Volume 108(10 suppl 1):II-111-II-115

Slides:

Advertisements

Similar presentations

3D Echocardiography. u 3D Transesophageal echocardiography has become practical for intraoperative use u Technology provides 3D visualization of MV and.

Advertisements

Mitral valve. Repair vs. Replacement >%80 of MR are repairable Produces more physiological flow states It better preserves LV function Less thrombolic.

Congenital mitral valve stenosis

Definition: the backward flow of blood into the LA during systole. *Read pages 10 – 17in The Echocardiographer’s Pocket Reference; Read pages 292 – 304.

Trends in Hospitalizations and Outcomes for Acute Cardiovascular Disease and Stroke, 1999–2011CLINICAL PERSPECTIVE by Harlan M. Krumholz, Sharon-Lise T.

Role of Device Therapy in FMR: Challenges and Opportunities

Quantitative Real-Time Three-Dimensional Echocardiography Provides New Insight into the Mechanisms of Mitral Valve Regurgitation Post-Repair of Atrioventricular.

Terminology Functional MR Ischemic MR Associated MR Organic MR

3D Echo and Secondary MR Also referred to as Functional, Ischemic, Carpentier Type IIIb Dr. Bollen Dr. Shernan.

Volume 81, Issue 1, Pages (January 1982)

Mitral Regurgitation: Epidemiology, Pathophysiology and When to Repair

Clinical, Echocardiographic, and Pathologic Features of Aortic Wall Dehiscence of Porcine Bioprosthetic Valves: A Cause of Rapidly Progressive Mitral.

Mitral Valve Surgery For Heart Failure

Structural and Functional Mitral Regurgitation:

Echocardiographic modalities for evaluation and risk stratification of heart failure patients. 3D indicates 3-dimensional; EF, ejection fraction; LA, left.

Volume 76, Issue 3, Pages (September 1979)

Current concepts in mitral valve prolapse—Diagnosis and management

Aortic Valve Adaptation to Aortic Root DilatationCLINICAL PERSPECTIVE

Cardiac Computed Tomography of Severe Aortic Endocarditis

Noninfectious Mitral Annular Disruption

Passive Ventricular Constraint Prevents Transmural Shear Strain Progression in Left Ventricle Remodeling by Allen Cheng, Tom C. Nguyen, Marcin Malinowski,

Circ Cardiovasc Imaging

Lindsay S. Rogers, MD, Amy L. Peterson, MD, J

The value of preoperative 3-dimensional over 2-dimensional valve analysis in predicting recurrent ischemic mitral regurgitation after mitral annuloplasty

2015 The American Association for Thoracic Surgery Consensus Guidelines: Ischemic mitral valve regurgitation Irving L. Kron, MD, Michael A. Acker, MD,

Ischemic Mitral Regurgitation

Philipp Blanke et al. JIMG 2015;8:

Effects and mechanisms of left ventricular false tendons on functional mitral regurgitation in patients with severe cardiomyopathy Mehul R. Bhatt, MD,

Wretched Excess: Stool-softener Abuse and Cardiogenic Shock

Simple repair approach for mitral regurgitation in Barlow disease

Consequences of mitral valve prolapse on chordal tension: Ex vivo and in vivo studies in large animal models Mathieu Granier, MD, MSc, Morten O. Jensen,

Interpapillary muscle distance independently affects severity of functional mitral regurgitation in patients with systolic left ventricular dysfunction

Volume 81, Issue 1, Pages (January 1982)

Posterior Leaflet Augmentation in Ischemic Mitral Regurgitation Increases Leaflet Coaptation and Mobility Arminder S. Jassar, MBBS, Masahito Minakawa,

Functional mitral stenosis after surgical annuloplasty for ischemic mitral regurgitation: Importance of subvalvular tethering in the mechanism and dynamic.

First Finite Element Model of the Left Ventricle With Mitral Valve: Insights Into Ischemic Mitral Regurgitation Jonathan F. Wenk, PhD, Zhihong Zhang,

Repair of posterior mitral valve prolapse with a novel leaflet plication clip in an animal model Eric N. Feins, MD, Haruo Yamauchi, MD, PhD, Gerald R.

Echocardiographic Assessment of Left Ventricular Systolic Function: An Overview of Contemporary Techniques, Including Speckle-Tracking Echocardiography

Predicting recurrent mitral regurgitation after mitral valve repair: A difficult endeavor and a necessity Denis Bouchard, MD, Louis P. Perrault, MD,

Successful repair of a variant of mitral arcade

The effect of pure mitral regurgitation on mitral annular geometry and three-dimensional saddle shape Tom C. Nguyen, MD, Akinobu Itoh, MD, Carl J. Carlhäll,

Spontaneous regression of submitral pseudoaneurysm after radiofrequency catheter ablation in a patient with Wolff-Parkinson-White syndrome Dongmin Kim,

Chordal cutting technique through aortotomy: A new approach to treat chronic ischemic mitral regurgitation Georges Fayad, MD, Thomas Modine, MD, Thierry.

Intermediate-term results of a nonresectional dynamic repair technique in 662 patients with mitral valve prolapse and mitral regurgitation Gerald M.

Muralidhar Padala, BS, Nikolay V. Vasilyev, MD, James W

Ischemic Mitral Regurgitation: Impact of the Left Ventricle and Mitral Valve in Patients with Left Ventricular Systolic Dysfunction Monvadi B. Srichai,

Chordal translocation for ischemic mitral regurgitation may ameliorate tethering of the posterior and anterior mitral leaflets Shinji Masuyama, MD, Akira.

No Structural Signposts: Afterload-Dependent Mitral Regurgitation

Barlow disease: Simple and complex

Echocardiographic visualization and quantification of mitral complex during mitral repair for severe functional mitral regurgitation Kikuko Obase, MD,

Intermittent regurgitation caused by incomplete leaflet closure of the Medtronic ADVANTAGE bileaflet heart valve: Analysis of the underlying mechanism

Effect of anterior strut chordal transection on the force distribution on the marginal chordae of the mitral valve Muralidhar Padala, PhD, Lazarina Gyoneva,

Pablo Blanco, MD, Luis Carapelli, MD CHEST

Elimination of Ischemic Mitral Regurgitation Does Not Alter Long-Term Left Ventricular Remodeling in the Ovine Model Kanji Matsuzaki, MD, PhD, Masato.

Jason H. Rogers et al. JCIN 2015;8:

Mitral valve hemodynamics after repair of acute posterior leaflet prolapse: Quadrangular resection versus triangular resection versus neochordoplasty

Repair of congenital tricuspid valve abnormalities with artificial chordae tendineae V.Mohan Reddy, MD, Doff B McElhinney, MD, Michael M Brook, MD, Norman.

Tricuspid Valve Prolapse Diagnosed by Cross-Sectional Echocardiography

Morten O. Jensen, PhD, Henrik Jensen, MD, PhD, Robert A

Annular or subvalvular approach to chronic ischemic mitral regurgitation? Frederick A. Tibayan, MD, Filiberto Rodriguez, MD, Frank Langer, MD, Mary K.

Imbalanced chordal force distribution causes acute ischemic mitral regurgitation: Mechanistic insights from chordae tendineae force measurements in pigs

Robert W. Loar, MD, Shiraz A

The effect of regional ischemia on mitral valve annular saddle shape

James S. Gammie et al. JACC 2018;71:25-36

PML AML Figure 1. Biplane Mode (X-plane) acquisition with 3D transoesophageal echocardiography. Left side panel: reference plane mid-oesophageal 4 chamber.

Posterior Chordal Cutting in Rheumatic Mitral Regurgitation Due to Hypomobility of the Posterior Leaflet Antonio Maria Calafiore, MD, Ibrahim Farah,

Nat. Rev. Cardiol. doi: /nrcardio

Mathieu Vergnat, MD, Arminder S. Jassar, MBBS, Benjamin M

Mechanism of higher incidence of ischemic mitral regurgitation in patients with inferior myocardial infarction: Quantitative analysis of left ventricular.

Masakazu Aoki, MD, Toshiaki Ito, MD, PhD

Presentation transcript:

Volume 108(10 suppl 1):II-111-II-115 Efficacy of Chordal Cutting to Relieve Chronic Persistent Ischemic Mitral Regurgitation by Emmanuel Messas, Bruno Pouzet, Bernard Touchot, J. Luis Guerrero, Gus J. Vlahakes, Michel Desnos, Philippe Menasché, Albert Hagège, and Robert A. Levine Circulation Volume 108(10 suppl 1):II-111-II-115 September 9, 2003 Copyright © American Heart Association, Inc. All rights reserved.

Figure 1. Left, at baseline, leaflet area exceeds that needed to cover the annulus, creating a coapting leaflet surface to prevent MR. Center, inferior infarction most distorts the base of the anterior leaflet, which is tethered by basal chordae to form a bend, reducing the coapting surface and causing MR. Right, basal chordal cutting can eliminate this bend, improve coaptation, and reduce MR; the marginal chordae prevent prolapse. Figure 1. Left, at baseline, leaflet area exceeds that needed to cover the annulus, creating a coapting leaflet surface to prevent MR. Center, inferior infarction most distorts the base of the anterior leaflet, which is tethered by basal chordae to form a bend, reducing the coapting surface and causing MR. Right, basal chordal cutting can eliminate this bend, improve coaptation, and reduce MR; the marginal chordae prevent prolapse. Emmanuel Messas et al. Circulation. 2003;108:II-111-II-115 Copyright © American Heart Association, Inc. All rights reserved.

Figure 2. Changes in MR stroke volume and leaflet tenting volume. Emmanuel Messas et al. Circulation. 2003;108:II-111-II-115 Copyright © American Heart Association, Inc. All rights reserved.

Figure 3. Mid-systolic apical 2-dimensional echo images. Figure 3. Mid-systolic apical 2-dimensional echo images. Left, normal mitral coaptation at baseline with normal papillary muscle position (top, arrows) and without color Doppler MR (below). Center, mild bulging of the ischemic inferior wall (3 grouped black arrows) with apical leaflet tenting relative to the annulus (dashes) in the direction of tethering (upward arrow). Mild to moderate MR in the more globular remodeled LV is seen below. Right, basal chordal cutting eliminated the anterior leaflet bend (arrow, top) with improved coaptation and no MR (below) despite important LV dilatation. The anterior leaflet convexity toward the left atrium is normal in this view considering the saddle shape of the mitral annulus.19 Emmanuel Messas et al. Circulation. 2003;108:II-111-II-115 Copyright © American Heart Association, Inc. All rights reserved.

Figure 4. Chronic follow-up after inferior MI and chordal cutting–color Doppler apical long-axis views. Figure 4. Chronic follow-up after inferior MI and chordal cutting–color Doppler apical long-axis views. A, sheep without chordal cutting at 8 weeks: moderate MR accompanies anterior leaflet angulation. B and C, sheep with chordal cutting at 8 weeks and 11 months post-MI, showing no MR and no prolapse. Emmanuel Messas et al. Circulation. 2003;108:II-111-II-115 Copyright © American Heart Association, Inc. All rights reserved.