annuloplasty in patients with chronic mitral regurgitation (MR) and advanced ischemic (ICM) or dilated cardiomyopathy (DCM). METHODS: From October 2001 to September 2006, 121 patients (age: 69 +/- 9 years) with a left ventricular ejection fraction ...

In addressing the current therapy for mitral regurgitation (MR), it is useful to distinguish primary MR from secondary (functional) MR. In primary MR, abnormalities of one or more of the components of the mitral valve cause it to leak, imparting a volume overload on the left ventricle (LV). Severe prolonged ...

OBJECTIVE: Recent trials suggest that using ergot-derived dopamine agonists such as cabergoline in the treatment of Parkinson's disease is associated with an increased risk of valvular heart disease. However, the dose of cabergoline used to treat hyperprolactinaemia is considerably less than that used in Parkinson's disease. DESIGN AND METHODS: A ...

BACKGROUND: Optimal repair of anomalous origin of left coronary artery from pulmonary artery (ALCAPA) relies on the creation of a dual-coronary system. If the anomalous coronary arises at a long distance from the aorta, we use various coronary extension techniques to facilitate tension-free implantation. METHODS: Thirty patients underwent ALCAPA operations ...

BACKGROUND AND AIM OF THE STUDY: Clinical and echocardiographic results were investigated to evaluate mitral valve repair in patients undergoing coronary artery bypass grafting (CABG) for ischemic cardiomyopathy (ICM) with moderately severe mitral regurgitation (MR). METHODS: A total of 78 patients (21 women, 57 men; mean age 69.5 +/- 7.8 ...

AIMS: Mitral regurgitation (MR) is common and independently predicts mortality in patients with left ventricular (LV) systolic dysfunction. Its management remains challenging because of the complexity and variety of potential mechanisms implicated. We sought to determine which LV functional characteristics are the most important determinants of the severity of the ...

Chronic volume overload from chronic severe mitral regurgitation (MR) results in neuroendocrine activation similar to the heart failure syndrome despite normal left ventricular (LV) ejection fraction (EF). Hence, the hypothesis that beta-blocker (BB) therapy may have a beneficial effect in these patients was tested using a large observational cohort. Our ...

BACKGROUND: Three-dimensional echocardiography offers new insights into valvar function in atrioventricular septal defects (AVSDs). The aim of this study was to identify a morphological marker to predict the functional outcomes of left atrioventricular valves (AVVs) following the repair of AVSDs. METHODS: Twenty-nine consecutive patients were evaluated preoperatively using 2-dimensional and ...

BACKGROUND: Anomalous origin of the left coronary artery from the pulmonary artery causes severe myocardial ischemia, global left ventricular dysfunction, and annular dilatation producing varying degrees of mitral regurgitation. Mitral regurgitation secondary to the left ventricular or papillary muscle dysfunction in infants will usually improve in the absence of ongoing ...

OBJECTIVE: Magnetic resonance imaging was used to evaluate left ventricular reverse remodeling at long-term follow-up (3-4 years) after restrictive mitral annuloplasty in patients with early stages of nonischemic, dilated cardiomyopathy, and severe mitral regurgitation. METHODS: Twenty-two selected patients (eligible to undergo magnetic resonance imaging) with mild to moderate heart failure ...

BACKGROUND: Significant mitral regurgitation is known to exacerbate left ventricular dysfunction in dilated cardiomyopathy. Although intervention on the regurgitant mitral valve is frequently described in adults, there is little pediatric data. METHODS: Five children (aged 3 months to 4 years) with dilated cardiomyopathy and mitral regurgitation underwent mitral valve repair ...

OBJECTIVE: This study investigated the feasibility of mitral valve (MV) repair in patients with active or healed infective endocarditis (IE) with mitral regurgitation and evaluated effects on left ventricular (LV) function and structure. METHODS: Subjects comprised 19 patients who underwent MV operations for IE between December 2004 and September 2007. ...

INTRODUCTION: The mitral valvar complex is difficult to visualise accurately in only two dimensions. Three-dimensional echocardiography gives new insight into the dynamic changes of intra-cardiac structures during the cardiac cycle. The aim of this study was to study the mitral annulus in systole and diastole in normal children using three-dimensional ...

BACKGROUND AND AIM OF THE STUDY: Ischemic mitral regurgitation (IMR) appears in 20-50% of patients after acute myocardial infarction, and entails an increased long-term mortality. In order to compensate for the diversified pathology in humans, this disease entity has been developed in pigs in order to allow investigations of therapeutic ...

BACKGROUND: Ischemic mitral regurgitation indicates a poor prognosis after acute myocardial infarction (AMI). This study addresses the clinical characteristics and contribution of ischemic mitral regurgitation to the midterm survival rate of patients following first AMI in our institution. METHODS: Between January 2000 and December 2002, patients who underwent 2-dimensional color ...

OBJECTIVES: Peak oxygen uptake (VO(2)) and ventilatory efficiency have prognostic implications in the population with congestive heart failure. This study evaluated quality-of-life functional capacity after the 2 treatment strategies of surgical ventricular restoration and transplantation for severe left ventricular dysfunction of ischemic cause. METHODS: The 75-patient study population (between 2004 ...

OBJECTIVE:Takayasu Arteritis (TA) is a rare disease that mainly affects large elastic arteries. It is more frequently seen in Asia, the Mediterranean basin, South Africa and Latin America. We have characterized its clinical manifestations and identified the cardiovascular mortality predictors in a cohort of 110 Mexican Mestizo patients.MATERIAL AND METHOD:Retrospective ...

PURPOSE: This study evaluated the short-term feasibility of a novel epicardial device that treats functional mitral regurgitation by simultaneously changing the mitral and the left ventricular geometry. DESCRIPTION: We implanted a prototype device that consists of 2 tissue anchors, a deflector, and a flexible tightening chord in 7 mongrel dogs ...

Functional mitral regurgitation (FMR) is a common finding in patients with ischemic or nonischemic dilated cardiomyopathy as a complication of left ventricular (LV) dysfunction and remodeling associated with a fibrotic remodeling response of mitral leaflets to abnormal valvular loading. Although mitral valve tenting is the main determinant of FMR, clinical ...

A 65-year-old female with catecholamine-dependent ischemic cardiomyopathy was admitted to our hospital. Preoperative examination revealed severe triple vessel coronary artery disease, severe mitral valve regurgitation and left ventricular (LV) dilatation associated with low ejection fraction. Coronary artery bypass grafting with four distal anastomoses, mitral valve plasty using original papillary muscle ...

The long-term benefit of angiotensin-converting enzyme inhibitors in pediatric patients with aortic valve regurgitation is under consideration. Eighteen patients with mid to severe aortic valve regurgitation were retrospectively evaluated. Echocardiographic parameters (left ventricular end-diastolic diameter, shortening fraction, left ventricular posterior wall thickness, and grade of aortic valve regurgitation) were analyzed ...

BACKGROUND: Long-term durability of combined coronary artery bypass grafting and of undersized mitral ring annuloplasty (UMRA) is uncertain. A considerable number of patients show recurrent regurgitation. This study examines the difference in the benefit of UMRA on clinical end points and recurrence of mitral regurgitation between responders and nonresponders of ...

Mitral regurgitation is commonly encountered in anesthesia clinical practice. Knowledge of the pathophysiology and proper anesthetic management is crucial to achieving optimal outcomes. Surgical advancements and early intervention have led to improved outcomes. An ASA class III, 58-year-old woman with mitral regurgitation secondary to rheumatic fever, presented for repair or ...

Chronic ischemic mitral regurgitation (IMR) is one of the leading causes of congestive heart failure and death. It is controversial whether mitral annuloplasty (MAP) per se can improve the long-term survival because IMR has been considered a disease of the left ventricle. We reviewed our experience of papillary muscle realignment ...

OBJECTIVE: Our study was undertaken to assess cardiac functions by tissue Doppler echocardiography in patient with primary episode of rheumatic carditis. METHODS: We divided 82 patients with rheumatic carditis were divided in two groups; 50 patients with mild and 32 patients with mitral regurgitation of grade two or more. A ...

AIMS: This study was aimed at exploring the predictive value of Doppler-Derived Mitral Deceleration Time (DT) on left ventricular reverse remodelling (LVRR) in patients with chronic ischaemic mitral regurgitation (CIMR) undergoing combined undersized mitral annuloplasty (UMRA) and coronary artery bypass grafting (CABG). METHODS AND RESULTS: Two hundred and fifteen patients ...

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac defect that usually presents as dilated cardiomyopathy in infancy. From 1984 to 2005, 13 (five males and eight females, 0.13%) out of 9,950 patients with congenital heart disease were identified as ALCAPA at ...

Chronic ischemic mitral regurgitation (IMR) is a common complication of myocardial infarction and severely affects cardiovascular mortality and morbidity. Multiple pathophysiologic mechanisms, such as left ventricular (LV) remodeling and dysfunction, annular dilation/dysfunction, and mechanical dyssynchrony, are involved in generating IMR, each of them having different weight. However, the prerequisite to ...

BACKGROUND: The mitral annulus and left ventricle are generally thought to be functionally coupled, in the sense that increases in left ventricular (LV) size, as seen in ischemic mitral regurgitation (MR), or decreases in LV size, as seen with inotropic stimulation, are thought to increase or decrease annular dimensions in ...

In ischemic and nonischemic cardiomyopathy, functional mitral regurgitation (MR) results from geometric abnormalities of the ventricle, which result in dysfunction of a morphologically normal mitral valve. Enlargement of the left ventricle causes geometric MR through annular dilation, increase in the interpapillary muscle distance, amplified leaflet tethering (elongation and stretch on ...

In June 2006, the American College of Cardiology/American Heart Association Guidelines for the Management of Patients with Valvular Heart disease were published. Although many recommendations were unchanged from the 1998 guidelines, several new suggestions bear comment. The new guidelines favor a more aggressive approach to most valve lesions. For patients ...

BACKGROUND: The mechanisms by which mitral regurgitation (MR) may lead to an adverse prognosis after reperfused acute myocardial infarction (AMI) have not been fully investigated. We hypothesized that in the early phase of ST-elevation AMI, MR may lead to progressive left ventricular (LV) remodeling and subsequent heart failure. METHODS AND ...

BACKGROUND: Acute rheumatic carditis is still a major problem in developing countries. Cardiac troponin-I (cTnI) has been identified as a sensitive and specific marker in the diagnosis of myocarditis in children and adults. METHODS: A prospective study was performed using Doppler echocardiography and cTnI in order to detect myocardial involvement ...

This study aimed to investigate the factors determining early left atrial (LA) reverse remodeling after mitral valve (MV) surgery. The left atrium is frequently dilated in patients with mitral stenosis (MS) or mitral regurgitation (MR). MV surgery usually results in LA volume reduction. However, the factors associated with LA reverse ...

BACKGROUND: Restrictive mitral annuloplasty with revascularization is considered the best approach to ischemic mitral regurgitation with heart failure, but late results are controversial. We report late outcome in relation to preoperative left ventricular end-diastolic diameter (LVEDD) cutoff values, previously identified to predict intermediate-term left ventricular reverse remodeling. METHODS: One hundred ...