共查询到20条相似文献,搜索用时 15 毫秒
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Ibrahim Sultan MD Edgar Aranda‐Michel Thomas G. Gleason MD Forozan Navid MD Arman Kilic MD 《Journal of cardiac surgery》2018,33(9):484-488
Background
Papillary muscle rupture (PMR) is a rare complication of a myocardial infarction. The aim of this study was to review our results of mitral valve surgery for acute PMR.Methods
Data from patients undergoing emergent mitral valve surgery for acute PMR between 2011 and 2017 at our institution were reviewed. Outcomes included operative morbidity and mortality, mitral valve reoperation, and hospital readmission.Results
A total of 2479 patients underwent mitral valve surgery during the study period including 24 (1.0%) for PMR. Mean age was 62 years, and two (8.3%) patients had prior open‐heart surgery. Overall Society of Thoracic Surgeons predicted risk of mortality was 17.5%. Operative mortality was 12.5% (n = 3) with an observed‐to‐expected mortality ratio of 0.71. There were no strokes, and new onset dialysis was required in two (8.3%) patients. Mean follow‐up was 2.40 ± 1.96 years. Three‐year mortality, mitral valve reoperation, and readmission rates were 21.1%, 5.0%, and 45.4%.Conclusions
Expeditious operative intervention for PMR can be associated with acceptable operative and longer‐term outcomes. 相似文献4.
Mitral valve replacement in a patients with an extensively calcified mitral anulus: Report of a case
Yoshiya Toyoda Tsutomu Shida Noboru Wakita Yasumi Matoba Nobuchika Ozaki 《Surgery today》1998,28(4):427-429
(Received for publication on Sept. 25, 1996; accepted on May 12, 1997) 相似文献
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Hiromichi Fujii Shigefumi Suehiro Toshihiko Shibata Yasuyuki Sasaki Tadahiro Murakami Hiroaki Kinoshita 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2001,49(2):122-124
A 67-year-old man, with a history of pulmonary tuberculosis since 18 years old, presented shortness of breath because of severe mitral regurgitation. Magnetic resonance imaging showed that the heart was displaced into the left thoracic cavity and rotated clockwise around its long axis. The forced expiratory volume per second was 1.06 l (46.7% of the predicted value) and the vital capacity was 2.48 l (72.1% of predicted value). Surgery was performed through a median sternotomy. An internal mammary artery harvest retractor was used to obtain operative exposure. Extensive pericardial suspension was used to push the over-inflated right lung across the midline. Extracorporeal circulation was established. The mitral valve was replaced with a mechanical prosthesis. The patient was weaned easily from extracorporeal circulation and was extubated on the day of surgery. If preoperative respiratory function is adequate, cardiac surgery can be performed safely in a patient with only one functional lung. 相似文献
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Makoto Kamada Kenji Ohsaka Susumu Nagamine Hidemitsu Kakihata 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2004,52(12):589-591
Left ventricular rupture following mitral valve replacement is one of the most serious complications. We report our experience
in successful treatment of type III left ventricular rupture following mitral valve replacement probably due to an oversize
prosthesis. A 67-year-old woman, with the history of percutaneous transluminal mitral commissurotomy 11 years previously,
underwent mitral valve replacement for mitral restenosis with a 27 mm CarboMedics mechanical bileaflet valve (Sulzer CarboMedics
Inc., Austin, TX, U.S.A.). There were some difficulties in placing the entire prosthesis into the annulus at the posterior
because of the oversize prosthesis. After the complete placement of the prosthesis, bulge of the left ventricular muscle was
evident around the left lateral region. Following the cessation of cardio-pulmonary bypass, type III left ventricular rupture,
half a circular rip between the papillary muscles and posterior mitral annulus, occurred. The rip was suture-closed and a
23 mm CarboMedics valve was placed. Postoperative ultrasonic cardiography showed no prosthetic stenosis, periprosthetic leak,
left ventricular pseudoaneurysm, nor left ventricular asynergy. Under cardioplegic arrest, we should not select the oversize
prosthesis to prevent left ventricular rupture. 相似文献
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Mikio Ninomiya Kuniyoshi Yagyu Yukihiro Kaneko Yutaka Kotsuka Shinichi Takamoto 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2001,49(4):230-235
OBJECTIVE: We evaluated effects of type, size, and orientation of mechanical mitral valve prostheses on hemolysis. METHODS: Subjects were 84 patients who had undergone mitral valve replacement. Lactate dehydrogenase was mainly used as a marker of hemolysis and was measured before surgery, 1 month after surgery, and in the late postoperative period. RESULTS: Valves used included 16 Medtronic-Hall, 32 St. Jude Medical, and 36 CarboMedics valves. Medtronic-Hall valves caused less hemolysis than St. Jude Medical or CarboMedics valves in the late postoperative period. This resulted because hemolysis due to Medtronic-Hall valves was more severe 1 month after surgery than in the late postoperative period and because hemolysis due to St. Jude Medical or CarboMedics valves was more severe in the late postoperative period than 1 month after surgery. One reason for this finding is that cardiac output was greater in the late postoperative period than 1 month after surgery, making regurgitation through the pivots of bileaflet valves more severe. The orifice area and the orientation of prostheses did not affect hemolysis. CONCLUSION: St. Jude Medical or CarboMedics valves caused more severe hemolysis than Medtronic-Hall valves in the late postoperative period. 相似文献
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Cristina Carro Stefano Marianeschi Simone Ghiselli Nicola Uricchio 《Interactive Cardiovascular and Thoracic Surgery》2022,34(6):1168
Mitral valve replacement in infants is challenging and there are limited alternative valves available. Since the Boston group published their first report on alternative valves for mitral valve replacement in infants, there has been a growth in the literature on the topic, mostly based on the use of a stented bovine jugular vein graft (Melody® valve). The challenges of the Melody valve are firstly in its length of 28 mm unexpanded, which has the potential to cause left ventricular outflow tract obstruction, and secondly, the valve needs mechanical dilatation, which is laborious. A modified No-React® Injectable Biopulmonic™ Prosthesis (Bio Integral Surgical, Inc., Mississauga, ON, Canada) which is shorter (19 mm) and simpler in that it is self-expanding was implanted in a 14-month-old child to replace her mitral valve. The operation was successful and the short-term function of the prosthesis is good. 相似文献
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Makoto Kamada Kenji Ohsaka Susumu Nagamine Hidemitsu Kakihata 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2004,52(7):335-338
Objectives: We reviewed our experience of mitral valve replacement (MVR) after percutaneous transluminal mitral commissurotomy (PTMC)
for mitral stenosis (MS). Methods: From December 1987 to December 2001, PTMC was conducted in 75 patients with symptomatic rheumatic MS. At mean follow-up of
8.4±3.5 years, 11 patients (14.7%) underwent MVR for mitral restenosis (9 cases) and mitral regurgitation (MR) (2 cases).
The mean interval between PTMC and MVR was 5.2±3.2 years. Results: There were 2 hospital deaths (due to low output syndrome and mediastinitis) and 2 complications (prosthetic valve endocarditis
and left ventricular rupture). The mitral valve area (MVA) at pre-PTMC, post-PTMC and pre-MVR was 1.02±0.48 cm2,1.55±0.59 cm2,1.04±0.23 cm2, respectively. The MVA significantly increased after PTMC (p<0.01), but decreased significantly to the pre-PTMC value at
pre-MVR (p<0.05). The left atrial dimension (LAD) significantly increased from 50.4±10.8 mm at pre-PTMC to 61.1±13.1 mm at
pre-MVR (p<0.05). The number of significant tricuspid regurgitation (TR) cases increased from 2 at pre-PTMC to 5 at pre-MVR.
The New York Heart Association class got better after PTMC (3 cases in class HI at pre-PTMC to 0 at post-PTMC), but at pre-MVR,
deteriorated to the same level at pre-PTMC (4 cases in class III). Conclusions: Our results of MVR after PTMC were reasonable to be considered despite their high risk at MVR resulting in 2 hospital deaths.
For the reliable relief of MS and control of TR, not PTMC but MVR combined with tricuspid annuloplasty may be preferable in
such two cases suffering from congestive heart failure with significant TR at first intervention. Close follow-ups like periodic
ultrasonic cardiography studies should be conducted to gain more information on the mitral restenosis, TR deterioration and
dilatation of the cardiac chambers. 相似文献
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目的分析主动脉瓣置换术(aortic valve replacement,AVR)同期不同方式处理中度功能性二尖瓣关闭不全(functional mitral regurgitation,FMR)对患者预后的影响。方法回顾性纳入2014~2018年在本中心接受AVR且合并中度FMR的118例患者,其中男84例、女34例,年龄(58.1±12.4)岁。根据不同二尖瓣处理方式将患者分为三组:A组(未处理,11例)、B组(二尖瓣修复,51例)及C组(二尖瓣置换,56例)。研究主要终点为患者近中期生存情况,次要终点为FMR改善情况。结果中位随访时间为29.5个月。围术期死亡5例,均为C组患者;术后早期A、B两组FMR改善率分别为90.9%、94.1%(P=0.694)。A、B、C三组中期死亡率分别为0.0%、5.9%、3.9%(P=0.264),而主要心脑血管病事件发生率分别为0.0%、9.8%、17.7%(P=0.230)。A、B两组中期FMR改善率分别为100.0%、94.3%(P>0.05)。结论对于接受AVR合并中度FMR的患者,不处理或同期修复二尖瓣更为合理,而二尖瓣置换可能会... 相似文献
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Hideo Nagara Hidetoshi Tamura Masaaki Atobe Manabu Matsumoto Hiroo Hiratsuka 《Surgery today》1978,8(4):326-332
Recently we treated a 24-year-old female IHSS patient by mitral valve replacement, using a porcine xenograft valve. Following
surgery, clinical manifestations improved markedly and postoperative cardiac catheterization revealed that the pressure gradient
between left ventricle and aorta had dropped to a minimum compared with the pre-operative value of 104 mmHg and end-diastolic
pressure of the left ventricle had returned to normal level. 相似文献
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目的 总结5岁以下二尖瓣病变患儿行二尖瓣置换手术的治疗经验.方法 2008年1月至2011年12月,共12例5岁以下的二尖瓣病变患儿进行二尖瓣置换手术.其中男9例,女3例;年龄4~58个月,平均(26.2±18.1)个月;体质量5.6 ~13.0 kg,平均(9.6±3.8) kg.患儿有中度以上二尖瓣反流或(和)明显的二尖瓣狭窄,均伴有明显的心功能衰竭.3例为二尖瓣成形术后再行二尖瓣置换术.均置入机械瓣膜,9例采用17 ~ 23号主动脉瓣反向置入,3例采用25~27号二尖瓣正向置入.结果 手术死亡1例(8.3%).术后心律失常2例,轻度溶血2例,经治疗均恢复正常.11例生存患儿心功能改善明显,未出现出血和血栓形成等异常情况.结论 严重二尖瓣病变对小年龄儿童的心功能影响极大,尽早手术干预是惟一的选择,二尖瓣置换术是二尖瓣成形手术效果不佳患儿的最后选择.采用型号相对较小的主动脉瓣倒置置入二尖瓣环内,基本解决了机械瓣瓣膜-患者不匹配的问题,但置入小型号机械瓣的患儿再次行二尖瓣置换术的可能较大;小年龄儿童有良好的抗凝依从性,但需加强监测抗凝指标,以防发生出血和栓塞. 相似文献
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Francis P. Cheung Cheng He Philippa R. Eaton Jim Dimitriou Andrew E. Newcomb 《Annals of thoracic and cardiovascular surgery》2022,28(3):214
Background: Concomitant mitral regurgitation (MR) is frequently seen in patients undergoing surgical aortic valve replacement (AVR) for severe aortic stenosis (AS). When the severity of MR is moderate or less, the decision to undertake simultaneous mitral valve intervention can be challenging.Methods: A systematic search of Medline, PubMed (NCBI), Embase and Cochrane Library was conducted to qualitatively assess the current evidence for concomitant mitral valve intervention for MR in patients with AS undergoing AVR. The primary outcome for this systematic review was the postoperative change in the severity of MR and other outcomes of interest included factors that predict improvement or persistence of MR and long-term impacts of residual MR.Results: A total of 17 studies were included. The percentage of patients demonstrating improvement in MR severity following AVR ranged from 17.2% to 72%; the studies that exclusively included patients with moderate functional MR and reported longer term echocardiographic follow-up of greater than 12 months demonstrated an improvement in MR severity of 45% to 72%.Conclusion: This systematic review demonstrates that a proportion of patients can exhibit an improvement in MR following isolated surgical AVR, but whether this confers any long-term morbidity and mortality benefit remains unclear. 相似文献
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We determined whether aortic prosthesis size influences survival and hemodynamic function. Eighty-nine patients who underwent small aortic valve replacement were followed. The small internal orifice area index (IOAI) group was defined as having an internal orifice area/body surface area ratio of < or = 1.3 cm(2)/m(2) (n = 34). The control group was defined as having an IOAI >1.3 cm(2)/m(2) (n = 55). The actuarial survival rate at 10 years was 74.5% in the small IOAI group and 75% in the control group (NS). Freedom from valve-related impairment at 10 years was 87% in the small IOAI group and 85% in the control group (NS). Postoperative pressure gradients were higher in the small IOAI group (p < 0.05). Left ventricular mass index decreased in both groups (albeit nonsignificantly in the small group, but significantly decreased in the control group). The long-term results of aortic valve replacement for patients with small aortic annulus were satisfactory. However, the postoperative pressure gradient through the prosthesis and left ventricular hypertrophy remained at a high level in the small IOAI group. 相似文献
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Stephen H. Little Jeffrey J. Popma Neal S. Kleiman G. Michael Deeb Thomas G. Gleason Steven J. Yakubov Stan Checuti Daniel OHair Tanvir Bajwa Mubashir Mumtaz Brijeshwar Maini Alan Hartman Stanley Katz Newell Robinson George Petrossian John Heiser William Merhi B. Jane Moore Michael J. Reardon 《The Journal of thoracic and cardiovascular surgery》2018,155(5):1991-1999
Objectives
Patients with symptomatic severe aortic stenosis and severe mitral regurgitation or severe tricuspid regurgitation were excluded from the major transcatheter aortic valve replacement trials. We studied these 2 subgroups in patients at extreme risk for surgery in the prospective, nonrandomized, single-arm CoreValve US Expanded Use Study.Methods
The primary end point was all-cause mortality or major stroke at 1 year. A favorable medical benefit was defined as a Kansas City Cardiomyopathy Questionnaire overall summary score greater than 45 at 6 months and greater than 60 at 1 year and with a less than 10-point decrease from baseline.Results
There were 53 patients in each group. Baseline characteristics for the severe mitral regurgitation and severe tricuspid regurgitation cohorts were age 84.2 ± 6.4 years and 84.9 ± 6.5 years; male, 29 (54.7%) and 22 (41.5%), and mean Society of Thoracic Surgeons score 9.9% ± 5.0% and 9.2% ± 4.0%, respectively. Improvement in valve regurgitation from baseline to 1 year occurred in 72.7% of the patients with severe mitral regurgitation and in 61.8% of patients with severe tricuspid regurgitation. A favorable medical benefit occurred in 31 of 47 patients (66.0%) with severe mitral regurgitation and 33 of 47 patients (70.2%) with severe tricuspid regurgitation at 6 months, and in 25 of 44 patients (56.8%) with severe mitral regurgitation and 24 of 45 patients (53.3%) with severe tricuspid regurgitation at 1 year. All-cause mortality or major stroke for the severe mitral regurgitation and severe tricuspid regurgitation cohorts were 11.3% and 3.8% at 30 days and 21.0% and 19.2% at 1 year, respectively. There were no major strokes in either group at 1 year.Conclusions
Transcatheter aortic valve replacement in patients with severe mitral regurgitation or severe tricuspid regurgitation is reasonable and safe and leads to improvement in atrioventricular valve regurgitation. 相似文献16.
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Rafael Campos-Arjona Jorge Rodríguez-Capitn Jos D. Martínez-Carmona Alexey Lavreshin Loudes Fernndez-Romero Jos M. Melero-Tejedor Manuel Jimnez-Navarro 《Annals of thoracic and cardiovascular surgery》2022,28(5):342
Purpose: Our aim was to evaluate the development of new significant mitral regurgitation and long-term survival after mitral repair surgery in functional mitral regurgitation.Methods: A retrospective observational analysis of the recurrence of functional mitral regurgitation (ischemic and nonischemic) and global mortality during follow-up of 176 patients who underwent mitral repair surgery between 1999 and 2018 in our center was conducted.Results: The etiology of functional mitral regurgitation was ischemic in 55.7% of cases. After surgery, mitral regurgitation was 0-I in 92.3% of cases. We conducted a long-term clinical follow-up of a mean 42.2 months and an echocardiographic follow-up of a mean 41.8 months. We observed mitral regurgitation of at least grade II in 52 patients (36.9%). Survival at 1, 3, and 5 years was 78.8%, 66.7%, and 52.3%, respectively. Predictive factors for global mortality were age (hazard ratio = 1.038, p = 0.01) and a depressed preoperative ejection fraction. After a competing risk analysis, we found the only predictive factor for the recurrence of mitral regurgitation in our series to be age (sub-hazard ratio = 1.03, 95% confidence interval = 1.01–1.06, p = 0.016).Conclusion: Repair surgery for functional mitral regurgitation shows age as the only independent predictor of recurrence. Age and depressed ejection fraction were predictors of mortality. 相似文献
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Ryo Hasegawa Hiroto Kitahara Kuniyoshi Watanabe Hideo Kuroda Jun Amano 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2001,49(12):711-713
Cases of valvular disease accompanied by systemic lupus erythematosus and antiphospholipid antibody syndrome are uncommon. Here, we present a surgical case of mitral stenosis and regurgitation with systemic lupus erythematosus and antiphospholipid antibody syndrome. Mitral valve replacement was performed, and the postoperative course was uneventful. Pathohistological findings of the mitral valve showed degenerative change due to chronic inflammation, proliferative fibrous change and calcification without thrombus formation. 相似文献
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Scott Johnson Martha R. Stroud John M. Kratz Scott M. Bradley Fred A. Crawford John S. Ikonomidis 《The Journal of thoracic and cardiovascular surgery》2019,157(1):213-222