10-year outcomes after left ventricular reconstruction: rethinking the impact of mitral regurgitation

Publication date: Available online 30 January 2019Source: The Annals of Thoracic SurgeryAuthor(s): Annelieke H.J. Petrus, Patrick Klein, Laurens F. Tops, Olaf M. Dekkers, Lotje A. Hoogervorst, Lotte E. Couperus, Saskia L.M.A. Beeres, Robert J.M. Klautz, Jerry BraunAbstractBackgroundHeart failure with reduced ejection fraction due to a post-infarction anteroseptal aneurysm carries a poor prognosis. Patients with refractory heart failure may be considered for advanced surgery, including left ventricular assist device implantation, heart transplantation and LV reconstruction. Aim of this study was to evaluate outcomes after an integrated approach of left ventricular reconstruction with concomitant procedures (mitral/tricuspid valve repair, coronary revascularization), and assess risk factors for event-free survival, focusing on left ventricular geometry/function and presence of functional mitral regurgitation(MR).MethodsOne hundred fifty-nine consecutive heart failure patients, who underwent left ventricular reconstruction between 2002-2011, were included. Mid-term echocardiographic and long-term clinical outcomes were evaluated. Preoperative risk factors were correlated to event-free survival (freedom from mortality, left ventricular assist device implantation and heart transplantation).ResultsMid-term echocardiography demonstrated decreased indexed left ventricular end-systolic volumes (89±42 preoperatively; 51±18ml/m2 at mid-term, p
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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Tricuspid regurgitation (TR) is common in orthotopic transplanted hearts secondary to endomyocardial biopsies and right heart catheterizations performed for rejection surveillance. The majority of patients develop mild to moderate TR while 7-10% develop severe TR and right heart failure. While there are no established protocols for managing severe TR in transplant recipients, surgical tricuspid valve repair or replacement can be performed if medical therapy fails but are generally limited to low risk patients.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 512 Source Type: research
ConclusionsPercutaneous mitral valve repair with MitraClip was associated with an enhancement in cardiopulmonary performance in patients with systolic heart failure and secondary MR.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Short Communication Source Type: research
We report our experience on concomitant AsMVR during LVAD surgery.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 880 Source Type: research
Publication date: December 2018Source: Canadian Journal of Cardiology, Volume 34, Issue 12Author(s): Frank Battaglia, Lisa Mielniczuk, Vincent ChanAbstractWe provide an update on Canada’s first neonatal heart transplant recipient who, after cardiac retransplantation, underwent a mitral valve replacement and tricuspid valve repair. Twenty-seven years after his initial heart surgery and 13 years after his most recent transplant, this patient developed heart failure with severe mitral regurgitation secondary to a calcified mitral valve. The patient was highly sensitized with no evidence of allograft rejection; therefore...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Publication date: Available online 29 September 2018Source: Canadian Journal of CardiologyAuthor(s): Frank Battaglia, Lisa Mielniczuk, Vincent ChanAbstractWe provide an update on Canada’s first neonatal heart transplant recipient, who, following cardiac re-transplantation, underwent a mitral valve replacement and tricuspid valve repair. Twenty-seven years after his initial heart surgery, and thirteen years following his most recent transplant, this patient developed heart failure with severe mitral regurgitation secondary to a calcified mitral valve. The patient was highly sensitized with no evidence of allograft rej...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Publication date: Available online 1 September 2018Source: Cor et VasaAuthor(s): Aleš Benák, Blanka Skalická, Jana Hašková, Martin Kotrč, Radka Kočková, Vladimír Pořízka, Michael Želízko, Josef Kautzner, Vojtěch MelenovskýAbstractAimChronic heart failure with left ventricular (LV) dysfunction is often associated with functional mitral regurgitation (MiR). This may be ameliorated, mitral valve morphology permitting, by implanting a MitraClip. Registry data demonstrate a positive effect on symptoms. A decrease in mortality and shorter hospitalisation ...
Source: Cor et Vasa - Category: Cardiology Source Type: research
ESC Heart Failure, EarlyView.
Source: ESC Heart Failure - Category: Cardiology Authors: Source Type: research
Congenital heart disease is the most common birth defect globally, affecting almost nine in every 1,000 babies. Tissue engineering, which involves combining regenerative cells, proteins, or drugs with biomaterials, is a promising strategy to treat co...
Source: Medgadget - Category: Medical Devices Authors: Tags: Cardiac Surgery Exclusive Materials Source Type: blogs
AbstractAlthough mitral regurgitation (MR) is prevalent in patients with end-stage heart failure, the impact of mitral valve (MV) surgery on outcomes after left ventricular assist device (LVAD) implantation and morphologic changes of MV remains unclear. We retrospectively reviewed 74 patients who underwent LVAD implantation as a bridge to transplant. Of these, 11 (15%) underwent MV repair concomitant with or prior to LVAD implantation, while 27 patients with preoperative significant (moderate or greater) MR did not undergo concomitant MV surgery. The mean interval between LVAD implantation and the last echocardiographic ex...
Source: Journal of Artificial Organs - Category: Transplant Surgery Source Type: research
AbstractFor the year 2017, more than 21,000 published references can be found in PubMed when entering the search term “cardiac surgery”. This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventio...
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
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