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Sample records for changed porcine mitral

  1. Clinical comparison of St. Jude and porcine mitral valve prostheses.

    Science.gov (United States)

    Douglas, P S; Hirshfeld, J W; Edie, R N; Stephenson, L W; Gleason, K; Edmunds, L H

    1988-01-01

    One hundred and six consecutive patients who had mitral valve replacement with either a St. Jude or porcine heterograft prosthesis were prospectively studied. The 2 groups are similar with respect to 67 clinical and operative factors and allow comparison of valve performance as an independent variable. Total follow-up is 3,312 patient-months (mean 36 months, range 2-57 months, 94% complete). There are no statistical differences in symptomatic improvement or mortality by life table analysis. Valve-related complications expressed as percent per patient-year are: reoperation: 1.8 St. Jude and 3.8 porcine; endocarditis: 1.2 and 1.9; regurgitant murmur: 2.3 and 1.9; hemolysis: 1.8 and 0.0; late thromboembolism: 1.8 and 1.0; hemorrhage: 2.9 and 2.9; and valve failure: 0.0 and 1.0. There were no significant differences found. Actuarial survival at 3 years was 78% in St. Jude and 81% in porcine patients. Forty-six percent of patients with St. Jude valves and 55% of patients with porcine valves were alive and free of all complications at latest follow-up. The clinical performance of St. Jude and porcine mitral valves are similar over this period of intermediate follow-up. PMID:3360831

  2. Increased expression of endothelin B receptor in static stretch exposed porcine mitral valve leaflets

    DEFF Research Database (Denmark)

    Pedersen, Lotte Gam; Zhao, J.; Yang, J.;

    2007-01-01

    The aim of this study was to evaluate the effect of mechanical stretch on the expression of ET-1 and ETA- and ETB-receptors in porcine mitral valve leaflets. Leaflet segments from 10 porcine mitral valves were exposed to a static stretch load of 1.5 N for 3.5 h in buffer at 37oC together...

  3. Tissue-engineered mitral valve chordae tendineae: Biomechanical and biological characterization of decellularized porcine chordae.

    Science.gov (United States)

    Gong, Wenhui; Li, Sen; Lei, Dong; Huang, Peng; Yuan, Zhize; You, Zhengwei; Ye, Xiaofeng; Zhao, Qiang

    2016-03-01

    Chordae tendineae are essential for maintaining mitral valve function. Chordae replacement is one of the valve repair procedures commonly used to treat mitral valve regurgitation. But current chordae alternatives (polytetrafluoroethylene, ePTFE) do not have the elastic and self-regenerative properties. Moreover, the ePTFE sutures sometimes fail due to degeneration, calcification and rupture. Tissue-engineered chordae tendineae may overcome these problems. The utility of xenogeneic chordae for tissue-engineered chordae tendineae has not yet been adequately explored. In this study, polyelectrolyte multilayers (PEM) film modified decellularized porcine mitral valve chordae (PEM-DPC) were developed to explore tissue-engineered chordae tendineae as neochordae substitutes. Fresh porcine mitral chordae were decellularized and reserved the major elastic fiber and collagen components. Decellularized chordae with a PEM film were produced with chitosan-heparin by a lay-by-lay technique. Mesenchymal stem cells and vascular endothelial cells could grow well on the surface of the PEM-DPC. The superior biomechanical properties of PEM-DPC were proved with good flexibility and strength both in vitro and in vivo. PEM-DPC can be developed for potential alternative mitral valve chordae graft. PMID:26708255

  4. Direct measurements of nitric oxide release in relation to expression of endothelial nitric oxide synthase in isolated porcine mitral valves

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Olsen, Lisbeth Høier; Aasted, Bent;

    2007-01-01

    The aim of this study was to measure the direct release of nitric oxide (NO) from the porcine mitral valve using a NO microelectrode. Furthermore, the expression and localization of endothelial nitric oxide synthase (eNOS) in the mitral valve was studied using immunohistochemistry, Western blotting...

  5. Early changes in pulmonary functions after mitral valve replacement

    OpenAIRE

    Saxena Pankaj; Luthra Suvitesh; Dhaliwal Rajinder; Rana Surinder; Behera Digambar

    2007-01-01

    Background: This study evaluates changes in pulmonary functions before and after mitral valve replacement (MVR). Materials and Methods: Twenty-five patients with rheumatic mitral lesions who had undergone MVR were divided into three groups, based on New York Heart Association (NYHA) class. They were evaluated for changes in pulmonary functions, preoperatively and postoperatively at 1 week, 1 month and 3 months to find any improvements after MVR. Results: Forced vital capacity (FVC), forc...

  6. Electrocardiographic Changes in Mitral Valve Prolapse Syndrome

    Directory of Open Access Journals (Sweden)

    Mohamad Mehdi Peighambari

    2014-03-01

    Full Text Available Background- Mitral valve prolapse syndrome (MVP is most common valvular abnormality in young and is correlated with increased frequency of cardiac dysrhythmias and sudden death. The aim of this study was to compare frequency of "early repolarization" in electrocardiogram (ECG between MVP patients and healthy adults. Methods- In this cross-sectional study, we compared ECG presentations of early repolarization including notch in descending arm of QRS and J-point and/or ST segment changes in 100 patients with MVP with 100 healthy individuals. MVP patients were referred to cardiology clinic with symptoms of palpitation, chest pain or anxiety. Results-The mean age in patients with MVP was significantly less than healthy subjects (29.5 ± 9.3 years versus 31.0 ± 6.9 years in control group, p=0.1967. We detected an early repolarization as a prevalent sign in ECG of patients, which was a notch in descending arm of QRS and/or ST segment or J-point elevation seen in 74% of patients ( 51% in inferior leads and 23% in I and aVL leads , whilst the same findings was seen in 8 men (8% in control group (p=0.0001. Conclusion- Early repolarization in ECG presented as a notch in descending arm of QRS and/or ST segment or J-point elevation is more frequent in in young patients with MVP syndrome.

  7. Quantitative Imaging Assessment of an Alternative Approach to Surgical Mitral Valve Leaflet Resection: An Acute Porcine Study.

    Science.gov (United States)

    Boronyak, Steven M; Fredi, Joseph L; Young, Michael N; Dumont, Douglas M; Williams, Phillip E; Byram, Brett C; Merryman, W David

    2016-07-01

    This study reports the initial in vivo use of a combined radiofrequency ablation and cryo-anchoring (RFC) catheter as an alternative to surgical mitral valve (MV) leaflet resection. Radiofrequency ablation thermally shrinks enlarged collagenous tissues, providing an alternative to leaflet resection, and cryo-anchoring provides reversible attachment of a catheter to freely mobile MV leaflets. Excised porcine MVs (n = 9) were tested in a left heart flow simulator to establish treatment efficacy criteria. Resected leaflet area was quantified by tracking markers on the leaflet surface, and leaflet length reductions were directly measured on echocardiography. Leaflet area decreased by 38 ± 2.7%, and leaflet length decreased by 9.2 ± 1.8% following RFC catheter treatment. The RFC catheter was then tested acutely in healthy pigs (n = 5) under epicardial echocardiographic guidance, open-chest without cardiopulmonary bypass, using mid-ventricular free wall access. Leaflet length was quantified using echocardiography. Quantitative assessment of MV leaflet length revealed that leaflet resection was successful in 4 of 5 pigs, with a leaflet length reduction of 13.3 ± 4.6%. Histological, mechanical, and gross pathological findings also confirmed that RFC catheter treatment was efficacious. The RFC catheter significantly reduces MV leaflet size in an acute animal model, providing a possible percutaneous alternative to surgical leaflet resection. PMID:26508331

  8. CHANGES OF PLASMA ENDOTHELIN CONCENTRATIONS BEFORE AND AFTER PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN PATIENTS WITH MITRAL STENOSIS

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 赵定菁; 朱树雄; 陶新智; 曾知恒; 夏树楹

    1996-01-01

    Plasma concentrations of endothalln in blood from the femoral vein and the antecnbital vein were measured in 35 patients with mitral stenosis and heart failure before and after percutaneous balloon mitral valvuloplasty(PBMV). The basal plasma concentrations of endothelin in blood from the antecubital vein inthe patients were significantly higher than those in 32 control subjects (15.40±3. 32 vs. 9.59±2.66 pg/ml, P<0. 001). Plasma endothefin concentrations in patients in New York Heart Asscclation functional classes Ⅱ and Ⅰ were significantly higher than thee in control subjects, spectiveiy. The concentrationsof endotheiin in patients with atrial fibrillation were also significantly higher than those in patients withnormal sinus rhythm. Ten to fifteen minutes after PBMV, plasma endothelin concentrations in blood (ramthe femoral vein significantly decreased from 16. 14±3.34 to 13. 74±3.78 pg/ml (P<0. 01). Seventy-two hours after the procedure, the concentrations of endothelin in blood from the antecnbital vein had fallen to 12. 31+2. 55 pg/ml (P<0. 001 vs. before PBMV and control subjects). Plasma endothelin concentrations still tended to be higher in patients with atrial fibrillation than those in normal sinus rhythm,but the difference did not reach statistlaal significance. There were ,Weak bnt signlficamly correlations of plasma endotbelin concentrations with the mean left atrial pressure (r= 0. 424, P<0. 001 ), mean right atrial pressure (r=0. 323, P<0. 01), mean transmittal pressure gradient (r=0. 397, P<0. 001), heart rate (r=0. 350,P<0. 005) and mitral valve area (r=-0. 454, P<0. 001) in the patients before and after PBMV.

  9. Physicochemical Changes of Antioxidant Peptides Hydrolyzed From Porcine Plasma Protein Subject to Free Hydroxyl Radical System

    OpenAIRE

    Hehong Yang; Yanqing Li; Peijun Li; Qian Liu; Baohua Kong; Xu Huang; Zengbao Wu

    2013-01-01

    Antioxidant peptides have attracted much attention for potential application as natural food ingredients but the fate of them, as well as oxidized proteins in foods during processing, is still poorly understood. Physicochemical changes in antioxidant peptides hydrolysated from porcine plasma protein were discussed in a free hydroxyl radical-mediated oxidation system. Porcine Plasma Protein Hydrolysates (PPH) was prepared by hydrolyzing porcine plasma protein with Alcalase for 5 h at pH 8.0, 5...

  10. Mitral stenosis

    Science.gov (United States)

    ... valve disease. Treat strep infections promptly to prevent rheumatic fever. Tell your provider if you have a family history of congenital heart diseases. Other than treating strep infections, mitral stenosis itself ...

  11. Dystrophin deficiency-induced changes in porcine skeletal muscle

    Science.gov (United States)

    A novel porcine stress syndrome was detected in the U.S. Meat Animal Research Center’s swine research population when two sibling barrows died of apparent stress symptoms (open mouth breathing, vocalization, and refusal to move or stand) after transport at 12 weeks of age. At eight weeks of age, the...

  12. Changes in peak left atrial longitudinal strain after percutaneous balloon mitral valvotomy and its long term impact on left atrial volumes in patients in sinus rhythm

    Directory of Open Access Journals (Sweden)

    Mohamed Ismail Ahmed

    2014-04-01

    Full Text Available Background: The prognostic signi cance of left atrial (LA size on cardiovascular outcome is now well recognised in literature. Balloon mitral valvotomy (BMV can reduce complications and improve outcome in rheumatic patients. On long term follow up in rheumatic mitral stenosis patients after BMV, left atrial volumes were shown to decrease. Methods: This is a prospective study that enrolled 54 patients who undergone successful BMV. Longitudinal Left atrial function was evaluated by speckle tracking derived strain. Left atrial volumes were measured before valvotomy, after the procedure and after 12 months during follow-up. The e ect of transmitral pressure gradient drop after balloon mitral valvotomy on left atrial strain was studied. In addition the relation between post-procedural increase of LA strain and left atrial volumes after 12 months was also evaluated. Results: There is signi cant reduction of mean trans-mitral pressure gradient from 13.104 ± 4.694 to 4.067±1.502 mmHg and signi cant improvement of mitral valve area from 1.0217 ±0.1178 to 1.766 ± 0.2307cms2 after the procedure (P value < 0.001. The mean peak longitudinal left atrial strain was much improved after BMV from 19.80±9.66 % to 34.39±12.86%. This di erence was statistically highly signi cant. (P value was <0.0001. The percent improvement of left atrial longitudinal strain correlated signi cantly with mean trans-mitral pressure gradient drop. Also left atrial mean peak left atrial longitudinal strain correlated signi cantly with left atrial volumes reductions after 12 months. Conclusions: Successful BMV results in reduction of mean left atrial volumes after 12 months which is well correlated with PALS percent change after BMV.

  13. Physicochemical Changes of Antioxidant Peptides Hydrolyzed From Porcine Plasma Protein Subject to Free Hydroxyl Radical System

    Directory of Open Access Journals (Sweden)

    Hehong Yang

    2013-01-01

    Full Text Available Antioxidant peptides have attracted much attention for potential application as natural food ingredients but the fate of them, as well as oxidized proteins in foods during processing, is still poorly understood. Physicochemical changes in antioxidant peptides hydrolysated from porcine plasma protein were discussed in a free hydroxyl radical-mediated oxidation system. Porcine Plasma Protein Hydrolysates (PPH was prepared by hydrolyzing porcine plasma protein with Alcalase for 5 h at pH 8.0, 55°C. The content of carbonyl groups increased significantly at various degrees when PPH exposed to free radical-mediated oxidation for different time and different concentrations of H2O2, while total sulfhydryls, reactive sulfhydryls and free amines contents decreased. It was concluded that PPH played an antioxidant role in the radical-mediated oxidation system. This provides a potential way for antioxidation in food production.

  14. Immediate Results of Percutaneous Trans-Luminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis

    OpenAIRE

    Seyfollah Abdi; Negar Salehi; Babak Ghodsi; Hossein Ali Basiri; Mahmoud Momtahen; Ata Firouzi; Hamid Reza Sanati; Farshad Shakerian; Mohsen Maadani; Homan Bakhshandeh; Soheila Chamanian; Mitra Chitsazan; Anoushiravan Vakili-Zarch

    2012-01-01

    Background Valvular heart diseases and mainly rheumatic heart diseases complicate about 1% of pregnancies. During pregnancy physiological hemodynamic changes of the circulation are the main cause of mitral stenosis (MS) decompensation. Prior to introduction of percutaneous mitral balloon commissuroplasty (PTMC), surgical comissurotomy was the preferred method of treatment in patients with refractory symptoms. PTMC is an established non-surgical treatment of rheumatic mitral stenosis. The stud...

  15. Laceration of anterior mitral leaflet postpercutaneous balloon mitral valvuloplasty for rheumatic mitral stenosis

    OpenAIRE

    Jadoon, Mehmood; Roberts, M. J.; Dixon, L.; Jones, Mark

    2012-01-01

    A 37-year-old Caucasian female with known rheumatic mitral stenosis was admitted for Balloon mitral valvuloplasty which was complicated with a laceration of anterior mitral leaflet (A2 scallop) resulting in severe mitral regurgitation. Intra-aortic balloon pump (IABP) was instituted and the patient was referred for emergency mitral surgery. During surgery anterior mitral leaflet was excised. Most of the posterior leaflet was preserved. Mitral valve was replaced with St Jude mitral mechanical ...

  16. Mitral valve prolapse

    Science.gov (United States)

    ... seen with some connective tissue disorders such as Marfan syndrome and other rare genetic disorders. Symptoms Many ... 66. Read More Atrial septal defect (ASD) Endocarditis Marfan syndrome Mitral valve surgery - minimally invasive Mitral valve ...

  17. Mitral Valve Disease

    Science.gov (United States)

    ... Tricuspid Valve Disease Cardiac Rhythm Disturbances Thoracic Aortic Aneurysm Pediatric and Congenital Heart Disease Heart abnormalities that are ... Transplantation End-stage Lung Disease Adult Lung Transplantation Pediatric Lung ... Aortic Aneurysm Mitral Valve Disease Overview The mitral valve is ...

  18. Transcatheter mitral valve repair for functional mitral regurgitation: coronary sinus approach.

    Science.gov (United States)

    Piazza, Nicolo; Bonan, Raoul

    2007-12-01

    Mitral regurgitation has become recognized as an important health problem. More specifically, functional mitral regurgitation is associated with worse outcomes in heart failure, postmyocardial infarction, and perioperative coronary artery bypass surgery patients. Many patients with severe mitral regurgitation are denied or refused mitral valve surgery. A less invasive procedure with possibly fewer potential complications may thus be attractive for patients with severe mitral regurgitation. Devices used for coronary sinus (CS) mitral annuloplasty are directed toward patients with functional mitral regurgitation. Because of its easy accessibility and close relationship to the posterior mitral annulus (MA), alterations of the CS geometry with percutaneous devices may translate to displacement of the posterior annulus and correct mitral leaflet coaptation. This review will focus on the contemporary CS annuloplasty devices: (1) Edwards MONARC system; (2) Cardiac Dimensions CARILLON; and (3) Viacor Shape Changing Rods system. In addition, important information obtained from recent imaging studies describing the relationship between the CS, MA, and coronary arteries will be reviewed. PMID:18042055

  19. Increased nitric oxide release and expression of endothelial and inducible nitric oxide synthases in mildly changed porcine mitral valve leaflets

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Olsen, Lisbeth Høier; Viuff, Birgitte;

    2007-01-01

    Background and aim of the study: Little is known of the local role of nitric oxide (NO) in heart valves in relation to heart valve diseases. The study aim was to examine NO release and the expression of both endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (i...

  20. Age-related changes in biomechanical properties of transgenic porcine pulmonary and aortic conduits

    International Nuclear Information System (INIS)

    The limitations associated with conventional valve prosthesis have led to a search for alternatives. One potential approach is tissue engineering. Most tissue engineering studies have described the biomechanical properties of heart valves derived from adult pigs. However, because one of the factors affecting the function of valve prosthesis after implantation is appropriate sizing for a given patient, it is important to evaluate the usefulness of a heart valve given the donor animal’s weight and age. The aim of this study was to evaluate how the age of a pig can influence the biomechanical and hemodynamical properties of porcine heart valve prosthesis after acellularization. Acellular porcine aortic and pulmonary valve conduits were used. Hearts were harvested from animals differing in weight and age. The biomechanical properties of the valves were then characterized using a uniaxial tensile test. Moreover, computer simulations based on the finite element method (FEM) were used to study the influence of biomechanical properties on the hemodynamic conditions. Studying biomechanical and morphological changes in porcine heart valve conduits according to the weight and age of the animals can be valuable for developing age-targeted therapy using tissue engineering techniques. (paper)

  1. The use of a high-power laser on swine mitral valve chordae tendineae.

    Science.gov (United States)

    Pinto, Nathali Cordeiro; Chavantes, M Cristina; Zezell, Denise; Deana, Alessandro; Benetti, Carolina; Marcos, Rodrigo Labat; Lopes, Luciana Almeida; Martins, Rodrigo A B Lopes; Aiello, Vera Demarchi; Jatene, Fabio Biscegli; Pomerantzeff, Pablo M A

    2016-08-01

    Worldwide, rheumatic fever remains a significant cause of mitral valve insufficiency. It is responsible for approximately 90 % of early childhood valvular surgeries in Brazil. Elongated or flail chordae are frequently responsible and require surgical correction. The purpose of this study was to analyze and compare the histological tissues of the mitral valve chordae and the mechanical resistance generated by the chordae, both with and without the application of a high-power laser. Twenty normal porcine mitral valve chordae were measured and divided randomly into the following two groups: control group (not subjected to a high-power laser) and laser group (subjected to photonic irradiation). Laser surgery was performed under controlled conditions, using following parameters: λ = 980-nm wavelength, power = 3 W, and energy = 60 J. A mechanical test machine was used in combination with a subsequent histological study to measure chordae tensile properties. A histological analysis demonstrated a typical collagen bundle arrangement in the control group; however, under a particular reached temperature range (48), the collagen bundles assumed different arrangements in the laser group. Significant reductions in the chordae tendineae lengths and changes in their resistance in the laser group were observed, as these chordae exhibited less rigid fibers. The chordae tendineae of normal porcine valves subjected to a high-power laser exhibited its length reduction and less stiffness compared to the control group. A histological analysis of the laser treatment specimens demonstrated differences in collagen bundle spatial organization, following slight changes into tissue temperature. PMID:27184152

  2. The use of a high-power laser on swine mitral valve chordae tendineae.

    Science.gov (United States)

    Pinto, Nathali Cordeiro; Chavantes, M Cristina; Zezell, Denise; Deana, Alessandro; Benetti, Carolina; Marcos, Rodrigo Labat; Lopes, Luciana Almeida; Martins, Rodrigo A B Lopes; Aiello, Vera Demarchi; Jatene, Fabio Biscegli; Pomerantzeff, Pablo M A

    2016-08-01

    Worldwide, rheumatic fever remains a significant cause of mitral valve insufficiency. It is responsible for approximately 90 % of early childhood valvular surgeries in Brazil. Elongated or flail chordae are frequently responsible and require surgical correction. The purpose of this study was to analyze and compare the histological tissues of the mitral valve chordae and the mechanical resistance generated by the chordae, both with and without the application of a high-power laser. Twenty normal porcine mitral valve chordae were measured and divided randomly into the following two groups: control group (not subjected to a high-power laser) and laser group (subjected to photonic irradiation). Laser surgery was performed under controlled conditions, using following parameters: λ = 980-nm wavelength, power = 3 W, and energy = 60 J. A mechanical test machine was used in combination with a subsequent histological study to measure chordae tensile properties. A histological analysis demonstrated a typical collagen bundle arrangement in the control group; however, under a particular reached temperature range (48), the collagen bundles assumed different arrangements in the laser group. Significant reductions in the chordae tendineae lengths and changes in their resistance in the laser group were observed, as these chordae exhibited less rigid fibers. The chordae tendineae of normal porcine valves subjected to a high-power laser exhibited its length reduction and less stiffness compared to the control group. A histological analysis of the laser treatment specimens demonstrated differences in collagen bundle spatial organization, following slight changes into tissue temperature.

  3. [Modern mitral valve surgery].

    Science.gov (United States)

    Bothe, W; Beyersdorf, F

    2016-04-01

    At the beginning of the 20th century, Cutler and Levine performed the first successful surgical treatment of a stenotic mitral valve, which was the only treatable heart valve defect at that time. Mitral valve surgery has evolved significantly since then. The introduction of the heart-lung machine in 1954 not only reduced the surgical risk, but also allowed the treatment of different mitral valve pathologies. Nowadays, mitral valve insufficiency has become the most common underlying pathomechanism of mitral valve disease and can be classified into primary and secondary mitral insufficiency. Primary mitral valve insufficiency is mainly caused by alterations of the valve (leaflets and primary order chords) itself, whereas left ventricular dilatation leading to papillary muscle displacement and leaflet tethering via second order chords is the main underlying pathomechanism for secondary mitral valve regurgitation. Valve reconstruction using the "loop technique" plus annuloplasty is the surgical strategy of choice and normalizes life expectancy in patients with primary mitral regurgitation. In patients with secondary mitral regurgitation, implanting an annuloplasty is not superior to valve replacement and results in high rates of valve re-insufficiency (up to 30 % after 3 months) due to ongoing ventricular dilatation. In order to improve repair results in these patients, we add a novel subvalvular technique (ring-noose-string) to the annuloplasty that aims to prevent ongoing ventricular remodeling and re-insufficiency. In modern mitral surgery, a right lateral thoracotomy is the approach of choice with excellent repair and cosmetic results. PMID:26907868

  4. The microRNA expression profile in porcine skeletal muscle is changed by constant heat stress.

    Science.gov (United States)

    Hao, Y; Liu, J R; Zhang, Y; Yang, P G; Feng, Y J; Cui, Y J; Yang, C H; Gu, X H

    2016-06-01

    Heat stress has profound effects on animal performance and muscle function, and microRNAs (miRNAs) play a critical role in muscle development and stress responses. To characterize the changes in miRNAs in skeletal muscle responding to heat stress, the miRNA expression profiles of longissimus dorsi muscles of pigs raised under constant heat stress (30 °C; n = 8) or control temperature (22 °C; n = 8) for 21 days were analyzed by Illumina deep sequencing. A total of 58 differentially expressed miRNAs were identified with 30 down-regulated and 28 up-regulated, and 63 differentially expressed target genes were predicted by miRNA-mRNA joint analysis. GO and KEGG analyses showed that the genes regulated by differentially expressed miRNAs were enriched in glucose metabolism, cytoskeletal structure and function and stress response. Real-time PCR showed that the mRNA levels of PDK4, HSP90 and DES were significantly increased, whereas those of SCD and LDHA significantly decreased by heat exposure. The protein levels of CALM1, DES and HIF1α were also significantly increased by constant heat. These results demonstrated that the change in miRNA expression in porcine longissimus dorsi muscle underlies the changes in muscle structure and metabolism in porcine skeletal muscle affected by constant heat stress. PMID:26857849

  5. Percutaneous Mitral Annuloplasty for Functional Mitral Regurgitation

    Science.gov (United States)

    Schofer, Joachim; Siminiak, Tomasz; Haude, Michael; Herrman, Jean P.; Vainer, Jindra; Wu, Justina C.; Levy, Wayne C.; Mauri, Laura; Feldman, Ted; Kwong, Raymond Y.; Kaye, David M.; Duffy, Stephen J.; Tübler, Thilo; Degen, Hubertus; Brandt, Mathias C.; Van Bibber, Rich; Goldberg, Steve; Reuter, David G.; Hoppe, Uta C.

    2014-01-01

    Background Functional mitral regurgitation (FMR), a well-recognized component of left ventricular remodeling, is associated with increased morbidity and mortality in heart failure patients. Percutaneous mitral annuloplasty has the potential to serve as a therapeutic adjunct to standard medical care. Methods and Results Patients with dilated cardiomyopathy, moderate to severe FMR, an ejection fraction CARILLON Mitral Annuloplasty Device European Union Study (AMADEUS). Percutaneous mitral annuloplasty was achieved through the coronary sinus with the CARILLON Mitral Contour System. Echocardiographic FMR grade, exercise tolerance, New York Heart Association class, and quality of life were assessed at baseline and 1 and 6 months. Of the 48 patients enrolled in the trial, 30 received the CARILLON device. Eighteen patients did not receive a device because of access issues, insufficient acute FMR reduction, or coronary artery compromise. The major adverse event rate was 13% at 30 days. At 6 months, the degree of FMR reduction among 5 different quantitative echocardiographic measures ranged from 22% to 32%. Six-minute walk distance improved from 307±87 m at baseline to 403±137 m at 6 months (P<0.001). Quality of life, measured by the Kansas City Cardiomyopathy Questionnaire, improved from 47±16 points at baseline to 69±15 points at 6 months (P<0.001). Conclusions Percutaneous reduction in FMR with a novel coronary sinus–based mitral annuloplasty device is feasible in patients with heart failure, is associated with a low rate of major adverse events, and is associated with improvement in quality of life and exercise tolerance. PMID:19597051

  6. Arteriosclerotic changes in the myocardium, lung, and kidney in dogs with chronic congestive heart failure and myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Falk, Bo Torkel; Jönsson, Lennart; Olsen, Lisbeth Høier;

    2006-01-01

    Background: The occurrence of small vessel arteriosclerosis in the myocardium, kidney, and lung in dogs with naturally occurring myxomatous mitral valve disease has not been previously investigated systematically. Methods: Twenty-one dogs with naturally occurring congestive heart failure and 21 age......-matched, sex-matched, and weight-matched control dogs underwent extensive pathological and histopathological examination. Morphometry and scoring of tissue sections were used to measure arterial narrowing and fibrosis in the myocardium, kidney, and lung; and intimal thickness and plaque formation in the aorta...... and pulmonary artery. Results: Dogs with congestive heart failure had significantly more arterial narrowing in the left ventricle (Pdogs. However...

  7. Effectiveness of Percutaneous Balloon Mitral Valvuloplasty for Rheumatic Mitral Stenosis with Mild to Severe Mitral Regurgitation

    OpenAIRE

    LinXiang Lu; Lang Hong; Jun Fang; LiangLong Chen

    2016-01-01

    This study is designed to test whether percutaneous balloon mitral valvuloplasty (PBMV) is effective for rheumatic mitral stenosis in Chinese patients with moderate to severe mitral regurgitation. Fifty-six patients with rheumatic mitral valve stenosis were divided into the mild, moderate, and severe regurgitation groups. Cardiac ultrasonography was measured before and 1 to 2 days after PBMV. Following PBMV, the mitral orifice was enlarged, and the left atrial diameter was reduced in the 3 pa...

  8. Mitral valve regurgitation

    Science.gov (United States)

    ... MVP) Rare conditions, such as untreated syphilis or Marfan syndrome Rheumatic heart disease. This is a complication ... the arteries Heart failure - overview High blood pressure Marfan syndrome Mitral valve prolapse Pulmonary embolus Stroke Update ...

  9. Balloon catheter dilatation for mitral stenosis and severe pulmonary hypertension

    International Nuclear Information System (INIS)

    Objective: To determine the safety and efficacy of percutaneous balloon mitral valvuloplasty (PBMV) for patients with mitral stenosis and severe pulmonary hypertension, and to assess the changes in pulmonary systolic pressure during follow-up. Methods: Forty-two patients with rheumatic mitral stenosis and severe pulmonary hypertension (pulmonary systolic pressure > 75 mmHg) underwent PBMV using standard Inoue technique, and the changes in clinical functional status and echo Doppler pulmonary systolic pressure during follow-up were assessed. Results: PBMV was successful in 39 patients. Immediately after the procedure, mitral valve area increased from (0.83 +- 0.12) cm2 to (1.75 +- 0.11) cm2, pulmonary systolic pressure decreased from (85 +- 7) mmHg to (61 +- 13) mmHg (all P < 0.001). Severe mitral regurgitation occurred in 3 patients, one of whom underwent mitral valve replacement. During follow-up (average 6 months), in 39 patients with successful PBMV, the clinical functional status was improved and pulmonary systolic pressure was further decreased despite unchanged mitral valve area. Conclusions: PBMV was safe and effective for patients with mitral stenosis and severe pulmonary hypertension. Clinical functional status was improved and pulmonary systolic pressure was continuously decreased during the short-term follow-up

  10. First pass radionuclide studies in evaluation of left and right ventricular function in patients with bioprosthetic mitral valve replacement after 9-11 years

    International Nuclear Information System (INIS)

    The results presented here show that first pass scintigraphy is an effective diagnostic tool in evaluating tissue valves at long term risk. At 123.8 +-8 months postoperatively, 13 out of 15 patients with porcine valves in the mitral position showed normal PTT, RFR and clinical function. Two patients with bioprostheses proven to be stenotic had abnormal PTT and RFR. Valve replacement was required in these patients. In 14 patients, left and right ESV and EDV were normal at rest. Left and right ventricular responses to exercise were abnormal since ESV and EDV did not change, possibly due to decreased ventricular compliance

  11. Plástica mitral Mitral repair

    Directory of Open Access Journals (Sweden)

    Domingo M Braile

    1990-08-01

    Full Text Available Foram estudados 101 pacientes submetidos a plástica da valva mitral em seis anos, com seguimento de 100%. Entre eles, 36 eram do sexo masculino e 65 do sexo feminino, com idade variando de dois a 62 anos (M = 28 ± 16,4. Desses, 57 (56,4% foram submetidos apenas a abordagem valvar mitral. Os demais foram submetidos a procedimentos associados, como plástica tricúspide (9,9%, revascularização do miocárdio (4,0%, entre outros. Não foi registrado óbito imediato. O índice de mortalidade tardia foi de 2% (AVC hemorrágico após cinco anos e septicemia, no primeiro ano. As complicações não fatais foram representadas pela endocardite evidenciada em dois pacientes (2%, sendo tratados e curados, e um paciente com reestenose mitral pós-plástica por reagudização da doença reumática. O estudo atuarial revelou um índice de 79,0 ± 17,7% de sobrevida, um total de 76,3 ± 17,8% de pacientes livres de complicações, 80,0 ± 17,9% de reoperações, 100,0% livres de tromboembolismo. Os resultados ecodoplercardiográficos registraram que 89% dos pacientes evoluíram com ausência de insuficiência. Dos 11% restantes, 7,4% apresentram insuficiência mitral discreta, 2,4% moderada e 2% importante. De acordo com a classificação da NYHA, os pacientes das classes III (83,8% e IV (16,2% passaram para as classes I (33,3%, II (60,6%, III (4,1% e IV (2%. Os autores concluem que o anel de pericárdio flexível conforma-se perfeitamente com o anel valvar, não produz hemólise e se endoteliza completamente a médio prazo.A hundred-and-one patients were studied in six years, with 100% of follow-up. Among them, 36 were male and 65 female, with an age range of two to 62 years (mean 28 ± 16.4%. Fifty seven of them (56.4% underwent just a mitral surgery, the others and other associated procedures, as tricuspid plastic (9.9%, coronary artery revascularization (4.0%, among others. Hospital mortality was not registered. The late mortality rate was 2% for AVC

  12. Diverticulum of the mitral valve, a rare cause of mitral regurgitation.

    LENUS (Irish Health Repository)

    Soo, Alan

    2010-12-01

    Non-infective mitral valve diverticulum is extremely rare. We present a case of intraoperatively diagnosed mitral valve diverticulum of a 69-year-old man presenting with mitral regurgitation who was successfully treated with mitral valve replacement.

  13. Protein profile changes during porcine oocyte aging and effects of caffeine on protein expression patterns.

    Directory of Open Access Journals (Sweden)

    Guang-Jian Jiang

    Full Text Available It has been shown that oocyte aging critically affects reproduction and development. By using proteomic tools, in the present study, changes in protein profiles during porcine oocyte aging and effects of caffeine on oocyte aging were investigated. By comparing control MII oocytes with aging MII oocytes, we identified 23 proteins that were up-regulated and 3 proteins that were down-regulated during the aging process. In caffeine-treated oocytes, 6 proteins were identified as up-regulated and 12 proteins were identified as down-regulated. A total of 38 differentially expressed proteins grouped into 5 regulation patterns were determined to relate to the aging and anti-aging process. By using the Gene Ontology system, we found that numerous functional gene products involved in metabolism, stress response, reactive oxygen species and cell cycle regulation were differentially expressed during the oocyte aging process, and most of these proteins are for the first time reported in our study, including 2 novel proteins. In addition, several proteins were found to be modified during oocyte aging. These data contribute new information that may be useful for future research on cellular aging and for improvement of oocyte quality.

  14. Homoenxerto mitral: uma realidade

    Directory of Open Access Journals (Sweden)

    Francisco Diniz Affonso da COSTA

    1998-07-01

    Full Text Available Fundamentos: A utilização de homoenxertos valvares aórticos criopreservados está associada a excelente qualidade de vida, com baixa morbidade e durabilidade satisfatória. Espera-se obter resultados semelhantes em posição mitral com o emprego de homoenxertos mitrais criopreservados. Objetivo: Avaliar os resultados imediatos e a curto prazo da substituição da valva mitral por homoenxerto mitral criopreservado. Casuística e Métodos: De julho/97 a fevereiro/98, 8 pacientes com média de idades de 40,3 ± 6,2 anos foram submetidos a substituição da valva mitral por homoenxerto mitral criopreservado. A técnica de implante consistiu de fixação látero-lateral dos músculos papilares, sutura anular contínua e anuloplastia com anel de Carpentier. Antes da alta, todos os pacientes realizaram ecocardiografia bidimensional com Doppler para análise da função valvar e ventricular. Os pacientes foram solicitados a retornar no primeiro mês e, subseqüentemente, a cada três meses de pós-operatório, para controles clínico e ecocardiográfico tardio. Resultados: Houve um óbito hospitalar de causa não relacionada ao enxerto. A avaliação ecocardiográfica antes da alta hospitalar demonstrou média das áreas valvares de 3,1 ± 0,6 cm2 e média dos gradientes médios de 3,5 ± 1,6 mmHg. A insuficiência valvar foi quantificada como inexistente ou trivial em 4 casos e leve em 3. A fração de ejeção de 57 ± 7% no pré-operatório foi adequadamente preservada no pós-operatório (62 ± 6%. Os níveis de hipertensão pulmonar regrediram significativamente de 87 ± 15 mmHg no pré-operatório para 48 ± 12 mmHg no pós-operatório. Houve também redução do tamanho da cavidade atrial esquerda de 61 ± 10 mm para 53 ± 7 mm. Nenhum paciente foi perdido do acompanhamento tardio. Após um tempo médio de seguimento de 4,1 ± 2,5 meses, os pacientes encontram-se funcionalmente bem e sem complicações pós-operatórias. O estudo ecocardiogr

  15. Changes in Serum NT-Pro BNP and Left Atrial BNP Levels after Percutaneous Transvenous Mitral Commissurotomy in Sinus Rhythm Versus Atrial Firilation

    Directory of Open Access Journals (Sweden)

    Leili Pourafkari

    2014-10-01

    Full Text Available Introduction: Natriuretic peptides are secreted from the heart in response to increased wall stress. Their levels are expected to be increased in patients with mitral stenosis (MS due tohigh left atrium (LA pressure and pulmonary artery pressure (PAP. Percutaneous transvenousmitral commissurotomy (PTMC if successful is pursued by a rapid decrease in LA pressure andsubsequent decrease in pulmonary artery pressure. The concurrent changes in natriuretic peptidelevels could be affected with heart rhythm.Methods: Forty five patients with severe rheumatic MS undergoing PTMC were enrolled. Weevaluated the serum NT-Pro BNP levels before and 24 hours after PTMC. BNP levels were alsomeasured from the blood samples obtained from LA before and 20 minutes after the procedure.Changes in biomarkers were assessed based on heart rhythm and success of the procedure.Results: While serum NT-Pro BNP levels showed significant decrease 24 hours after theprocedure (P= 0.04, BNP levels taken 20 minutes after PTMC from LA were similar to theirbaseline concentrations (P= 0.26. NT-Pro BNP levels decreased 51.7±182.86 pg/ml for SR and123.4±520 pg/ml for AF (P= 0.68.Conclusion: Immediate changes in BNP levels did not predict the success of procedure probablydue to the additional balloon inflation attempts in LA in several patients and half-life of BNP. BNPlevels obtained later may be of more value considering the half-life of this marker. Heart rhythmwas not found to influence the changes in biomarker levels. BNP and NT-pro BNP changes werenot found to predict success of the procedure.

  16. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    International Nuclear Information System (INIS)

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy

  17. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Murdoch, Dale, E-mail: dale_murdoch@health.qld.gov.au [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia); McAulay, Laura [The Prince Charles Hospital, Brisbane (Australia); Walters, Darren L. [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia)

    2014-11-15

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy.

  18. Changes in the Swine Gut Microbiota in Response to Porcine Epidemic Diarrhea Infection

    OpenAIRE

    Koh, Hyeon-Woo; Kim, Myun Soo; Lee, Jong-Soo; Kim, Hongik; Park, Soo-Je

    2015-01-01

    The gastrointestinal tract of mammals is a complex ecosystem with distinct environments and comprises hundreds of different types of bacterial cells. The gut microbiota may play a critical role in the gut health of the host. We herein attempted to identify a microbiota shift that may be affected by porcine epidemic diarrhea (PED). We observed significant differences in microbiota between the control and PED virus (PEDV)-infected groups at both the phylum and genus level. Most commensal bacter...

  19. Advanced electrocardiographic parameters change with severity of mitral regurgitation in Cavalier King Charles Spaniels in sinus rhythm

    DEFF Research Database (Denmark)

    Pakkanen, M. Spiljak; Petric, A. Domanjko; Olsen, Lisbeth Høier;

    2012-01-01

    Multiple advanced resting ECG (A-ECG) techniques have improved the diagnostic or prognostic value of ECG in detecting human cardiac diseases even before onset of clinical signs or changes in conventional ECG....

  20. Rotura ventricular após substituição da valva mitral Ventricular disruption after mitral valve replacement

    Directory of Open Access Journals (Sweden)

    Marcelo Campos Christo

    1989-04-01

    Full Text Available Entre 1979 e 1988, 4 casos de rotura do ventrículo esquerdo (VE, após substituição da valva mitral (SVM, foram registrados entre 332 pacientes. Os autores reconhecem, entre seus casos, 3 roturas na junção atrioventricular, ocorridas logo após a saída de by-pass e 1 rotura em parede posterior do VE, ocorrida na unidade de terapia intensiva (UTI. Os pacientes eram todos do sexo feminino e tinham, em média, 58 anos de idade. Tais acidentes aconteceram 3 vezes após substituição isolada da valva mitral e 1 vez em operação combinada de SVM e revascularização do miocárdio. Admitem que o mecanismo principal da rotura está ligado à criação de zona de acinesia isquêmica, localizada em parede do VE, secundária à superdistensão de anel mitral. Relacionam o desencadeamento dos acidentes com a superdistensão dos anéis valvares, avaliados com medidores inadequados, usados em corações profundamente relaxados pela cardioplegia. Preconizam modificações na cabeça desses medidores, adaptando-os a cabos maleáveis, de modo a permitir um posicionamento mais perfeito da cabeça do medidor do anel mitral. Admitem que o perfil mais ou menos elevado das próteses não parece haver influenciado no aparecimento, ou na prevenção desses acidentes, mas sim na determinação do tipo anatômico da lesão. Estão de acordo com outros autores, quando admitem que a fragilidade do miocárdio, em pacientes idosos, agravada com a remoção do aparelho valvar mitral (ventrículo sem sustentação, criaria condições para o aparecimento desses acidentes. Consideram desejável a preservação do aparelho valvar mitral nas SVM, mas consideram que técnicas seguras, com essa finalidade, precisam ser ainda desenvolvidas.Between 1979 and 1988 four fatal cases of left ventricular disruption after mitral valve replacement were registered among 332 patients submitted to mitral valve replacement, with two different types of porcine prosthesis in isolated or

  1. Serial Changes of Neointimal Tissue after Everolimus-Eluting Stent Implantation in Porcine Coronary Artery: An Optical Coherence Tomography Analysis

    Directory of Open Access Journals (Sweden)

    Hoyoun Won

    2014-01-01

    Full Text Available Purposes. The serial changes in neointimal tissues were compared between everolimus-eluting stent (EES and bare-metal stent (BMS in the porcine coronary artery using optical coherence tomography (OCT. Methods. Serial (1, 3, and 6 month follow-up after stent implantation OCT examinations were performed in 15 swine with 15 BMS- and 15 EES-treated lesions in porcine coronary arteries. Results. In BMS-implanted lesions, neointimal volume decreased from 7.3 mm3 to 6.9 mm3 and 6.4 mm3 at 1, 3, and 6 months follow-up without statistical significance (P=0.369. At the time points of 1, 3, and 6 months, neointimal tissue appearance was mainly a homogeneous pattern (80.0%, 93.3%, and 100%, resp., while the other pattern was layered. In contrast, in EES-implanted lesions, neointimal volume significantly increased from 4.8 mm3 to 9.8 mm3 between 1 and 3 months but significantly decreased to 8.6 mm3 between 3 and 6 months (P<0.001. Between 1 and 3 months, the layered pattern of neointimal tissue increased from 26.7% to 66.7% but decreased to 20.0% between 3 and 6 months. Conclusions. EES had a biphasic pattern of neointimal amounts that correlated with changes in neointimal morphology.

  2. CTS Trials Network: A paradigm shift in the surgical treatment of moderate ischemic mitral regurgitation?

    Science.gov (United States)

    Afifi, Ahmed

    2015-01-01

    The Cardiothoracic Surgery Trials Network has reported results of the one-year follow up of their randomized trial "Surgical Treatment of Moderate Ischemic Mitral Regurgitation". They studied 301 patients with moderate ischemic mitral regurgitation (IMR) undergoing coronary artery bypass grafting (CABG) with or without mitral repair with the primary end-point of change in left ventricular end-diastolic volume index (LVEDVI) at one year and multiple clinical and echocardiographic secondary endpoints. Although their results were against repairing the mitral valve, the debate on surgical management of moderate IMR remains unsettled.

  3. Left atrial myxoma, ruptured chordae tendinae causing mitral regurgitation and coronary artery disease

    Directory of Open Access Journals (Sweden)

    Bhupesh Kumar

    2014-01-01

    Full Text Available Mitral regurgitation is uncommon with left atrial myxoma. The echocardiographic assessment of presence of mitral regurgitation and its severity are impaired by the presence of left atrial myxoma. We describe an uncommon association of left atrial myxoma with coronary artery disease and mitral regurgitation. MR was reported as mild on pre-operative transthoracic echocardiography but found to be severe due to ruptured chordae tendinae during intra-operative transesophageal echocardiography, which lead to change in the surgical plan to mitral valve replacement in addition to excision of myxoma.

  4. Insuficiencia mitral grave posvalvuloplastia mitral percutánea

    Directory of Open Access Journals (Sweden)

    Julio C. Echarte Martínez

    2010-01-01

    Full Text Available RESUMENIntroducciónLa valvuloplastia mitral percutánea es en la actualidad el tratamiento de elección en pacientesportadores de estenosis mitral de etiología reumática si la anatomía es apropiada.La insuficiencia mitral grave posvalvuloplastia continúa siendo un desafío.ObjetivoDeterminar las causas de insuficiencia mitral grave posvalvuloplastia mitral.Material y métodosSe realizaron 110 valvuloplastias mitrales percutáneas en forma consecutiva en 107 pacientes(3 repetidas por reestenosis en el Instituto de Cardiología y Cirugía Cardiovascular deCuba, entre el 17 de junio de 1998 y el 30 de junio de 2004 (106 por el método de Inoue y 4por Multitrack; el tiempo de evolución promedio fue de 24,6 meses (máximo 72 y mínimo1,93 meses. La insuficiencia mitral se clasificó por ecocardiografía Doppler en leve si elárea regurgitante era menor de 4 cm2, moderada si era de 4-8 cm2. y grave si era > 8 cm2 ypor ventriculografía izquierda según los criterios de Sellers. Para lograr correlación entre laclasificación por ecocardiografía Doppler color de tres grados y la de Sellers (cuatro gradosla insuficiencia mitral 1+ se consideró leve, 2+ y 3+ moderada y 4+, grave.ResultadosSe produjeron cinco insuficiencias mitrales graves posprocedimiento (4,54% del total. Tresde ellas necesitaron reemplazo valvular mitral por rotura de la valva anterior. Las dos restantesse encuentran bajo tratamiento médico.ConclusiónLos mecanismos de producción de la insuficiencia mitral posvalvuloplastia mitral percutáneason multifactoriales. Puede ocurrir en manos expertas.REV ARGENT CARDIOL 2010;78:222-227.

  5. The Viable Mitral Annular Dynamics and Left Ventricular Function after Mitral Valve Repair by Biological Rings

    Directory of Open Access Journals (Sweden)

    Farideh Roshanali

    2012-12-01

    /s. Recruitment of LVEF reserve during stress was observed in the pericardial ring and normal groups (Group I from 54.6±6.2 to 64.6±7.3%, P<0.005; and Group IV from 55.3 ± 5.7 to 66 ± 6.2%, P<0.05, but no significant changes were detected in the prosthetic ring groups (Group II from 50.4 ± 5 to 55.0 ± 5.1, and Group III from 51.1 ± 6.6 to 53.8 ± 4.7. There was a significant MASE increase in both of the studied longitudinal segments at rest and during stress in Groups I and IV compared with the prosthetic ring groups. There was no calcification of the pericardial rings. Conclusions: The use of treated autologous pericardium rings for mitral valve annuloplasty yields excellent mitral annular dynamics, preserves LV function during stress conditions, and leaves no echocardiographic signs of degeneration.

  6. Mitral stenosis in 15 dogs

    International Nuclear Information System (INIS)

    Mitral stenosis was diagnosed in 15 young to middle-aged dogs. There were 5 Newfoundlands and 4 bull terriers affected, suggesting a breed predisposition for this disorder. Clinical signs included cough, dyspnea, exercise intolerance, and syncope. Soft left apical diastolic murmurs were heard only in 4 dogs, whereas 8 dogs had systolic murmurs characteristic of mitral regurgitation. Left atrial enlargement was the most prominent radiographic feature. Left-sided congestive heart failure was detected by radiographs in 11 dogs within 1 year of diagnosis. Electrocardiographic abnormalities varied among dogs and included atrial and ventricular enlargement, as well as atrial and ventricular arrhythmias. Abnormalities on M-mode and two-dimensional echocardiograms included abnormal diastolic motion of the mitral valve characterized by decreased leaflet separation, valve doming, concordant motion of the parietal mitral valve leaflet, and a decreased E-to-F slope. Increased mitral valve inflow velocities and prolonged pressure half-times were detected by Doppler echocardiography. Cardiac catheterization, performed in 8 dogs, documented a diastolic pressure gradient between the left atrial, pulmonary capillary wedge, or pulmonary artery diastolic pressures and the left ventricular diastolic pressure. Necropsy showed mitral stenosis caused by thickened, fused mitral valve leaflets in 5 dogs and a supramitral ring in another dog. The outcome in affected dogs was poor; 9 of 15 dogs were euthanatized or died by 2 1/2 years of age

  7. Long-term follow-up of Captopril-mediated decrease of regurgitation in aortic and mitral insufficiency. Pt. 2. Hemodynamic changes

    Energy Technology Data Exchange (ETDEWEB)

    Kropp, J.; Biersack, H.J. (Bonn Univ. (Germany). Dept. of Nuclear Medicine); Heck, I. (Lukas Hospital, Altenkirchen (Germany). Dept. of Internal Medicine); Nitsch, J. (St.-Agnes Hospital, Bocholt (Germany). Dept. of Internal Medicine); Reske, S.N. (City Hospital, Wuppertal (Germany). Dept. of Nuclear Medicine)

    Nineteen patients with aortic- and 10 patients with mitral insufficiency were investigated by gated-radionuclide-ventriculography (RNVG). RNVG was performed before and 1 h after administration of 25 mg of Captopril (C) as well as during longterm treatment. From the RNVG studies ejection fraction (EF), left ventricular end-diastolic volume index and regurgitation volume index were derived. EF remained unchanged after C as heart rate. All hemodynamic benefits could be maintained during long-term treatment. (orig./MG).

  8. Mitral Regurgitation after Percutaneous Balloon Mitral Valvotomy in Patients with Rheumatic Mitral Stenosis: A Single-Center Study

    Directory of Open Access Journals (Sweden)

    Naser Aslanabadi

    2015-10-01

    Full Text Available Background: Percutaneous balloon mitral valvotomy (BMV is the gold standard treatment for rheumatic mitral stenosis (MS in that it causes significant changes in mitral valve area (MVA and improves leaflet mobility. Development of or increase in mitral regurgitation (MR is common after BMV. This study evaluated MR severity and its changes after BMV in Iranian patients.Methods: We prospectively evaluated consecutive patients with severe rheumatic MS undergoing BMV using the Inoue balloon technique between February 2010 and January 2013 in Madani Heart Center, Tabriz, Iran. New York Heart Association (NYHA functional class and echocardiographic and catheterization data, including MVA, mitral valve mean and peak gradient (MVPG and MVMG, left atrial (LA pressure, pulmonary artery systolic pressure (PAPs, and MR severity before and after BMV, were evaluated.Results: Totally, 105 patients (80% female at a mean age of 45.81 ± 13.37 years were enrolled. NYHA class was significantly improved after BMV: 55.2% of the patients were in NYHA functional class III before BMV compared to 36.2% after the procedure (p value < 0.001. MVA significantly increased (mean area = 0.64 ± 0.29 cm2 before BMV vs. 1.90 ± 0.22 cm2 after BMV; p value < 0.001 and PAPs, LA pressure, MVPG, and MVMG significantly decreased. MR severity did not change in 82 (78.1% patients, but it increased in 18 (17.1% and decreased in 5 (4.8% patients. Patients with increased MR had a significantly higher calcification score (2.03 ± 0.53 vs.1.50 ± 0.51; p value < 0.001 and lower MVA before BMV (0.81± 0.23 vs.0.94 ± 0.18; p value = 0.010. There were no major complications.Conclusion: In our study, BMV had excellent immediate hemodynamic and clinical results inasmuch as MR severity increased only in some patients and, interestingly, decreased in a few. Our results, underscore BMV efficacy in severe MS. The echocardiographic calcification score was useful for identifying patients likely to

  9. Comparison between Doppler echocardiography and hot-film anemometry in measuring the turbulent shear stress downstream of artificial mitral valves: a methodological study

    Institute of Scientific and Technical Information of China (English)

    SUN Yi; LI Rui-jie; LI Gan-niu; LI Bin; WANG Yu; MA Run-wei; YANG Bai-hui

    2013-01-01

    Background Turbulent shear stress (TSS) plays an important role in the research of fluid dynamics of heart valves.This study aimed to perform a quantitative study of TSS downstream of porcine artificial mitral valves in order to verify the correlation of hot-film anemometry (HFA) and Doppler echocardiography combined with computer-aided image analysis for the detection of TSS.Methods A porcine model of mitral valve replacement was established.HFA and Doppler ultrasound techniques were used to directly and indirectly measure TSS-relevant parameters of the artificial mitral valve following different mitral valve replacements:different approaches were used to reserve the subvalvular apparatus of the mitral valve.A correlation analysis was then carried out.Results There was a significant correlation between the HFA and Doppler ultrasound combined with computer-aided image analysis of the TSS at the same time and at the same site.No significant difference was found in the TSS measured by the two methods.Conclusions Compared with HFA,Doppler echocardiography combined with computer-aided image analysis is a safe,non-invasive,and real-time method that enables accurate and quantitative detection of TSS downstream in vivo,objectively reflecting the flow field downstream of the artificial mitral valve.Doppler ultrasound combined with computeraided image analysis can be employed for quantitatively evaluating the downstream hemodynamic performance of the mitral valve.

  10. Serotonin markers show altered transcription levels in an experimental pig model of mitral regurgitation

    DEFF Research Database (Denmark)

    Cremer, Signe Emilie; Zois, Nora Elisabeth; Moesgaard, S. G.;

    2015-01-01

    -uptake transporter (SERT) in MMVD-affected valves, increased valvular 5-HT synthesis and decreased clearance have been suggested. It remains unknown how haemodynamic changes associated with mitral regurgitation (MR) affect 5-HT markers in the mitral valve, myocardium and circulation. Twenty-eight pigs underwent...

  11. Monitoring of immune activation using biochemical changes in a porcine model of cardiac arrest

    Directory of Open Access Journals (Sweden)

    Anton Amann

    2001-01-01

    Full Text Available In animal models, immune activation is often difficult to assess because of the limited availability of specific assays to detect cytokine activities. In human monocytes/macrophages, interferon-γ induces increased production of neopterin and an enhanced activity of indoleamine 2,3-dioxygenase, which degrades tryptophan via the kynurenine pathway. Therefore, monitoring of neopterin concentrations and of tryptophan degradation can serve to detect the extent of T helper cell 1-type immune activation during cellular immune response in humans. In a porcine model of cardiac arrest, we examined the potential use of neopterin measurements and determination of the tryptophan degradation rate as a means of estimating the extent of immune activation. Urinary neopterin concentrations were measured with high-performance liquid chromatography (HPLC and radioimmunoassay (RIA (BRAHMS Diagnostica, Berlin, Germany. Serum and plasma tryptophan and kynurenine concentrations were also determined using HPLC. Serum and urine neopterin concentrations were not detectable with HPLC in these specimens, whereas RIA gave weakly (presumably false positive results. The mean serum tryptophan concentration was 39.0 Ī 6.2 μmol/l, and the mean kynurenine concentration was 0.85 Ī 0.33 μmol/l. The average kynurenine-per-tryptophan quotient in serum was 21.7Ī 8.4 nmol/μmol, and that in plasma was 20.7Ī 9.5 nmol/μmol (n = 7, which corresponds well to normal values in humans. This study provides preliminary data to support the monitoring of tryptophan degradation but not neopterin concentrations as a potential means of detecting immune activation in a porcine model. The kynurenine-per-tryptophan quotient may serve as a short-term measurement of immune activation and hence permit an estimate of the extent of immune activation.

  12. Mitral isthmus ablation in patients with prosthetic mitral valves

    Institute of Scientific and Technical Information of China (English)

    LONG De-yong; MA Chang-sheng; JIANG Hong; DONG Jian-zeng; LIU Xing-peng; HUANG He; TANG Yan-hong; WU Gang; HUANG Cong-xin

    2010-01-01

    Background Previous studies have investigated the technique of linear ablation at the mitral isthmus (MI) in patients with idopathic atrial fibrillation (AF), but MI ablation in patients with prosthetic natural mitral valves (MVs) was not described in detail. Present study sought to summarize our initial experience of ablating MI in patients with prosthetic MVs Methods Patients with drug refractory AF and prosthetic MVs were eligible for this study, and the patients with natural MVs but received MI ablation served as control group. Left atrium (LA) mapping and ablation was carried out guided by CARTO system. The anatomy of MI was assessed via computer topography scan.Results During the study period, a consecutive of 19 patients (male/female=12/7, mean age of (48±-6) years) with prosthetic MVs (16 with metal valves, 3 with biologic valves) entered for AF ablation, other 35 patients served as control group. In study group, mapping along MI documented lower voltages ((2.0±1.0) vs. (3.1±1.3) mV, P=0.002), more fragmented potentials (19/19 vs. 20/15, P<0.001 ), and higher impedance ((132±34) vs. (110±20) Ω, P=0.004). After initial ablation, more residual gaps along the MI lesions were found in study group (2.4±0.4 vs. 1.7±0.3, P <0.001). The mean length of MI ((6.2±3.3) vs. (7.1±2.3) cm, P=0.25) was comparable between 2 groups, but the MI in study group was much thicker ((3.1 ±1.8) vs. (2.1±1.07) cm, P=0.01 ) and all were found as pouch type (19/19 vs. 2/35, P <0.001). The follow-up results were comparable (65.1% vs. 72.3%, P=0.30).Conclusion For patients with prosthetic MVs, linear ablation at MI could be successfully carried out despite anatomical and pathological changes.

  13. Degenerative processes in bioprosthetic mitral valves in juvenile pigs

    Directory of Open Access Journals (Sweden)

    Pedersen Torben B

    2011-05-01

    Full Text Available Abstract Background Glutaraldehyde-treated bioprosthetic heart valves are commonly used for replacement of diseased heart valves. However, calcification and wear limit their durability, and the development of new and improved bioprosthetic valve designs is needed and must be evaluated in a reliable animal model. We studied glutaraldehyde-treated valves 6 months after implantation to evaluate bioprosthetic valve complications in the mitral position in juvenile pigs. Materials The study material comprised eight, 5-month old, 60-kg pigs. All pigs received a size 27, glutaraldehyde-treated, stented, Carpentier-Edwards S.A.V. mitral valve prosthesis. After six months, echocardiography was performed, and the valves explanted for gross examination, high resolution X-ray, and histological evaluation. Results Five pigs survived the follow-up period. Preexplant echocardiography revealed a median peak and mean velocity of 1.61 m/s (range: 1.17-2.00 and 1.20 (SD = ±0.25, respectively, and a median peak and mean pressure difference of 10.42 mmHg (range: 5.83-16.55 and 6.51 mmHg (SD = ±2.57, respectively. Gross examination showed minor thrombotic depositions at two commissures in two valves and at all three commissures in three valves. High resolution X-ray imaging revealed different degrees of calcification in all explanted valves, primarily in the commissural and belly areas. In all valves, histological evaluation demonstrated various degrees of fibrous sheath formation, limited immunological infiltration, and no overgrowth of host endothelium. Conclusions Bioprosthetic glutaraldehyde-treated mitral valves can be implanted into the mitral position in pigs and function after 6 months. Echocardiographic data, calcification, and histological examinations were comparable to results obtained in sheep models and human demonstrating the suitability of the porcine model.

  14. Robotic mitral valve surgery.

    Science.gov (United States)

    Kypson, Alan P; Nifong, L Wiley; Chitwood, W Randolph

    2003-12-01

    A renaissance in cardiac surgery has begun. The early clinical experience with computer-enhanced telemanipulation systems outlines the limitations of this approach despite some procedural success. Technologic advancements, such as the use of nitinol U-clips (Coalescent Surgical Inc., Sunnyvale, CA) instead of sutures requiring manual knot tying, have been shown to decrease operative times significantly. It is expected that with further refinements and development of adjunct technologies, the technique of computer-enhanced endoscopic cardiac surgery will evolve and may prove to be beneficial for many patients. Robotic technology has provided benefits to cardiac surgery. With improved optics and instrumentation, incisions are smaller. The ergometric movements and simulated three-dimensional optics project hand-eye coordination for the surgeon. The placement of the wristlike articulations at the end of the instruments moves the pivoting action to the plane of the mitral annulus. This improves dexterity in tight spaces and allows for ambidextrous suture placement. Sutures can be placed more accurately because of tremor filtration and high-resolution video magnification. Furthermore, the robotic system may have potential as an educational tool. In the near future, surgical vision and training systems might be able to model most surgical procedures through immersive technology. Thus, a "flight simulator" concept emerges where surgeons may be able to practice and perform the operation without a patient. Already, effective curricula for training teams in robotic surgery exist. Nevertheless, certain constraints continue to limit the advancement to a totally endoscopic computer-enhanced mitral valve operation. The current size of the instruments, intrathoracic instrument collisions, and extrathoracic "elbow" conflicts still can limit dexterity. When smaller instruments are developed, these restraints may be resolved. Furthermore, a working port incision is still required for

  15. 术中三维超声检测二尖瓣成形前后瓣环空间构型的变化%The annulus configuration changes after mitral repair measured by three dimensional echocardiography

    Institute of Scientific and Technical Information of China (English)

    张海波; 孟旭; 郭勇; 何怡华; 韩杰; 李岩

    2014-01-01

    目的 观察术中三维超声技术检测二尖瓣成形术前后二尖瓣环空间构型的变化.方法 选择单纯二尖瓣退行性变导致重度瓣膜反流患者36例,无其他合并心脏疾病.入院后体表二维超声检测,在手术室术前经食管三维超声检测复查二尖瓣反流部位和程度,以及二尖瓣瓣环空间构型,包括二尖瓣环环径、横径、纵径、瓣环高度、前叶合后叶非平面夹角等,并初步确立手术成形方法.术后同样进行三维食管超声检测相同内容.结果 36例患者术前体表二维超声检查与术中发现完全吻合者26例(72.2%),部分吻合6例(16.7%),差距较大4例(1 1.1%).在整个心动周期中二尖瓣环持续呈“马鞍形”,于前外侧交界、后内侧交界处较低,于前瓣环、后瓣环较高.手术前后瓣环周长、瓣环横径和瓣环纵径分别为(12.4±1.4)、(7.5±0.5)cm;(34.8±2.7)、(21.8 ±1.8)mm;(34.9±3.1)、(20.4±2.1)mm.手术前后瓣环周长、瓣环横径和瓣环纵径差异均有统计学意义(均P <0.05).在收缩期,前瓣环与后瓣环之间夹角较大,在舒张期,前叶侧瓣环与后叶侧瓣环之间夹角较小.二尖瓣成形术后二尖瓣瓣环周长、横径、纵径较术前有减少.术前二尖瓣横径和纵径测量值几乎相同,在术后则纵径/横径达到93%.瓣环高度由术前(8.4±0.6) mm降低到术后的(3.0±0.1)mm,瓣环高度/横径比值由术前24%降低到14%.前后瓣环非平面夹角在成形术后由(135±14)°增加为(145±13)°,与术前比较,差异均有统计学意义(均P<0.05).结论 二尖瓣成形术后瓣环空间构型会由于人工瓣环的使用而发生变化.%Objective To investigate the configuration changes after mitral repair by three dimensional echocardiography in the operation room.Methods Serious mitral prolapse without other cardiac disorders were chosen.The routine two dimensional echocardiography was performed after admission.3 dimensional

  16. Valva mitral heteróloga sem suporte: resultados clínicos a médio prazo Heterologous mitral stentless valve: mid-term clinical results

    Directory of Open Access Journals (Sweden)

    Mario O Vrandecic

    1996-09-01

    sistólico e diastólico final, em avaliações ecocardiográficas seriadas CONCLUSÃO: As valvas mitrais porcinas sem suporte têm mostrado melhor performance hemodinâmica, com maior possibilidade de manutenção da função e do tamanho do ventrículo esquerdo. Embora este estudo tenha demonstrado uma curva de aprendizado bem definida relacionada a um novo substituto valvar e à técnica cirúrgica, estes fatores são superados com treino e aderência à técnica atualmente em uso.The concept of replacing diseased mitral valve with porcine mitral stentless valve allowed to address the "idiosyncrasy" of the left ventricular flow and contractility. From March 92 to December 95, 108 patients had their mitral valves replaced by stentless mitral valves. Their age varied from 11 to 65 years (mean 35.22 ± 14.98. There were 67 (62% females and 41 (38% males. The predominant ethiology was rheumatic heart disease 94 (87% cases, followed by a prosthetic dysfunction 6 (5.6% cases, myxomatous disease 5 (4.6% cases, infective endocarditis 2 (1.9% cases and ischemic lesion 1 (0.9% case, 26 (24.1% patients had mitral stenosis, 24 (22.2% mitral regurgitation and the remaining 58 (53.7% mixed lesions; 21.3% of the patients had previous open heart operations. The great majority of the operated patients (97.2% were in functional class III and IV (NYHA. Associated procedures were performed in 9.3% (10 of the cases. RESULTS: Hospital mortality occurred in 7 (6.5% patients non valved related with exception of one whom developed early endocarditis. Of the 101 remaining 3 required reoperations, in two due to valved size mismatch and 1 due to papillary muscle tear. Of the 98 remaining patients, 2 were lost to follow-up, 96 patients have been followed for 3.2 to 45 months. During the late follow-up there were six (6.25% deaths, of the 3 patients with late prosthetic endocarditis, 2 had their valves replaced with standard bioprosthesis, with one death. The third patient expired before

  17. [Mitral Valve Replacement with a Low-Profile Bioprosthesis in Combination with Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy;Report of a Case].

    Science.gov (United States)

    Furukawa, Koji; Sakaguchi, Shuhei; Nakamura, Eisaku; Yano, Mitsuhiro

    2015-06-01

    An 83-year-old woman diagnosed with hypertrophic obstructive cardiomyopathy was referred to our hospital. Her echocardiogram revealed diffuse left ventricular hypertrophy, severe mitral valve regurgitation with systolic anterior motion of the mitral valve, and left ventricular obstruction with a peak outflow gradient of 142 mmHg. Cardiac catheterization revealed a peak pressure gradient of 60 mmHg across the left ventricular outflow tract. Because of the patient's advanced age, as well as uncertainty regarding our ability to resolve her mitral regurgitation, we performed mitral valve replacement with a St. Jude Medical Epic porcine low-profile bioprosthesis in combination with septal myectomy. The patient's postoperative course was uneventful. At 1 year after the operation, her functional status was New York Heart Association class I. The echocardiogram showed the peak outflow gradient markedly decreased to 9 mmHg. PMID:26066877

  18. Changes in antigenicity of porcine serum albumin in gamma-irradiated sausage extract by treatment with pepsin and trypsin

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Koth-Bong-Woo-Ri; Song, Eu-Jin [Department of Food Science and Technology/Institute of Food Science, Pukyong National University, Busan 608-737 (Korea, Republic of); Lee, So-Young [Traditional Food Research Group, Korea Food Research Institute, Seongnam 463-746 (Korea, Republic of); Park, Jin-Gyu [Radiation Food Science and Biotechnology, Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongup 580-185 (Korea, Republic of); Lee, Ju-Woon [National Federation of Fisheries Cooperatives, Fisheries Economic Institute, Seoul 138-827 (Korea, Republic of); Byun, Myung-Woo [Department of Culinary Nutrition, Woosong University, Daejon 300-718 (Korea, Republic of); Ahn, Dong-Hyun, E-mail: dhahn@pknu.ac.kr [Department of Food Science and Technology/Institute of Food Science, Pukyong National University, Busan 608-737 (Korea, Republic of)

    2011-11-15

    Pork is known as an allergenic food with porcine serum albumin (PSA, 66 kDa) representing the major allergen. This study was conducted to investigate the change in antigenicity of PSA in gamma-irradiated sausage extract treated with pepsin and trypsin. Sausage products (A and B) were irradiated at 1, 3, 10, and 20 kGy. After irradiation, sausage proteins were extracted and digested with pepsin (1:200, 30 min) and trypsin (1:300, 5, 30, 60, 90, and 120 min). The binding ability of PSA in extracts of the irradiated sausages (A and B) decreased by over 3 kGy relative to the binding ability of PSA in extracts of intact sausages and showed no notable differences when the dose of radiation ranged from 3 to 20 kGy. After treatment with pepsin and trypsin, the binding ability of PSA in extracts of the irradiated sausages was decreased more relative to that of intact sausages and showed no significant differences when the period of trypsin treatment is increased or when the dose of irradiation is increased. The sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) results indicated that there was no visible change in the intensity of the PSA band in extracts of the irradiated sausages. After pepsin and trypsin treatment, the intensity of PSA band faded with increasing doses of irradiation. In conclusion, antigenicity of PSA in pork sausages could be reduced by gamma irradiation. - Highlights: > Change in antigenicity of PSA in irradiated sausage extract (ISE) was examined. > Binding ability of PSA in ISE was decreased compared to intact extract. > Binding ability of PSA in ISE after enzyme treatments was also further decreased. > Intensity of PSA band in ISE after enzyme treatments became weak.

  19. Changes in antigenicity of porcine serum albumin in gamma-irradiated sausage extract by treatment with pepsin and trypsin

    International Nuclear Information System (INIS)

    Pork is known as an allergenic food with porcine serum albumin (PSA, 66 kDa) representing the major allergen. This study was conducted to investigate the change in antigenicity of PSA in gamma-irradiated sausage extract treated with pepsin and trypsin. Sausage products (A and B) were irradiated at 1, 3, 10, and 20 kGy. After irradiation, sausage proteins were extracted and digested with pepsin (1:200, 30 min) and trypsin (1:300, 5, 30, 60, 90, and 120 min). The binding ability of PSA in extracts of the irradiated sausages (A and B) decreased by over 3 kGy relative to the binding ability of PSA in extracts of intact sausages and showed no notable differences when the dose of radiation ranged from 3 to 20 kGy. After treatment with pepsin and trypsin, the binding ability of PSA in extracts of the irradiated sausages was decreased more relative to that of intact sausages and showed no significant differences when the period of trypsin treatment is increased or when the dose of irradiation is increased. The sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) results indicated that there was no visible change in the intensity of the PSA band in extracts of the irradiated sausages. After pepsin and trypsin treatment, the intensity of PSA band faded with increasing doses of irradiation. In conclusion, antigenicity of PSA in pork sausages could be reduced by gamma irradiation. - Highlights: → Change in antigenicity of PSA in irradiated sausage extract (ISE) was examined. → Binding ability of PSA in ISE was decreased compared to intact extract. → Binding ability of PSA in ISE after enzyme treatments was also further decreased. → Intensity of PSA band in ISE after enzyme treatments became weak.

  20. 20. Immediate EIN-hospital results of percutaneous transvenous mitral commissurotomy in patients with mitral restenosis after closed mitral commissurotomy

    OpenAIRE

    D.M.T. Rahman

    2016-01-01

    Rheumatic mitral stenosis is a very common problem in our population having an incidence of 54 percent among rheumatic heart disease with a female preponderance of 2:1. Percutaneous transvenous initral conimissurotomy (PTMC) using an Inoue balloon catheter is of established efficacy and safety and is an alternative to surgical valvotomy in selected patients with rheumatic mitral stenosis. Nine hundred and ninety (990) patients with rheumatic mitral stenosis who underwent PTMC were evaluated c...

  1. Mitral regurgitation jet around neoannulus: Mitral valve replacement in erysipelothrix rhusiopathiae endocarditis

    Directory of Open Access Journals (Sweden)

    Rahul Basu

    2013-01-01

    Full Text Available A 50-year-old male presented with erysipelothrix rhusiopathiae (ER endocarditis of the mitral valve, severe mitral regurgitation, and heart failure. The ER endocarditis destroyed the native mitral annulus therefore a new annulus was created for the suspension of the mitral bioprosthesis. Postoperative neoannulus dehiscence and leak prompted to redo surgery where transesophageal echocardiography (TEE played an important role in pointing out the exact location of perineoannular leaks for repair.

  2. Promising results after percutaneous mitral valve repair

    DEFF Research Database (Denmark)

    Ihlemann, Nikolaj; Franzen, Olaf; Jørgensen, Erik;

    2011-01-01

    Mitral valve regurgitation (MR) is the secondmost frequent valve disease in Europe. Untreated MR causes considerable morbidity and mortality. In the elderly, as many as half of these patients are denied surgery because of an estimated high surgical risk. Percutaneous mitral valve repair with the ...... with the MitraClip system resembles the Alfieristitch where a clip is used to connect the tip of the mitral valve leaflets....

  3. Promising results after percutaneous mitral valve repair

    DEFF Research Database (Denmark)

    Ihlemann, Nikolaj; Franzen, Olaf; Jørgensen, Erik;

    2011-01-01

    Mitral valve regurgitation (MR) is the secondmost frequent valve disease in Europe. Untreated MR causes considerable morbidity and mortality. In the elderly, as many as half of these patients are denied surgery because of an estimated high surgical risk. Percutaneous mitral valve repair...... with the MitraClip system resembles the Alfieristitch where a clip is used to connect the tip of the mitral valve leaflets....

  4. Mapping of mitral regurgitant defects by cardiovascular magnetic resonance in moderate or severe mitral regurgitation secondary to mitral valve prolapse

    Directory of Open Access Journals (Sweden)

    Raffel Owen C

    2008-04-01

    Full Text Available Abstract Purpose In mitral valve prolapse, determining whether the valve is suitable for surgical repair depends on the location and mechanism of regurgitation. We assessed whether cardiovascular magnetic resonance (CMR could accurately identify prolapsing or flail mitral valve leaflets and regurgitant jet direction in patients with known moderate or severe mitral regurgitation. Methods CMR of the mitral valve was compared with trans-thoracic echocardiography (TTE in 27 patients with chronic moderate to severe mitral regurgitation due to mitral valve prolapse. Contiguous long-axis high temporal resolution CMR cines perpendicular to the valve commissures were obtained across the mitral valve from the medial to lateral annulus. This technique allowed systematic valve inspection and mapping of leaflet prolapse using a 6 segment model. CMR mapping was compared with trans-oesophageal echocardiography (TOE or surgical inspection in 10 patients. Results CMR and TTE agreed on the presence/absence of leaflet abnormality in 53 of 54 (98% leaflets. Prolapse or flail was seen in 36 of 54 mitral valve leaflets examined on TTE. CMR and TTE agreed on the discrimination of prolapse from flail in 33 of 36 (92% leaflets and on the predominant regurgitant jet direction in 26 of the 27 (96% patients. In the 10 patients with TOE or surgical operative findings available, CMR correctly classified presence/absence of segmental abnormality in 49 of 60 (82% leaflet segments. Conclusion Systematic mitral valve assessment using a simple protocol is feasible and could easily be incorporated into CMR studies in patients with mitral regurgitation due to mitral valve prolapse.

  5. Changes in phosphorylation of myofibrillar proteins during postmortem development of porcine muscle

    DEFF Research Database (Denmark)

    Huang, Honggang; Larsen, Martin Røssel; Lametsch, Rene

    2012-01-01

    phosphorylated protein bands with the highest scores. The results indicate that the phosphorylation pattern of myofibrillar proteins in PM muscle is mainly changed with PM time, but only to a minor extent influenced by the rate of pH decline, suggesting that the phosphorylation of myofibrillar proteins may......A gel-based phosphoproteomic study was performed to investigate the postmortem (PM) changes in protein phosphorylation of the myofibrillar proteins in three groups of pigs with different pH decline rates, from PM 1 h to 24 h. The global phosphorylation level in the group with a fast pH decline rate...... was higher than that in the slow and intermediate groups at early PM time, but became the lowest at 24 h. The protein phosphorylation level of seven individual protein bands was only significantly (ptime, and two protein bands were subjected to a synergy effect between PM time and p...

  6. Proteomic changes of the porcine small intestine in response to chronic heat stress.

    Science.gov (United States)

    Cui, Yanjun; Gu, Xianhong

    2015-12-01

    Acute heat stress (HS) negatively affects intestinal integrity and barrier function. In contrast, chronic mild HS poses a distinct challenge to animals. Therefore, this study integrates biochemical, histological and proteomic approaches to investigate the effects of chronic HS on the intestine in finishing pigs. Castrated male crossbreeds (79.00 ± 1.50 kg BW) were subjected to either thermal neutral (TN, 21 °C; 55% ± 5% humidity; n=8) or HS conditions (30 °C; 55% ± 5% humidity; n=8) for 3 weeks. The pigs were sacrificed after 3 weeks of high environmental exposure and the plasma hormones, the intestinal morphology, integrity, and protein profiles of the jejunum mucosa were determined. Chronic HS reduced the free triiodothyronine (FT3) and GH levels. HS damaged intestinal morphology, increased plasma d-lactate concentrations and decreased alkaline phosphatase activity of intestinal mucosa. Proteome analysis of the jejunum mucosa was conducted by 2D gel electrophoresis and mass spectrometry. Fifty-three intestinal proteins were found to be differentially abundant, 18 of which were related to cell structure and motility, and their changes in abundance could comprise intestinal integrity and function. The down-regulation of proteins involved in tricarboxylic acid cycle (TCA cycle), electron transport chain (ETC), and oxidative phosphorylation suggested that chronic HS impaired energy metabolism and thus induced oxidative stress. Moreover, the changes of ten proteins in abundance related to stress response and defense indicated pigs mediated long-term heat exposure and counteracted its negative effects of heat exposure. These findings have important implications for understanding the effect of chronic HS on intestines.

  7. Subacute Staphylococcus epidermidis Bacterial Endocarditis Complicated by Mitral-Aortic Intervalvular Fibrosa Pseudoaneurysm

    Directory of Open Access Journals (Sweden)

    Diane Elegino-Steffens

    2012-01-01

    Full Text Available The patient is a 75-year-old man with a history significant for hypertension and congestive heart failure who underwent a bioprosthetic aortic valve replacement secondary to acute onset of aortic insufficiency. Cultures of the native valve were positive for Staphylococcus epidermidis sensitive to nafcillin and intravenous cefazolin was initiated. On postoperative day 24, he developed acute decompensated heart failure. A transesophageal echocardiogram demonstrated a structurally abnormal mitral valve with severe regurgitation, anterior and posterior leaflet vegetations, and scallop prolapse. There was also evidence of a mitral-aortic intervalvular fibrosa pseudoaneurysm (P-MAIF with systolic expansion and flow within the aneurysm. Antibiotic treatment was changed from cefazolin to vancomycin for presumed development of methicillin-resistant Staphylococcus. He subsequently underwent a bioprosthetic mitral valve replacement and has restoration of health without sequella. This case highlights the development of a P-MAIF as a rare complication of both aortic or mitral valve replacement and infective endocarditis.

  8. [Spontaneous compensation of severe mitral insufficiency secondary to rupture of chordae tendineae in an athlete].

    Science.gov (United States)

    Ordzhonikidze, Z G; Pavlov, V I; Mazxerkina, I A; Druzhinin, A E

    2007-01-01

    The article describes an observation of spontaneous compensation of severe mitral insufficiency due to chordal avulsion in a 52-year-old sportsman adapted to hard physical load. After a physical load, the sportsman developed symptoms of acute mitral insufficiency. EchoCG revealed myxomatous degeneration of mitral cusps, chordal avulsion, severe mitral insufficiency, and volume overload of the left heart. The patient refused surgical treatment; conservative therapy was conducted. A three-year follow-up revealed an unexpectedly fast decrease in the size of heart cavities and the speed of regurgitation. The authors reckon that the these fast changes took place due to the sportsmen's heart adaptation to volume overload. PMID:17564044

  9. 二尖瓣成形术中使用二维平面人工环影响瓣环生理性空间构型%The three dimensional annulus configuration changes after application of two dimensional artificial mitral annuloplasty

    Institute of Scientific and Technical Information of China (English)

    张海波; 孟旭; 郭勇; 何怡华; 韩杰; 李岩

    2015-01-01

    Objective To investigate the mitral annular three dimensional configuration changes after application of two dimensional mitral annuloplasty.Methods Includes criteria:serious mitral prolapse without other cardiac disorders,with age ranged from 18 to 60 years old.Three dimensional echocardiography was performed before the surgery in the operation room.The mitral annular three dimensional configuration,the mitral prolapse and regurgitation grades were examined.And same procedure was done after the mitral repair.All the measure results were expressed as x ± s and the statistical analysis was performed using SPSS 19.0 software.Results Totally 42 cases were enrolled,including 28 posterior prolapse and 14 anterior prolapse cases.All the mitral repair got satisfied none or mild regurgitation.The mitral annulus moved consistently as saddle shape during the whole cardiac cycle,the lowest annulus part was at the commissure and the highest part was at the anterior and posterior annulus centers.During the systolic phase the non-planer angel between anterior and posterior annuls was bigger than in diastolic phase.The annulus circumference,transverse,longitudinal diameters decreased compared with before the surgery.Preoperative mitral transverse diameter and longitudinal diameter values are almost the equal size,indicating the mitral annulus was in nearly round shape.However the longitudinal/transverse ratio reached 0.88 after surgery which implied the annulus configuration recovery after annuloplasty.After the mitral annuloplasty the annular height decreased from (8.4 ± 0.6) mm to (3.2 ±0.1) mm while the annular height/transverse diameter ratio decreased from 0.24 to 0.15,which may be affected by the application of the two dimensional rigid artificial annulus.Non-planar angle between the anterior and posterior mitral annuls increased from(136 ± 13)degrees to(145 ± 14) degrees after mitral repair.Conclusion The mitral annulus configuration may have planarization changes due

  10. Mitral valve prolapse - report of 3 cases

    International Nuclear Information System (INIS)

    Prolapse of mitral valve is characterized by its unique auscultatory, echocardiographic and angiographic findings and may be associated with various disease entities such as congenital heart disease, coronary heart disease and Marfan's syndrome etc. Authors report recent experience of 3 cases of prolapsed mitral valve, 2 cases associated with A.S.D. and 1 case with Marfan's syndrome.

  11. Embolizing Papillary Fibroelastoma of the Mitral Valve

    OpenAIRE

    Mazzucco, Alessandro; Faggian, Giuseppe; Bortolotti, Uberto; Bonato, Raffaele; Pittarello, Demetrio; Centonze, Giuseppe; Thiene, Gaetano

    1991-01-01

    We report a case of myocardial infarction secondary to coronary embolization of a papillary fibroelastoma of the anterior mitral leaflet. The patient underwent successful operation. The English literature describes only 9 other surgically excised papillary fibroelastomas of the mitral valve. In 5 of these cases, the patient presented with signs of cerebral or coronary embolization.

  12. Mitral valve repair in acquired dextrocardia.

    Science.gov (United States)

    Elmistekawy, Elsayed; Chan, Vincent; Hynes, Mark; Mesana, Thierry

    2015-10-01

    Surgical correction of valvular heart disease in patients with dextrocardia is extremely rare. We report a surgical case of mitral valve repair in a patient with acquired dextrocardia. Successful mitral valve repair was performed through a right lateral thoracotomy. We describe our surgical strategy and summarize the literature.

  13. Surgical treatment of functional mitral regurgitation

    NARCIS (Netherlands)

    Braun, Jerry

    2012-01-01

    In this thesis the surgical options for treatment of functional mitral regurgitation (MR) are described. In functional MR, the mitral valve has a normal anatomy, which distinguishes this type of insufficiency from organic MR. Regurgitation in functional MR is related to an abnormal geometry of the l

  14. Mitral valve disease—morphology and mechanisms

    Science.gov (United States)

    Levine, Robert A.; Hagége, Albert A.; Judge, Daniel P.; Padala, Muralidhar; Dal-Bianco, Jacob P.; Aikawa, Elena; Beaudoin, Jonathan; Bischoff, Joyce; Bouatia-Naji, Nabila; Bruneval, Patrick; Butcher, Jonathan T.; Carpentier, Alain; Chaput, Miguel; Chester, Adrian H.; Clusel, Catherine; Delling, Francesca N.; Dietz, Harry C.; Dina, Christian; Durst, Ronen; Fernandez-Friera, Leticia; Handschumacher, Mark D.; Jensen, Morten O.; Jeunemaitre, Xavier P.; Le Marec, Hervé; Le Tourneau, Thierry; Markwald, Roger R.; Mérot, Jean; Messas, Emmanuel; Milan, David P.; Neri, Tui; Norris, Russell A.; Peal, David; Perrocheau, Maelle; Probst, Vincent; Pucéat, Michael; Rosenthal, Nadia; Solis, Jorge; Schott, Jean-Jacques; Schwammenthal, Ehud; Slaugenhaupt, Susan A.; Song, Jae-Kwan; Yacoub, Magdi H.

    2016-01-01

    Mitral valve disease is a frequent cause of heart failure and death. Emerging evidence indicates that the mitral valve is not a passive structure, but—even in adult life—remains dynamic and accessible for treatment. This concept motivates efforts to reduce the clinical progression of mitral valve disease through early detection and modification of underlying mechanisms. Discoveries of genetic mutations causing mitral valve elongation and prolapse have revealed that growth factor signalling and cell migration pathways are regulated by structural molecules in ways that can be modified to limit progression from developmental defects to valve degeneration with clinical complications. Mitral valve enlargement can determine left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, and might be stimulated by potentially modifiable biological valvular–ventricular interactions. Mitral valve plasticity also allows adaptive growth in response to ventricular remodelling. However, adverse cellular and mechanobiological processes create relative leaflet deficiency in the ischaemic setting, leading to mitral regurgitation with increased heart failure and mortality. Our approach, which bridges clinicians and basic scientists, enables the correlation of observed disease with cellular and molecular mechanisms, leading to the discovery of new opportunities for improving the natural history of mitral valve disease. PMID:26483167

  15. Mitral valve disease--morphology and mechanisms.

    Science.gov (United States)

    Levine, Robert A; Hagége, Albert A; Judge, Daniel P; Padala, Muralidhar; Dal-Bianco, Jacob P; Aikawa, Elena; Beaudoin, Jonathan; Bischoff, Joyce; Bouatia-Naji, Nabila; Bruneval, Patrick; Butcher, Jonathan T; Carpentier, Alain; Chaput, Miguel; Chester, Adrian H; Clusel, Catherine; Delling, Francesca N; Dietz, Harry C; Dina, Christian; Durst, Ronen; Fernandez-Friera, Leticia; Handschumacher, Mark D; Jensen, Morten O; Jeunemaitre, Xavier P; Le Marec, Hervé; Le Tourneau, Thierry; Markwald, Roger R; Mérot, Jean; Messas, Emmanuel; Milan, David P; Neri, Tui; Norris, Russell A; Peal, David; Perrocheau, Maelle; Probst, Vincent; Pucéat, Michael; Rosenthal, Nadia; Solis, Jorge; Schott, Jean-Jacques; Schwammenthal, Ehud; Slaugenhaupt, Susan A; Song, Jae-Kwan; Yacoub, Magdi H

    2015-12-01

    Mitral valve disease is a frequent cause of heart failure and death. Emerging evidence indicates that the mitral valve is not a passive structure, but--even in adult life--remains dynamic and accessible for treatment. This concept motivates efforts to reduce the clinical progression of mitral valve disease through early detection and modification of underlying mechanisms. Discoveries of genetic mutations causing mitral valve elongation and prolapse have revealed that growth factor signalling and cell migration pathways are regulated by structural molecules in ways that can be modified to limit progression from developmental defects to valve degeneration with clinical complications. Mitral valve enlargement can determine left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, and might be stimulated by potentially modifiable biological valvular-ventricular interactions. Mitral valve plasticity also allows adaptive growth in response to ventricular remodelling. However, adverse cellular and mechanobiological processes create relative leaflet deficiency in the ischaemic setting, leading to mitral regurgitation with increased heart failure and mortality. Our approach, which bridges clinicians and basic scientists, enables the correlation of observed disease with cellular and molecular mechanisms, leading to the discovery of new opportunities for improving the natural history of mitral valve disease.

  16. Misconceptions and Facts About Mitral Regurgitation.

    Science.gov (United States)

    Argulian, Edgar; Borer, Jeffrey S; Messerli, Franz H

    2016-09-01

    Mitral regurgitation is a common heart valve disease. It is defined to be primary when it results from the pathology of the mitral valve apparatus itself and secondary when it is caused by distortion of the architecture or function of the left ventricle. Although the diagnosis and management of mitral regurgitation rely heavily on echocardiography, one should bear in mind the caveats and shortcomings of such an approach. Clinical decision making commonly focuses on the indications for surgery, but it is complex and mandates precise assessment of the mitral pathology, symptom status of the patient, and ventricular performance (right and left) among other descriptors. It is important for healthcare providers at all levels to be familiar with the clinical picture, diagnosis, disease course, and management of mitral regurgitation.

  17. Transcatheter mitral valve implantation via transapical approach

    DEFF Research Database (Denmark)

    Sondergaard, Lars; Brooks, Matthew; Ihlemann, Nikolaj;

    2015-01-01

    OBJECTIVES: As many as 50% of patients with severe symptomatic mitral valve regurgitation are denied surgical valve replacement or repair due to high operative risk. We describe an early series of cases of transcatheter implantation with a CardiAQ™ mitral valve via a transapical approach. METHODS......: Three consecutive patients with an Society of Thoracic Surgeons (STS) mortality score of >22% were selected for transcatheter mitral valve implantation (TMVI) on compassionate grounds. All patients were elderly, had severe mitral regurgitation (MR), were in Class IV heart failure and deemed unsuitable...... bypass surgery (n = 2), severe pulmonary hypertension (n = 1) and moderate to severe chronic renal failure (n = 3). A CardiAQ mitral valve was implanted using fluoroscopy and transoesophageal (TEE) guidance via a standard transapical approach. RESULTS: Accurate prosthesis positioning and deployment...

  18. Mitral Valve Repair: The Chordae Tendineae

    Directory of Open Access Journals (Sweden)

    Carlos-A Mestres

    2015-10-01

    Full Text Available Repair of the mitral valve is the treatment of choice for mitral valve regurgitation when the anatomy is favorable. It is well known that mitral valve repair enjoys better clinical and functional results than any other type of valve substitute. This fact is beyond doubt regardless of the etiology of the valve lesion and is of particular importance in degenerative diseases.This review analyzes the most important advances in the knowledge of the anatomy, pathophysiology, and chordal function of the mitral valve as well as the different alternatives in the surgical repair and clinical results of the most prevalent diseases of the mitral valve. An attempt has been made to organize the acquired information available in a practical way.

  19. Real-time Three-dimensional Echocardiography in Assessment of Congenital Double Orifice Mitral Valve

    Institute of Scientific and Technical Information of China (English)

    LU Qing; FU Manli; LU Xiaofang; XIE Mingxing; WANG Xinfang; WANG Jing; YANG Yali; YUAN Li; HE Lin; LIU Xiatian

    2006-01-01

    The application of real-time three-dimensional echocardiography (RT 3DE) in the diagnosis of double orifice mitral valve (DOMV) was explored. Five cases of DOMV were examined by using 2-dimensional echocardiography (2DE) and RT 3DE. The spatial morphology of malformed mitral valve and its change in hemodynamics were observed. DOMV associated with partial atrioventricular septal defect was found in 3 cases (in which 2 cases had cleft mitral valve) and isolated DOMV in 2 cases; and moderate to severe mitral regurgitation was detected in 3 cases, and mild mitral regurgitation in 1, and no regurgitation in 1 case; 1 case had complicated rhumatic heart disease.Three cases were preoperatively discovered by 2DE, while 2 missed (1 case was discovered postoperatively). Four cases were diagnosed by RT 3DE preoperatively, and 1 case was diagnosed postoperatively (not examined by RT 3DE preoperatively). It was suggested that RT 3DE is a reliable technique in the diagnosis of DOMV; it permitted comprehensive and noninvasive assessment of mitral valve and may supplement 2D TTE in the assessment of DOMV.

  20. Traumatic Mitral Valve and Pericardial Injury

    Directory of Open Access Journals (Sweden)

    Nissar Shaikh

    2013-01-01

    Full Text Available Cardiac injury after blunt trauma is common but underreported. Common cardiac trauma after the blunt chest injury (BCI is cardiac contusion; it is very rare to have cardiac valve injury. The mitral valve injury during chest trauma occurs when extreme pressure is applied at early systole during the isovolumic contraction between the closure of the mitral valve and the opening of the aortic valve. Traumatic mitral valve injury can involve valve leaflet, chordae tendineae, or papillary muscles. For the diagnosis of mitral valve injury, a high index of suspicion is required, as in polytrauma patients, other obvious severe injuries will divert the attention of the treating physician. Clinical picture of patients with mitral valve injury may vary from none to cardiogenic shock. The echocardiogram is the main diagnostic modality of mitral valve injuries. Patient’s clinical condition will dictate the timing and type of surgery or medical therapy. We report a case of mitral valve and pericardial injury in a polytrauma patient, successfully treated in our intensive care unit.

  1. The future of transcatheter mitral valve interventions

    DEFF Research Database (Denmark)

    Maisano, Francesco; Alfieri, Ottavio; Banai, Shmuel;

    2015-01-01

    the transcatheter intervention armamentarium. Recently, the feasibility of transcatheter mitral valve implantation in native non-calcified valves has been reported in very high-risk patients. Acknowledging the lack of scientific evidence to date, it is difficult to predict what the ultimate future role...... of transcatheter mitral valve interventions will be. The purpose of the present report is to review the current state-of-the-art of mitral valve intervention, and to identify the potential future scenarios, which might benefit most from the transcatheter repair and replacement devices under development....

  2. Mitral Valve Replacement with Half-and-Half Technique for Recurrent Mitral Paravalvular Leakage.

    Science.gov (United States)

    Morisaki, Akimasa; Kato, Yasuyuki; Takahashi, Yosuke; Shibata, Toshihiko

    2015-05-01

    Reoperation for paravalvular leakage can cause recurrent paravalvular leakage through severe damage to the mitral annulus. Previously, mitral valve replacement using a half-and-half technique for extensive mitral annular calcification was reported; here, application of the technique to treat recurrent paravalvular leakage is described. A 78-year-old male with three prior mitral valve replacements developed recurrent paravalvular leakage, for which he had undergone his third mitral valve replacement at the age of 69 years. On this occasion, a mechanical valve with circumferential equine pericardial patch reinforcement of the annulus had been used. Five years later, the patient developed hemolytic anemia and congestive heart failure due to recurrent paravalvular leakage. Intraoperatively, broad dehiscence was seen between the prosthetic valve and mitral annulus at two sites, the anterior and posterior commissures, without infection. A fourth mitral valve replacement was performed with a St. Jude Medical valve, using a half-and-half technique. This entailed the use of non-everting mattress sutures on the anterior half of the annulus, and everting mattress sutures on the left atrial wall around the posterior half of the annulus. Extensive annular defects required reinforcement of the posterior mitral annulus with a bovine pericardial patch. Postoperative echocardiography showed no paravalvular leakage. The half-and-half technique may be useful in treating recurrent paravalvular leakage of the mitral valve. PMID:26901904

  3. [Experimental principles for preserving annulo-ventricular integrity of the mitral valve].

    Science.gov (United States)

    Gams, E; Schad, H; Heimisch, W

    1996-06-01

    Despite numerous improvement in cardiac surgery the results in mitral valve replacement are still not satisfactory, since impaired left ventricular function continues to be a problem during the postoperative course. In order to investigate the effect of mitral valve replacement on left ventricular function canine experiments were performed: During extracorporeal circulation bileaflet mitral valve prostheses were implanted preserving the ventriculo-annular continuity. Flexible wires were slung around the chordae of the subvalvular mitral apparatus and brought to the outside through the left ventricular wall. Left ventricular diameters were measured by sonomicrometry, left ventricular stroke volume, left ventricular enddiastolic volume and ejection fraction by dye dilution technique as well as left ventricular and aortic pressure by catheter tip manometers. After finishing cardiopulmonary bypass control values were registered and different preload values achieved by volume loading with blood transfusions to left ventricular enddiastolic pressures of 12 mm Hg. Subsequently under normovolumic conditions the chordae tendineae of the anterior and posterior papillary muscles of the mitral valve were cut from the outside, while the heart was beating, by application of electrocautery on the steel wires. Following severance of the ventriculo-annular continuity of the mitral valve again function curves of left ventricular hemodynamics were made during volume transfusions. When the chordae had been divided the left ventricular enddiastolic diameter increased by 10% in the major axis, while in the minor axis no significant changes occurred. The systolic shortening was impaired substantially by reduction of 43% during the ejection phase when the subvalvular mitral apparatus had been severed. Left ventricular enddiastolic volume was increased by 18% at any preload level, while left ventricular ejection fraction was reduced by 16%. Consequently left ventricular stroke volume was

  4. Mitral Annular Kinetics, Left Atrial and Left Ventricular Diastolic Function Post Mitral Valve Repair in Degenerative Mitral Regurgitation

    Directory of Open Access Journals (Sweden)

    Chun eSchiros

    2015-08-01

    Full Text Available Objective: The relationship of mitral annular (MA kinetics to left ventricular (LV and left atrial (LA function before and after mitral valve repair has not been well studied. Here we sought to provide comprehensive analysis that relates to MA motions, LA and LV diastolic function post mitral valve repair. Methods: Three-dimensional analyses of mitral annular motion, LA function and LV volumetric and diastolic strain rates were performed on 35 degenerative mitral regurgitation (MR patients at baseline and 1-year post mitral valve repair, and 51 normal controls, utilizing cardiac magnetic resonance imaging with tissue tagging. Results: All had normal LV ejection fraction (EF at baseline. LV and LA EFs decreased 1-year post-surgery vs. controls. LV early-diastolic myocardial strain rates decreased post-surgery along with decreases in normalized early-diastolic filling rate, E/A ratio and early-diastolic MA relaxation rates. Post-surgical LA late active kick remained higher in MR patients vs. control. LV and LA EFs were significantly associated with peak MA centroid to apex shortening. Furthermore, during LV systolic phase, peak LV ejection and LA filling rates were significantly correlated with peak MA centroid to apex shortening rate, respectively. While during LV diastolic phase, both peak early diastolic MA centroid to apex relaxation rate and LA ejection rate were positively significantly associated with LV peak early diastolic filling rate. Conclusions— MA motion is significantly associated with LA and LV function. Mitral annular motion, left atrial function and left ventricular diastolic strain rates are still impaired one year post mitral valve repair. Long term effects of these impairments should be prospectively evaluated.

  5. Mitral valve prolapse - report of 3 cases

    Energy Technology Data Exchange (ETDEWEB)

    Han, Moon Hee; Im, Chung Ki; Im, Dong Ran; Han, Man Chung; Lee, Young Woo; Seo, Jung Don [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-12-15

    Prolapse of mitral valve is characterized by its unique auscultatory, echocardiographic and angiographic findings and may be associated with various disease entities such as congenital heart disease, coronary heart disease and Marfan's syndrome etc. Authors report recent experience of 3 cases of prolapsed mitral valve, 2 cases associated with A.S.D. and 1 case with Marfan's syndrome.

  6. Parabolic resection for mitral valve repair.

    Science.gov (United States)

    Drake, Daniel H; Drake, Charles G; Recchia, Dino

    2010-02-01

    Parabolic resection, named for the shape of the cut edges of the excised tissue, expands on a common 'trick' used by experienced mitral surgeons to preserve tissue and increase the probability of successful repair. Our objective was to describe and clinically analyze this simple modification of conventional resection. Thirty-six patients with mitral regurgitation underwent valve repair using parabolic resection in combination with other techniques. Institution specific mitral data, Society of Thoracic Surgeons data and preoperative, post-cardiopulmonary bypass (PCPB) and postoperative echocardiography data were collected and analyzed. Preoperative echocardiography demonstrated mitral regurgitation ranging from moderate to severe. PCPB transesophageal echocardiography demonstrated no regurgitation or mild regurgitation in all patients. Thirty-day surgical mortality was 2.8%. Serial echocardiograms demonstrated excellent repair stability. One patient (2.9%) with rheumatic disease progressed to moderate regurgitation 33 months following surgery. Echocardiography on all others demonstrated no or mild regurgitation at a mean follow-up of 22.8+/-12.8 months. No patient required mitral reintervention. Longitudinal analysis demonstrated 80% freedom from cardiac death, reintervention and greater than moderate regurgitation at four years following repair. Parabolic resection is a simple technique that can be very useful during complex mitral reconstruction. Early and intermediate echocardiographic studies demonstrate excellent results.

  7. Single-centre experience with mitral valve repair in asymptomatic patients with severe mitral valve regurgitation

    NARCIS (Netherlands)

    W.J. van Leeuwen (Wouter); S.J. Head (Stuart); L.E. de Groot-de Laat (Lotte); M.L. Geleijnse (Marcel); A.J.J.C. Bogers (Ad); L.A. van Herwerden (Lex); A.P. Kappetein (Arie Pieter)

    2013-01-01

    textabstractOBJECTIVES: Guidelines recommend surgical mitral valve repair in selected patients with asymptomatic severe mitral valve regurgitation (MR), but the role of repair remains a matter of debate. Survival analyses of operated asymptomatic patients have been reported, but long-term haemodynam

  8. Genotypic change of porcine circovirus type 2 on Japanese pig farms as revealed by restriction fragment length polymorphism analysis.

    Science.gov (United States)

    Takahagi, Yoichi; Nishiyama, Yasutaka; Toki, Shinji; Yonekita, Taro; Morimatsu, Fumiki; Murakami, Hiroshi

    2008-06-01

    Porcine circovirus type 2 (PCV2) has been recognized as the causal agent of postweaning multisystemic wasting syndrome and can be divided into two major genotypic groups. We developed a method of restriction fragment length polymorphism (RFLP) analysis of PCV2 open reading frame 2 for easy discrimination between the two major groups. Genotyping of PCV2 isolates from 10 Japanese commercial pig farms was performed, and the analysis revealed that both PCV2 groups and at least five RFLP types of PCV2 are prevalent in Japan. On two farms, the genotypes of the PCV2 isolates in the spring of 2007 were different from those in the autumn of 2006. One genotype may have become dominant within only six months on these farms.

  9. Anterior Mitral Leaflet Augmentation for Ischemic Mitral Regurgitation Performed Via a Right Thoracotomy Approach.

    Science.gov (United States)

    Mihos, Christos G; Pineda, Andres M; Horvath, Sofia A; Santana, Orlando

    2016-01-01

    Ischemic mitral regurgitation (MR) after myocardial infarction is associated with poor long-term survival, and the optimal treatment strategy remains debated. The most common repair technique used is a restrictive annuloplasty. However, up to 15% to 30% of patients experience recurrent MR owing to progressive left ventricular remodeling and geometric distortion of the mitral valve apparatus. Anterior mitral leaflet augmentation using a pericardial patch, in combination with a true-sized mitral annuloplasty, has been proposed as an adjunctive technique to increase the durability of valve repair for ischemic MR. Herein, we describe 2 cases of anterior mitral leaflet augmentation with annuloplasty repair for severe ischemic MR via a minimally invasive right thoracotomy, and review the literature regarding patient selection and clinical outcomes of this technique.

  10. Emergency mitral valve replacement for acute severe mitral regurgitation following balloon mitral valvotomy: Pathophysiology of hemodynamic collapse and peri-operative management issues

    Directory of Open Access Journals (Sweden)

    Praveen Reddy Bayya

    2014-01-01

    Full Text Available Severe mitral regurgitation (MR following balloon mitral valvotomy (BMV needing emergent mitral valve replacement is a rare complication. The unrelieved mitral stenosis is compounded by severe MR leading to acute rise in pulmonary hypertension and right ventricular afterload, decreased coronary perfusion, ischemia and right ventricular failure. Associated septal shift and falling left ventricular preload leads to a vicious cycle of myocardial ischemia and hemodynamic collapse and needs to be addressed emergently before the onset of end organ damage. In this report, we describe the pathophysiology of hemodynamic collapse and peri-operative management issues in a case of mitral valve replacement for acute severe MR following BMV.

  11. Age-related changes in relative expression stability of commonly used housekeeping genes in selected porcine tissues

    Directory of Open Access Journals (Sweden)

    Looft Christian

    2011-10-01

    Full Text Available Abstract Background Gene expression analysis using real-time RT-PCR (qRT-PCR is increasingly important in biological research due to the high-throughput and accuracy of qRT-PCR. For accurate and reliable gene expression analysis, normalization of gene expression data against housekeeping genes or internal control genes is required. The stability of reference genes has a tremendous effect on the results of relative quantification of gene expression by qRT-PCR. The expression stability of reference genes could vary according to tissues, age of individuals and experimental conditions. In the pig however, very little information is available on the expression stability of reference genes. The aim of this research was therefore to develop a new set of reference genes which can be used for normalization of mRNA expression data of genes expressed in varieties of porcine tissues at different ages. Results The mRNA expression stability of nine commonly used reference genes (B2M, BLM, GAPDH, HPRT1, PPIA, RPL4, SDHA, TBP and YWHAZ was determined in varieties of tissues collected from newborn, young and adult pigs. geNorm, NormFinder and BestKeeper software were used to rank the genes according to their stability. geNorm software revealed that RPL4, PPIA and YWHAZ showed high stability in newborn and adult pigs, while B2M, YWHAZ and SDHA showed high stability in young pigs. In all cases, GAPDH showed the least stability in geNorm. NormFinder revealed that TBP was the most stable gene in newborn and young pigs, while PPIA was most stable in adult pigs. Moreover, geNorm software suggested that the geometric mean of three most stable gene would be the suitable combination for accurate normalization of gene expression study. Conclusions Although, there was discrepancy in the ranking order of reference genes obtained by different analysing software methods, the geometric mean of the RPL4, PPIA and YWHAZ seems to be the most appropriate combination of

  12. Cine MR imaging in mitral valve prolapse

    International Nuclear Information System (INIS)

    This study was undertaken to assess the ability of cine MR imaging to evaluate the direction, timing, and severity of mitral regurgitation in patients with mitral valve prolapse (MVP). The population of this study was 33 patients with MVP diagnosed by two-dimensional echocardiography and 10 patients with rheumatic mitral valve disease (MSR) for comparison. 7 patients with MVP and 5 with MSR had atrial fibrillation and/or history of congestive heart failure as complications. Mitral regurgitation was graded for severity by color Doppler flow imaging in all patients. Direction and size of systolic flow void in the left atrium were analyzed by contiguous multilevel cine MR images and the maximum volumes of flow void and left atrium were measured. Although flow void was found at the center of the left atrium in most of MSR, it was often directed along the postero-caudal atrial wall in anterior leaflet prolapse and along the anterocranial atrial wall in posterior leaflet prolapse. In MVP, the maximum volume of flow void was often seen in late systole. The maximum volume of flow void and that of left atrium were significantly larger in patients with atrial fibrillation and/or history of congestive heart failure. The length and volume of flow void were increased with clinical severity and degree of regurgitation determined by color Doppler flow imaging. Thus cine MR imaging provides a useful means for detection and semiquantitative evaluation of mitral regurgitation in subjects with MVP. (author)

  13. VALVULOPLASTIA MITRAL PERCUTÁNEA EN LA GESTANTE CON ESTENOSIS MITRAL. RESULTADOS A LARGO PLAZO / Percutaneous mitral valvuloplasty in pregnant women with mitral stenosis: long-term results

    Directory of Open Access Journals (Sweden)

    Julio C Echarte-Martínez

    2010-06-01

    Full Text Available Percutaneous mitral valvuloplasty can be performed during pregnancy without a high risk of maternal-fetal mortality. In Cuba, there was no precedent of the implementation of this technique in this kind of patients. Nine valvuloplasties were performed in pregnant women (using the Inoue method, form a total of 110 procedures carried out in a consecutive way between June 17th 1998 and June 30th 2004 at the Cardiology and Cardiovascular Surgery Institute, which were assessed up to June 17th 2009. The longest follow-up was 11 years, the minimum 6.26 years and the average 8.26 years. Before the valvuloplasty, the pregnant women were in the functional classes III and IV (New York Heart Association. The valvular areas measured by echo-planimetry were ≤1,01 cm2 . A patient presenting a valvular area of 1.52 cm2, showed after the valvuloplasty a moderated mitral insufficiency which evolved to a severe insufficiency at 26 weeks, being necessary a mitral valve replacement with no maternal or fetal complication. The other patients did not present adverse events during the long-term follow-up or any alteration in the development of the children. There was no mortality. Therefore, it can be concluded that the percutaneous mitral valvuloplasty is a feasible procedure in pregnant women with mitral stenosis and its results are maintained in the short, medium and long-run.

  14. [Mitral surgery by superior biatrial septotomy].

    Science.gov (United States)

    Saade, A; Delepine, G; Lemaitre, C; Baehrel, B

    1995-01-01

    The superior biatrial septotomy approach consists of two semicircular right atrial and septal incisions joined at the superior end of the interatrial septum and extended across the dome of the left atrium, allowing exposure of the mitral valve by reflecting the ventricular side using stay sutures. From 1991 to 1993, 81 patients underwent mitral valve surgery by this technic. Mitral valve operation was combined with other cardiac procedures in 30 patients (37%) and was performed as a second operation in 21 patients (25.9%). Duration of cardiopulmonary bypass and aortic occlusion was not significantly different from that of patients operated via a conventional left atrial approach. The five hospital deaths (6.2%) were not related to this operative approach. Only 2 patients (3.3%) with preoperative in sinus rythm were discharged in atrial fibrillation after operation. In one patient (1.6%), atrioventricular block appeared at late follow-up. There were no cases of bleeding, atrioventricular nodal dysfunction or intra-atrial shunting related to the approach. This approach provides excellent exposure of the mitral valve even in unfavorable situations such as a small left atrium, dense adhesions from previous procedures or a previously implanted aortic prosthesis, without damage to various cardiac structures due to excessive traction. No retractor or vena cava repair are required. These data support a wide application of the superior biatrial septotomy approach in mitral valve surgery.

  15. A heart team's perspective on interventional mitral valve repair

    DEFF Research Database (Denmark)

    Treede, Hendrik; Schirmer, Johannes; Rudolph, Volker;

    2012-01-01

    Surgical mitral valve repair carries an elevated perioperative risk in the presence of severely reduced ventricular function and relevant comorbidities. We sought to assess the feasibility of catheter-based mitral valve repair using a clip-based percutaneous edge-to-edge repair system in selected...... patients at high surgical risk with mitral regurgitation grade 3 or worse....

  16. Surgical treatment of mitral valve insufficiency by valve repair

    Directory of Open Access Journals (Sweden)

    Murad Henrique

    2002-01-01

    Full Text Available OBJECTIVE: To analyze the short term results of mitral valve repair in a consecutive series of mitral insufficiency patients from different ethiologies. METHODS: A retrospective study was made of 86 patients with mitral insufficiency operated on between May 1992 and May 2001 for mitral valve repair. Mitral insufficiency was severe in 77 patients and moderate in 9. The functional class of the patients was I in 4, II in 48, III in 29 and IV in 5 patients. The etiology was rheumatic in 47 (54.6% cases. RESULTS: Mitral valve repair was performed by only one procedure on the mitral valve in 6 patients, two procedures in 29, and three or more procedures in 51 (59.3% patients. Mitral annuloplasty was performedin 81 patients, with the Braile posterior pericardial ring being the mostcommonly used (87.2%. Hospital mortality was 3.5%. There was improvement in the funcional class in 79 (91.8% patients. Mitral valve function was normal in 80 (93% patients and moderate mitral insufficiency occurred in 6 patients. CONCLUSION: Mitral valve repair can be performed with low mortality (3.5% and high probability of valve function recovery (93%. It should be the procedure of choice in patients with mitral insufficiency.

  17. Mitral Valve Regurgitation Causing Right Upper Lobe Pulmonary Edema

    OpenAIRE

    Young, Andrew L.; Langston, Charles S.; Schiffman, Robert L.; Shortsleeve, Michael J.

    2001-01-01

    When radiography is performed in patients with mitral regurgitation, cardiogenic pulmonary edema is a typical finding; however, asymmetric pulmonary edema has also been reported. We describe the case of a patient in whom mitral valve regurgitation caused isolated pulmonary edema in the right upper lung. We include a discussion of pulmonary edema in conjunction with mitral regurgitation.

  18. Porcine embryonic stem cells

    DEFF Research Database (Denmark)

    Hall, Vanessa Jane

    2008-01-01

    The development of porcine embryonic stem cell lines (pESC) has received renewed interest given the advances being made in the production of immunocompatible transgenic pigs. However, difficulties are evident in the production of pESCs in-vitro. This may largely be attributable to differences...... in porcine pre-implantation development compared to the mouse and human. Expression of oct4, nanog and sox2 differs in the zona-enclosed porcine blastocyst compared to its mouse and human counterparts, which may suggest that other factors may be responsible for maintaining porcine pluripotency in the early...

  19. Atrial Fibrillation and Early Clinical Outcomes After Mitral Valve Surgery in Patients with Rheumatic vs. Non-Rheumatic Mitral Stenosis

    OpenAIRE

    S J Mirhosseini; Sadegh Ali-Hassan-Sayegh; Mehdi Hadadzadeh; Nafiseh Naderi; S. M. Y Mostafavi Pour Manshadi

    2012-01-01

    Background: Atrial fibrillation (AF) is the most common arrhythmia after open heart surgery that can lead to early morbidity and mortality following operation. Mitral stenosis (MS) is a structural abnormality of the mitral valve apparatus that can be resulted from previous rheumatic fever or non-rheumatic fever such as congenital mitral stenosis, malignant carcinoid disease etc. This study was designed to test the hypothesis that type of mitral stenosis can affect the incidence, duration and ...

  20. Percutaneous treatment of Lutembacher syndrome in a case with difficult mitral valve crossing.

    Science.gov (United States)

    Bhambhani, Anupam; Somanath, H S

    2012-03-01

    Most cases of combination congenital cardiac anomalies are treated with open-heart surgeries because the coexisting anomalies change the cardiac anatomy in an adverse way, making catheter manipulations complex. Lutembacher syndrome is a combination of acquired mitral stenosis and congenital ostium secundum atrial septal defect. The large defect in the septum makes an Inoue balloon catheter unstable, which provides excessive space for free floatation of the catheter, making its passage into the left ventricle difficult by Inoue technique. We present a case of elective definitive percutaneous treatment of Lutembacher syndrome, discussing the technical difficulties faced in mitral valve crossing and reviewing the possible strategies to improve chances of success. PMID:22388316

  1. 33. Moderate ischemic mitral regurgitation: Revascularization alone versus revascularization and mitral valve repair

    Directory of Open Access Journals (Sweden)

    H. bakr

    2016-07-01

    Study made from January, 2014 to August, 2015, at Medina Cardiac Centre that the presence of moderate (2+ ischaemic mitral regurgitation in ischaemic heart disease patients undergoing revascularization alone does not add any additional burden to the operative risk nor does it affect the immediate and early outcome of these patients. That revascularization alone can ameliorate moderate ischaemic mitral regurgitation in most patients postoperatively. This improvement is translated into an improvement in the functional class and the quality of life postoperatively there is no statistical difference between two groups.Also a procedure to address the mitral valve in moderate IMR should be considered in patients with a worse preoperative left ventricular profile.

  2. Percutaneous valve repair for mitral regurgitation using the Carillon Mitral Contour System. Description of the method and case report.

    Science.gov (United States)

    Siminiak, Tomasz; Firek, Ludwik; Jerzykowska, Olga; Kałmucki, Piotr; Wołoszyn, Maciej; Smuszkiewicz, Piotr; Link, Rafał

    2007-03-01

    Mitral regurgitation may result from left ventricular dilatation and cause progression of heart failure. Percutaneous techniques for mitral valve repair are under development. Techniques utilizing a trans-coronary venous approach exploit the anatomical relationship between the mitral annulus and the venous system of the heart. The coronary sinus, great cardiac vein and the origin of the anterior interventricular vein surround the posterior mitral annulus. This enables percutaneous approaches to annuloplasty for mitral regurgitation. Devices can be implanted into the coronary veins that modify the shape and size of the mitral annulus. We present a case of ischaemic mitral regurgitation successfully treated by use of a percutaneous approach, the Carillon Mitral Contour System. Significant reduction of the mitral regurgitation jet was observed. The patient was discharged 4 days after the procedure. During the follow-up visits, the patient showed an improved general condition and increased exercise capacity. Procedural steps are shown in detail and the current status of the coronary sinus based technique is discussed. Percutaneous techniques for mitral valve repair may be an attractive alternative to cardiac surgery in heart failure patients with secondary mitral regurgitation. The Carillon Mitral Contour System is under ongoing clinical evaluation in the AMADEUS trial. PMID:17436155

  3. Estimation of time elapsed since the death from identification of morphological and histological time-related changes in dental pulp: An observational study from porcine teeth

    Science.gov (United States)

    Mehendiratta, Monica; Jain, Kanu; Boaz, Karen; Bansal, Mohit; Manaktala, Nidhi

    2015-01-01

    Aim: Putrefaction of the human body with its rate and stages of the various changes occurring in this entire process have been explored widely by the forensic medicine experts to estimate the time elapsed since death. However, experimental data reported in literature pertaining to rates of putrefaction of the dental pulp retrieved from jaws of the dead is scarce. This study makes an attempt to find out the series of various changes which occur during the process of putrefaction of the dental pulp in a coastal environment like that of Southern India. An attempt has also been made to estimate the time elapsed since the death by assessing the duration for which dental pulp remains microscopically intact. Materials and Methods: Three different study setups at different times, followed one by other were created. In each setup, 10 specimens of porcine jaws with teeth were buried in surface soil and 10 specimens in subsurface soil. Dental pulp was retrieved at an interval of every 24 h to see for the various changes. All the environmental parameters including average daily rainfall precipitation, temperature, soil humidity, soil temperature, and soil pH were recorded. Results: A specific series of morphological changes in terms of changes in size, color, consistency, and odor; and a sequence of histological changes were observed from both surface and subsurface samples. Conclusion: Dental pulp buried in a coastal environment goes through a specific series of morphological and histological changes which can be interpreted up to 144 h from burial, after which pulp ceases to exist. PMID:26005296

  4. Palliative Mitral Valve Repair During Infancy for Neonatal Marfan Syndrome.

    Science.gov (United States)

    Kitahara, Hiroto; Aeba, Ryo; Takaki, Hidenobu; Shimizu, Hideyuki

    2016-05-01

    An infant with neonatal Marfan syndrome (nMFS), a condition that is nearly always lethal during infancy, was referred to our hospital with symptoms of congestive heart failure resulting from severe mitral valve insufficiency. During mitral valve repair, the use of an annuloplasty ring was waived until annular dilatation was achieved after 2 palliative mitral valvuloplasty procedures. After the definitive operation, the patient's mitral valve function remained within normal limits until the last follow-up when the patient was 11 years old. To the best of our knowledge, this patient has the longest recorded survival after mitral valve repair. PMID:27106438

  5. Severe mitral regurgitation due to an extraordinary heart defect.

    Science.gov (United States)

    García-Ropero, Álvaro; Cortés García, Marcelino; Aldamiz Echevarría, Gonzalo; Farré Muncharaz, Jerónimo

    2016-09-01

    A previously non-described cause of mitral regurgitation is presented. An asymptomatic 50-year old male who was casually diagnosed of mitral valve Barlow's disease underwent cardiac surgery due to severe mitral regurgitation. In the operating theatre, a longitudinal fissure of 1.5-2.0 cm length, along the posterior mitral leaflet, was found responsible for the insufficiency. This defect had features of a potential congenital origin and it was successfully repaired with direct suture. Whether it is an atypical mitral cleft, a variation of Barlow's morphology spectrum or a new congenital heart defect remains unclear. PMID:27217424

  6. The serpentine mitral valve and cerebral embolism

    Directory of Open Access Journals (Sweden)

    Ker James

    2011-02-01

    Full Text Available Abstract Valvular strands, well-delineated filiform masses, attached to cardiac valve edges are associated with cerebral embolism and stroke. Strokes, caused by emboli from valvular strands, tend to occur among younger persons. In this case report a valvular strand, giving a peculiar serpentine appearance to the mitral valve is described. This mitral valvular strand was the only explanation for an episode of cerebral embolism, presenting with a transient right sided hemiparesis. It is proposed that a randomized study involving combined treatment with aspirin and clopidogrel is warranted in young patients with valvular strands, presenting with a first episode of cerebral embolism.

  7. ECHOCARDIOGRAPHIC AND LABORATORY MARKERS OF CHRONIC HEART FAILURE: WHETHER IT IS POSSIBLE TO USE THEM IN RHEUMATIC MITRAL DISEASES?

    Directory of Open Access Journals (Sweden)

    T. A. Kazakovtseva

    2009-01-01

    Full Text Available Aim. To find echocardiographic indicators of heart remodelling that improve estimation of heart failure (HF severity. To evaluate sensitivity of laboratory markers of HF, brain (BNP and atrial (ANP natriuretic peptides, in patients with mitral heart diseases of rheumatic aetiology.Material and methods. 100 patients with rheumatic mitral disease and chronic HF (CHF of I-IV class (NYHA were examined. Echocardiography was performed in all patients with evaluation of the standard indices to define disease severity. Indices of sphericity, myocardial stress of the left ventricle, etc were also evaluated. BNP and ANB levels were assessed by enzyme immunoassay method.Results. CHF severity had the strongest correlations with atrial sizes, left atrial systolic function and level of pulmonary hypertension. Moderate increase of BNP level in severe CHF (III-IV class and its rare increase in mild CHF (I-II class were detected. Significant changes of ANP level were not found. Moderate correlation of BNP level with myocardium mass index, level of pulmonary hypertension and mitral regurgitation was detected.Conclusion. Intensity of heart remodelling in rheumatic mitral diseases is mainly determined by the left atrial area, left atrial systolic function, mitral orifice size, levels of mitral regurgitation and pulmonary hypertension, size and ejection fraction of right ventricle. Normal BNP level does not confirm an absence of CHF or negative prognosis in patients with rheumatic heart disease.

  8. Mitral valve repair and redo repair for mitral regurgitation in a heart transplant recipient

    Directory of Open Access Journals (Sweden)

    Bouma Wobbe

    2012-09-01

    Full Text Available Abstract A 37-year-old man with end-stage idiopathic dilated cardiomyopathy underwent an orthotopic heart transplant followed by a reoperation with mitral annuloplasty for severe mitral regurgitation. Shortly thereafter, he developed severe tricuspid regurgitation and severe recurrent mitral regurgitation due to annuloplasty ring dehiscence. The dehisced annuloplasty ring was refixated, followed by tricuspid annuloplasty through a right anterolateral thoracotomy. After four years of follow-up, there are no signs of recurrent mitral or tricupid regurgitation and the patient remains in NYHA class II. Pushing the envelope on conventional surgical procedures in marginal donor hearts (both before and after transplantation may not only improve the patient’s functional status and reduce the need for retransplantation, but it may ultimately alleviate the chronic shortage of donor hearts.

  9. Determinants of exercise-induced increase of mitral regurgitation in patients with acute coronary syndromes

    DEFF Research Database (Denmark)

    Pecini, Redi; Hammer-Hansen, Sophia; Dalsgaard, Morten;

    2010-01-01

    Mechanisms behind exercise-induced increase of mitral regurgitation (MR) in patients with chronic ischemic heart disease have been described earlier. We describe the determinants of exercise-induced changes in MR in patients with non-ST-elevation acute coronary syndrome (NSTACS)....

  10. Effect of closed mitral valvotomy on spirometric pulmonary function tests in mitral stenosis.

    OpenAIRE

    Kadam P; Pantvaidya S; Jagtap S; Rajgor K

    1997-01-01

    The effect of closed mitral valvotomy on the spirometric pulmonary functions was studied in 25 patients with mitral stenosis. The tests were performed before and after operation, the latter at varying intervals (4 to 6 weeks and 8 to 12 months). The preoperative values were considerably low. After 4 to 6 weeks following surgery, further significant reduction in Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1) was observed. This was ascribed to the residual healing...

  11. Predictors of Developing Significant Mitral Regurgitation Following Percutaneous Mitral Commissurotomy with Inoue Balloon Technique

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    Abdelfatah A. Elasfar

    2011-01-01

    Full Text Available Background. Despite the high technical expertise in percutaneous mitral commissurotomy (PMC, mitral regurgitation (MR remains a major procedure-related complication. The aim of this work is to find out the most sensitive and applicable predictors of development of significant mitral regurgitation (SMR following percutaneous mitral commissurotomy using Inoue balloon technique. Methods. We studied prospectively the preprocedural (clinical, echocardiography, and hemodynamic and procedural predictors of significant mitral regurgitation (identified as increase of ≥2/4 grades of pre-PMC MR by color Doppler flow mapping following valvuloplasty using Inoue balloon in 108 consecutive patients with severe mitral stenosis. Multiple stepwise logistic regression analysis was performed for variables found positive on univariate analysis to determine the most important predictor(s of developing SMR. Results. The incidence of SMR following PMC using Inoue technique was 18.5% (10 patients. MV scoring systems were the only variables that showed significant differences between both groups (Group A without SMR and Group B with SMR. However, no clinical, other echocardiographic measurements, hemodynamic or procedural variables could predict the development of SMR. Using multiple regression analysis, the best predictive factor for the risk of SMR after Inoue BMV was the total MR-echo score with a cutoff point of 7 and a predictive percentage of 97.7%. Conclusions. The total MR-echo score is the only independent predictor of SMR following PMC using Inoue technique with a cutoff point of 7.

  12. Porcine incisional hernia model: Evaluation of biologically derived intact extracellular matrix repairs

    OpenAIRE

    Monteiro, Gary A; Delossantos, Aubrey I.; Rodriguez, Neil L.; Patel, Paarun; Franz, Michael G.; Wagner, Christopher T.

    2013-01-01

    We compared fascial wounds repaired with non-cross-linked intact porcine-derived acellular dermal matrix versus primary closure in a large-animal hernia model. Incisional hernias were created in Yucatan pigs and repaired after 3 weeks via open technique with suture-only primary closure or intraperitoneally placed porcine-derived acellular dermal matrix. Progressive changes in mechanical and biological properties of porcine-derived acellular dermal matrix and repair sites were assessed. Porcin...

  13. Percutaneous and minimally invasive approaches to mitral valve repair for severe mitral regurgitation-new devices and emerging outcomes

    Directory of Open Access Journals (Sweden)

    Fadi E Shamoun

    2015-01-01

    Full Text Available Mitral valve disease is common in the United States and around the world, and if left untreated, increases cardiovascular morbidity and mortality. Mitral valve repair is technically more demanding than mitral valve replacement. Mitral valve repair should be considered the first line of treatment for mitral regurgitation in younger patients, mitral valve prolapse, annular dilatation, and with structural damage to the valve. Several minimally invasive percutaneous treatment options for mitral valve repair are available that are not restricted to conventional surgical approaches, and may be better received by patients. A useful classification system of these approaches proposed by Chiam and Ruiz is based on anatomic targets and device action upon the leaflets, annulus, chordae, and left ventricle. Future directions of minimally invasive techniques will include improving the safety profile through patient selection and risk stratification, improvement of current imaging and techniques, and multidisciplinary education.

  14. Mitral valve disease in Marfan's syndrome.

    OpenAIRE

    Marlow, N; Gregg, J. E.; Qureshi, S A

    1987-01-01

    Cardiovascular disease in Marfan's syndrome presenting in childhood affects the mitral valve more often than the aortic valve or the aorta, as in adults. Early evaluation of the cardiovascular system is necessary for any child in whom Marfan's syndrome is suspected.

  15. Surgical strategy for mild ischemic mitral insufficiency

    Institute of Scientific and Technical Information of China (English)

    GU Cheng-xiong; WEI Hua; YU Yang

    2010-01-01

    @@ To the Editor: We read with the interest the article by FAN Hong-guang and colleagues~1 having obtained outstanding early and long-term clinical outcomes of left ventricular restoration for the patients with postinfarction ventricular aneurysm and low left ventricular ejection fraction (LVEF) of mean 37.7%. We would like to comment on surgical strategy for mild ischemic mitral insufficiency.

  16. Effect of natural and synthetic antioxidants on protein oxidation and colour and texture changes in refrigerated stored porcine liver pâté.

    Science.gov (United States)

    Estévez, Mario; Ventanas, Sonia; Cava, Ramón

    2006-10-01

    The antioxidant effect of two plant essential oils (sage and rosemary) and one synthetic antioxidant (BHT) on refrigerated stored porcine liver pâté (4°C/90 days) was evaluated. Pâtés with no added antioxidants were used as controls. Liver pâtés were analysed for protein oxidation, modification of heme (HI) and non-heme iron (NHI) concentrations, and colour and texture characteristics at days 0, 30, 60 and 90 of refrigerated storage. The amount of carbonyls from protein oxidation significantly (p<0.05) increased during refrigerated storage, and this increase was significantly higher in the control pâtés than in their treated counterparts. Antioxidants successfully protected heme molecules from degradation and significantly inhibited the increase of NHI in refrigerated stored liver pâtés. Colour changes seemed not to be directly related to oxidative processes since pâtés with added antioxidants suffered greater colour modifications than the controls. The addition of rosemary essential oil significantly reduced hardness of liver pâtés. Sage and rosemary essential oils exhibited similar antioxidant properties to BHT denoting their suitability as alternatives to synthetic antioxidants.

  17. 5. Mitral valve replacement for mitral stenosis: 15 years single center experience

    Directory of Open Access Journals (Sweden)

    A. Arifi

    2016-07-01

    Full Text Available Mitral valve replacement (MVR with either a bioprosthetic or a mechanical valve is the treatment of choice for severe mitral stenosis. This study aimed to evaluate and compare the early and late outcome of mitral valve replacement (mechanical versus bioprosthetic for severe mitral stenosis. A retrospective cohort study was performed on prospectively collected data involving mitral stenosis patients who have undergone MVR with either bioprosthetic (BMV (n = 50 or mechanical (MMV (n = 145 valves in our institute from 1999 to 2012. Data were analyzed for early and late mortality, NYHA functional classes, stroke, early and late valve-related complications, and survival. Chi Square test, logistic regression, Kaplan Meier curve, and dependent proportions tests were performed. A total of 195 patients were included in the study with a follow-up of 190 patients (97.5%. One patient died early post-operatively; twelve patients died late in the post-operative period, BMV group (6 and the MMV (6. The Late mortality had significantly associated with post-op stroke (p < 0.001 and post-op NYHA classes III and IV (p = 0.002. Post-op NYHA class was significantly associated with age (p = 0.003, pulmonary disease (p = 0.02, mitral valve implant type (p = 0.01, and post-op stroke (p = 0.02; 14 patients had strokes in the MMV (9 and in the BMV (5 groups. NYHA classes were significantly better after the replacement surgeries (p < 0.001. Bioprosthetic valves were significantly associated with worse survival (p = 0.03, worse NYHA post-op (p = 0.01, and more re-operations (p = 0.006. Survival was significantly better with mechanical valves (p = 0.03. When the two groups were matched for age and mitral regurgitation, the analysis revealed that bioprosthetic valves were significantly associated with re-operations (p = 0.02 but not significantly associated with worse survival (p = 0.4 or worse NYHA (p = 0.4. Mechanical mitral valve

  18. New mitral annular force transducer optimized to distinguish annular segments and multi-plane forces.

    Science.gov (United States)

    Skov, Søren Nielsen; Røpcke, Diana Mathilde; Ilkjær, Christine; Rasmussen, Jonas; Tjørnild, Marcell Juan; Jimenez, Jorge H; Yoganathan, Ajit P; Nygaard, Hans; Nielsen, Sten Lyager; Jensen, Morten Olgaard

    2016-03-21

    Limited knowledge exists about the forces acting on mitral valve annuloplasty repair devices. The aim of this study was to develop a new mitral annular force transducer to measure the forces acting on clinically used mitral valve annuloplasty devices. The design of an X-shaped transducer in the present study was optimized for simultaneous in- and out-of-plane force measurements. Each arm was mounted with strain gauges on four circumferential elements to measure out-of-plane forces, and the central parts of the X-arms were mounted with two strain gauges to measure in-plane forces. A dedicated calibration setup was developed to calibrate isolated forces with tension and compression for in- and out-of-plane measurements. With this setup, it was possible with linear equations to isolate and distinguish measured forces between the two planes and minimize transducer arm crosstalk. An in-vitro test was performed to verify the crosstalk elimination method and the assumptions behind it. The force transducer was implanted and evaluated in an 80kg porcine in-vivo model. Following crosstalk elimination, in-plane systolic force accumulation was found to be in average 4.0±0.1N and the out-of-plane annular segments experienced an average force of 1.4±0.4N. Directions of the systolic out-of-plane forces indicated movements towards a saddle shaped annulus, and the transducer was able to measure independent directional forces in individual annular segments. Further measurements with the new transducer coupled with clinical annuloplasty rings will provide a detailed insight into the biomechanical dynamics of these devices. PMID:26903412

  19. New mitral annular force transducer optimized to distinguish annular segments and multi-plane forces.

    Science.gov (United States)

    Skov, Søren Nielsen; Røpcke, Diana Mathilde; Ilkjær, Christine; Rasmussen, Jonas; Tjørnild, Marcell Juan; Jimenez, Jorge H; Yoganathan, Ajit P; Nygaard, Hans; Nielsen, Sten Lyager; Jensen, Morten Olgaard

    2016-03-21

    Limited knowledge exists about the forces acting on mitral valve annuloplasty repair devices. The aim of this study was to develop a new mitral annular force transducer to measure the forces acting on clinically used mitral valve annuloplasty devices. The design of an X-shaped transducer in the present study was optimized for simultaneous in- and out-of-plane force measurements. Each arm was mounted with strain gauges on four circumferential elements to measure out-of-plane forces, and the central parts of the X-arms were mounted with two strain gauges to measure in-plane forces. A dedicated calibration setup was developed to calibrate isolated forces with tension and compression for in- and out-of-plane measurements. With this setup, it was possible with linear equations to isolate and distinguish measured forces between the two planes and minimize transducer arm crosstalk. An in-vitro test was performed to verify the crosstalk elimination method and the assumptions behind it. The force transducer was implanted and evaluated in an 80kg porcine in-vivo model. Following crosstalk elimination, in-plane systolic force accumulation was found to be in average 4.0±0.1N and the out-of-plane annular segments experienced an average force of 1.4±0.4N. Directions of the systolic out-of-plane forces indicated movements towards a saddle shaped annulus, and the transducer was able to measure independent directional forces in individual annular segments. Further measurements with the new transducer coupled with clinical annuloplasty rings will provide a detailed insight into the biomechanical dynamics of these devices.

  20. Long-term benefit of myectomy and anterior mitral leaflet extension in obstructive hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Vriesendorp, Pieter A; Schinkel, Arend F L; Soliman, Osama I I; Kofflard, Marcel J M; de Jong, Peter L; van Herwerden, LA; Ten Cate, Folkert J; Michels, Michelle

    2015-01-01

    Severely symptomatic patients with obstructive hypertrophic cardiomyopathy (HC) may benefit from surgical myectomy. In patients with enlarged mitral leaflets and mitral regurgitation, myectomy can be combined with anterior mitral leaflet extension (AMLE) to stiffen the midsegment of the leaflet. The

  1. [Association of anorexia nervosa and mitral valve prolapse].

    Science.gov (United States)

    Amano, K; Sakamoto, T; Hada, Y; Hasegawa, I; Takahashi, T; Suzuki, J; Takahashi, H

    1986-01-01

    Four cases of anorexia nervosa recently encountered were reported in respect to their cardiovascular manifestations including prolapse of the cardiac valves and other poorly recognized cardiac findings. All four patients, aged 13 to 32 years, were women and had marked emaciation (35 to 44% weight loss of the ideal body weight) with typical hormone abnormalities. Chest radiographs showed a small cardiac shadow, and sinus bradycardia with low voltage was present in their electrocardiograms. One case, 13-year-old, had a mid-systolic click and occasionally a late systolic murmur, and also an abdominal continuous hum. Echocardiography including two-dimensional color flow-mapping disclosed mitral valve prolapse in all, and tricuspid valve prolapse in two. Mild to moderate pericardial effusion was noted in all between the right ventricle and diaphragm, and pericardiocentesis in one case had no effect on the valve movements. No inflammatory changes were observed in the specimen of the pericardium and also of the fluid. An association of mitral valve prolapse and anerexia nervosa was discussed based on the previous studies, but the final conclusion remains unknown. PMID:3681005

  2. Mitral annulus morphologic and functional analysis using real time tridimensional echocardiography in patients submitted to unsupported mitral valve repair

    Directory of Open Access Journals (Sweden)

    Marco Antônio Vieira Guedes

    2015-09-01

    Full Text Available AbstractIntroduction:Mitral valve repair is the treatment of choice to correct mitral insufficiency, although the literature related to mitral valve annulus behavior after mitral repair without use of prosthetic rings is scarce.Objective:To analyze mitral annulus morphology and function using real time tridimensional echocardiography in individuals submitted to mitral valve repair with Double Teflon technique.Methods:Fourteen patients with mitral valve insufficiency secondary to mixomatous degeneration that were submitted to mitral valve repair with the Double Teflon technique were included. Thirteen patients were in FC III/IV. Patients were evaluated in preoperative period, immediate postoperative period, 6 months and 1 year after mitral repair. Statistical analysis was made by repeated measures ANOVA test and was considered statistically significant P<0.05.Results:There were no deaths, reoperation due to valve dysfunction, thromboembolism or endocarditis during the study. Posterior mitral annulus demonstrated a significant reduction in immediate postoperative period (P<0.001, remaining stable during the study, and presents a mean of reduction of 25.8% comparing with preoperative period. There was a significant reduction in anteroposterior and mediolateral diameters in the immediate postoperative period (P<0.001, although there was a significant increase in mediolateral diameter between immediate postoperative period and 1 year. There was no difference in mitral internal area variation over the cardiac cycle during the study.Conclusion:Segmentar annuloplasty reduced the posterior component of mitral annulus, which remained stable in a 1-year-period. The variation in mitral annulus area during cardiac cycle remained stable during the study.

  3. Iterative Learning of Transcatheter Mitral Valve Replacement in Mitral Valve Annulus Calcification: Management and Prevention of Transcatheter Mitral Valve Replacement Dislocation.

    Science.gov (United States)

    Hulman, Michal; Bena, Martin; Artemiou, Panagiotis; Gasparovic, Ivo; Hudec, Vladan; Rajani, Ronak; Bapat, Vinayak

    2016-10-01

    Transcatheter mitral valve replacement using balloon-expandable valves is an emerging technique for the treatment of patients with significant mitral regurgitation who have been judged to be inoperable owing to significant mitral valve annulus calcification. Although initial reports have been promising, there remains a lack of consensus as to how to plan for transcatheter mitral valve replacement deployment in terms of appropriateness, sizing, and positioning to mitigate the risks of valve displacement and paravalvular regurgitation. We describe two cases of transcatheter mitral valve replacement in patients with significant mitral valve annulus calcification. The first was complicated by valve displacement into the left atrium, which was successfully managed by surgical redeployment and fixation. The second case was thereafter performed successfully using iterative learning and the application of specific preprocedural planning techniques acquired from a root cause analysis of the first case. We describe our experience with both cases and the specific planning principles required to prevent transcatheter mitral valve replacement displacement in patients with mitral valve annulus calcification. PMID:27645964

  4. Acellularization-Induced Changes in Tensile Properties Are Organ Specific - An In-Vitro Mechanical and Structural Analysis of Porcine Soft Tissues.

    Directory of Open Access Journals (Sweden)

    Stefan Schleifenbaum

    Full Text Available Though xenogeneic acellular scaffolds are frequently used for surgical reconstruction, knowledge of their mechanical properties is lacking. This study compared the mechanical, histological and ultrastructural properties of various native and acellular specimens.Porcine esophagi, ureters and skin were tested mechanically in a native or acellular condition, focusing on the elastic modulus, ultimate tensile stress and maximum strain. The testing protocol for soft tissues was standardized, including the adaption of the tissue's water content and partial plastination to minimize material slippage as well as templates for normed sample dimensions and precise cross-section measurements. The native and acellular tissues were compared at the microscopic and ultrastructural level with a focus on type I collagens.Increased elastic modulus and ultimate tensile stress values were quantified in acellular esophagi and ureters compared to the native condition. In contrast, these values were strongly decreased in the skin after acellularization. Acellularization-related decreases in maximum strain were found in all tissues. Type I collagens were well-preserved in these samples; however, clotting and a loss of cross-linking type I collagens was observed ultrastructurally. Elastins and fibronectins were preserved in the esophagi and ureters. A loss of the epidermal layer and decreased fibronectin content was present in the skin.Acellularization induces changes in the tensile properties of soft tissues. Some of these changes appear to be organ specific. Loss of cross-linking type I collagen may indicate increased mechanical strength due to decreasing transverse forces acting upon the scaffolds, whereas fibronectin loss may be related to decreased load-bearing capacity. Potentially, the alterations in tissue mechanics are linked to organ function and to the interplay of cells and the extracellular matrix, which is different in hollow organs when compared to skin.

  5. Changes in the histochemical properties and meat quality traits of porcine muscles during the growing-finishing period as affected by feed restriction, slaughter age, or slaughter weight.

    Science.gov (United States)

    Bee, G; Calderini, M; Biolley, C; Guex, G; Herzog, W; Lindemann, M D

    2007-04-01

    In this study, the degree of contractile and metabolic development of myofibers in porcine LM, rectus femoris (RF), and dark and light portions of the semitendinosus (STD and STL, respectively) was determined, and their impact on meat quality was compared at the same age but different BW (trial 1) or at a given BW but different age (trial 2) in 48 Swiss Large White barrows from 12 litters after the growing and finishing period. The barrows had ad libitum (A) or restricted (R, 80% of A) feed access. In trial 1, at 113 and 154 d of age, 6 barrows in treatment A (62.1 and 99.5 kg of BW, respectively) and 6 siblings in treatment R (51.0 and 86.6 kg of BW, respectively) were slaughtered. In trial 2, a similar protocol was used except that the barrows were slaughtered at 61.3 (104 or 119 d of age, respectively) or 101.3 kg of BW (145 or 167 d of age, respectively). Muscle fibers were stained and classified as slow oxidative (SO), fast oxidative-glycolytic (FOG), or fast glycolytic (FG), and fiber area and distribution were determined. At 113 and 154 d of age, R barrows had smaller (P slaughtered at the same BW, the myofiber size did not differ (P > or = 0.11). However, the LM tended to have fewer (P = 0.06) SO and more (P slaughtered at the same age or the same BW as the A barrows, shear force values and cooking losses were greater (P changes in myofiber type distribution among the younger-lighter and older-heavier barrows indicated that myofiber maturation was already completed in the younger-lighter barrows. Although changes in meat quality traits were affected by the feeding regimen, they were not related to myofiber characteristics.

  6. Effect of Mitral Inflow Pattern on Diagnosis of Severe Mitral Regurgitation in Patients with Chronic Organic Mitral Regurgitation

    OpenAIRE

    Quader, Nishath; Katta, Prasanth; Najib, Mohammad Q; Chaliki, Hari P

    2013-01-01

    Background To determine sensitivity and specificity of E wave velocity in patients with severe chronic organic mitral regurgitation (MR) and normal left ventricular ejection fraction (EF) and to evaluate prevalence of A wave dominance in patients with severe MR. Methods We compared 35 patients with quantified severe, chronic, quantified, organic MR due to flail/prolapsed leaflets who had reparative surgery with 35 age-matched control subjects. Exclusion criteria: EF < 60%, atrial fibrillation...

  7. Transcatheter mitral valve repair with mitraclip for significant mitral regurgitation long after heart transplantion.

    Science.gov (United States)

    Ferraro, Paolo; Biondi-Zoccai, Giuseppe; Giordano, Arturo

    2016-07-01

    The role of transcatheter mitral valve repair with MitraClip implantation is becoming increasingly important for high-risk surgical patients with significant mitral regurgitation. Eligibility criteria for MitraClip are however rather strict, and the risk-benefit balance of this device in off-label settings remains unclear. Patients with prior heart transplantation may represent particularly challenging candidates for MitraClip, given their peculiar atrial anatomy. We hereby present the case of a 72-year-old gentleman with prior heart transplantation and significant mitral regurgitation who, after heart team consensus, was referred to us for MitraClip implantation. After careful planning, we were able to successfully implant two clips, achieving a significant improvement in the severity of the mitral regurgitation. Similarly favorable findings were confirmed at 3-month clinical and transthoracic/transesophageal echocardiographic follow-up. This clinical vignette highlights the key procedural milestones for successfully implanting MitraClip in patients with significant mitral regurgitation and prior heart transplantation. © 2015 Wiley Periodicals, Inc. PMID:26333048

  8. Ekhokardiografi Endokardiosis Penyakit Katup Mitral Jantung Anjing (ECHOCARDIOGRAPHY OF ENDOCARDIOSIS MITRAL VALVE HEART DISEASE IN DOGS

    Directory of Open Access Journals (Sweden)

    Deni Noviana

    2013-08-01

    Full Text Available Endocardiosis is a disease commonly found in Pomeranian dog characterized by progressive myxomatousdegeneration of the atrio-ventricular valves especially in the mitral valve. The purpose of this study was todefine the diagnose and severeity of this disease on the Pomeranian by using brightness mode, motion mode,dan color flow Doppler echocardiography technique. Echocardiography was performed on 8 Pomeranianconsisting of 6 males and 2 females with age range of 2-14 years. Brightness mode echocardiography wasused to see the echotexture of endocardium, mitral valve, and the valve movement. The results showedendocardium thickening, along with chronic fibrosis and nodular thickening of the anterior and posteriormitral valve leaflet. Three out of seven cases showed prolapsed of the mitral valve. Motion modeechocardiography was performed in order to measure left ventricle internal dimension, myocardium thickness,fractional shortening, left atrial and aortic dimension. The results showed myocardium thickening, alongwith left atrial enlargement. Color flow Doppler echocardiography was used to confirm the mitral valveregurgitation. Three of seven cases showed the presence of regurgitation signed by turbulence color of theprolapsed mitral valve. Based on the degree of severity, scoring system used in this study, endocardiosis canbe divided into three types that are mild, moderate and severe.

  9. Cine MR imaging in mitral valve prolapse; Study on mitral regurgitation and left atrial volume

    Energy Technology Data Exchange (ETDEWEB)

    Kumai, Toshihiko (Chiba Univ. (Japan). School of Medicine)

    1993-02-01

    This study was undertaken to assess the ability of cine MR imaging to evaluate the direction, timing, and severity of mitral regurgitation in patients with mitral valve prolapse (MVP). The population of this study was 33 patients with MVP diagnosed by two-dimensional echocardiography and 10 patients with rheumatic mitral valve disease (MSR) for comparison. 7 patients with MVP and 5 with MSR had atrial fibrillation and/or history of congestive heart failure as complications. Mitral regurgitation was graded for severity by color Doppler flow imaging in all patients. Direction and size of systolic flow void in the left atrium were analyzed by contiguous multilevel cine MR images and the maximum volumes of flow void and left atrium were measured. Although flow void was found at the center of the left atrium in most of MSR, it was often directed along the postero-caudal atrial wall in anterior leaflet prolapse and along the anterocranial atrial wall in posterior leaflet prolapse. In MVP, the maximum volume of flow void was often seen in late systole. The maximum volume of flow void and that of left atrium were significantly larger in patients with atrial fibrillation and/or history of congestive heart failure. The length and volume of flow void were increased with clinical severity and degree of regurgitation determined by color Doppler flow imaging. Thus cine MR imaging provides a useful means for detection and semiquantitative evaluation of mitral regurgitation in subjects with MVP. (author).

  10. Echocardiographic analysis of a malfunctioning Davila-Sierra mitral valve

    OpenAIRE

    Tri, Terry B.; Gregoratos, Gabriel

    1981-01-01

    Although the Davila-Sierra mitral valve prosthesis was removed from the market nearly a decade ago, a number of patients still have this valve in place. We recently studied the echocardiographic features of a malfunctioning Davila-Sierra mitral valve prosthesis. Abnormalities that suggested improper functioning of the prosthesis included a markedly delayed poppet opening and an early diastolic hump believed to represent motion of the mitral annulus. Previously described echocardiographic indi...

  11. An unusual instance of mitral valve prolapse in endomyocardial fibrosis

    Directory of Open Access Journals (Sweden)

    Dalal J

    1978-01-01

    Full Text Available This is a report of an unusual case showing a mitral valve prolapse in the presence of a biventricular endomyocardial fibrosis (EMF. The EMF was strongly suspected on left ventricular angiography and later proved at autopsy. The prolapse of the mitral valve was detected at echocardiography. To the best of our knowledge this is the first report of a case of EMF associated with mitral valve prolapse.

  12. Acute aortic and mitral valve regurgitation following blunt chest trauma.

    Science.gov (United States)

    Bernabeu, Eduardo; Mestres, Carlos A; Loma-Osorio, Pablo; Josa, Miguel

    2004-03-01

    Traumatic rupture of intracardiac structures is an uncommon phenomenon although there are a number of reports with regards to rupture of the tricuspid, mitral and aortic valves. We report the case of a 25-year-old patient who presented with acute aortic and mitral valve regurgitation of traumatic origin. Both lesions were seen separated by 2 weeks. Pathophysiology is reviewed. The combination of both aortic and mitral lesions following blunt chest trauma is almost exceptional.

  13. Phenotypes and genotypes of old and contemporary porcine strains indicate a temporal change in the S. aureus population structure in pigs

    DEFF Research Database (Denmark)

    Gongora, Carmen Espinosa; Moodley, Arshnee; Lipinska, Urszula;

    2014-01-01

    with particular reference to the occurrence of ST398. METHODS: We analysed a unique collection of 91 porcine strains isolated in six countries between 1973 and 2009 using a biotyping scheme described in the 1970's in combination with spa typing and multi-locus sequence typing (MLST). The collection comprised 32...... in the 1970's. In addition, various phenotypic and genotypic differences were observed between old and contemporary isolates. Some biotypes commonly reported in pigs in the 1970's were either absent (human ecovar) or rare (biotype A) among contemporary isolates. Nine clonal lineages found among old porcine...

  14. Beat-rate dependent mitral flow patterns for in vitro hemodynamic applications.

    Science.gov (United States)

    Vismara, Riccardo; Fiore, Gianfranco B

    2010-12-01

    The conservative surgery approach for restoring the functionality of heart valves has predominated during the last two decades, particularly for the mitral valve. In vitro pulsatile testing is a key methodology for the investigation of heart valve hemodynamics, and particularly for the ideation, validation and optimization of novel techniques in heart valve surgery. Traditionally, however, pulsatile mock loops have been developed for the study of aortic valve substitutes, and scarce attention has been paid in replicating the mitral flow patterns with due hemodynamic fidelity. In this work we provide detailed analytical expressions to produce beat-rate dependent, physiologic-like mitral flow patterns for in vitro applications. The approach we propose is based on a biomechanical analysis of the factors which govern hemodynamic changes in the mitral flow pattern, namely in terms of E and A wave contours and E/A peaks ratio, when switching from rest to mild exercise conditions. The patterns from the model we obtained were in good agreement with clinical literature data in terms of i) gradual superimposition of the E and A wave, which yielded a single peak at 96 bpm; ii) decrease in the E/A ratio with increasing heart rate; iii) amount of flow delivered by each of the two waves. The proposed method provides a physiologically representative, beat-rate dependent analytical expression of the mitral flow pattern, which can be used in in vitro hydrodynamic investigations to accurately replicate the changes that the flow waves experience when the heart rate shifts from rest to mild exercise conditions.

  15. Mitral-aortic annular enlargement: modification of Manouguian's technique

    Directory of Open Access Journals (Sweden)

    Costa Mario Gesteira

    2002-01-01

    Full Text Available We hereby present a technical modification for mitral-aortic annular enlargement. The mitral valve is replaced through the retro-septal approach, avoiding patches for left atrial roof closure. We report a mitral-aortic valve replacement in a patient whose original annuli would preclude adequate prostheses. The simultaneous annular enlargement may be necessary for avoiding patient-prosthesis mismatch and for reconstructing destroyed mitral and aortic annuli. The technique may minimize the risk of bleeding and of paravalvular leakage, using an approach well known to cardiac surgeons.

  16. Peri-procedural imaging for transcatheter mitral valve replacement.

    Science.gov (United States)

    Natarajan, Navin; Patel, Parag; Bartel, Thomas; Kapadia, Samir; Navia, Jose; Stewart, William; Tuzcu, E Murat; Schoenhagen, Paul

    2016-04-01

    Mitral regurgitation (MR) has a high prevalence in older patient populations of industrialized nations. Common etiologies are structural, degenerative MR and functional MR secondary to myocardial remodeling. Because of co-morbidities and associated high surgical risk, open surgical mitral repair/replacement is deferred in a significant percentage of patients. For these patients transcatheter repair/replacement are emerging as treatment options. Because of the lack of direct visualization, pre- and intra-procedural imaging is critical for these procedures. In this review, we summarize mitral valve anatomy, trans-catheter mitral valve replacement (TMVR) options, and imaging in the context of TMVR. PMID:27054104

  17. Abordaje transeptal para el reemplazo valvular mitral

    OpenAIRE

    Juan C. Medrano; Carlos A. Ingino; Carlos A. Rapallo; Carlos Barrero; Félix Ramírez; Arnaldo Milani; Miguel Rubio; Raúl A. Borracci

    2010-01-01

    IntroducciónA pesar de que es técnicamente más demandante, el acceso a la válvula mitral por vía transeptal permite una exposición mayor de sus valvas y del aparato subvalvular, en especial en aurículas pequeñas, en reoperaciones o cuando se combina con el tratamiento de la válvula tricuspídea.ObjetivosEvaluar las dificultades técnicas y las complicaciones asociadas con el abordaje transeptal para el reemplazo valvular mitral.Material y métodosEntre 2006 y 2009 se incluyeron 62 pacientes cons...

  18. Fracture embolization of a Duromedics mitral prosthesis.

    OpenAIRE

    Baumgartner, F J; Munro, A I; Jamieson, W R

    1997-01-01

    The Duromedics bileaflet pyrolitic carbon mechanical prosthesis was introduced by Hemex in 1982 and subsequently acquired by Baxter. This communication documents a case of sudden leaflet fracture of a Duromedics mitral valve 48 months after implantation, which was managed successfully by replacement with a St. Jude Medical mechanical prosthesis. The patient presented in acute distress with paroxysmal atrial tachycardia and pulmonary edema. Transesophageal echocardiography was used to diagnose...

  19. Normal joint mobility in mitral valve prolapse

    OpenAIRE

    Marks, J S; Sharp, J.; Brear, S. G.; Edwards, J. D.

    1983-01-01

    Thirty-seven adults (19 male, 18 female) with mitral valve prolapse (MVP) were examined for evidence of joint hypermobility scored on a 0-9 scale. None of the patients had hypermobility scores exceeding 3, and comparison with 37 healthy age and sex matched controls recruited from hospital staff failed to show an increased prevalence of hypermobility in MVP. There was no evidence that the MVP syndrome is a forme fruste of a heritable disorder of connective tissue.

  20. Preservation versus non-preservation of mitral valve apparatus during mitral valve replacement: a meta-analysis of 3835 patients

    Science.gov (United States)

    Sá, Michel Pompeu Barros de Oliveira; Ferraz, Paulo Ernando; Escobar, Rodrigo Renda; Martins, Wendell Santos; de Araújo e Sá, Frederico Browne Correia; Lustosa, Pablo César; Vasconcelos, Frederico Pires; Lima, Ricardo Carvalho

    2012-01-01

    Resection of the chordopapillary apparatus during mitral valve replacement has been associated with a negative impact on survival. Mitral valve replacement with the preservation of the mitral valve apparatus has been associated with better outcomes, but surgeons remain refractory to its use. To determine if there is any real difference in preservation vs non-preservation of mitral valve apparatus during mitral valve replacement in terms of outcomes, we performed a systematic review and meta-analysis using MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles to search for clinical studies that compared outcomes (30-day mortality, postoperative low cardiac output syndrome or 5-year mortality) between preservation vs non-preservation during mitral valve replacement from 1966 to 2011. The principal summary measures were odds ratios (ORs) with 95% confidence interval and P-values (that will be considered statistically significant when <0.05). The ORs were combined across studies using a weighted DerSimonian–Laird random-effects model. The meta-analysis was completed using the software Comprehensive Meta-Analysis version 2 (Biostat Inc., Englewood, NJ, USA). Twenty studies (3 randomized and 17 non-randomized) were identified and included a total of 3835 patients (1918 for mitral valve replacement preservation and 1917 for mitral valve replacement non-preservation). There was significant difference between mitral valve replacement preservation and mitral valve replacement non-preservation groups in the risk of 30-day mortality (OR 0.418, P <0.001), postoperative low cardiac output syndrome (OR 0.299, P <0.001) or 5-year mortality (OR 0.380, P <0.001). No publication bias or important heterogeneity of effects on any outcome was observed. In conclusion, we found evidence that argues in favour of the preservation of mitral valve apparatus during mitral valve replacement. PMID:23027596

  1. Left ventricular outflow tract obstruction due to anomalous mitral valve: successful mitral valve replacement in a four month old infant.

    OpenAIRE

    Morais, P.; Westaby, S.; Hallidie-Smith, K A

    1986-01-01

    A four month old infant was investigated for heart failure was found to have mitral incompetence and severe subvalvar aortic stenosis. The left ventricular outflow tract obstruction was found to be due to an anatomically anomalous mitral valve. The obstruction could only be relieved by removal of the mitral valve and its replacement with a St Jude's prosthesis. Two years after operation the child is fit and active. There have been no difficulties with anticoagulant treatment.

  2. Cost-utility analysis of percutaneous mitral valve repair in inoperable patients with functional mitral regurgitation in German settings

    OpenAIRE

    Borisenko, Oleg; Haude, Michael; Hoppe, Uta C.; Siminiak, Tomasz; Lipiecki, Janusz; Goldberg, Steve L; Mehta, Nawzer; Bouknight, Omari V; Bjessmo, Staffan; Reuter, David G.

    2015-01-01

    Background To determine the cost-effectiveness of the percutaneous mitral valve repair (PMVR) using Carillon® Mitral Contour System® (Cardiac Dimensions Inc., Kirkland, WA, USA) in patients with congestive heart failure accompanied by moderate to severe functional mitral regurgitation (FMR) compared to the prolongation of optimal medical treatment (OMT). Methods Cost-utility analysis using a combination of a decision tree and Markov process was performed. The clinical effectiveness was determ...

  3. A clinical comparison of purified bovine and purified porcine insulins.

    OpenAIRE

    Olczak, S A; Greenwood, R H

    1985-01-01

    Twenty four patients with established insulin dependent diabetes treated with twice daily soluble and isophane bovine insulins were changed to equivalent doses of either purified bovine Neusulin and Neuphane (Wellcome) or purified porcine Actrapid and Monotard (Novo) insulins. After 6 months treatment the porcine group showed a 35% fall in insulin binding antibodies and a 14% reduction in insulin dosage. The group changed to purified bovine insulins showed no significant change in insulin bin...

  4. Innovations in minimally invasive mitral valve pair.

    Science.gov (United States)

    Sündermann, Simon H; Seeburger, Joerg; Scherman, Jacques; Mohr, Friedrich Wilhelm; Falk, Volkmar

    2012-12-01

    Mitral valve (MV) insufficiency is the second most common heart valve disease represented in cardiac surgery. The gold standard therapy is surgical repair of the valve. Today, most centers prefer a minimally invasive approach through a right-sided mini-thoracotomy. Despite the small access, there is still the need to use cardiopulmonary bypass (CPB), and the operation has to be performed on the arrested heart. New devices have been developed to optimize the results of surgical repair by implementing mechanisms for post-implantation adjustment on the beating heart or the avoidance of CPB. Early attempts with adjustable mitral annuloplasty rings go back to the early 1990s. Only a few devices are available on the market. Recently, a mitral valve adjustable annuloplasty ring was CE-marked and is under further clinical investigation. In addition, a sutureless annuloplasty band to be implanted on the beating heart is under preclinical and initial clinical investigation for transatrial and transfemoral transcatheter implantation. Furthermore, new neochord systems are being developed, which allow for functional length adjustment on the beating heart after implantation. Some devices were developed for percutaneous MV repair implanted into the coronary sinus to reshape the posterior MV annulus. Other percutaneous devices are directly fixed to the posterior annulus to alter its shape. Several disadvantages have been observed preventing a broad clinical use of some of these devices. There is a continuous effort to develop innovative techniques to optimize MV repair and to decrease invasiveness. PMID:23315719

  5. Heat sensitivity of porcine IgG.

    Science.gov (United States)

    Metzger, J J; Bourdieu, C; Rouze, P; Houdayer, M

    1975-09-01

    The sensitivity to heat of porcine IgG was studied. The serum from immunized pigs was heated at 56 degrees C for 30 min as for decomplementation. The elution pattern of the serum proteins on an agarose gel column showed a dramatic change with the appearance of a large peak of the gel-excluded material. This peak contained mainly IgG molecules which still retained its antibody activity. This fact points to misinterpretations which can easily occur in 7S and 19S antibody recognition during the porcine immune response. Correlation is suggested of this property with the large number of interheavy chain disulfide bridges present in porcine IgG.

  6. Gargantuan left atrium: a sequela of mitral regurgitation and mitral stenosis.

    Science.gov (United States)

    Omslaer, Brian T; Biederman, Robert W W

    2015-06-01

    Cardiac magnetic resonance imaging and echocardiography revealed a gargantuan left atrium measuring 18.9 cm × 15.7 cm × 11.3 cm in a 56-year-old patient diagnosed with severe rheumatic mitral stenosis, severe pulmonary hypertension, and permanent atrial fibrillation. A chest x-ray also revealed a cardiothoracic ratio approaching 1.0 and a transthoracic echocardiogram measured diameters as large as 19.2 cm. The patient then underwent mitral valve replacement and left atrial reduction surgery and has had no further admissions or complications. PMID:25556297

  7. Role of percutaneous mitral valve repair in the contemporary management of mitral regurgitation.

    Science.gov (United States)

    Rana, Bushra S; Calvert, Patrick A; Punjabi, Prakash P; Hildick-Smith, David

    2015-10-01

    Percutaneous mitral valve (MV) repair has been performed in over 20,000 patients worldwide. As clinical experience in this technique grows indications for its use are being defined. Mitral regurgitation (MR) encompasses a complex heterogeneous group and its treatment is governed by determining a clear understanding of the underlying aetiology. Surgical MV repair remains the gold standard therapy for severe MR. However in select groups of high-risk surgical patients, a percutaneous approach to MV repair is establishing its role. This review gives an overview of the published data in percutaneous MV repair and its impact on the contemporary management of MR. PMID:26101091

  8. Changes in leukocyte subsets of pregnant gilts experimentally infected with porcine reproductive and respiratory syndrome virus and relationships with viral load and fetal outcome

    Science.gov (United States)

    In spite of more than two decades of extensive research, the understanding of porcine reproductive and respiratory syndrome virus (PRRSv) immunity is still incomplete. A PRRSv infection of the late term pregnant female can result in abortions, early farrowings, fetal death, and the birth of weak, co...

  9. Troca valvar com preservação de cordas e plástica na cirurgia da insuficiência mitral crônica Valve replacement with chordal preservation and valvuloplasty for chronic mitral insufficiency

    Directory of Open Access Journals (Sweden)

    José Luiz Dancini

    2004-03-01

    in end-systolic volume (P=0.0040, with no change in the ejection fraction (P=0.5586. The patients undergoing mitral valve replacement had a similar drop in ejection fraction (P=0.0001 and P=0.0296. CONCLUSION: The 3 surgical techniques used provided clinical improvement. Patients undergoing valvuloplasty had better preservation of ventricular function. No significant difference was observed in cardiac performance between the 2 groups undergoing mitral valve replacement with chordal preservation within a 6-month follow-up.

  10. [Percutaneous mitral valve annuloplasty with the carillon mitral contour system by cardiac dimensions. A minimally invasive therapeutic option for the treatment of severe functional mitral valve regurgitation].

    Science.gov (United States)

    Degen, Hubertus; Lickfeld, Thomas; Stoepel, Carsten; Haude, Michael

    2009-09-01

    Morbidity in patients with systolic heart failure is significantly increased by functional mitral valve regurgitation. In addition to pharmaceutical treatment or surgical reconstruction of the impaired valve, minimally invasive procedures have continuously advanced into the focus of interest. The Carillon Mitral Contour System (Cardiac Dimensions) is a new catheter-based method to converge dehiscent mitral valve leaflets with implantation of a nitinol clip into the coronary sinus, leading to a closer approach of the valve leaflets with subsequent decrease in mitral regurgitation. The device is implanted via a central venous catheter, using a special delivery system under fluoroscopy. The immediate success of minimizing mitral valve regurgitation is verified by online transesophageal echocardiography (TEE), device-related impairment of perfusion of contiguous coronary vessels is ruled out by coronary angiography performed simultaneously during deployment of the device. As soon as reduction of the mitral valve regurgitation is demonstrated in TEE, the Carillon System is disconnected from the delivery system, before, however, the Carillon device can be withdrawn into the delivery system as necessary. Following the successful implantation of the Carillon Mitral Contour System, a left ventricular lead for cardiac resynchronization therapy can still be successfully placed alongside through the coronary sinus. PMID:19784563

  11. The Effect of Local Hydration Environment on the Mechanical Properties and Unloaded Temporal Changes of Isolated Porcine Annular Samples.

    Science.gov (United States)

    Gruevski, Kristina M; Gooyers, Chad E; Karakolis, Thomas; Callaghan, Jack P

    2016-10-01

    Preventing dehydration during in vitro testing of isolated layers of annulus fibrosus tissue may require different test conditions than functional spine units. The purpose of the study was twofold: (A) to quantify changes in mass and thickness of multilayer annulus samples in four hydration environments over 120 min; and (B) to quantify cycle-varying biaxial tensile properties of annulus samples in the four environments. The environments included a saline bath, air, relative humidity control, and misting combined with controlled humidity. The loading protocol implemented 24 cycles of biaxial tensile loading to 20% strain at a rate of 2%/s with 3-, 8-, and 13-min of intermittent rest. Specimen mass increased an average (standard deviation) 72% (11) when immersed for 120 min (p tensile testing. PMID:27479500

  12. Mitral valve prolapse and body habitus in children.

    Science.gov (United States)

    Arfken, C L; Schulman, P; McLaren, M J; Lachman, A S

    1993-01-01

    Mitral valve prolapse has generally been associated in adults with a thin body habitus. However, prior studies used biased samples or limited anthropometric measures. In addition, no information has been available on the subjective assessment of body habitus and diagnosis of mitral valve prolapse, especially in children. We conducted a cross-sectional study on 813 children with uniform assessment of anthropometric measures and mitral valve prolapse. Consistent with research conducted on adults, those subjects with mitral valve prolapse were lighter, thinner, and had, on average, lower values for several, quantifiable anthropometric parameters with the exception of height. However, the subjective assessment showed that while the assessment did not differ by diagnosis, those subjects with mitral valve prolapse were never described as fat. These data support an association between mitral valve prolapse and slender body habitus and extends it to children, thus underscoring the clinical importance that a thin body habitus may be a marker for mitral valve prolapse throughout the age span. This association may partly explain the observed genetic distribution of mitral valve prolapse.

  13. Early changes in contractility and coronary blood flow in the normal areas of the ischemic porcine heart.

    Science.gov (United States)

    Pashkow, F; Holland, R; Brooks, H

    1977-03-01

    The regional responses of normal myocardium distant from an ischemic area were studied during acute anterior descending occlusion in the open-chest chloralose-anesthetized pig. Three markers of regional response in both normal and ischemic areas were used: surface ECG electrode, a force gauge in series with left ventricular outer wall fibers, and coronary blood inflow to each region as determined by electromagnetic cuff-probes. Following brief anterior descending artery occlusion (120 sec)., a characteristic rapid decline in contractile force and evolution of TQ-ST segment changes was observed in the ischemic area. In contrast, in the distant area increases in contractil force (p less than 0.001) and coronary blood flow (p less than 0.002) occurred. These distant responses were essentially obliterated following transection and cannulation of the artery supplying this region (p less than 0.05). The findings are consistent with a reflex neurovascular mechanism operating within the intact heart. This reflex is rapidly activated in order to maintain adequate levels of cardiac performance despite sudden loss of functional myocardial mass.

  14. Mitral valve prolapse: associations with symptoms and anxiety.

    Science.gov (United States)

    Arfken, C L; Lachman, A S; McLaren, M J; Schulman, P; Leach, C N; Farrish, G C

    1990-03-01

    Mitral valve prolapse has been studied extensively in the adult population, but less is known about it in children. Therefore, 813 children between 9 and 14 years of age were examined by a team of cardiologists and technicians. The children also responded to a questionnaire concerning the presence of symptoms and the What I Think and Feel anxiety instrument. The prevalence of mitral valve prolapse using auscultatory criteria was 4.2% (6.2% for girls, 2.3% for boys). Of those with mitral valve prolapse, 85% had a solitary click, 9% had a click and systolic murmur, and 6% had multiple clicks. Children with auscultatory mitral valve prolapse were less likely to have symptoms than those free of cardiac abnormalities. No difference in average anxiety scores was detected between the two groups. It is concluded that auscultatory mitral valve prolapse is common in children and not accompanied by an increased likelihood of symptoms or anxiety.

  15. ECG-gated multi-detector row CT for assessment of mitral valve disease: initial experience

    International Nuclear Information System (INIS)

    Our objective was to evaluate applicability and image quality of contrast-enhanced, retrospectively ECG-gated multi-detector row CT (MDCT) for visualization of anatomical details of the mitral valve and its apparatus, and to determine the value of MDCT for diagnosing abnormal findings of the mitral valve. Twenty consecutive patients with mitral valve disease underwent MDCT preoperatively. Two readers assessed visibility of the mitral valve annulus, mitral valve leaflets, tendinous cords, and papillary muscles by using a four-point Likert grading scale. Abnormal mitral valve findings [thickening of the mitral valve leaflets, presence of mitral annulus calcification (MAC), and calcification of the valvular leaflets] were compared with preoperative echocardiography and intraoperative findings. Visibility of the mitral valve annulus and mitral valve leaflets was good or excellent in 15 patients (75%) and in 19 patients (95%) for papillary muscles. The MDCT yielded a 95-100% agreement compared with echocardiography and surgery with regard to the assessment of mitral valve leaflet thickening and the presence of calcifications of the mitral valve annulus or mitral valve leaflets. Intermodality agreement between MDCT and echocardiography was excellent with regard to classification of mitral valve leaflet thickness (κ=1.00) and good regarding classification of MAC thickness (κ=0.73). Contrast-enhanced, retrospectively ECG-gated MDCT allows good to excellent visualization of anatomical details of the mitral valve and its apparatus, and demonstrates good agreement with echocardiography and surgery in diagnosing mitral valve abnormalities. (orig.)

  16. Acellularization-Induced Changes in Tensile Properties Are Organ Specific - An In-Vitro Mechanical and Structural Analysis of Porcine Soft Tissues

    OpenAIRE

    Schleifenbaum, Stefan; Prietzel, Torsten; Aust, Gabriela; Boldt, Andreas; Fritsch, Sebastian; Keil, Isabel; Koch, Holger; Möbius, Robert; Scheidt, Holger A.; Wagner, Martin F. X.; Hammer, Niels

    2016-01-01

    Introduction Though xenogeneic acellular scaffolds are frequently used for surgical reconstruction, knowledge of their mechanical properties is lacking. This study compared the mechanical, histological and ultrastructural properties of various native and acellular specimens. Materials and Methods Porcine esophagi, ureters and skin were tested mechanically in a native or acellular condition, focusing on the elastic modulus, ultimate tensile stress and maximum strain. The testing protocol for s...

  17. Pseudopapillary fibroelastoma of the mitral valve.

    Science.gov (United States)

    Madu, E; Myles, J; Fraker, T D

    1995-01-01

    Papillary fibroelastomas are well-recognized benign cardiac neoplasms. They are primarily asymptomatic, but occasionally are associated with neurologic and cardiac symptoms. Pseudopapillary fibroelastomas presenting with usual clinical and echocardiographic manifestations of papillary fibroelastoma but lacking characteristic histologic features have not been described previously. This article describes a 42-year-old, previously healthy female admitted with sudden hemiparesis and dysarthria. Symptoms completely resolved within 4 days. Extensive investigations revealed no etiology except for a pedunculated mitral valve mass with echocardiographic appearance suggestive of papillary fibroelastoma. Histologic staining, however, failed to reveal characteristic features of papillary fibroelastoma.

  18. Noradrenaline-induced enhancement of oscillatory local field potentials in the mouse accessory olfactory bulb does not depend on disinhibition of mitral cells.

    Science.gov (United States)

    Leszkowicz, Emilia; Khan, Selina; Ng, Stephanie; Ved, Nikita; Swallow, Daniel L; Brennan, Peter A

    2012-05-01

    The olfactory bulb differs from other brain regions by its use of bidirectional synaptic transmission at dendrodendritic reciprocal synapses. These reciprocal synapses provide tight coupling of inhibitory feedback from granule cell interneurons to mitral cell projection neurons in the accessory olfactory bulb (AOB), at the first stage of vomeronasal processing. It has been proposed that both the mGluR2 agonist DCG-IV and noradrenaline promote mate recognition memory formation by reducing GABAergic feedback on mitral cells. The resultant mitral cell disinhibition is thought to induce a long-lasting enhancement in the gain of inhibitory feedback from granule to mitral cells, which selectively gates the transmission of the learned chemosensory information. However, we found that local infusions of both noradrenaline and DCG-IV failed to disinhibit AOB neural activity in urethane-anaesthetised mice. DCG-IV infusion had similar effects to the GABA(A) agonist isoguvacine, suggesting that it increased GABAergic inhibition in the AOB rather than reducing it. Noradrenaline infusion into the AOB also failed to disinhibit mitral cells in awake mice despite inducing long-term increases in power of AOB local field potentials, similar to those observed following memory formation. These results suggest that mitral cell disinhibition is not essential for the neural changes in the AOB that underlie mate recognition memory formation in mice.

  19. Porcine SLITRK1

    DEFF Research Database (Denmark)

    Larsen, Knud Erik; Momeni, Jamal; Farajzadeh, Leila;

    2014-01-01

    The membrane protein SLITRK1 functions as a developmentally regulated stimulator of neurite outgrowth and variants in this gene have been implicated in Tourette syndrome. In the current study we have cloned and characterized the porcine SLITRK1 gene. The genomic organization of SLITRK1 lacks intr...

  20. Progression to calcific mitral stenosis in end-stage renal disease.

    Science.gov (United States)

    D'Cruz, I A; Madu, E C

    1995-12-01

    A 59-year-old man with end-stage renal disease and on hemodialysis had neither mitral stenosis nor mitral calcification on echo-Doppler examination in 1989, but had extensive mitral calcification and definite mitral stenosis on conventional and transesophageal echocardiography in 1994. The left ventricle had marked concentric hypertrophy. To our knowledge this is the first documentation of the development of calcific mitral stenosis in end-stage renal disease revealed by serial echo-Doppler studies.

  1. Use of autologous pericardium for mitral leaflet reconstruction in a child with endocarditis

    Directory of Open Access Journals (Sweden)

    Olcay Murat Disli

    2013-06-01

    Full Text Available We present a case of successful repair of the mitral valve for active infective endocarditis. Mitral valve repair was performed through debridement of vegetation and abscess, resection and repair of the posterior mitral leaflet and posterior repair with autologous pericardium. Postoperative period was uneventfully, with no evidence of recurrent infection, and echocardiogram showed mitral valve competence with mild mitral regurgitation. We demonstrate that valve repair is a feasible choice in cases of active endocarditis in children.

  2. En face view of the mitral valve: definition and acquisition.

    Science.gov (United States)

    Mahmood, Feroze; Warraich, Haider Javed; Shahul, Sajid; Qazi, Aisha; Swaminathan, Madhav; Mackensen, G Burkhard; Panzica, Peter; Maslow, Andrew

    2012-10-01

    A 3-dimensional echocardiographic view of the mitral valve, called the "en face" or "surgical view," presents a view of the mitral valve similar to that seen by the surgeon from a left atrial perspective. Although the anatomical landmarks of this view are well defined, no comprehensive echocardiographic definition has been presented. After reviewing the literature, we provide a definition of the left atrial and left ventricular en face views of the mitral valve. Techniques used to acquire this view are also discussed. PMID:22859687

  3. Mitral valve prolapse in patients with Hashimoto's thyroiditis Tiroiditis de Hashimoto y prolapso de la válvula mitral

    Directory of Open Access Journals (Sweden)

    Federico Uribe Londoño

    1991-03-01

    Full Text Available The prevalence of mitral valve prolapse was determined en 67 patients with Hashimoto's thyroiditis (TH, and in 48 healthy control individuals. Mitral valve prolapse was found in 14 of 67 (20.9% patients with TH and in none of the controls. The presence of mitral valve prolapse should be investigated whenever this diagnosed. Se investigó la prevalencia de prolapso de la válvula mitral por ecocardiografía modo M y bidimensional en 67 pacientes que cumplían como mínimo tres de los criterios de Fisher y asociados, para el diagnóstico clínico de tiroiditis de Hashimoto (TH y que fueron comprobados por biopsia por aspiración de la glándula tiroides, con aguja fina, leída según los criterios de Kline; se incluyeron como controles 48 individuos normales. Se encontraron 14 casos (20.9% de prolapso de la válvula mitral en los pacientes con TH y ninguno entre los controles. Desconocemos por qué en esta serle la frecuencia del prolapso de la válvula mitral en pacientes con TH fue solamente la mitad de la observada en otra serle (41%, a pesar de que se utilizaron procedimientos y criterios diagnósticos similares. Con base en los hallazgos se sugIere buscar el prolapso de la válvula mitral en todo paciente con TH.

  4. Advanced electrocardiography can predict mitral regurgitation in cavalier king charles spaniels with myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Spiljak, Maja; Petric, Alexandra; Olsen, Lisbeth Høier;

    2011-01-01

    . Clinic for Surgery and Small Animal Medicine, Veterinary Faculty, University of Ljubljana, Slovenia. 3. Department of Basic Animal and Veterinary Sciences, Faculty of Life Sciences, University of Copenhagen, Denmark. 4. Quality Control Department, Metallurgical and Chemical Industry Cinkarna Celje, INC......ADVANCED ELECTROCARDIOGRAPHY CAN PREDICT MITRAL REGURGITATION IN CAVALIER KING CHARLES SPANIELS WITH MYXOMATOUS MITRAL VALVE DISEASE. M Spiljak1, AD Petric2, LH Olsen3, A Stepancic4, T Falk3, CE Rasmussen3, V Starc1. 1. Institute of Physiology, Medical Faculty, University of Ljubljana, Slovenia. 2......., Slovenia Recently, multiple advanced resting electrocardiographic (ECG) techniques have been applied in humans for detection of cardiac autonomic and repolarisation function. This has improved the diagnostic and/or prognostic value of short-time ECG in detection of common human cardiac diseases even before...

  5. The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical and Hemodynamic Follow-Up.

    Science.gov (United States)

    Celiento, Michele; Blasi, Stefania; De Martino, Andrea; Pratali, Stefano; Milano, Aldo D; Bortolotti, Uberto

    2016-02-01

    We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 patients) and 29 mm (40 patients). Follow-up ended in December 2012 and is 97% complete, with a cumulative duration of 611 patient-years (mean duration, 6 ± 4.6 yr; maximum, 17.7 yr). The early mortality rate was 10% (6% in elective patients); late deaths occurred in 31 patients (5 valve-related). Actuarial survival rates at 5, 10, and 15 years were 74% ± 5%, 50% ± 6%, and 37% ± 8%. The mean NYHA class in survivors was 1.4 ± 0.6 (P <0.0001). Thromboembolic episodes occurred in 4 patients, with an actuarial freedom at 15 years of 91% ± 5%. No cases of endocarditis were observed. Four patients needed reoperation, 2 for structural failure, and 1 each for perivalvular leakage and valve thrombosis. Actuarial freedom from structural failure and from reoperation, respectively, was 93% ± 5% and 91% ± 5% at 15 years. Echocardiographic follow-up in 24 patients with 27-mm prostheses showed a mean gradient of 5 ± 1.7 mmHg and an effective orifice area of 1.57 ± 0.3 cm(2); in 16 patients with 29-mm prostheses, the mean gradient was 4.5 ± 1.9 mmHg, and the effective orifice area, 1.63 ± 0.4 cm(2). During nearly 17 years of follow-up, the Mosaic bioprosthesis has shown good overall clinical and hemodynamic performance after mitral valve replacement. PMID:27047280

  6. Can percutaneous mitral balloon valvuloplasty reduce ongoing inflammation in patients with rheumatic mitral stenosis?

    Directory of Open Access Journals (Sweden)

    Fatih Uzun

    2015-09-01

    Full Text Available Objective: In the pathophysiology of rheumatic heart valve disease, chronic systemic inflammatory process plays an important role. In this study, we aimed to investigate whether the percutaneous transluminal mitral balloon valvuloplasty (PTMV has any effect on the chronic systemic inflammatory response in patients with rheumatic mitral stenosis (RMS. Methods: In this study, we used neutrophil to lymphocyte ratio (NLR, which is a simply available and inexpensive biomarker of systemic inflammatory response, to evaluate the level of inflammation. A total of 41 consecutive patients with severe RMS undergoing successful PTMV were included in the study. Laboratory assessments of all patients by the measuring of NLR before and after the PTMV procedure were performed. Results: Before and after the PTMV, the mean lymphocyte counts were found 2.1±0.6 x103 /µL and 1.9±0.6 x103 / µL (p=0.01, and the mean leukocyte counts were 4.8±1.4 x103 /µL and 4.4±1.3 x103 /µL (p=0.069 respectively. NLR values were determined as 2.7 ± 1.0 and 2.2 ± 0.8. After the PTMV, there was a significant decrease in NLR in patients with rheumatic mitral stenosis patients (p=0.001. In the correlation analysis, there was significant negative correlation between the mitral valve area and NLR (p= 0.004- r=0.440, and there was significant positive correlation between left atrial diameter and NLR (p=0.028 r=0.344. Conclusion: This study showed significant decrease in NLR after PTMV in patients with RMS, which means reduced inflammation after PTMV. Larger studies are needed to confirm the results.

  7. Xenotransplantation and porcine cytomegalovirus.

    Science.gov (United States)

    Denner, Joachim

    2015-01-01

    Porcine microorganisms may be transmitted to the human recipient when xenotransplantation with pig cells, tissues, and organs will be performed. Most of such microorganisms can be eliminated from the donor pig by specified or designated pathogen-free production of the animals. As human cytomegalovirus causes severe transplant rejection in allotransplantation, considerable concern is warranted on the potential pathogenicity of porcine cytomegalovirus (PCMV) in the setting of xenotransplantation. On the other hand, despite having a similar name, PCMV is different from HCMV. The impact of PCMV infection on pigs is known; however, the influence of PCMV on the human transplant recipient is unclear. However, first transplantations of pig organs infected with PCMV into non-human primates were associated with a significant reduction of the survival time of the transplants. Sensitive detection methods and strategies for elimination of PCMV from donor herds are required.

  8. Etiología de la insuficiencia mitral pura en Costa Rica: estudio ecocardiográfico

    Directory of Open Access Journals (Sweden)

    Esquivel M. Lidieth

    2003-04-01

    series internacionales. La causa isquémica ocupó el tercer lugar. La mayoría de los casos fueron leves a moderadas y de los casos con insuficiencia mitral severa, se dió la misma proporción.Introduction: International studies have demonstrated that mitral valve mixoid degeneration and coronary artery disease are the most frequent causes of pure mitral regurgitation. This cardiac ultrasound study was designed to know each cause prevalence in Costa Rica. Methods: We included all patients referred to our institution since July 1998 to July 2000 in whom was detected organic pure mitral regurgitation. We performed M-mode and bidimensional imaging and pulsed, continuous and colour flow mapping exploration. We classified patients in rheumatic disease, mixoid degenerative changes, secondary to coronary artery disease, to accelerated degenerative changes, to endocarditis, to collagen disease or other, regarding international criteria. We also assessed severity of mitral regurgitation classifying it in mild, moderate and severe. Results: We studied 82 patients, 48 females (59.7% and 34 males (37.8% between 14 and 87 years old (mean 50.3 +/- 20.7. There were 27 patients with pure mitral regurgitation of rheumatic origin (32.9%, 25 with mixoid degenerative valve disease (30.5%, 12 with coronary artery disease (14.6%, 9 with age-related changes (11%, 4 with mitral annulus elongation secondary to dilated cardiomyopathy not previously suspected (4.9%, 2 with systemic lupus erythematosus valve involvement (2.4%, 2 with no obvious cause (2.4% and one with endocarditis (1.2%. Sixty-two cases had mild or moderate mitral regurgitation (76.7% and 18 severe (21.9%. Sixty-one patients had left ventricle systolic function preserved (75.6% and 21 with some degree of diminished function. Conclusion: In this study we find a similar prevalence of rheumatic disease and mixoid degenerative disease as most frequent causes of mitral regurgitation, a fact different from international series

  9. [Mitral valve replacement in dextrocardia and situs inversus].

    Science.gov (United States)

    Uchimuro, Tomoya; Fukui, Toshihiro; Matsuyama, Shigefumi; Tabata, Minoru; Takanashi, Shuichirou

    2012-09-01

    Cardiac surgery for acquired valvular diseases in patients with dextrocardia is extremely rare. We report a surgical case of mitral valve replacement and tricuspid annuloplasty in a patient with dextrocardia and situs inversus. A 74-year-old man with dextrocardia and situs inversus, who had undergone patch closure of atrial septal defect 25 years before, was referred for surgical treatment of severe mitral and tricuspid valve regurgitation. Preoperative computed tomography( CT) showed dextrocardia, situs inversus, interruption of the inferior vena cava with an azygos vein continuation, and drainage of the hepatic vein into the right atrium. Under redo-median sternotomoy, cardiopulmonary bypass was established by cannulating the ascending aorta, the superior vena cava, the right femoral and the hepatic veins. The surgeon operated from the left side of the operating table, and had an excellent exposure to the mitral and tricuspid valves during the operation. Mitral valve replacement and tricuspid annuloplasty were performed successfully. The postoperative course was uneventful.

  10. Degenerative Mitral Stenosis: Unmet Need for Percutaneous Interventions.

    Science.gov (United States)

    Sud, Karan; Agarwal, Shikhar; Parashar, Akhil; Raza, Mohammad Q; Patel, Kunal; Min, David; Rodriguez, Leonardo L; Krishnaswamy, Amar; Mick, Stephanie L; Gillinov, A Marc; Tuzcu, E Murat; Kapadia, Samir R

    2016-04-19

    Degenerative mitral stenosis (DMS) is an important cause of mitral stenosis, developing secondary to severe mitral annular calcification. With the increase in life expectancy and improved access to health care, more patients with DMS are likely to be encountered in developed nations. These patients are generally elderly with multiple comorbidities and often are high-risk candidates for surgery. The mainstay of therapy in DMS patients is medical management with heart rate control and diuretic therapy. Surgical intervention might be delayed until symptoms are severely limiting and cannot be managed by medical therapy. Mitral valve surgery is also challenging in these patients because of the presence of extensive calcification. Hence, there is a need to develop an alternative percutaneous treatment approach for patients with DMS who are otherwise inoperable or at high risk for surgery. In this review, we summarize the available data on the epidemiology of DMS and diagnostic considerations and current treatment strategies for these patients. PMID:27142604

  11. A self-retaining retractor for mitral valve operations.

    Science.gov (United States)

    Cosgrove, D M

    1986-08-01

    A new self-retaining retractor for mitral valve operations is described. It is universally adjustable, may be affixed to any sternal retractor, and is completely removable when not required for the intracardiac portion of the procedure.

  12. Self-retaining pledgeted suture as retractor for mitral procedure.

    Science.gov (United States)

    Ng, Choi-Keung; Benedikt, Peter; Schwarz, Christian; Hartl, Peter

    2009-04-01

    A simple reliable maneuver to optimize exposure of the left atrium for mitral valve operations is described. It offers more space to mobilize the valvular structure, facilitating complicated reconstruction in the posteromedial commisural area.

  13. Echocardiography derived three-dimensional printing of normal and abnormal mitral annuli

    Directory of Open Access Journals (Sweden)

    Feroze Mahmood

    2014-01-01

    Full Text Available Aims and Objectives: The objective of this study was to assess the clinical feasibility of using echocardiographic data to generate three-dimensional models of normal and pathologic mitral valve annuli before and after repair procedures. Materials and Methods: High-resolution transesophageal echocardiographic data from five patients was analyzed to delineate and track the mitral annulus (MA using Tom Tec Image-Arena software. Coordinates representing the annulus were imported into Solidworks software for constructing solid models. These solid models were converted to stereolithographic (STL file format and three-dimensionally printed by a commercially available Maker Bot Replicator 2 three-dimensional printer. Total time from image acquisition to printing was approximately 30 min. Results: Models created were highly reflective of known geometry, shape and size of normal and pathologic mitral annuli. Post-repair models also closely resembled shapes of the rings they were implanted with. Compared to echocardiographic images of annuli seen on a computer screen, physical models were able to convey clinical information more comprehensively, making them helpful in appreciating pathology, as well as post-repair changes. Conclusions: Three-dimensional printing of the MA is possible and clinically feasible using routinely obtained echocardiographic images. Given the short turn-around time and the lack of need for additional imaging, a technique we describe here has the potential for rapid integration into clinical practice to assist with surgical education, planning and decision-making.

  14. Olfactory aversive conditioning alters olfactory bulb mitral/tufted cell glomerular odor responses

    Directory of Open Access Journals (Sweden)

    Max L Fletcher

    2012-03-01

    Full Text Available The anatomical organization of receptor neuron input into the olfactory bulb (OB allows odor information to be transformed into an odorant-specific spatial map of mitral/tufted cell glomerular activity at the upper level of the olfactory bulb. In other sensory systems, neuronal representations of stimuli can be reorganized or enhanced following learning. While the mammalian OB has been shown to undergo experience-dependent plasticity at the glomerular level, it is still unclear if similar representational change occurs within mitral/tufted cell glomerular odor representations following learning. To address this, odorant-evoked glomerular activity patterns were imaged in mice expressing a GFP-based calcium indicator (GCaMP2 in OB mitral/tufted cells. Glomerular odor responses were imaged before and after olfactory associative conditioning to aversive foot shock. Following conditioning, we found no overall reorganization of the glomerular representation. Training, however, did significantly alter the amplitudes of individual glomeruli within the representation in mice in which the odor was presented together with foot shock. Further, the specific pairing of foot shock with odor presentations lead to increased responses primarily in initially weakly activated glomeruli. Overall, these results suggest that associative conditioning can enhance the initial representation of odors within the olfactory bulb by enhancing responses to the learned odor in some glomeruli.

  15. Pathogenesis of Mitral Valve Disease in Mucopolysaccharidosis VII Dogs

    OpenAIRE

    Bigg, Paul W.; Baldo, Guilherme; Sleeper, Meg M.; O'Donnell, Patricia A.; Bai, Hanqing; Rokkam, Venkata R.P.; Liu, Yuli; Wu, Susan; Giugliani, Roberto; Casal, Margret L.; Haskins, Mark E.; Ponder, Katherine P.

    2013-01-01

    Mucopolysaccharidosis VII (MPS VII) is due to deficient activity of β-glucuronidase (GUSB) and results in the accumulation of glycosaminoglycans (GAGs) in lysosomes and multisystemic disease with cardiavascular manifestations. The goal here was to determine the pathogenesis of mitral valve (MV) disease in MPS VII dogs. Untreated MPS VII dogs had a marked reduction in the histochemical signal for structurally-intact collagen in the MV at 6 months of age, when mitral regurgitation had developed...

  16. Live three-dimensional transesophageal echocardiography in mitral valve surgery

    Institute of Scientific and Technical Information of China (English)

    MA Ning; LI Zhi-an; MENG Xu; YANG Ya

    2008-01-01

    Background Live three-dimensional transesophageal echocardiography (live-3D-TEE) is a new technique, but its clinical value is unclear at present. This study aimed to investigate the feasibility, imaging quality and accuracy of live-3D-TEE for assessing mitral valve morphology to determine if live-3D-TEE has important value in mitral valve surgery.Methods Twenty-four patients with mitral valve disease (mean age (47.1 rdiography (2D-TEE) before and after mitral valve surgery. Sensitivity, specificity, and total consistency rates of live-3D-TEE for diagnosing ruptured chordae were calculated and compared to surgeon's findings. We also compared the diagnostic accuracy of mitral valve disease between live-3D-TEE and 2D-TEE.Results Live-3D-TEE allowed visualization of the anatomic structure of the heart online and clearly identified the valvular apparatus and their defects. Sensitivity and specificity for the detection of ruptured chordae by live-3D-TEE were 87.5% and 100% respectively, and the total consistency rate was 95.8%. Additional defects not diagnosted by 2D-TEE were found in three cases (12.5%) preoperatively by live-3D-TEE. Live-3D-TEE could evaluate the function of prosthetic or native valves immediately after operation. One case was re-repaired (4.2%) using guidance by live-3D-TEE. Conclusion Live-3D-TEE enabled evaluation of mitral valve function and provided adequate valuable information before and after mitral valve surgery. We conclude that live-3D-TEE can play an important role in mitral valve surgery.

  17. Prognostic factors of rheumatic mitral stenosis during pregnancy and puerperium

    Directory of Open Access Journals (Sweden)

    Paulo José Bastos Barbosa

    2000-09-01

    Full Text Available OBJECTIVE: To identifity characteristics associated with complications during pregnancy and puerperium in patients with rheumatic mitral stenosis. METHODS: Forty-one pregnant women (forty-five pregnancies with mitral stenosis, followed-up from 1991 to 1999 were retrospectively evaluated. Predictor variables: the mitral valve area (MVA, measured by echocardiogram, and functional class (FC before pregnancy (NYHA criteria.Maternal events: progression of heart failure, need for cardiac surgery or balloon mitral valvulotomy, death, and thromboembolism. Fetal/neonatal events: abortion, fetal or neonatal death, prematurity or low birth weight ( or = II and III versus I was also associated with a risk for maternal events (RR=2.7; 95% CI=1.4-5.3.MVA and FC were not importantly associated with these events, although a smaller frequency of fetal/neonatal events was observed in patients who had undergone balloon valvulotomy. CONCLUSION: In pregnant women with mitral stenosis, the MVA and the FC are strongly associated with maternal complications but are not associated with fetal/neonatal events. Balloon mitral valvulotomy could have contributed to reducing the risks of fetal/neonatal events in the more symptomatic patients who had to undergo this procedure during pregnancy.

  18. Development of left ventricular hypertrophy in a novel porcine model of mitral regurgitation

    DEFF Research Database (Denmark)

    Ravn, Nathja; Zois, Nora Elisabeth; Moesgaard, Sophia G.;

    2014-01-01

    traction sutures that where applied in transmyocardial fashion. A sham operated control group (n = 13) was included. Echocardiographic LV size and heart weight assessed at euthanasia were used to evaluate the development of LV enlargement and eccentric hypertrophy after 8 weeks follow-up. RESULTS: Eight...

  19. Acetylsalicylic acid-induced changes in the chemical coding of extrinsic sensory neurons supplying the prepyloric area of the porcine stomach.

    Science.gov (United States)

    Rytel, L; Calka, J

    2016-03-23

    Acetylsalicylic acid is a popular drug that is commonly used to treat fever and inflammation, but which can also negativity affect the mucosal layer of the stomach, although knowledge concerning its influence on gastric innervation is very scarce. Thus, the aim of the present study was to study the influence of prolonged acetylsalicylic acid supplementation on the extrinsic primary sensory neurons supplying the porcine stomach prepyloric region. Fast Blue (FB) was injected into the above-mentioned region of the stomach. Acetylsalicylic acid was then given orally to the experimental gilts from the seventh day after FB injection to the 27th day of the experiment. After euthanasia, the nodose ganglia (NG) and dorsal root ganglia (DRG) were collected. Sections of these ganglia were processed for routine double-labelling immunofluorescence technique for substance P (SP), calcitonine gene related peptide (CGRP), galanin (GAL), neuronal isoform of nitric oxide synthase (nNOS) and vasoactive intestinal polypeptide (VIP). Under physiological conditions within the nodose ganglia, the percentage of the FB-labeled neurons immunoreactive to particular substances ranged between 17.9 ± 2.7% (VIP-like immunoreactive (LI) neurons in the right NG) and 60.4 ± 1.7% (SP-LI cells within the left NG). Acetylsalicylic acid supplementation caused a considerable increase in the expression of all active substances studied within both left and right NG and the percentage of neurons positive to particular substances fluctuated from 47.2 ± 3.6% (GAL-LI neurons in the right NG) to 67.2 ± 2.0% (cells immunoreactive to SP in the left NG). All studied substances were also observed in DRG neurons supplying the prepyloric region of the stomach, but the number of immunoreactive neurons was too small to conduct a statistical analysis. The obtained results show that ASA may influence chemical coding of the sensory neurons supplying the porcine stomach, but the exact mechanisms of this action still

  20. Chordal geometry determines the shape and extent of systolic anterior mitral motion: in vitro studies.

    Science.gov (United States)

    Cape, E G; Simons, D; Jimoh, A; Weyman, A E; Yoganathan, A P; Levine, R A

    1989-05-01

    In patients with hypertrophic cardiomyopathy, the mitral valve moves anteriorly and assumes a unique shape, with mitral-septal contact centrally and preserved valve orifice area laterally. This shape is not clearly predicted by the Venturi mechanism, which stresses flow above the valve as opposed to changes intrinsic to the valve. On the other hand, it has been suggested that displacement of the papillary muscles anteriorly and toward one another, as observed in this disease, can promote anterior mitral valve motion and produce this unusual shape. The purpose of this in vitro study was to test the hypotheses that anterior motion of a membrane in a flow field can be generated by altering the distribution or effectiveness of chordal tension tethering the membrane, and that the shape achieved by this membrane depends on the geometry of chordal tension. Accordingly, a horizontal leaflet mounted in a flow chamber was attached by chords at its distal end to a series of upstream screws. Chordal tension could be varied by turning the screws or redirected by shifting the screws anteriorly. Anterior leaflet motion having the same unusual configuration seen in patients was reproduced by decreasing central chordal restraint while tension on the leaflet edges was maintained. Directing chordal tension anteriorly caused greater degrees of anterior motion at earlier stages in the release of chordal restraint; increased flow rate had a similar but less marked effect. These studies suggest that primary geometric alterations in the papillary-mitral apparatus can play an important role in determining the presence and geometry of systolic anterior mitral motion. The nature of these alterations suggests a role for anterior and inward papillary muscle displacement in promoting such motion. The geometric factors embodied in this model can explain many observed features of this motion not adequately explained by the Venturi effect, such as early systolic onset and the importance of a

  1. Mitral tissue inhibitor of metalloproteinase 2 is associated with mitral valve surgery outcome.

    Directory of Open Access Journals (Sweden)

    Tsung-Hsien Lin

    Full Text Available BACKGROUND: Matrix metalloproteinases play a role in regulating cardiac remodeling. We previously reported an association between tissue inhibitor of metalloproteinase 2 (TIMP-2 expression and mitral valve (MV disease. However, the determinants and prognostic value of mitral TIMP2 after MV surgery are unknown. METHODS: This retrospective study of 164 patients after MV surgery in a tertiary medical center in Taiwan assessed mitral TIMP2 on a semiquantitative scale (0-2 by immunohistochemical staining. The primary endpoints were the composite of cardiovascular death and heart failure admission. RESULTS: Mean age was 50.4±13.7 years. After a mean follow-up period of 101±59 months, primary endpoints had occurred in 25 (15.2% subjects. Patients with and without primary endpoint events significantly differed in terms of age (56.6±14.4 vs. 49.2±13.4 years, respectively; p = 0.013 and left ventricular end-systolic diameter (LVESD (39.7±8.2 vs. 35.5±7.5 mm, p = 0.010 at surgery. The TIMP2 had a significant dose-dependent association with development of a primary endpoint (p = 0.002. Kaplan-Meier analysis showed that TIMP2 expression has a significant positive association with primary endpoint-free survival (log-rank test; p = 0.004. Cox regression analysis showed that independent predictors of primary endpoints were TIMP2 (hazard ratio [HR] 0.28; 95% confidence interval [CI] 0.12-0.65; p = 0.003, age (HR 1.05; 95% CI 1.02-1.09; p = 0.003 and LVESD (HR 1.05; 95% CI 1.01-1.10; p = 0.020. CONCLUSIONS: The lack of mitral TIMP2 expression is associated with increases in cardiovascular death and heart failure following MV surgery.

  2. Cleft in the Anterior Mitral Valve Leaflet Assessed by Real-time 3D Echocardiography

    OpenAIRE

    Tahir Bezgin; Cem Doğan; Ali Karagöz; Ali Elveran; Cihangir Kaymaz

    2016-01-01

    Abstract: Cleft in the anterior mitral leaflet is an infrequent congenital anomaly most often encountered in association with other congenital heart defects. The importance of the lesion is that it is often a correctable cause of Mitral Regurgitation (MR).

  3. Myocardial Infarction Alters Adaptation of the Tethered Mitral Valve

    NARCIS (Netherlands)

    Dal-Bianco, Jacob P; Aikawa, Elena; Bischoff, Joyce; Guerrero, J Luis; Hjortnaes, Jesper; Beaudoin, Jonathan; Szymanski, Catherine; Bartko, Philipp E; Seybolt, Margo M; Handschumacher, Mark D; Sullivan, Suzanne; Garcia, Michael L; Mauskapf, Adam; Titus, James S; Wylie-Sears, Jill; Irvin, Whitney S; Chaput, Miguel; Messas, Emmanuel; Hagège, Albert A; Carpentier, Alain; Levine, Robert A

    2016-01-01

    BACKGROUND: In patients with myocardial infarction (MI), leaflet tethering by displaced papillary muscles induces mitral regurgitation (MR), which doubles mortality. Mitral valves (MVs) are larger in such patients but fibrosis sets in counterproductively. The investigators previously reported that e

  4. 心脏二尖瓣病变的多层螺旋CT诊断%Multi-slice Spiral Computed Tomography in the Diagnosis of Mitral Valve Diseases

    Institute of Scientific and Technical Information of China (English)

    吴丽娜; 鹿强

    2016-01-01

    本文从心脏二尖瓣多层螺旋CT研究方法、正常解剖的螺旋CT表现、二尖瓣血流动力特征及心肌改变、二尖瓣膜病螺旋CT表现四个方面分析了心脏二尖瓣病变螺旋CT的诊断价值,并简要介绍了MDCT/EBCT、MRI与US技术在心脏二尖瓣病变诊断方面的优缺点及展望。%This paper analyzed the clinical value of the multi-slice computed tomography in the diagnosis of heart mitral valve diseases in four aspects: the research method of multi-slice CT in heart mitral valve diseases, the manifestations of multi-slice CT in the normal anatomy, the characteristics of hemodynamics and myocardial changes in mitral valve diseases, and the manifestations of multi-slice CT in mitral valve diseases. The paper also brielfy introduced the pros and cons as well as the development prospect of the application of multi-detector computed tomography/electron-beam computed tomography and magnetic resonance imaging and ultrasonography in the diagnosis of mitral valve diseases.

  5. Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: Role of transesophageal echocardiography

    OpenAIRE

    Shreedhar S Joshi; Ashwini Thimmarayappa; P S Nagaraja; Jagadeesh, A. M.; Arul Furtado; Seetharam Bhat

    2014-01-01

    Pseudoaneurysm of mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare cardiac surgical condition. P-MAIVF commonly occurs as a complication of aortic and mitral valve replacement surgeries. The surgical trauma during replacement of the valves weakens the avascular mitral and aortic intervalvular area. We present a case of P-MAIVF recurrence 5 years after a primary repair. Congestive cardiac failure was the presenting feature with mitral and aortic regurgitation. In view of the recurrence,...

  6. Repeated mitral valve replacement in a patient with extensive annular calcification

    OpenAIRE

    Kitamura Tadashi; Fukuda Sachito; Sawada Takahiro; Miura Sumio; Kigawa Ikutaro; Miyairi Takeshi

    2011-01-01

    Abstract Background Mitral valve replacement in the presence of severe annular calcification is a technical challenge. Case report A 47-year-old lady who had undergone mitral and aortic valve replacement for rheumatic disease 27 years before presented with dyspnea. At reoperation, extensive mitral annular calcification was hindering the disc motion of the Starr-Edwards mitral prosthesis. The old prosthesis was removed and a St Jude Medical mechanical valve was implanted after thorough annular...

  7. Transaortic aortomitral junction reconstruction and mitral valve leaflet repair for recurrent endocarditis.

    Science.gov (United States)

    Chiu, Peter; Allen, Jeremiah G; Woo, Y Joseph

    2015-03-01

    Transaortic interventions on the mitral valve are rarely performed, but offer advantages over traditional approaches in certain circumstances, including either extensive involvement of the aortomitral junction with endocarditis or the patient requiring reoperation for aortic and mitral disease. Herein is presented a case of recurrent endocarditis involving aortomitral continuity, reconstructed using a transaortic mitral valve repair and reconstruction of the aortic and mitral annuli with a pericardial patch, followed by aortic root replacement. PMID:26204680

  8. Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial

    OpenAIRE

    Siminiak, Tomasz; Wu, Justina C.; Haude, Michael; Hoppe, Uta C.; Sadowski, Jerzy; Lipiecki, Janusz; Fajadet, Jean; Shah, Amil M.; Feldman, Ted; Kaye, David M; Goldberg, Steven L.; Levy, Wayne C.; Solomon, Scott D.; Reuter, David G.

    2012-01-01

    Aims Functional mitral regurgitation (FMR) contributes to morbidity and mortality in heart failure (HF) patients. The aim of this study was to determine whether percutaneous mitral annuloplasty could safely and effectively reduce FMR and yield durable long-term clinical benefit. Methods and results The impact of mitral annuloplasty (Carillon Mitral Contour System) was evaluated in HF patients with at least moderate FMR. Patients in whom the device was placed then acutely recaptured for clinic...

  9. Our First Experience on Percutaneous Transvenous Mitral Commissurotomy (PTMC: Case Report

    Directory of Open Access Journals (Sweden)

    Aziz Karabulut

    2005-01-01

    Full Text Available Rheumatic heart disease remains a significant healt problem especially in devaloping countries. In rheumatic heart disease, mitral valve is affected in nearly all cases; mitral stenosis is the most common lesion. Percutaneous Transvenous Mitral Commissurotomy (PTMC is an important tool in the treatment of rheumatic mitral stenosis. In this study, our first PTMC case is presented, and the PTMC indications and the comparison of patients underwent PTMC with those patients underwent surgical intervention is discussed with the literature.

  10. Severe mitral annular calcification in rheumatic heart disease: A rare presentation

    OpenAIRE

    Vijayvergiya, Rajesh; Vaiphei, Kim; Rana, Sandeep S

    2012-01-01

    Severe mitral annular calcification (MAC) is frequently seen in patients with advanced age and chronic kidney disease, but it is rare in rheumatic heart disease (RHD). We hereby report a case of 45-year-old female with chronic RHD, who had severe MAC and mitral regurgitation. Fluoroscopy revealed a “crown”-like severe calcification of the mitral annulus. Autopsy of the heart revealed a calcified posterior mitral annulus, fused commissures, and calcified nodules at the atrial aspect of the mit...

  11. Exercise tolerance in mitral stenosis and chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Serial radionuclide ventriculography was performed using a newly developed ''real-time'' system, and left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), stroke volume (SV), and cardiac output (CO) were measured during graded supine exercise in five patients with mitral stenosis (MS), in five patients with chronic obstructive pulmonary disease (COPD) and in five healthy subjects. Simultaneous pulmonary gas exchange analysis permitted determining the anaerobic threshold, which is the point during incremental exercise when lactate begins to accumulate in the blood. LVEF at the anaerobic threshold was not significantly changed in any patient groups and in healthy subjects, but RVEF at the anaerobic threshold was lower in COPD and MS patients as compared with healthy subjects. In MS, SV during exercise was reduced at the anaerobic threshold, but not in COPD or in healthy subjects. In conclusion, reduced working capacity is related to decreased RVEF in both COPD and MS, but the inhibited increase in CO during exercise is also important for the working capacity in MS. (author)

  12. Porcine prion protein amyloid.

    Science.gov (United States)

    Hammarström, Per; Nyström, Sofie

    2015-01-01

    Mammalian prions are composed of misfolded aggregated prion protein (PrP) with amyloid-like features. Prions are zoonotic disease agents that infect a wide variety of mammalian species including humans. Mammals and by-products thereof which are frequently encountered in daily life are most important for human health. It is established that bovine prions (BSE) can infect humans while there is no such evidence for any other prion susceptible species in the human food chain (sheep, goat, elk, deer) and largely prion resistant species (pig) or susceptible and resistant pets (cat and dogs, respectively). PrPs from these species have been characterized using biochemistry, biophysics and neurobiology. Recently we studied PrPs from several mammals in vitro and found evidence for generic amyloidogenicity as well as cross-seeding fibril formation activity of all PrPs on the human PrP sequence regardless if the original species was resistant or susceptible to prion disease. Porcine PrP amyloidogenicity was among the studied. Experimentally inoculated pigs as well as transgenic mouse lines overexpressing porcine PrP have, in the past, been used to investigate the possibility of prion transmission in pigs. The pig is a species with extraordinarily wide use within human daily life with over a billion pigs harvested for human consumption each year. Here we discuss the possibility that the largely prion disease resistant pig can be a clinically silent carrier of replicating prions.

  13. Percutaneous and off-pump treatments for functional mitral regurgitation.

    Science.gov (United States)

    Fukamachi, Kiyotaka

    2008-01-01

    A new era in the treatment of functional mitral regurgitation is emerging with new devices that can be placed percutaneously or minimally invasively without cardiopulmonary bypass. These devices are categorized into three groups: annuloplasty, edge-to-edge repair, and ventricular reshaping. Percutaneous annuloplasty devices, implanted via the coronary sinus, mimic surgical annuloplasty by reducing the mitral annular anterior-posterior (or septal-lateral) dimension. Several devices, such as the PTMA, CARILLON, Monarch, and PS3 systems, are in clinical trials. Percutaneous edge-to-edge repair devices mimic the surgical Alfieri edge-to-edge repair technique, creating a double-orifice mitral valve; of these, MitraClip is in clinical trials. Ventricular reshaping devices treat both mitral annular dilatation and papillary muscle displacement (and thus leaflet tethering). The surgical Coapsys device is currently in clinical trials, and its percutaneous "interventional" version, iCoapsys, is being prepared for a clinical trial. Numerous issues need to be addressed before these devices can become standard therapies for functional mitral regurgitation. Device safety and efficacy must be demonstrated in carefully designed clinical trials with the goal of achieving outcomes equal to or better than those of surgical repair. PMID:18414987

  14. Mitral valve repair: an echocardiographic review: Part 2.

    Science.gov (United States)

    Maslow, Andrew

    2015-04-01

    Echocardiographic imaging of the mitral valve before and immediately after repair is crucial to the immediate and long-term outcome. Prior to mitral valve repair, echocardiographic imaging helps determine the feasibility and method of repair. After the repair, echocardiographic imaging displays the new baseline anatomy, assesses function, and determines whether or not further management is necessary. Three-dimensional imaging has improved the assessment of the mitral valve and facilitates communication with the surgeon by providing the surgeon with an image that he/she might see upon opening up the atrium. Further advancements in imaging will continue to improve the understanding of the function and dysfunction of the mitral valve both before and after repair. This information will improve treatment options, timing of invasive therapies, and advancements of repair techniques to yield better short- and long-term patient outcomes. The purpose of this review was to connect the echocardiographic evaluation with the surgical procedure. Bridging the pre- and post-CPB imaging with the surgical procedure allows a greater understanding of mitral valve repair. PMID:25440616

  15. Mitral valve repair in a patient with mesocardia.

    Science.gov (United States)

    Morisaki, Akimasa; Hattori, Koji; Motoki, Manabu; Takahashi, Yosuke; Nishimura, Shinsuke; Shibata, Toshihiko

    2014-01-01

    A 75-year-old man was referred for treatment of mitral valve prolapse secondary to tendon rupture. He had been receiving oral and inhaled corticosteroids for bronchial asthma and bronchial ectasia. Chest X-ray showed cardiomegaly with protrusion of the right atrium shadow. Computed tomography revealed dislocation and counterclockwise rotation of the heart with the apex of the heart located in the mid-thorax, indicating mesocardia. We believed that it would have been difficult to expose the mitral valve through a right-sided left atrial approach. Thus, we planned to perform mitral valve repair via a trans-septal approach. The right thoracotomy approach was not suitable because of respiratory dysfunction. After a median sternotomy, the left anterior descending coronary artery was identified just beneath the midline of the sternum. Even after decompression of the heart under cardiopulmonary bypass, we could not obtain a good view of the right side of the left atrium. By a transseptal approach with a self-retaining retractor and atrial hooks, we obtained adequate exposure of the mitral valve and performed the mitral valve repair uneventfully.

  16. Immediate, intermediate and long term clinical outcomes of percutaneous transvenous mitral commissurotomy

    Directory of Open Access Journals (Sweden)

    Satya Narayana Murthy Jayanthi Sriram

    2015-03-01

    Conclusions: MV score, Mitral valve area, mitral gradient and pulmonary artery pressures appeared to influence the outcome of PTMC. A clear-cut prospective assessment of individual components of the mitral valve apparatus using 3-D echocardiographic images may provide a more precise prediction of the PTMC outcome based on its morphological abnormalities.

  17. Real-world experience of MitraClip for treatment of severe mitral regurgitation

    DEFF Research Database (Denmark)

    Chan, Pak Hei; She, Hoi Lam; Alegria-Barrero, Eduardo;

    2012-01-01

     Percutaneous edge-to-edge mitral valve repair with the MitraClip(®) was shown to be a safe and feasible alternative compared to conventional surgical mitral valve repair. Herein is reported our experience on MitraClip(®) for high-risk surgical candidates with severe mitral regurgitation (MR)....

  18. Long-term follow-up results of percutaneous balloon mitral valvuloplasty in mitral stenosis with severe pulmonary hypertension

    International Nuclear Information System (INIS)

    Objective: To assess long-term results (more than 5-year) after percutaneous balloon mitral valvuloplasty (PBMV) on mitral stenosis (MS) with severe pulmonary hypertension. Methods: Thirty patients after PBMV underwent critical evaluations including echocardiography, chest film and clinical status throughout the follow-up period (6.4 +- 1.4 years). Results: Before and after PBMV and at follow-up, mean mitral valve areas were (1.19 +- 0.32) cm2 vs (1.99 +- 0.45) cm2 vs (1.44 +- 0.42) cm2 respectively (P<0.01 respectively). Restenosis rate was 53.3% at the end of follow-up. There were twenty-eight (93.3%) patients who obtained at least I class (NYHA class) improvement in cardiac function shortly after PBMV. At the end of follow-up, twenty-two (73.3%) patients were still in class I or II without mitral re-operation or repeated valvuloplasty. Conclusions: Long-term follow-up results after PBMV in mitral stenosis with severe pulmonary hypertension was satisfied, and PBMV can be an excellent therapy to improve the clinical status of such patients

  19. SERUM MAGNESIUM LEVELS IN AORTIC AND MITRAL VALVE REPLACEMENT SURGERIES

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-08-01

    Full Text Available BACKGROUND : The purpose of the study was to analyze serum magnesium concentration in patients undergoing Aortic and Mitral Valve replacement surgeries. METHODS: This prospective study was conducted in 60 patients who underwent elective Aortic and Mitral va lve replacement surgeries. Blood samples from radial artery were collected just before induction of anesthesia and three days post - operatively for estimation of serum magnesium. RESULTS: Magnesium level was 2.02mg/dl at baseline, 2.28mg/dl, 2.08mg/dl and 1 .90mg/dl respectively on three consecutive days post - operatively. CONCLUSION: The lowering of serum magnesium in Aortic and Mitral valve replacement surgeries postoperatively recommends the use of routine serum magnesium determination and administration to prevent post - operative arrhythmias.

  20. The Ross II procedure: pulmonary autograft in the mitral position.

    Science.gov (United States)

    Athanasiou, Thanos; Cherian, Ashok; Ross, Donald

    2004-10-01

    The surgical management of mitral valve disease in women of childbearing age, young patients, and children with congenital mitral valve defects is made difficult by the prospect of lifelong anticoagulation. We suggest the use of a pulmonary autograft in the mitral position (Ross II procedure) as an alternative surgical technique. We present a review of the literature, historical perspectives, indications, selection criteria, and surgical technique for the Ross II procedure. Our literature search identified 14 studies that reported results from the Ross II operation. Performed in 103 patients, the overall in-hospital mortality was 7 (6.7%), with a late mortality of 10 (9%). Although further research is needed, current evidence suggests the Ross II operation is a valuable alternative in low-risk young patients where valve durability and the complication rate from other procedures is unsatisfactory and anticoagulation not ideal.

  1. Percutaneous coronary intervention for acute myocardial infarction with mitral regurgitation.

    Science.gov (United States)

    Tu, Yan; Zeng, Qing-Chun; Huang, Ying; Li, Jian-Yong

    2016-09-01

    Ischemic mitral regurgitation (IMR) is a common complication of acute myocardial infarction (AMI). Current evidences suggest that revascularization of the culprit vessels with percutaneous coronary artery intervention (PCI) or coronary artery bypass grafting can be beneficial for relieving IMR. A 2.5-year follow-up data of a 61-year-old male patient with ST-segment elevation AMI complicated with IMR showed that mitral regurgitation area increased five days after PCI, and decreased to lower steady level three months after PCI. This finding suggest that three months after PCI might be a suitable time point for evaluating the possibility of IMR recovery and the necessity of surgical intervention of the mitral valve for AMI patient. PMID:27582769

  2. Sudden cardiac death and mitral and aortic valve disease

    Directory of Open Access Journals (Sweden)

    Bockeria O.L.

    2013-09-01

    Independent determinants of sudden death were left ventricular ejection fraction and atrial fibrillation. The main cause of death in patients with mitral valve stenosis is a thromboembolism from the left heart chambers to systemic circulation, and the risk of the latter increases with atrial fibrillation. There is no sudden cardiac death in mitral valve stenosis. The absence of left ventricular remodeling in mitral valve stenosis probably explains this finding. Onset of symptoms and signs of left ventricular dysfunction are the main predictors of sudden death and are indications for surgery. It should be emphasized that the database of sudden cardiac death in patients with valvular heart disease is very limited compared to patients with coronary heart disease and cardiomyopathies. Some issues related to predictors and mechanisms of SCD are currently poorly understood, therefore prevention of sudden cardiac death is difficult, especially in asymptomatic patients.

  3. Activation of the TLR/MyD88/NF-κB signal pathway contributes to changes in IL-4 and IL-12 production in piglet lymphocytes infected with porcine circovirus type 2 in vitro.

    Directory of Open Access Journals (Sweden)

    Dianning Duan

    Full Text Available Porcine circovirus type 2 (PCV2 causes immunosuppression in pigs. One causative factor is an imbalance in cytokine levels in the blood and lymphoid tissues. Many studies have reported changes in cytokine production, but the regulatory mechanisms involved have not yet been elucidated. In this study, we investigated alteration and regulation of IL-4 and IL-12 production in lymphocytes following incubation with PCV2 in vitro. The levels of IL-4 decreased and levels of IL-12 increased in lymphocyte supernatants, and the DNA-binding activity of NF-κB and the expression of p65 in the nucleus and p-IκB in the cytoplasm of lymphocytes increased after incubation with PCV2. However, these effects were reversed when lymphocytes were coincubated with PCV2 and the NF-κB inhibitor BAY11-7082. In addition, the expression of MyD88 protein increased and the expression of mRNA for the toll-like receptors (TLRs TLR2, TLR3, TLR4 and TLR9 was upregulated when lymphocytes were incubated with PCV2. However, no change was seen in TLR7 and TLR8 mRNA expression. In conclusion, this study showed that PCV2 induced a decrease in IL-4 and an increase in IL-12 production in lymphocytes, and these changes were regulated by the TLR-MyD88-NF-κB signal pathway.

  4. Left-sided approach for mitral valve replacement in a case of dextrocardia with situs solitus.

    Science.gov (United States)

    Kikon, Mhonchan; Kazmi, Aamir; Gupta, Anubhav; Grover, Vijay

    2013-11-01

    Mitral valve surgery in dextrocardia is technically challenging due to its anatomical malposition. Minor modifications are required in the surgical technique to counteract the problems during cannulation and exposure of the mitral valve. We report a case of a patient with dextrocardia, situs solitus, rheumatic heart disease, severe mitral regurgitation, moderate pulmonary artery hypertension, and severe left ventricular dysfunction who underwent mitral valve replacement using a two-stage right atrial cannulation with left-sided left atrial atriotomy, with the surgeon standing on the left side of the patient. Our approach for mitral valve surgery in this clinical setting is simple.

  5. Septic Cerebral Embolisation in Fulminant Mitral Valve Infective Endocarditis

    Science.gov (United States)

    Doolub, Gemina

    2015-01-01

    A 37-year-old male with known intravenous drug use was admitted with an acute onset of worsening confusion and speech impairment. His vitals and biochemical profile demonstrated severe sepsis, with a brain CT showing several lesions suspicious for cerebral emboli. He then went on to have a bedside transthoracic echocardiogram that was positive for vegetation on the mitral valve, with associated severe mitral regurgitation. Unfortunately, before he was stable enough to be transferred for valve surgery, he suffered an episode of acute pulmonary oedema requiring intubation and ventilation on intensive care unit. PMID:26120312

  6. Three-dimensional echocardiography of the mitral valve: lessons learned.

    Science.gov (United States)

    Maffessanti, Francesco; Mirea, Oana; Tamborini, Gloria; Pepi, Mauro

    2013-07-01

    Three-dimensional echocardiography has markedly improved our understanding of normal and pathologic mitral valve (MV) mechanics. Qualitative and quantitative analysis of three-dimensional (3D) data on the mitral valve could have a clinical impact on diagnosis, patient referral, surgical strategies, annuloplasty ring design and evaluation of the immediate and long-term surgical outcome. This review covers the contribution of 3D echocardiography in the diagnosis of MV disease, its role in selecting and monitoring surgical procedures, and in the assessment of surgical outcomes. Moreover, advantages of this technique versus the standard 2D modality, as well as future applications of advanced analysis techniques, will be reviewed. PMID:23686753

  7. Mitral valve operations at a high-volume pediatric heart center: Evolving techniques and improved survival with mitral valve repair versus replacement

    Directory of Open Access Journals (Sweden)

    Christopher W Baird

    2012-01-01

    Full Text Available Mitral valve disease is quite variable and can occur as an isolated defect or in association with other complex left sided lesions. These lesions are often best described with detailed pre-operative imaging studies to define the valve anatomy and to access associated left heart disease. Depending on the type of mitral valve disease, various surgical repair techniques have led to improved survival in the recent era. We describe lesion specific approach to mitral valve repair and results.

  8. Mathematical multi-scale model of the cardiovascular system including mitral valve dynamics. Application to ischemic mitral insufficiency

    Directory of Open Access Journals (Sweden)

    Moonen Marie

    2011-09-01

    Full Text Available Abstract Background Valve dysfunction is a common cardiovascular pathology. Despite significant clinical research, there is little formal study of how valve dysfunction affects overall circulatory dynamics. Validated models would offer the ability to better understand these dynamics and thus optimize diagnosis, as well as surgical and other interventions. Methods A cardiovascular and circulatory system (CVS model has already been validated in silico, and in several animal model studies. It accounts for valve dynamics using Heaviside functions to simulate a physiologically accurate "open on pressure, close on flow" law. However, it does not consider real-time valve opening dynamics and therefore does not fully capture valve dysfunction, particularly where the dysfunction involves partial closure. This research describes an updated version of this previous closed-loop CVS model that includes the progressive opening of the mitral valve, and is defined over the full cardiac cycle. Results Simulations of the cardiovascular system with healthy mitral valve are performed, and, the global hemodynamic behaviour is studied compared with previously validated results. The error between resulting pressure-volume (PV loops of already validated CVS model and the new CVS model that includes the progressive opening of the mitral valve is assessed and remains within typical measurement error and variability. Simulations of ischemic mitral insufficiency are also performed. Pressure-Volume loops, transmitral flow evolution and mitral valve aperture area evolution follow reported measurements in shape, amplitude and trends. Conclusions The resulting cardiovascular system model including mitral valve dynamics provides a foundation for clinical validation and the study of valvular dysfunction in vivo. The overall models and results could readily be generalised to other cardiac valves.

  9. R-R interval variations influence the degree of mitral regurgitation in dogs with myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Reimann, M. J.; Moller, J. E.; Haggstrom, J.;

    2014-01-01

    Mitral regurgitation (MR) due to myxomatous mitral valve disease (MMVD) is a frequent finding in Cavalier King Charles Spaniels (CKCSs). Sinus arrhythmia and atrial premature complexes leading to R-R interval variations occur in dogs. The aim of the study was to evaluate whether the duration...... of congestive heart failure due to MMVD. The severity of MR was evaluated in apical four-chamber view using colour Doppler flow mapping (maximum % of the left atrium area) and colour Doppler M-mode (duration in ms). The influence of the ratio between present and preceding R-R interval on MR severity...

  10. Percutaneous Mitral Valve Repair in Mitral Regurgitation Reduces Cell-Free Hemoglobin and Improves Endothelial Function.

    Directory of Open Access Journals (Sweden)

    Christos Rammos

    Full Text Available Endothelial dysfunction is predictive for cardiovascular events and may be caused by decreased bioavailability of nitric oxide (NO. NO is scavenged by cell-free hemoglobin with reduction of bioavailable NO up to 70% subsequently deteriorating vascular function. While patients with mitral regurgitation (MR suffer from an impaired prognosis, mechanisms relating to coexistent vascular dysfunctions have not been described yet. Therapy of MR using a percutaneous mitral valve repair (PMVR approach has been shown to lead to significant clinical benefits. We here sought to investigate the role of endothelial function in MR and the potential impact of PMVR.Twenty-seven patients with moderate-to-severe MR treated with the MitraClip® device were enrolled in an open-label single-center observational study. Patients underwent clinical assessment, conventional echocardiography, and determination of endothelial function by measuring flow-mediated dilation (FMD of the brachial artery using high-resolution ultrasound at baseline and at 3-month follow-up. Patients with MR demonstrated decompartmentalized hemoglobin and reduced endothelial function (cell-free plasma hemoglobin in heme 28.9±3.8 μM, FMD 3.9±0.9%. Three months post-procedure, PMVR improved ejection fraction (from 41±3% to 46±3%, p = 0.03 and NYHA functional class (from 3.0±0.1 to 1.9±1.7, p<0.001. PMVR was associated with a decrease in cell free plasma hemoglobin (22.3±2.4 μM, p = 0.02 and improved endothelial functions (FMD 4.8±1.0%, p<0.0001.We demonstrate here that plasma from patients with MR contains significant amounts of cell-free hemoglobin, which is accompanied by endothelial dysfunction. PMVR therapy is associated with an improved hemoglobin decompartmentalization and vascular function.

  11. Ecodopplercardiografia transesofágica intra-operatória: utilidade na cirurgia da valva mitral The usefulness of intraoperative transesofageal echocardiography for mitral valve surgery

    Directory of Open Access Journals (Sweden)

    Álvaro Villela de Moraes

    1992-12-01

    valor no auxílio do planejamento cirúrgico nas doenças da VM, bem como na avaliação imediaata dos resultados operatórios possibilitando ao cirurgião uma adequada análise anatômica e funcional da estrutura abordada.The usefulness of routine intraoperative transesophageal echocardiography (TEE for mitral valve (MV surgery was studied in 65 patients (pts with MV disease (mean age = 31 ± 14.8 to 62 yrs: 1 - Mitral regurgitation (MR: 19 pts-MV prolapse in 12 pts; Ischemic in 6 pts and post repair of ASD: 1 pt; 2 - Mitral stenosis (MS: 23 pts (4 of them with previous surgery; 3 - MS+MR and/or tricuspid valve (TV lesions: 16 pts; 4 - Bioprosthetic valve (BV dysfunction: 6 pts and 5 - Left atrial myxoma: 1 pt. Initial precardiopulmonary bypass TEE was used to confirm MV dysfunction, TV involvement and to assess LV function. On the 1 st run bypass (RBP, the MV commissurotomy was performed in 27 pts (23 with MS and 4 with MS+MR; the MV was replaced with BV (pericardial #21 to #29 in 18 pts (6 with BV dysfunction and 12 with MS+MR and the MV repair was performed in all of 19 pts with MR. The 2nd RBP was required in 7 pts (11%: 1 pt with MR; 4 pts with MS+MR and 2 pts with MS. TEE caused changes in pre pump plans in 9 pts with TV lesions and in 10 pts with MS or MS+MR - preservation of native in 6 pts in which replacement was planned. Thus intraoperative TEE provides helpful information in MV surgery and can help avoid a mitral replacement in pts with MS or MS+MR.

  12. The Evolving Role of Percutaneous Mitral Valve Repair

    Science.gov (United States)

    Stewart, Merrill H.; Jenkins, J. Stephen

    2016-01-01

    Background: Mitral regurgitation (MR) is the second leading cause of valvular heart disease in the United States behind aortic stenosis. The percutaneous repair of the mitral valve (MitraClip, Abbott, Inc.) has been approved in the United States since 2013 as an alternative to traditional mitral valve surgery. However, many questions are left unanswered about when to perform this procedure and whom to perform it on. Methods: We reviewed major published literature on the MitraClip from 2003-2016 to help guide clinical decision-making. A PubMed search was conducted using the phrase “mitraclip” or “percutaneous mitral valve repair” to identify relevant articles pertaining to the clip as well as surgical valve repair. Results: The clinical trials EVEREST I and EVEREST II (Endovascular Valve Edge-to-Edge Repair Study) demonstrated the safety and efficacy of the MitraClip but did not prove its superiority to surgical repair in the population studied. Numerous subsequent registries have suggested that the success of the MitraClip varies with the patient population studied. The currently enrolling Cardiovascular Outcomes for Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional MR (COAPT) trial hopes to answer some of these questions. Conclusion: The MitraClip is a new and exciting technology for percutaneously treating disease processes traditionally managed with surgery. The future of the clip and its patient population is dependent on further studies. PMID:27660576

  13. Mitral valve perforation appearing years after radiofrequency ablation

    DEFF Research Database (Denmark)

    Fisch-Thomsen, Marie; Jensen, Jesper K; Egeblad, Henrik;

    2011-01-01

    The case is reported of a young adult with Wolff-Parkinson-White (WPW) syndrome who, three years after a complicated radiofrequency (RF) catheter ablation procedure, developed dyspnea on exertion. Echocardiography revealed severe mitral valve regurgitation caused by a perforation of the posterior...

  14. Exercise Testing Induces Fatal Thromboembolism: from Mechanical Mitral Valve

    OpenAIRE

    Yavuzgil, Oguz; Ozerkan, Filiz; Gurgun, Cemil; Zoghi, Mehdi; Can, Levent.; AKIN, Mustafa

    2002-01-01

    Thromboembolism is still one of the most important complications of prosthetic heart valves. Embolism to a major coronary branch is rare, but acute proximal occlusions can be fatal, even when the coronary arteries are otherwise normal and intervention is rapid. We report a fatal complication of an exercise test in a patient who had a St. Jude bileaflet mitral valve.

  15. Evaluation of mitral valve replacement anchoring in a phantom

    Science.gov (United States)

    McLeod, A. Jonathan; Moore, John; Lang, Pencilla; Bainbridge, Dan; Campbell, Gordon; Jones, Doug L.; Guiraudon, Gerard M.; Peters, Terry M.

    2012-02-01

    Conventional mitral valve replacement requires a median sternotomy and cardio-pulmonary bypass with aortic crossclamping and is associated with significant mortality and morbidity which could be reduced by performing the procedure off-pump. Replacing the mitral valve in the closed, off-pump, beating heart requires extensive development and validation of surgical and imaging techniques. Image guidance systems and surgical access for off-pump mitral valve replacement have been previously developed, allowing the prosthetic valve to be safely introduced into the left atrium and inserted into the mitral annulus. The major remaining challenge is to design a method of securely anchoring the prosthetic valve inside the beating heart. The development of anchoring techniques has been hampered by the expense and difficulty in conducting large animal studies. In this paper, we demonstrate how prosthetic valve anchoring may be evaluated in a dynamic phantom. The phantom provides a consistent testing environment where pressure measurements and Doppler ultrasound can be used to monitor and assess the valve anchoring procedures, detecting pararvalvular leak when valve anchoring is inadequate. Minimally invasive anchoring techniques may be directly compared to the current gold standard of valves sutured under direct vision, providing a useful tool for the validation of new surgical instruments.

  16. Intraoperative evaluation of transmitral pressure gradients after edge-to-edge mitral valve repair.

    Directory of Open Access Journals (Sweden)

    Jan N Hilberath

    Full Text Available OBJECTIVE: Edge-to-edge repair of the mitral valve (MV has been described as a viable option used for the surgical management of mitral regurgitation (MR. Based on the significant changes in MV geometry associated with this technique, we hypothesized that edge-to-edge MV repairs are associated with higher intraoperative transmitral pressure gradients (TMPG compared to conventional methods. METHODS: Patient records and intraoperative transesophageal echocardiography (TEE examinations of 552 consecutive patients undergoing MV repair at a single institution over a three year period were assessed. After separation from cardiopulmonary bypass (CPB, peak and mean TMPG were recorded for each patient and subsequently analyzed. RESULTS: 84 patients (15% underwent edge-to-edge MV repair. Peak and mean TMPG were significantly higher compared to gradients in patients undergoing conventional repairs: 10.7 ± 0.5 mmHg vs 7.1 ± 0.2 mmHg; P<0.0001 and 4.3 ± 0.2 mmHg vs 2.8 ± 0.1 mmHg; P<0.0001. Only patients with mean TMPG ≥ 7 mmHg (n = 9 required prompt reoperation for iatrogenic mitral stenosis (MS. No differences in peak and mean TMPG were observed among edge-to-edge repairs performed in isolation, compared to those performed in combination with annuloplasty: 11.0 ± 0.7 mmHg vs 10.3 ± 0.6 mmHg and 4.4 ± 0.3 mmHg vs 4.3 ± 0.3 mmHg. There were no differences in TMPG between various types of annuloplasty techniques used in combination with the edge-to-edge repairs. CONCLUSIONS: Edge-to-edge MV repairs are associated with higher intraoperative peak and mean TMPG after separation from CPB compared to conventional repair techniques. Unless gradients are severely elevated, these findings are not necessarily suggestive of iatrogenic MS. Thus, in the immediate postoperative period mildly elevated TMPG can be expected and tolerated after edge-to-edge mitral repairs.

  17. 7 CFR 1230.611 - Porcine animal.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Porcine animal. 1230.611 Section 1230.611 Agriculture... CONSUMER INFORMATION Procedures for the Conduct of Referendum Definitions § 1230.611 Porcine animal. The term Porcine animal means a swine, that is raised: (a) As a feeder pig, that is, a young pig sold...

  18. Application of Percutaneous Balloon Mitral Valvuloplasty in Patients of Rheumatic Heart Disease Mitral Stenosis Combined with Tricuspid Regurgitation

    Directory of Open Access Journals (Sweden)

    Zhang-Qiang Chen

    2015-01-01

    Full Text Available Background: Tricuspid regurgitation (TR is frequently associated with severe mitral stenosis (MS, the importance of significant TR was often neglected. However, TR influences the outcome of patients. The aim of this study was to investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV procedure in rheumatic heart disease patients with mitral valve (MV stenosis and tricuspid valve regurgitation. Methods: Two hundred and twenty patients were enrolled in this study due to rheumatic heart disease with MS combined with TR. Mitral balloon catheter made in China was used to expand MV. The following parameters were measured before and after PBMV: MV area (MVA, TR area (TRA, atrial pressure and diameter, and pulmonary artery pressure (PAP. The patients were followed for 6 months to 9 years. Results: After PBMV, the MVAs increased significantly (1.7 ± 0.3 cm 2 vs. 0.9 ± 0.3 cm 2 , P 0.05. The PAP and left ventricular ejection fraction appeared no statistical difference compared with the postoperative (P > 0.05, the remaining patients without serious complications. Conclusions: PBMV is a safe and effective procedure for MS combined with TR in patients of rheumatic heart disease. It can alleviate the symptoms and reduce the size of TR. It can also improve the quality-of-life and prognosis. Its recent and mid-term efficacy is certain. While its long-term efficacy remains to be observed.

  19. Amplatzer occlusion of paravalvular leak of mitral mechanical prosthesis following a reoperation for thrombosed mitral mechanical prosthesis

    OpenAIRE

    Nikolic, Aleksandar; Schranz, Ditmaer; HRISTOV, Nikola; Mitrev, Zan

    2008-01-01

    We describe a case of a 46-year-old woman with dehiscence and paravalvular leak of a second-time replaced mitral mechanical prosthesis, successfully treated with Amplatzer occlusion of the paravalvular leak, thus avoiding a second reoperation and improving the patient’s symptoms.

  20. Radionuclide assessment of left ventricular diastolic function in patients with mitral stenosis before and after percutaneous transvenous mitral commissurotomy; Use of list mode method in patients with atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Seishi; Iwasaka, Toshiji; Kimura, Yutaka; Ohkubo, Naohiko; Matsuura, Takashi; Inada, Mitsuo; Shiraishi, Tomokuni (Kansai Medical School, Moriguchi, Osaka (Japan))

    1991-07-01

    To evaluate the effect of percutaneous transvenous mitral commissurotomy (PTMC), equilibrium radionuclide angiocardiography was performed in eight patients with mitral stenosis who had atrial fibrillation. Accurate cardiac function in patients with atrial fibrillation is difficult to assess, since the wide fluctation of cardiac cycle makes the ventricular hemodynamics variable. A new processing algorhythm was devised to make multiple gated images discriminated from a heart rate distribution histogram. We obtained about 1,000 beats data by list mode acquisition, and processed a heart rate distribution histogram. The data in the area {+-}5% of the most frequent heart rate were converted into frame mode and a representative time activity curve was derived. Mitral valve area calculated by echocardiography increased from 1.3{+-}0.5 to 2.0{+-}0.6 (cm{sup 2}) significantly (p<0.01). The mean transmitral pressure gradient measured by catheterization decreased from 12.4{+-}5.9 to 4.9{+-}3.7 (mmHg) significantly (p<0.01) and the clinical symptoms improved in all patients. The change in left ventricular ejection fraction from 43{+-}9 to 48{+-}13 (%) was not statistically significant, but peak filling rate (PFR) derived from the time activity curve increased from 1.5{+-}0.3 to 2.0{+-}0.4 (EDV/sec) significantly (p<0.01). Thus PFR is a noninvasive parameter that can evaluate the effect of PTMC. (author).

  1. 3. Early outcomes of minimally invasive versus conventional mitral valve surgery in mitral valve diseases. A single institutional experience

    Directory of Open Access Journals (Sweden)

    E. Nourelden

    2016-07-01

    Full Text Available Minimally invasive techniques in cardiac surgery gained popularity due to many advantages like less postoperative pain, minimal blood loss, less hospital stay, less cost. Minimally invasive mitral valve surgery through right anterolateral mini thoracotomy became safe technique. In our study we compared mini-MV surgery with conventional technique regarding cross clamp time, bypass time, total blood loss, reopening for bleeding, and hospital and ICU length of stay. In our institution between 2010 and 2015, 147patients underwent minimally invasive mitral surgery through right lateral minithoracotomy 8 cm incision and 118 patient underwent conventional mitral valve surgery through median sternotomy in minimally invasive technique: mean age was 38 ± 20 vs 59 ± 21, 70.7% were female (n = 104 vs 39.8% (n = 47, 23.8% were associated with tricuspid valve regurgitation (n = 33 vs 55% in conventional technique (n = 65, 0.08% were able to use endovascular clamp (n = 12, mean Euroscore predected risk of mortality 14.7 ± 13.6% vs 8.7 ± 10.9%. Minimally invasive mitral valve repair surgery was accomplished in 77.5% (n = 114 vs 46.15% (n = 55 and replacement of mitral valve in 22.4% (n = 30 vs 53.8% (n = 64 , concomitant procedures consists of tricuspid valve surgery in 23.8% (n = 35 vs 55% (n = 65, primary mitral valve repair included implantation of rigid annuloplasty ring in 79.6% vs 38.9% (n = 46, duration of cardiopulmonary bypass in minimally invasive surgery was 123 ± 64 min vs 116 ± 62 min, cross clamp time was 64 ± 27 min vs 59 ± 23 min, postoperative mechanical ventilation time 4 ± 1.5 h vs 6.5 ± 2 h, ICU lenght of stay (LOS was 48 ± 12 h vs 3 ± 1 days. Minimally invasive mitral surgery can be performed very safely with excellent early results. mini-MV surgery can be performed with a reasonable operative time, good perioperative course with decrease in postoperative ICU and hospital

  2. Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients

    Directory of Open Access Journals (Sweden)

    Elaine Soraya Barbosa de Oliveira Severino

    2011-12-01

    Full Text Available INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses. A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8% pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (PINTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months. The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was

  3. Quinapril therapy in patients with chronic mitral regurgitation.

    Science.gov (United States)

    Schön, H R; Schröter, G; Barthel, P; Schömig, A

    1994-05-01

    Pre- and afterload reduction is known to have beneficial effects in patients with chronic mitral regurgitation. To date, no controlled study has been reported analyzing the long term influence of angiotensin-converting enzyme inhibitor treatment on patients with chronic mitral regurgitation. Therefore the aim of this study was to assess the effects of one year angiotensin-converting enzyme inhibition with quinapril on myocardial performance in patients with chronic mitral regurgitation. Twelve patients with moderate to severe isolated chronic mitral regurgitation and no coronary disease on coronary angiography were studied under control conditions and followed up until one year of quinapril therapy (10-20mg/day) using echocardiography and simultaneous right heart catheterization, and radionuclide ventriculography at rest and exercise. As the result of a significant pre- and afterload reduction after one year quinapril treatment regurgitant fraction fell from 0.43 +/- 0.10 at control before therapy to 0.25 +/- 0.08 (p = 0.0001), left ventricular end-diastolic volume was reduced from 146 +/- 26 to 109 +/- 24 ml/m2 (p = 0.0001) and end-systolic volume decreased from 63 +/- 43 to 47 +/- 29 ml/m2 (p = 0.02). Left ventricular ejection fraction at control averaged 0.59 +/- 0.20 at rest, increased to 0.65 +/- 0.21 with maximum exercise and was unchanged after one year quinapril therapy. After one year treatment left ventricular mass was reduced by 15% (p = 0.0004) and septal wall thickness decreased from 11.8 +/- 0.7 to 10.8 +/- 0.8 mm (p = 0.0006). Moreover, there was significant functional improvement of nearly one NYHA class after one year quinapril therapy. In conclusion, in patients with chronic mitral regurgitation long term angiotensin-converting enzyme inhibition with quinapril reduces regurgitation and decreases left ventricular size and mass thereby demonstrating functional improvement. In addition, these data suggest that angiotensin-converting enzyme inhibition

  4. The prevention and management of complications during and immediately after percutaneous balloon mitral valvuloplasty

    International Nuclear Information System (INIS)

    Objective: To approach the cause and treatment of complication during and immediately after percutaneous balloon mitral valvuloplasty. Methods: One thousand three hundred and eleven patients with mitral stenosis were treated by percutaneous transseptal balloon mitral valvuloplasty. Among them, 42 patients with complications were retrospectively analyzed. Results: The overall complications rate was 3.2% (42/1311) including atrial fibrillation 0.8% (10/1311), acute pericardial tamponade 0.31% (4/1311), severe mitral insufficiency 0.46% (6/1311), femoral arterial venous fistula 0.69% (9/1311), acute pulmonary edema and iatrogenic atrial septal defect 0.23% (3/1311), respectively. Coronary air embolism, arterial thrombosis and transient cerebrovascular accident was 0.15% (2/1311) for every other one. Balloon rupture was 0.08%(1/1311). Conclusions: The complications of percutaneous balloon mitral valvuloplasty rarely occur. It is a safe and efficient nonsurgical method for treating rheumatic mitral stenosis

  5. [Simultaneous operation of WPW syndrome combined with mitral regurgitation caused by infective endocarditis].

    Science.gov (United States)

    Sueda, T; Nakashima, Y; Hamanaka, Y; Ishihara, H; Matsuura, Y; Isobe, F

    1990-03-01

    A case of WPW syndrome combined with mitral regurgitation caused by infective endocarditis underwent surgical division of accessory pathway and mitral valve replacement preserving posterior leaflet simultaneously. A 56-years old woman suffered atrial fibrillation with pseudo VT and cardiac failure caused by mitral regurgitation. Electro-physiological study (EPS) revealed accessory pathway in postero-lateral wall in left atrium and atrio-fascicular pathway like James bundle in AV node. ECHO cardiography showed mitral valve prolapse and severe regurgitation. Accessory pathway was divided surgically and deep freeze coagulation was followed. Perforation of anterior leaflet and chordal rupture of posterior leaflet caused by infective endocarditis were repaired by annuloplasty (Kay and McGoon method) at first, but regurgitation retained moderately. After re-clamping of aorta, mitral valve was replaced with prosthesis (SJM 29 mm) preserving posterior leaflet. Postoperative examination revealed division of accessory pathway and no regurgitation of mitral prosthesis. PMID:2348136

  6. Anuloplastia sem suporte para tratamento da insuficiência mitral reumática Non-supported mitral annuloplasty technique for treatment of rheumatic mitral insufficiency

    Directory of Open Access Journals (Sweden)

    Renato A. K Kalil

    1992-09-01

    Full Text Available Desde 1974, temos empregado anuloplastia sem suporte para tratamento da insuficiência mitral de etiologia reumática em uma população predominantemente jovem. A avaliação dos resultados tardios forma a base deste relato. São 154 pacientes com insuficiência mitral isolada (sem estenose ou dupla lesão, sendo 55 (36% do sexo masculino e 99 (64% do feminino, idade média = 36 ± 16 (5 a 73 anos; as lesões associadas foram: 47 lesões aórticas, 21 tricuspídeas e 2 comunicações interatriais; a classe funcional pré-operatória foi I-II em 19% e III-IV em 81 % e o índice cardiotorácico 0,61 ± 0,10. Todos os pacientes foram submetidos a uma anuloplastia similar à descrita por WOOLER et alii 21 que consiste na redução da porção mural do anel mitral obtida pela aplicação de dois pontos ancorados em feltros nas comissuras, sem comprometer a extensão de cúspide septal. Quando necessário, procedimentos adicionais sobre as cordas tendíneas foram realizados. Nenhum paciente recebeu suporte anular por anel ou barra posterior. A mortalidade precoce foi de 3 (1,9% pacientes: falência miocárdica (1 e embolia pulmonar (2. A mortalidade tardia foi de 9 (5,8%, falência miocárdica (3, septicemia (1, embolia pulmonar (1 e morte súbita (1 e causa desconhecida (3. Reoperações foram realizadas em 28 (18,2% casos, dos quais 2 (1,3% por disfunção de prótese aórtica. Sopro sistólico residual esteve presente em 48% dos casos. Complicações tardias: embolias sistêmicas 5,8% (1/3 como prótese aórtica, endocardite infecciosa 1,3% e embolia pulmonar 0,7%. Classe funcional pós-operatória (p. a. foi I - II em 84% e III - IV em 16%; índice cardiotorácico p. o. 0,58 ± 0,10. Probalidade atuarial de sobrevida tardia é estimada em 79,5 ± 5,3% aos 10 anos e 71,0 ± 7,4% aos 14 anos. Sobrevida sem eventos: 67,9 ± 8,9% aos 10 anos e 56,1 ± 11,7% aos 14 anos. A insuficiência mitral reumática pode ser tratada efetivamente por anuloplastia

  7. The relationship between respiration-related membrane potential slow oscillations and discharge patterns in mitral/tufted cells: what are the rules?

    Directory of Open Access Journals (Sweden)

    Virginie Briffaud

    Full Text Available BACKGROUND: A slow respiration-related rhythm strongly shapes the activity of the olfactory bulb. This rhythm appears as a slow oscillation that is detectable in the membrane potential, the respiration-related spike discharge of the mitral/tufted cells and the bulbar local field potential. Here, we investigated the rules that govern the manifestation of membrane potential slow oscillations (MPSOs and respiration-related discharge activities under various afferent input conditions and cellular excitability states. METHODOLOGY AND PRINCIPAL FINDINGS: We recorded the intracellular membrane potential signals in the mitral/tufted cells of freely breathing anesthetized rats. We first demonstrated the existence of multiple types of MPSOs, which were influenced by odor stimulation and discharge activity patterns. Complementary studies using changes in the intracellular excitability state and a computational model of the mitral cell demonstrated that slow oscillations in the mitral/tufted cell membrane potential were also modulated by the intracellular excitability state, whereas the respiration-related spike activity primarily reflected the afferent input. Based on our data regarding MPSOs and spike patterns, we found that cells exhibiting an unsynchronized discharge pattern never exhibited an MPSO. In contrast, cells with a respiration-synchronized discharge pattern always exhibited an MPSO. In addition, we demonstrated that the association between spike patterns and MPSO types appeared complex. CONCLUSION: We propose that both the intracellular excitability state and input strength underlie specific MPSOs, which, in turn, constrain the types of spike patterns exhibited.

  8. Response of porcine hepatocytes in primary culture to plasma from severe viral hepatitis patients

    Institute of Scientific and Technical Information of China (English)

    Yong-Bo Cheng; Ying-Jie Wang; Shi-Chang Zhang; Jun Liu; Zhi Chen; Jia-Jia Li

    2005-01-01

    AIM: To observe the effects of plasma from patients with severe viral hepatitis (SVHP) on the growth and metabolism of porcine hepatocytes and the clinical efficiency of bioartificial liver device.METHODS: Hepatocytes were isolated from male porcines by collagenase perfusion. The synthesis of DNA and total protein, leakages of AST and LDH, changes in glutathione (GSH), catalase and morphology of porcine hepatocytes exposed to SVHP were investigated to indicate the effect of plasma from patients with severe hepatitis on the growth, injury, detoxification, and morphology of porcine hepatocytes.RESULTS: The synthesis of DNA and protein was inhibited in the medium containing 100% SVHP compared to the controls. The leakages of LDH and AST increased in porcine hepatocytes following exposure to 100% SVHP for 5 h. The difference between 100% SVHP and 10% newborn calf serum (NCS) was significant in t-test (LDH: t = 24.552, P = 0.001; AST: t = 4.169, P =0.014). After exposure to SVHP for 24 h, alterations in GSH status were significant (F = 2.746, P<0.05) between porcine hepatocytes in 100% SVHP and 10% NCS, but no alteration occurred in the culture medium after 48 h (F = 4.378, P<0.05). A similar profile was observed in catalase activity. Many round vacuoles were observed in porcine hepatocytes cultured in SVHP. The membranes of these cells became indistinct and almost all the cells died on d 5.CONCLUSION: Plasma from patients with severe hepatitis inhibits the growth, injures membrane, disturbs GSH homeostasis and induces morphological changes of porcine hepatocytes. It is suggested that SVHP should be pretreated to reduce the toxin load and improve the performance of porcine hepatocytes in extracorporeal liver-support devices.

  9. An Atypical Mitral Valve Prolapse in a Patient With Behçet's Disease

    OpenAIRE

    Yoon, Se-Jung; Choi, Eui-Young; Jung, Jae-Hun; Rim, Se-Joong

    2011-01-01

    We report the case of a 42-year-old male who was admitted to the hospital with progressive dyspnea. Cardiomegaly and diffuse pulmonary edema were visible on chest X-ray and multiple oral and genital ulcers on physical examination. On admission, echocardiography revealed mitral valve prolapse (MVP) predominantly involving a basal portion of the posterior leaflet, with severe mitral regurgitation. A successful mitral valve replacement with St. Jude #29 was performed, after pre-treatment with pr...

  10. Severe haemolytic anaemia after replacement of the mitral valve by a St Jude medical prosthesis.

    OpenAIRE

    Feld, H; Roth, J

    1989-01-01

    Severe haemolytic anaemia developed in a 33 year old patient after the mitral valve was replaced with a St Jude medical prosthesis. This was the patient's third thoracotomy. She had already had a mitral commissurotomy and a mitral valve bioprosthesis. The patient had an E+ antibody to red blood cells as well as a paraprosthetic leak. The haemolysis became less severe once the population of E+ red cells was completely haemolysed. However, the patient continued to require transfusions to remain...

  11. Exposure of the mitral valve using flexible self-retaining retractors and an atrial hook.

    Science.gov (United States)

    Shibata, Toshihiko; Yasuoka, Takashi; Inoue, Kazushige; Ikuta, Takeshi; Bito, Yasuyuki

    2007-10-01

    We hereby present our technique for using the self-retaining flexible arm retractor and its attachments for mitral valve exposure. The Aortic Valve Assistant, which was developed for aortic valve exposure, is also very useful for exposure of the inferior wall of the left atrium. Our modified atrial hook provides excellent exposure of the anterior mitral annulus. Extensive dissection and the combined use of the flexible arm and attachments allows us comfortable access for mitral valve operations.

  12. The cumulative risks of prolapsing mitral valve. 40 years of follow-up.

    OpenAIRE

    Chapman, D W

    1994-01-01

    Prolapsing mitral valve is a common cardiac condition, occurring in approximately 16 million people in the United States alone. Primary prolapsing mitral valve may be familial or nonfamilial and may be associated with myxomatous degeneration of the mitral valve leaflets, such as occurs in Marfan syndrome and other connective tissue disorders. Secondary forms may be associated with such entities as rheumatic fever (especially after commissurotomy) and coronary artery disease (in the presence o...

  13. Percutaneous transfemoral-transseptal implantation of a second-generation CardiAQ™ mitral valve bioprosthesis

    DEFF Research Database (Denmark)

    Ussia, Gian Paolo; Quadri, Arshad; Cammalleri, Valeria;

    2016-01-01

    bioprosthesis and 30-day follow-up. METHODS AND RESULTS: The procedure was performed percutaneously, without any left extracorporeal circulatory support. The patient had severe mitral regurgitation with severely depressed ventricular function and other comorbidities. The patient was deemed extreme high risk...... echocardiography and fluoroscopy were utilised for device positioning and deployment. The mitral valve prosthesis was implanted with mild mitral regurgitation. The postoperative course was uneventful and at 30-day follow-up the patient is in NYHA Class I, with good function of the mitral valve bioprosthesis...

  14. Outcome of Cox Maze procedure concomitant with mitral valve operation in treatment of atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Sai; CHEN Ru-kun; DONG Ai-qiang; WANG Yong-qin; CHEN Suo-cheng; LI Zhi-jun

    2006-01-01

    @@ Atrial fibrillation (AF) is fairly common in patients with chronic mitral valve disease and a markedly dilated left atrium. These patients rarely return to sinus rhythm spontaneously, even after a successful mitral valve operation. The Maze procedure,developed by Cox and associates,1-5 has been used in patients undergoing a mitral valve operation.Restoration of normal sinus rhythm and atrial contraction in such patients have been reported by some groups. This study will summarize retrospectively a group of patients who underwent the Cox Maze procedure for the treatment of AF associated with rheumatic mitral valve disease in China.

  15. Mitral valve repair [version 1; referees: 3 approved

    OpenAIRE

    Alberto Pozzoli; Michele De Bonis; Ottavio Alfieri

    2016-01-01

    Mitral regurgitation (MR) is the most common valvular heart disease in the Western world. The MR can be either organic (mainly degenerative in Western countries) or functional (secondary to left ventricular remodeling in the context of ischemic or idiopathic dilated cardiomyopathy). Degenerative and functional MR are completely different disease entities that pose specific decision-making problems and require different management. The natural history of severe degenerative MR is clearly unfav...

  16. Mitral valve repair with a malleable bovine pericardium ring

    Directory of Open Access Journals (Sweden)

    Marco Antônio Volpe

    2000-11-01

    Full Text Available OBJECTIVE: To describe a surgical procedure utilizing a malleable bovine pericardium ring in mitral valve repair and clinical and echodopplercadiographic results. METHODS: Thirty-two (25 female and 7 male patients, aged between 9 and 66 (M=36.4±17.2 years, were studied over a 16-month period, with 100% follow-up. In 23 (72% of the patients, the mitral approach was the only one applied; 9 patients underwent associated operations. The technique applied consisted of measuring the perimeter of the anterior leaflet and implanting, according to this measurement, a flexible bovine pericardium prosthesis for reinforcement and conformation of the posterior mitral annulus, reducing it to the perimeter of the anterior leaflet with adjustment of the valve apparatus. RESULTS: The patient survival ratio was 93.8%, with 2 (6.2% fatal outcomes, one from unknown causes, the other due to left ventricular failure. Only one reoperation was performed. On echodopplercardiography, 88% of the patients had functional recovery of the mitral valve (50% without and 38% with mild insufficiency and no hemodynamic repercussions. Of four (12% of the remaining patients, 6% had moderate and 6% had seigre insufficiency. Twenty-eight percent of class II patients and 72% of class III patients passed into classes I (65%, II (32%, and III (3%, according to NYHA classification criteria. CONCLUSION: Being flexible, the bovine pericardium ring fit perfectly into the valve annulus, taking into account its geometry and contractility. Valve repair was shown to be reproducible, demonstrating significant advantages during patient evolution, which did not require anticoagulation measures.

  17. Mixoma atrial gigante simulando estenose mitral grave em paciente jovem

    Directory of Open Access Journals (Sweden)

    Eric Paiva Vilela

    2010-10-01

    Full Text Available Homem de 20 anos, previamente hígido, com quadro clínico de dispneia paroxística noturna e cansaço aos médios esforços com evolução em torno de dez dias, apresentou, ao exame ecocardiográfico, mixoma em átrio esquerdo funcionando como estenose mitral grave.

  18. LEFT ATRIUM THROMBOSIS IN PATIENTS WITH RHEUMATIC MITRAL VALVULAR DISEASE

    Directory of Open Access Journals (Sweden)

    N. D. Kaverin

    2012-01-01

    Full Text Available Systemic thromboembolism — fairly common complication of mitral valvular disease, often leading to disability or fatal consequences for the patient. The source of emboli in most cases, are blood clots localized in the left atrium. The survey reflected basic views on the pathogenesis, diagnosis, treatment and prevention of intraatrial thrombosis according to new scientific advances. Articles (reviews, meta-analyzes and original researchs from Pub Med database, as well as domestic literature were used.

  19. LEFT ATRIUM THROMBOSIS IN PATIENTS WITH RHEUMATIC MITRAL VALVULAR DISEASE

    Directory of Open Access Journals (Sweden)

    N. D. Kaverin

    2014-07-01

    Full Text Available Systemic thromboembolism — fairly common complication of mitral valvular disease, often leading to disability or fatal consequences for the patient. The source of emboli in most cases, are blood clots localized in the left atrium. The survey reflected basic views on the pathogenesis, diagnosis, treatment and prevention of intraatrial thrombosis according to new scientific advances. Articles (reviews, meta-analyzes and original researchs from Pub Med database, as well as domestic literature were used.

  20. Right ventricular function before and after percutaneous balloon mitral valvuloplasty.

    Science.gov (United States)

    Burger, W; Brinkies, C; Illert, S; Teupe, C; Kneissl, G D; Schräder, R

    1997-01-01

    Aim of this study was to evaluate right ventricular performance in patients with mitral stenosis and its modification by balloon valvuloplasty. Right ventricular volumes of 24 patients with postrheumatic mitral stenosis were determined by thermodilution 1 or 2 days before and 1 or 2 days after valvuloplasty. Right ventricular ejection fraction at rest was 43 (36-47)% (median and interquartile range). Right ventricular end-diastolic volume was 100 (86-119) ml/m2. Supine bicycle exercise (50 Watt) reduced right ventricular ejection fraction to 30 (29-37)% (P volume to 124 (112-141) ml/m2 (P improvement of right ventricular ejection fraction correlated inversely with the value of this parameter before valvuloplasty (r = -0.88, P volume (r = 0.57, P < 0.01). The right ventricular function curve, disturbed before commissurotomy, was reestablished by the procedure. In conclusion, at the here investigated stage of mitral stenosis right ventricular function is reversibly impaired. This is predominantly caused by the hemodynamic consequences of the valvular defect and not by an impairment of right ventricular myocardial function.

  1. Techniques for ensuring the correct length of new mitral chords.

    Science.gov (United States)

    Duran, Carlos M G; Pekar, Filip

    2003-03-01

    Repair of degenerative mitral insufficiency has extensively been shown to be superior to replacement. In the majority of cases, the culprit lesion is limited to the posterior mitral leaflet (PML), which is treated with quadrangular resection of the prolapsing PML, annular plication of the corresponding segment of the annulus, and prosthetic annuloplasty. Anterior mitral leaflet (AML) prolapse is less common and is not always considered an indication for repair despite availability of a variety of surgical maneuvers specifically designed for its treatment. Although reliable if properly performed, chordal shortening at the papillary muscle level is technically demanding. Chordal transfer from the PML with the 'flip-over' technique is highly reproducible, but limited by the very frequent presence of an abnormal PML. Although feasible, transfer of an anterior basal chord to the prolapsing free edge assumes that the basal chords can be sectioned with impunity. More recently, chord replacement with expanded polytetrafluoroethylene (PTFE) sutures has become increasingly popular because of its availability, theoretical simplicity, and demonstrated long-term durability. Although papillary and leaflet anchoring of the neo-chord has not been shown to be a problem, the determination of its appropriate length remains intuitive and based on personal experience. Here, simple surgical maneuvers designed to ensure safe and reproducible results of single or multiple chord replacement with PTFE sutures are described. PMID:12701786

  2. Mitral valve surgery for mitral regurgitation caused by Libman-Sacks endocarditis: a report of four cases and a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Bijl Marc

    2010-03-01

    Full Text Available Abstract Libman-Sacks endocarditis of the mitral valve was first described by Libman and Sacks in 1924. Currently, the sterile verrucous vegetative lesions seen in Libman-Sacks endocarditis are regarded as a cardiac manifestation of both systemic lupus erythematosus (SLE and the antiphospholipid syndrome (APS. Although typically mild and asymptomatic, complications of Libman-Sacks endocarditis may include superimposed bacterial endocarditis, thromboembolic events, and severe valvular regurgitation and/or stenosis requiring surgery. In this study we report two cases of mitral valve repair and two cases of mitral valve replacement for mitral regurgitation (MR caused by Libman-Sacks endocarditis. In addition, we provide a systematic review of the English literature on mitral valve surgery for MR caused by Libman-Sacks endocarditis. This report shows that mitral valve repair is feasible and effective in young patients with relatively stable SLE and/or APS and only localized mitral valve abnormalities caused by Libman-Sacks endocarditis. Both clinical and echocardiographic follow-up after repair show excellent mid- and long-term results.

  3. Valvoplastia mitral em pacientes jovens com cardiopatia reumática Mitral valvuloplasty in young patients with rheumatic heart disease

    Directory of Open Access Journals (Sweden)

    Fernando Antônio Fantini

    1992-06-01

    Full Text Available No período, de setembro de 1988 a janeiro de 1992, 56 pacientes com até 20 anos de idade (4 a 20 anos, média de 12,7 com insuficiência mitral pura ou predominante de etiologia reumática foram submetidos a valvoplastia mitral. Noventa e quatro por cento dos pacientes estavam em classe funcional III ou IV da NYHA. A técnica cirúrgica básica usada em todos os pacientes foi a anuloplastia assimétrica preconizada por Reed et alii 31, associada em 69,7% dos casos a outros procedimentos sobre as cúspides e aparelho subvalvar mitral. Dois pacientes foram submetidos, concomitantemente, a plastia da valva tricúspide e 4 a troca da valva aórtica. Estudo ecodopplercardiográfico per-operatório foi utilizado após a correção em todos os casos e mostrou ausência de lesões residuais em 76% dos pacientes e insuficiência mitral discreta nos demais. Náo houve mortalidade hospitalar. Ecopplercardiograma realizado antes da alta hospitalar mostrou boa correlação com o estudo per-operatório. Foi possível colher informações do seguimento tardio de 53 pacientes. Ocorreu 1 óbito tardio três meses após a cirurgia, por morte súbita. Quatro pacientes foram reoperados e submetidos a troca valvar: uma paciente no 4º mês de pós-operatório (PO, por falha primária do procedimento, e outros três no 6º, 34º e 38º meses de PO, por comprovada recidiva da cardite reumática. Os demais encontram-se em classe funcional I e II (NYHA. Concluímos, baseados nos resultados apresentados, que a anuloplastia mitral assimétrica é um excelente procedimento para pacientes jovens com valvopatia reumática, constituindo-se numa boa alternativa à troca de valva ou implante de anéis, sendo, no entanto, extremamente importante o controle de recidivas da doença reumática.From September 1988 to July 1990, 56 patients under 20 years of age (mean 12.7 ± 5.12 years with pure or predominant mitral valve regurgitation secondary to rheumatic valve disease

  4. Valvoplastia mitral em pacientes jovens com cardiopatia reumática Mitral valvuloplasty in young patients with rheumatic heart disease

    OpenAIRE

    Fernando Antônio Fantini; Leonardo Ferber Drumond; Bayard Gontijo Filho; Mário Osvaldo Vrandecic; João Alfredo Paula e Silva; Juscelino Teixeira Barbosa; Luiz Fernando Bracarense; Carlos Alberto Hemetério Oliveira; Cristiana Gutierrez; Adelso Aparecido Pedroza; Maria da Glória Cruvinel Horta

    1992-01-01

    No período, de setembro de 1988 a janeiro de 1992, 56 pacientes com até 20 anos de idade (4 a 20 anos, média de 12,7) com insuficiência mitral pura ou predominante de etiologia reumática foram submetidos a valvoplastia mitral. Noventa e quatro por cento dos pacientes estavam em classe funcional III ou IV da NYHA. A técnica cirúrgica básica usada em todos os pacientes foi a anuloplastia assimétrica preconizada por Reed et alii 31, associada em 69,7% dos casos a outros procedimentos sobre as cú...

  5. In vivo dynamic deformation of the mitral valve annulus.

    Science.gov (United States)

    Eckert, Chad E; Zubiate, Brett; Vergnat, Mathieu; Gorman, Joseph H; Gorman, Robert C; Sacks, Michael S

    2009-09-01

    Though mitral valve (MV) repair surgical procedures have increased in the United States [Gammie, J. S., et al. Ann. Thorac. Surg. 87(5):1431-1437, 2009; Nowicki, E. R., et al. Am. Heart J. 145(6):1058-1062, 2003], studies suggest that altering MV stress states may have an effect on tissue homeostasis, which could impact the long-term outcome [Accola, K. D., et al. Ann. Thorac. Surg. 79(4):1276-1283, 2005; Fasol, R., et al. Ann. Thorac. Surg. 77(6):1985-1988, 2004; Flameng, W., P. Herijgers, and K. Bogaerts. Circulation 107(12):1609-1613, 2003; Gillinov, A. M., et al. Ann. Thorac. Surg. 69(3):717-721, 2000]. Improved computational modeling that incorporates structural and geometrical data as well as cellular components has the potential to predict such changes; however, the absence of important boundary condition information limits current efforts. In this study, novel high definition in vivo annular kinematic data collected from surgically implanted sonocrystals in sheep was fit to a contiguous 3D spline based on quintic-order hermite shape functions with C(2) continuity. From the interpolated displacements, the annular axial strain and strain rate, bending, and twist along the entire annulus were calculated over the cardiac cycle. Axial strain was shown to be regionally and temporally variant with minimum and maximum values of -10 and 4%, respectively, observed. Similarly, regionally and temporally variant strain rate values, up to 100%/s contraction and 120%/s elongation, were observed. Both annular bend and twist data showed little deviation from unity with limited regional variations, indicating that most of the energy for deformation was associated with annular axial strain. The regionally and temporally variant strain/strain rate behavior of the annulus are related to the varied fibrous-muscle structure and contractile behavior of the annulus and surrounding ventricular structures, although specific details are still unavailable. With the high resolution

  6. Detailed Transthoracic and Transesophageal Echocardiographic Analysis of Mitral Leaflets in Patients Undergoing Mitral Valve Repair.

    Science.gov (United States)

    Ghulam Ali, Sarah; Fusini, Laura; Tamborini, Gloria; Muratori, Manuela; Gripari, Paola; Mapelli, Massimo; Zanobini, Marco; Alamanni, Francesco; Pepi, Mauro

    2016-07-01

    A recent histological study of resected scallop-P2 in mitral valve (MV) prolapse, showed that chordae tendinae may be missing or hidden in superimposed fibrous tissue of the leaflets, contributing to their thickening. This may have relevant clinical implication because detailed analysis of MV leaflets has a central role in the evaluation of patients undergoing repair. The aim of this study was to analyze MV leaflets focusing on thickness of prolapsing segments and the presence of chordal rupture (CR). We enrolled 246 patients (age 63 ± 13 years, 72 men) with isolated P2 prolapse and also 50 age-matched patients with normal MV anatomy as control group. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) were retrospectively analyzed to quantify the length and the proximal and distal thickness of both anterior (A2) and posterior (P2) MV scallops. Measurements were performed at end diastole in the standard TTE and TEE views. TTE and TEE measurements were feasible in all cases. Echocardiographically 176 patients had CR (group A), 45 had no rupture (group B), and 25 had an uncertain diagnosis (group C). All pathological groups showed thickening and elongation of involved leaflets versus normal, whereas no differences in leaflets characteristics were found among MV groups. Most patients undergoing MV repair had CR with thickening of the prolapsed segment. These findings are in agreement with recent histological studies showing superimposed fibrous tissue on MV leaflets partially including ruptured chordae. This may also explain that in cases without ruptured chordae, thickness of the leaflets is markedly increased (hidden chordae?). In conclusion, detailed analysis of MV apparatus may further improve knowledge of these patients and may influence surgical timing. PMID:27184171

  7. Predictors of outcome of mitral valve prolapse in patients with the Marfan syndrome.

    Science.gov (United States)

    Rybczynski, Meike; Treede, Hendrik; Sheikhzadeh, Sara; Groene, Eike F; Bernhardt, Alexander M J; Hillebrand, Mathias; Mir, Thomas S; Kühne, Kristine; Koschyk, Dietmar; Robinson, Peter N; Berger, Jürgen; Reichenspurner, Hermann; Meinertz, Thomas; von Kodolitsch, Yskert

    2011-01-15

    Mitral valve prolapse has a prevalence of 2% to 3% in the general population, with adverse outcomes such as mitral valve regurgitation (MVR), heart failure, and endocarditis. Predictors of outcomes are used in idiopathic mitral valve prolapse for the timing of surgery, but such predictors are unknown in Marfan syndrome. Therefore, a population-based cohort study of 112 patients (49 male, 63 female; mean age 34 ± 15 years) with classic Marfan syndrome and mitral valve prolapse with moderate or less MVR at baseline was conducted. During 4.6 ± 3.6 years of follow-up, progression of MVR was observed in 41 patients and valve-related events, which comprised mitral valve endocarditis (7 events), heart failure (5 events), and mitral valve surgery (25 events), were observed in 31 patients. Multivariate Cox proportional-hazards regression analysis identified a flail mitral leaflet (hazard ratio [HR] 3.262, 95% confidence interval [CI] 1.406 to 7.566, p = 0.006) and increased indexed end-systolic left ventricular diameters (HR 1.113, 95% CI 1.043 to 1.188, p = 0.001) as independent predictors of progression of MVR. Similarly, mitral valve-related events were independently predicted by a flail mitral leaflet (HR 5.343, 95% CI 2.229 to 12.808, p moderate (HR 16.849, 95% CI 2.205 to 128.76, p = 0.006) degree of MVR. Conversely, aortic dilatation, dural ectasia, and sporadic mode of inheritance were not associated with outcome. In conclusion, the same clinical determinants that predict outcomes in idiopathic mitral valve prolapse also predict outcomes in mitral valve prolapse associated with Marfan syndrome. PMID:21211604

  8. Plastia da valva mitral com a técnica do "Duplo Teflon": resultados de 10 anos Mitral valve repair with "Double Teflon" technique: 10-year results

    OpenAIRE

    Carlos Manuel de Almeida Brandão; Marco Antonio Vieira Guedes; Marcos Floripes da Silva; Marcelo Luiz Vieira; Pablo Maria Alberto Pomerantzeff; Noedir Antonio Groppo Stolf

    2007-01-01

    OBJETIVO: O objetivo deste trabalho é apresentar os resultados clínicos tardios da plástica da valva mitral com a técnica do "Duplo Teflon". MÉTODOS: A plástica de "Duplo Teflon" consiste em técnica de reparo mitral com ressecção quadrangular da cúspide posterior, anuloplastia segmentar com plicatura do anel com de fios com "pledgets" sobre uma tira de Teflon, e sutura borda a borda da cúspide. Entre abril de 1994 e dezembro de 2003, 133 pacientes com diagnóstico de insuficiência mitral degen...

  9. Porcine Ex Vivo intestinal segment model

    OpenAIRE

    Ripken, D.; Hendriks, H.F.J.

    2015-01-01

    This chapter describes the use of the porcine ex vivo intestinal segment model. This includes the advantages and disadvantages of the segment model and a detailed description of the isolation and culture as well as the applications of the porcine ex vivo intestinal segment model in practice. Compared to the Ussing chamber (Chap. 24) the porcine ex vivo small intestinal segment model is a relatively simple to use intestinal tissue model. The main difference being that the tissue segment is not...

  10. Porcine type I interferons: polymorphic sequences and activity against PRRSV

    Directory of Open Access Journals (Sweden)

    Sang Yongming

    2011-06-01

    Full Text Available Abstract Background Type I interferons (IFN are a heterogeneous group of cytokines central to innate and adaptive antiviral immune responses. We have recently reported that porcine type I IFNs comprise at least 39 functional genes with diverse antiviral activity against porcine reproductive and respiratory syndrome virus (PRRSV. Here we report that potential cytokine polymorphisms exist in several genes of porcine type I IFNs. Results We have detected more than 100 potential polymorphic mutations, which include nucleotide substitutions and deletions, within the coding regions of porcine type I IFNs. Approximately 50% of the nucleotide changes were mutations that resulted in non-conserved amino acid substitution, as well as deletions that produced frame shifts in the open reading frames (ORFs. We have identified more than 20 polymorphic mutants that showed alterations in anti-PRRSV and anti-vesicular stomatitis virus (VSV activity in vitro. In particular, some mutations in IFN-α2, IFN-α3, IFN-α8, IFN-α12 and IFN-ω5 significantly altered the antiviral activity of expressed proteins in comparison to the wild-type or variant with more similarity to the wild-type. Conclusions Multiple polymorphic isoforms potentially exist within subtypes of the porcine type I IFN family. Polymorphic mutations are more common in multiple-member subtypes than single-member subtypes, and most are found within the IFN-α subclass. Some polymorphic isoforms have altered amino acid composition and shifted ORFs, which show significantly different antiviral activity in vitro.

  11. Repeated episodes of focal cerebral ischemia in a patient with mitral valve prolapse and migraine headache

    Directory of Open Access Journals (Sweden)

    Raičević Ranko

    2002-01-01

    Full Text Available Migraine is episodic, paroxysmal disorder where the headache represents the central symptom and is followed with different combinations of neurological gastrointestinal and vegetative changes. Not until the diagnostic procedures were developed, ischemic lesions were verified even in the patients with ordinary migraine. This is a report of a patient with migraine headache followed twice by verified episodes of temporary ischemic attacks and verified focal ischemic lesion of cerebral parenchyma. The mitral valve prolapse was also detected. This all imposed the administration of combined prophylactic antimigrainous and anticoagulant therapy as an imperative because of the risk of the development of repeated ischemia of cerebral tissue. This association also confirmed an opinion that migraine is a wider disorder with the dominant dysfunction of limbic system.

  12. Early effect of surgery for ischemic mitral insufficiency: a report of 46 cases

    Directory of Open Access Journals (Sweden)

    Ning-ning YUAN

    2013-07-01

    Full Text Available Objective To investigate early effect of coronary artery bypass grafting (CABG combined with mitral valve replacement or repair for ischemic mitral regurgitation (insufficiency. Methods The clinical data of 46 patients with ischemic mitral regurgitation hospitalized in Cardiovascular Department of General Hospital of PLA from December 2006 to November 2011 were retrospectively analyzed. Among the 46 patients, there were 34 males and 12 females, aged 66.8±76.4 years, and 16 of them received CABG combined with mitral valve replacement, and 30 received CABG combined with mitral valve repair. The left ventricular diameter (LVD and left ventricular ejection fraction (LVEF of each patient were determined before and after operation. Results One patient receiving CABG combined with mitral valve replacement died of early postoperative heart failure, and the remaining 45 patients were cured. Seven days after operation, the echocardiography showed a significant reduction of LVD (from 51.8±10.4 mm to 46.8±8.1mm, P<0.05, but no significant difference in LVEF before and after operation (53.43%±11.6% and 54.3%±10.1%, respectively was found. Conclusion The early outcome of CABG combining mitral valve surgery for ischemic mitral regurgitation is satisfactory, but further follow-up is still needed for evaluating the long-term results.

  13. Mechanisms and predictors of mitral regurgitation after high-risk myocardial infarction

    DEFF Research Database (Denmark)

    Meris, Alessandra; Amigoni, Maria; Verma, Anil;

    2012-01-01

    Mitral regurgitation (MR) has been associated with adverse outcomes after myocardial infarction (MI). Without structural valve disease, functional MR has been related to left ventricular (LV) remodeling and geometric deformation of the mitral apparatus. The aims of this study were to elucidate th...

  14. Mini-maze suffices as adjunct to mitral valve surgery in patients with preoperative atrial fibrillation

    NARCIS (Netherlands)

    Tuinenburg, AE; Van Gelder, IC; Tieleman, RG; Grandjean, JG; Huet, RCG; Van der Maaten, JMAA; Pieper, EG; De Kam, PJ; Ebels, MSCT; Crijns, HJGM

    2000-01-01

    Mini-Maze and Mitral Valve Surgery. Introduction: After mitral valve (MV) surgery, preoperative atrial fibrillation (AF) often recurs while cardioversion therapy generally fails. Additional Cox maze surgery improves postoperative arrhythmia outcome, but the extensive nature of such an approach limit

  15. A randomized study of combining maze surgery for atrial fibrillation with mitral valve surgery

    NARCIS (Netherlands)

    Jessurun, ER; Van Hemel, NM; Defauw, JJ; De La Riviere, AB; Stofmeel, MAM; Kingma, JH; Ernst, JMPG

    2003-01-01

    Aim Mitral valve surgery seldom suppresses atrial fibrillation (AF), present prior to surgery. Maze III surgery eliminates AF in >80% of cases, the reason why combining this procedure with mitral valve surgery in patients with AF seems worthwhile. We prospectively studied the outcome of combining th

  16. Percutaneous interventional mitral regurgitation treatment using the Mitra-Clip system

    DEFF Research Database (Denmark)

    Boekstegers, P; Hausleiter, J; Baldus, S;

    2014-01-01

    The interventional treatment of mitral valve regurgitation by the MitraClip procedure has grown rapidly in Germany and Europe during the past years. The MitraClip procedure has the potential to treat high-risk patients with secondary mitral valve regurgitation and poor left ventricular function. ...

  17. A Genomics-Based Model for Prediction of Severe Bioprosthetic Mitral Valve Calcification.

    Science.gov (United States)

    Ponasenko, Anastasia V; Khutornaya, Maria V; Kutikhin, Anton G; Rutkovskaya, Natalia V; Tsepokina, Anna V; Kondyukova, Natalia V; Yuzhalin, Arseniy E; Barbarash, Leonid S

    2016-01-01

    Severe bioprosthetic mitral valve calcification is a significant problem in cardiovascular surgery. Unfortunately, clinical markers did not demonstrate efficacy in prediction of severe bioprosthetic mitral valve calcification. Here, we examined whether a genomics-based approach is efficient in predicting the risk of severe bioprosthetic mitral valve calcification. A total of 124 consecutive Russian patients who underwent mitral valve replacement surgery were recruited. We investigated the associations of the inherited variation in innate immunity, lipid metabolism and calcium metabolism genes with severe bioprosthetic mitral valve calcification. Genotyping was conducted utilizing the TaqMan assay. Eight gene polymorphisms were significantly associated with severe bioprosthetic mitral valve calcification and were therefore included into stepwise logistic regression which identified male gender, the T/T genotype of the rs3775073 polymorphism within the TLR6 gene, the C/T genotype of the rs2229238 polymorphism within the IL6R gene, and the A/A genotype of the rs10455872 polymorphism within the LPA gene as independent predictors of severe bioprosthetic mitral valve calcification. The developed genomics-based model had fair predictive value with area under the receiver operating characteristic (ROC) curve of 0.73. In conclusion, our genomics-based approach is efficient for the prediction of severe bioprosthetic mitral valve calcification. PMID:27589735

  18. Unusual Giant Right Atrium in Rheumatic Mitral Stenosis and Tricuspid Insufficiency

    OpenAIRE

    Jean Baptiste Anzouan-Kacou; Christophe Konin; Iklo Coulibaly; Roland N'guetta; Anicet Adoubi; Esaïe Soya; Bénédicte Boka

    2011-01-01

    Dilation and hypertrophy of the atria occur in patients with valvular heart disease especially in mitral regurgitation, mitral stenosis or tricuspid abnormalities. In sub-saharan Africa, rheumatic fever is still the leading cause of valvular heart disease. We report a case of an unusual giant right atrium in context of rheumatic stenosis and severe tricuspid regurgitation in a 58-year-old woman.

  19. Application Progress of MRI in Diagnosis of Cardiac Mitral Valve Diseases%磁共振在心脏二尖瓣病变诊断中的应用进展

    Institute of Scientific and Technical Information of China (English)

    耿德海; 吴丽娜

    2015-01-01

    本文从心脏二尖瓣磁共振研究方法、正常解剖的磁共振表现、二尖瓣血流动力特征及心肌改变、二尖瓣膜病磁共振表现4个方面介绍心脏二尖瓣病变磁共振诊断的临床价值。%The clinical effectiveness of application of MRI (Magnetic Resonance Imaging) in diagnosis of cardiac mitral valve diseases was introduced in this paper from aspects of the MRI research method, the MRI manifestations of the normal anatomy, the blood lfow dynamics features and myocardial changes of mitral valves, as well as the MRI manifestations of mitral valve diseases.

  20. Characterization of the porcine synovial fluid proteome and a comparison to the plasma proteome.

    Science.gov (United States)

    Bennike, Tue Bjerg; Barnaby, Omar; Steen, Hanno; Stensballe, Allan

    2015-12-01

    Synovial fluid is present in all joint cavities, and protects the articular cartilage surfaces in large by lubricating the joint, thus reducing friction. Several studies have described changes in the protein composition of synovial fluid in patients with joint disease. However, the protein concentration, content, and synovial fluid volume change dramatically during active joint diseases and inflammation, and the proteome composition of healthy synovial fluid is incompletely characterized. We performed a normative proteomics analysis of porcine synovial fluid, and report data from optimizing proteomic methods to investigate the proteome of healthy porcine synovial fluid (Bennike et al., 2014 [1]). We included an evaluation of different proteolytic sample preparation techniques, and an analysis of posttranslational modifications with a focus on glycosylation. We used pig (Sus Scrofa) as a model organism, as the porcine immune system is highly similar to human and the pig genome is sequenced. Furthermore, porcine model systems are commonly used large animal models to study several human diseases. In addition, we analyzed the proteome of human plasma, and compared the proteomes to the obtained porcine synovial fluid proteome. The proteome of the two body fluids were found highly similar, underlining the detected plasma derived nature of many synovial fluid components. The healthy porcine synovial fluid proteomics data, human rheumatoid arthritis synovial fluid proteomics data used in the method optimization, human plasma proteomics data, and search results, have been deposited to the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifier PXD000935. PMID:26543887

  1. Tachykinins in the porcine pancreas

    DEFF Research Database (Denmark)

    Schmidt, P T; Tornøe, K; Poulsen, Steen Seier;

    2000-01-01

    The localization, release, and effects of substance P and neurokinin A were studied in the porcine pancreas and the localization of substance P immunoreactive nerve fibers was examined by immunohistochemistry. The effects of electrical vagus stimulation and capsaicin infusion on tachykinin releas...... antagonists. We conclude that tachykinins stimulate both endocrine and exocrine pancreatic functions through NK-1 receptors. Tachykinins are not involved in vagal regulation of pancreatic secretion in pigs but could constitute part of an alternative stimulatory system....

  2. Valvoplastia mitral percutânea complicada com tamponamento cardíaco em paciente gestante Percutaneous mitral valvuloplasty complicated by cardiac tamponade in a pregnant patient

    Directory of Open Access Journals (Sweden)

    Luís Seca

    2008-11-01

    Full Text Available A ocorrência de Hemopericárdio com Tamponamento Cardíaco é uma complicação da Valvoplastia Mitral Percutânea por balão (VMB, que apesar de pouco freqüente, pode ter graves conseqüências materno-fetais. Este artigo descreve o caso de um tamponamento cardíaco após VMB em uma mulher de 28 anos, com estenose mitral reumática severa na 20ª semana de gravidez.The occurrence of hemopericardium with cardiac tamponade is a complication of percutaneous balloon mitral valvuloplasty (BMV which, although uncommon, may have severe maternal and fetal consequences. This article describes a case of cardiac tamponade following BMV in a 28-year-old woman with severe rheumatic mitral stenosis in the 20th week of gestation.

  3. CT and MR imaging of the mitral valve: radiologic-pathologic correlation.

    Science.gov (United States)

    Morris, Michael F; Maleszewski, Joseph J; Suri, Rakesh M; Burkhart, Harold M; Foley, Thomas A; Bonnichsen, Crystal R; Anavekar, Nandan S; Young, Phillip M; Williamson, Eric E; Glockner, James F; Araoz, Philip A

    2010-10-01

    Computed tomography (CT) and magnetic resonance (MR) imaging are increasingly important adjuncts to echocardiography for the evaluation of mitral valve disease. The mitral valve may be involved in various acquired or congenital conditions with resultant regurgitation or stenosis, and many of these conditions can be identified with CT or MR imaging. In addition, CT is useful for detecting and monitoring postoperative complications after mitral valve repair or replacement. As the use of CT and MR imaging increases, awareness of the CT and MR imaging appearances of the normal mitral valve and the various disease processes that affect it may foster recognition of unsuspected mitral disease in patients undergoing imaging for other purposes. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.306105518/-/DC1. PMID:21071378

  4. Changes in the Subpopulations of Porcine Peripheral Blood Lymphocytes Induced by Exposure to Low Doses of Zearalenone (ZEN) and Deoxynivalenol (DON).

    Science.gov (United States)

    Dąbrowski, Michał; Obremski, Kazimierz; Gajęcka, Magdalena; Gajęcki, Maciej Tadeusz; Zielonka, Łukasz

    2016-01-01

    Zearalenone and deoxynivalenol are secondary metabolites of fungi of the genus Fusarium. The presence of mycotoxins in cereals and the resulting contamination of feeds and foods pose health risks for animals and humans. The dangers associated with high doses of mycotoxins have been extensively researched but very little is known about NOAEL (No Observed Adverse Effect Level) doses or exposure to a combination of mycotoxins (mixed mycotoxicoses). The aim of this study was to determine the effects of six-week exposure to NOAEL doses of individual and combined mycotoxins on the subpopulations of CD4⁺8(-), CD4(-)8⁺ and CD4⁺8⁺ lymphocytes in the peripheral blood of pigs. The experiment was performed on 72 gilts with average body weight of 25 kg, divided into three experimental groups (E1, E2 and E3, administered zearalenone (ZEN), deoxynivalenol (DON) and ZEN + DON, respectively, on a daily basis) and a control group (C) receiving placebo. Changes in lymphocyte subpopulations were evaluated by flow cytometry at weekly intervals (experimental days 7, 14, 21, 28, 35 and 42). A linear increase in the percentage of CD4⁺8⁺ lymphocytes was highly correlated with time (r = 0.682) in group C. The correlations and linear increase in the above subpopulation were disrupted in the remaining groups. In group E3, a statistically significant (p ZEN and DON exerted stronger immunomodulatory effects. PMID:27128894

  5. Changes in the Subpopulations of Porcine Peripheral Blood Lymphocytes Induced by Exposure to Low Doses of Zearalenone (ZEN and Deoxynivalenol (DON

    Directory of Open Access Journals (Sweden)

    Michał Dąbrowski

    2016-04-01

    Full Text Available Zearalenone and deoxynivalenol are secondary metabolites of fungi of the genus Fusarium. The presence of mycotoxins in cereals and the resulting contamination of feeds and foods pose health risks for animals and humans. The dangers associated with high doses of mycotoxins have been extensively researched but very little is known about NOAEL (No Observed Adverse Effect Level doses or exposure to a combination of mycotoxins (mixed mycotoxicoses. The aim of this study was to determine the effects of six-week exposure to NOAEL doses of individual and combined mycotoxins on the subpopulations of CD4+8−, CD4−8+ and CD4+8+ lymphocytes in the peripheral blood of pigs. The experiment was performed on 72 gilts with average body weight of 25 kg, divided into three experimental groups (E1, E2 and E3, administered zearalenone (ZEN, deoxynivalenol (DON and ZEN + DON, respectively, on a daily basis and a control group (C receiving placebo. Changes in lymphocyte subpopulations were evaluated by flow cytometry at weekly intervals (experimental days 7, 14, 21, 28, 35 and 42. A linear increase in the percentage of CD4+8+ lymphocytes was highly correlated with time (r = 0.682 in group C. The correlations and linear increase in the above subpopulation were disrupted in the remaining groups. In group E3, a statistically significant (p < 0.05 decrease in CD4+8+ counts was observed in week 5, which could point to a transient depletion of regulatory mechanisms of immune responses. The noted results also suggest that in mixed mycotoxicosis, ZEN and DON exerted stronger immunomodulatory effects.

  6. Cognitive tools pipeline for assistance of mitral valve surgery

    Science.gov (United States)

    Schoch, Nicolai; Philipp, Patrick; Weller, Tobias; Engelhardt, Sandy; Volovyk, Mykola; Fetzer, Andreas; Nolden, Marco; De Simone, Raffaele; Wolf, Ivo; Maleshkova, Maria; Rettinger, Achim; Studer, Rudi; Heuveline, Vincent

    2016-03-01

    For cardiac surgeons, mitral valve reconstruction (MVR) surgery is a highly demanding procedure, where an artificial annuloplasty ring is implanted onto the mitral valve annulus to re-enable the valve's proper closing functionality. For a successful operation the surgeon has to keep track of a variety of relevant impact factors, such as patient-individual medical history records, valve geometries, or tissue properties of the surgical target, and thereon-based deduce type and size of the best-suitable ring prosthesis according to practical surgery experience. With this work, we aim at supporting the surgeon in selecting this ring prosthesis by means of a comprehensive information processing pipeline. It gathers all available patient-individual information, and mines this data according to 'surgical rules', that represent published MVR expert knowledge and recommended best practices, in order to suggest a set of potentially suitable annuloplasty rings. Subsequently, these rings are employed in biomechanical MVR simulation scenarios, which simulate the behavior of the patient-specific mitral valve subjected to the respective virtual ring implantation. We present the implementation of our deductive system for MVR ring selection and how it is integrated into a cognitive data processing pipeline architecture, which is built under consideration of Linked Data principles in order to facilitate holistic information processing of heterogeneous medical data. By the example of MVR surgery, we demonstrate the ease of use and the applicability of our development. We expect to essentially support patient-specific decision making in MVR surgery by means of this holistic information processing approach.

  7. Pulsed Doppler echocardiographic analysis of mitral regurgitation after myocardial infarction.

    Science.gov (United States)

    Loperfido, F; Biasucci, L M; Pennestri, F; Laurenzi, F; Gimigliano, F; Vigna, C; Rossi, E; Favuzzi, A; Santarelli, P; Manzoli, U

    1986-10-01

    In 72 patients with previous myocardial infarction (MI), mitral regurgitation (MR) was assessed by pulsed-wave Doppler echocardiography and compared with physical and 2-dimensional echocardiographic findings. MR was found by Doppler in 29 of 42 patients (62%) with anterior MI, 11 of 30 (37%) with inferior MI (p less than 0.01) and in none of 20 normal control subjects. MR was more frequent in patients who underwent Doppler study 3 months after MI than in those who underwent Doppler at discharge (anterior MI = 83% vs 50%, p less than 0.01; inferior MI = 47% vs 27%, p = not significant). Of 15 patients who underwent Doppler studies both times, 3 (all with anterior MI) had MR only on the second study. Of the patients with Doppler MR, 12 of 27 (44%) with a left ventricular (LV) ejection fraction (EF) greater than 30% and 1 of 13 (8%) with an EF of 30% or less (p less than 0.01) had an MR systolic murmur. Mitral prolapse or eversion and papillary muscle fibrosis were infrequent in MI patients, whether or not Doppler MR was present. The degree of Doppler MR correlated with EF (r = -0.61), LV systolic volume (r = 0.47), and systolic and diastolic mitral anulus circumference (r = 0.52 and 0.51, respectively). Doppler MR was present in 24 of 28 patients (86%) with an EF of 40% or less and in 16 of 44 (36%) with EF more than 40% (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3766410

  8. Complete Transversal Disc Fracture in a Björk-Shiley Delrin Mitral Valve Prosthesis 43 Years After Implantation.

    Science.gov (United States)

    González-Santos, Jose María; Arnáiz-García, María Elena; Dalmau-Sorlí, María José; Sastre-Rincón, Jose Alfonso; Hernández-Hernández, Jesús; Pérez-Losada, María Elena; Sagredo-Meneses, Víctor; López-Rodríguez, Javier

    2016-10-01

    A patient who underwent previous implantation of a mitral valve replacement with a Björk-Shiley Delrin (BSD) mitral valve prosthesis during infancy was admitted to our institution 43 years later after an episode of syncope and cardiac arrest. Under extreme hemodynamic instability, a mitral valve prosthetic dysfunction causing massive mitral regurgitation was identified. The patient underwent an emergent cardiac operation, and a complete disc fracture with partial disc migration was found. Exceptional cases of mechanical prosthetic heart valve fracture exist. We report the first case of complete transversal disc rupture of a BSD mitral valve prosthesis after the longest period of implantation ever reported in that position. PMID:27645963

  9. Hemodynamics and annuloplasty in isolated mitral regurgitation in children.

    Science.gov (United States)

    Sulayman, R; Mathew, R; Thilenius, O G; Replogle, R; Arcilla, R A

    1975-12-01

    Isolated mitral insufficiency in children is quantitated angiographically by comparing the stroke volumes of the right ventricle and left ventricle. The disease results in greater enlargement of the left atrium than of the left ventricle and is accompanied by a significant increase in left atrial "distensibility." Right and left heart pressures may be normal or may be increased; they tend to be elevated in the group with regurgitant fractions of over 50%. Annuloplasty results in marked clinical and hemodynamic improvement and may even be corrective.

  10. Percutaneous mitral valve edge-to-edge repair

    DEFF Research Database (Denmark)

    Nickenig, Georg; Estevez-Loureiro, Rodrigo; Franzen, Olaf;

    2014-01-01

    BACKGROUND: The use of transcatheter mitral valve repair (TMVR) has gained widespread acceptance in Europe, but data on immediate success, safety, and long-term echocardiographic follow-up in real-world patients are still limited. OBJECTIVES: The aim of this multinational registry is to present...... a real-world overview of TMVR use in Europe. METHODS: The Transcatheter Valve Treatment Sentinel Pilot Registry is a prospective, independent, consecutive collection of individual patient data. RESULTS: A total of 628 patients (mean age 74.2 ± 9.7 years, 63.1% men) underwent TMVR between January 2011...

  11. RVOT mural and mitral valve endocarditis: A case report.

    Science.gov (United States)

    Jawad, Maadh; Cardozo, Shaun

    2015-01-01

    Mural endocarditis is a very rare condition. This entity involves bacterial growth on cardiac walls. In addition, concomitant valvular endocarditis, along with mural endocarditis, is an extremely rare combination. The diagnosis of mural endocarditis is difficult and requires more advanced cardiac imaging, such as a transesophageal echocardiogram. The differential diagnoses of mural masses include vegetations, thrombi, metastasis, and benign and malignant tumors. We present a rare and unusual case of Methicillin-Resistant Staphylococcus aureus bacteremia with findings of both right ventricular outflow tract mural endocarditis and valvular endocarditis involving the mitral valve.

  12. Chorea in a pregnant woman with rheumatic mitral stenosis.

    Science.gov (United States)

    Fam, Neil P; Chisholm, Robert J

    2003-05-01

    Chorea gravidarum is a rare movement disorder of pregnancy with a broad differential diagnosis. Although often a benign condition, it may indicate underlying acute rheumatic fever, antiphospholipid antibody syndrome or a hypercoagulable state. However, now that rheumatic fever is rare in western countries, chorea gravidarum occurs most commonly in patients with chronic rheumatic heart disease. Heightened awareness of chorea gravidarum and the morbidity of the often associated rheumatic heart disease, particularly in immigrants from developing countries, is essential for early diagnosis and effective management. A case of chorea gravidarum in a woman with rheumatic mitral stenosis is described. The diagnostic approach, pathophysiology and management of this rare condition are discussed. PMID:12772024

  13. Porcine Ex Vivo intestinal segment model

    NARCIS (Netherlands)

    Ripken, D.; Hendriks, H. F J

    2015-01-01

    This chapter describes the use of the porcine ex vivo intestinal segment model. This includes the advantages and disadvantages of the segment model and a detailed description of the isolation and culture as well as the applications of the porcine ex vivo intestinal segment model in practice. Compare

  14. Porcine Ex Vivo intestinal segment model

    NARCIS (Netherlands)

    Ripken, D.; Hendriks, H.F.J.

    2015-01-01

    This chapter describes the use of the porcine ex vivo intestinal segment model. This includes the advantages and disadvantages of the segment model and a detailed description of the isolation and culture as well as the applications of the porcine ex vivo intestinal segment model in practice. Comp

  15. 7 CFR 1230.18 - Porcine animal.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Porcine animal. 1230.18 Section 1230.18 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... animal. Porcine animal means a swine, that is raised as (a) a feeder pig, that is, a young pig sold...

  16. Pre-operative Tei Index does not predict left ventricular function immediately after mitral valve repair

    Directory of Open Access Journals (Sweden)

    Chirojit Mukherjee

    2012-01-01

    Full Text Available Echocardiographic assessment of systolic left ventricular (LV function in patients with severe mitral regurgitation (MR undergoing mitral valve (MV repair can be challenging because the measurement of ejection fraction (EF or fractional area change (FAC in pathological states is of questionable value. The aim of our study was to evaluate the usefulness of the pre-operative Tei Index in predicting left ventricular EF or FAC immediately after MV repair. One hundred and thirty patients undergoing MV repair with sinus rhythm pre- and post-operatively were enrolled in this prospective study. Twenty-six patients were excluded due to absence of sinus rhythm post-operatively. Standard transesophageal examination(IE 33,Philips,Netherlands was performed before and after cardiopulmonary bypass according to the guidelines of the ASE/SCA. FAC was determined in the transgastric midpapillary short-axis view. LV EF was measured in the midesophageal four- and two-chamber view. For calculation of the Tei Index, the deep transgastric and the midesophageal four-chamber view were used. Statistical analysis was performed with SPSS 17.0. values are expressed as mean with standard deviation. LV FAC and EF decreased significantly after MV repair (FAC: 56±12% vs. 50±14%, P<0.001; EF: 58±11 vs. 50±12Έ P<0.001. The Tei Index decreased from 0.66±0.23 before MV repair to 0.41±0.19 afterwards (P<0.001. No relationship between pre-operative Tei Index and post-operative FAC or post-operative EF were found (FAC: r=−0.061, P=0.554; EF: r=−0.29, P=0.771. Conclusion: Pre-operative Tei Index is not a good predictor for post-operative FAC and EF in patients undergoing MV repair.

  17. Surgical treatment of partial atrioventricular septal defect: functional analysis of the mitral valve in the postoperative period

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    Josué Viana Castro Neto

    2002-11-01

    Full Text Available OBJECTIVE: To study mitral valve function in the postoperative period after correction of the partial form of atrioventricular septal defect. METHODS: Fifty patients underwent surgical correction of the partial form of atrioventricular septal defect. Their mean age was 11.8 years and 62% of the patients were males. Preoperative echocardiography showed moderate and severe mitral insufficiency in 44% of the patients. The mitral valve cleft was sutured in 45 (90% patients (group II - GII. Echocardiographies were performed in the early postoperative period, and 6 and 12 months after hospital discharge. RESULTS: The patients who had some type of arrhythmia in the postoperative period had ostium primum atrial septal defect of a larger size (2.74 x 2.08 cm. All 5 patients in group I (GI, who did not undergo closure of the cleft, had a competent mitral valve or mild mitral insufficiency in the preoperative period. One of these patients began to have moderate mitral insufficiency in the postoperative period. On the other hand, in GII, 88.8% and 82.2% of the patients had competent mitral valve or mild mitral insufficiency in the early and late postoperative periods, respectively. CONCLUSION: The mitral valve cleft was repaired in 90% of cases. Echocardiography revealed competent mitral valve or mild mitral insufficiency in 88.8% and 82.2% of GII patients in the early and late postoperative periods, respectively.

  18. Effect of recombinant porcine IGF-binding protein-3 on proliferation of embryonic porcine myogenic cell cultures in the presence and absence of IGF-I.

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    Pampusch, M S; Kamanga-Sollo, E; White, M E; Hathaway, M R; Dayton, W R

    2003-02-01

    IGF-binding protein (IGFBP)-3 is produced by cultured porcine embryonic myogenic cell (PEMC) cultures and is secreted into the medium. Levels of secreted IGFBP-3 and IGFBP-3 mRNA are significantly reduced during differentiation and increase after differentiation is complete, suggesting that IGFBP-3 may play some role in myogenesis and/or in changes in myogenic cell proliferation that accompany differentiation. IGFBP-3 reportedly may either suppress or stimulate proliferation of cultured cells depending on cell type. Additionally, IGFBP-3 has been shown to affect proliferation via both IGF-dependent and IGF-independent mechanisms in some cell types but not all. Currently, the effect, if any, of IGFBP-3 on myogenic cell proliferation is not known. Consequently, the goal of this study was to assess the IGF-I-dependent and IGF-I-independent actions of recombinant porcine IGFBP-3 on proliferation of cultured porcine myogenic cells. To facilitate these investigations, we have expressed porcine IGFBP-3 in the baculovirus system, purified and characterized the expressed recombinant porcine IGFBP-3 (rpIGFBP-3), and produced and characterized an anti-porcine IGFBP-3 antibody that neutralizes the biological activity of porcine IGFBP-3. rpIGFBP-3 suppressed IGF-I-stimulated proliferation of PEMCs in a concentration-dependent manner with equimolar concentrations of IGF-I and rpIGFBP-3, resulting in complete suppression of IGF-I-stimulated proliferation. rpIGFBP-3 also suppressed Long-R3-IGF-I-stimulated proliferation of PEMC, indicating that rpIGFBP-3 possesses IGF-independent activity in this cell system. These data have established that IGFBP-3 has the potential to affect proliferation of PEMCs during critical periods of muscle development that may impact ultimate muscle mass achievable postnatally. PMID:12553871

  19. Mediators of increased blood flow in porcine skin

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    H. D. Moore

    1992-01-01

    Full Text Available Nicotinates and benzalkonium chloride (B.Cl cause inflammatory changes in human skin, thought to be dependent upon prostaglandin formation. This study has examined the effects of hexyl-nicotinate (HN and B.Cl on blood flow in porcine skin. The role of prostaglandins and interleukin (IL-1 in the blood flow response has been investigated. Blood flow was increased by both HN and B.Cl, the response to B.Cl being more protracted. Cyclooxygenase inhibitor pretreatment reduced these responses. IL-1-like biological activity was identified in normal porcine epidermis and the amounts recovered from inflamed skin were similar. Thus prostaglandin formation in HN or B.Cl-induced inflammation, if IL-1 dependent, is not associated with the loss of significant amounts of the cytokine from the epidermis.

  20. Surgical treatment of early acute thrombosis of mechanical mitral prosthesis.

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    Jiang, Shengli; Zhang, Tao; Ren, Chonglei; Wang, Yao

    2010-10-01

    Prosthetic valve thrombosis is a rare but life threatening complication of mechanical heart valve prosthesis. A 44-year-old woman diagnosed with rheumatic heart disease with severe mitral valve stenosis, moderate tricuspid valve insufficiency, and atrial fibrillation underwent transseptal mitral valve replacement and tricuspid valvuloplasty in our department. Heparin and warfarin were routinely used postoperatively. Although the international normalized ratio (INR), activated partial thromboplastin time ratio, and platelet count were satisfactory, the patient presented with severe dyspnea suddenly 10 days after discharge; echocardiogram showed that the prosthetic posterior leaflet was immobile. The patient suffered cardiac arrest suddenly during the examination and cardiopulmonary resuscitation was carried out successfully. Emergent surgery was performed, confirming the prosthetic valve thrombosis. The prosthetic valve was replaced with another mechanical prosthesis. The patient recovered smoothly and was discharged 14 days later with atrial fibrillation. During the 12-months follow-up period, her prosthetic valve and heart function were normal with INR around 3.0. This case highlights the need for awareness among clinicians for the possibility of valve thrombosis in the early postoperative period. PMID:20961833

  1. Right lateral mini-thoracotomy for mitral valve surgery.

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    Reser, Diana; Holubec, Tomas; Yilmaz, Murat; Guidotti, Andrea; Maisano, Francesco

    2015-01-01

    Since the 1990 s, minimally invasive cardiac surgery has gained wide acceptance due to patient and economic demand. The advantages are less trauma, less bleeding, less wound infections, less pain and faster recovery. Many studies showed that the outcomes are comparable with those of conventional sternotomy. Right lateral mini-thoracotomy evolved into a routine and safe access in specialized centres for minimally invasive mitral valve surgery. The 6-cm incision is performed over the fifth intercostal space in the inframammary groove. With a double-lumen tube, the right lung is deflated before entering the pleural cavity. A soft tissue retractor is used to minimize rib spreading. The stab incisions for the endoscopic camera and the transthoracic clamp are performed in the right anterior and posterior axillary line in the third intercostal space. Surgery on the mitral valve is performed in a standard fashion under a direct vision with video assistance. One chest tube is inserted. The intercostal space is adapted with braided sutures to prevent lung herniation. Ropivacaine is used for local infiltration. The pectoral muscle, subcutaneous tissue and skin are adapted with running sutures. Complications of a right lateral mini-thoracotomy are rare (conversion to sternotomy, rethoracotomy, phrenic nerve palsy, wound infection and thoracic wall hernia) and well manageable.

  2. Repeated mitral valve replacement in a patient with extensive annular calcification

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    Kitamura Tadashi

    2011-11-01

    Full Text Available Abstract Background Mitral valve replacement in the presence of severe annular calcification is a technical challenge. Case report A 47-year-old lady who had undergone mitral and aortic valve replacement for rheumatic disease 27 years before presented with dyspnea. At reoperation, extensive mitral annular calcification was hindering the disc motion of the Starr-Edwards mitral prosthesis. The old prosthesis was removed and a St Jude Medical mechanical valve was implanted after thorough annular debridement. Postoperatively the patient developed paravalvular leak and hemolytic anemia, subsequently undergoing reoperation three days later. The mitral valve was replaced with an Edwards MIRA valve, with a bulkier sewing cuff, after more aggressive annular debridement. Although initially there was no paravalvular leak, it recurred five days later. The patient also developed a small cerebral hemorrhage. As the paravalvular leak and hemolytic anemia gradually worsened, the patient underwent reoperation 14 days later. A Carpentier-Edwards bioprosthetic valve with equine pericardial patches, one to cover the debrided calcified annulus, another as a collar around the prosthesis, was used to eliminate paravalvular leak. At 7 years postoperatively the patient is doing well without any evidence of paravalvular leak or structural valve deterioration. Conclusion Mitral valve replacement using a bioprosthesis with equine pericardial patches was useful to overcome recurrent paravalvular leak due to severe mitral annular calcification.

  3. Surgical interventions in patients undergoing percutaneous balloon mitral valvotomy : a retrospective analysis of anaesthetic considerations.

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    Tempe Deepak

    2004-01-01

    Full Text Available Between 1990 and 2000, 5499 balloon mitral valvotomies were performed at GB Pant Hospital. Amongst these, 45 patients required surgical intervention, which form the basis of this report. There were 18 males and 27 females with the mean age of 26.5+/-8.3 years and weight of 42.9+/-7.39 kg. Thirty-five patients underwent open-heart surgery and 10 closed-heart surgery. Twenty-five patients developed acute severe mitral regurgitation during balloon mitral valvotomy and required emergency open-heart surgery. Morphine based anaesthetic technique with careful attention to haemodynamic monitoring was used in these patients. All patients required a high inotropic support to terminate the cardiopulmonary bypass. The closed-heart surgical procedures included emergency exploration for cardiac tamponade (4, exploration + closed mitral valvotomy (4, and elective closed mitral valvotomy (2. The overall mortality was 9%, which is much higher than the reported mortality for elective mitral valve replacement. Morphine based anaesthetic technique is useful in these patients. Adequate oxygenation, vasodilators, inotropes and diuretics are required for preoperative stabilisation of patients who develop acute mitral regurgitation, while those who develop cardiac tamponade need volume replacement along with inotropes and immediate surgical decompression of the tamponade.

  4. Nectin-1 spots regulate the branching of olfactory mitral cell dendrites.

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    Fujiwara, Takeshi; Inoue, Takahito; Maruo, Tomohiko; Rikitake, Yoshiyuki; Ieki, Nao; Mandai, Kenji; Kimura, Kazushi; Kayahara, Tetsuro; Wang, Shujie; Itoh, Yu; Sai, Kousyoku; Mori, Masahiro; Mori, Kensaku; Takai, Yoshimi; Mizoguchi, Akira

    2015-09-01

    Olfactory mitral cells extend lateral secondary dendrites that contact the lateral secondary and apical primary dendrites of other mitral cells in the external plexiform layer (EPL) of the olfactory bulb. The lateral dendrites further contact granule cell dendrites, forming dendrodendritic reciprocal synapses in the EPL. These dendritic structures are critical for odor information processing, but it remains unknown how they are formed. We recently showed that the immunoglobulin-like cell adhesion molecule nectin-1 constitutes a novel adhesion apparatus at the contacts between mitral cell lateral dendrites, between mitral cell lateral and apical dendrites, and between mitral cell lateral dendrites and granule cell dendritic spine necks in the deep sub-lamina of the EPL of the developing mouse olfactory bulb and named them nectin-1 spots. We investigated here the role of the nectin-1 spots in the formation of dendritic structures in the EPL of the mouse olfactory bulb. We showed that in cultured nectin-1-knockout mitral cells, the number of branching points of mitral cell dendrites was reduced compared to that in the control cells. In the deep sub-lamina of the EPL in the nectin-1-knockout olfactory bulb, the number of branching points of mitral cell lateral dendrites and the number of dendrodendritic reciprocal synapses were reduced compared to those in the control olfactory bulb. These results indicate that the nectin-1 spots regulate the branching of mitral cell dendrites in the deep sub-lamina of the EPL and suggest that the nectin-1 spots are required for odor information processing in the olfactory bulb. PMID:26169026

  5. Surgical treatment of tricuspid regurgitation after mitral valve surgery: a retrospective study in China

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    Li Zong-Xiao

    2012-04-01

    Full Text Available Abstract Background Functional tricuspid regurgitation (TR occurs in patients with rheumatic mitral valve disease even after mitral valve surgery. The aim of this study was to analyze surgical results of TR after previous successful mitral valve surgery. Methods From September 1996 to September 2008, 45 patients with TR after previous mitral valve replacement underwent second operation for TR. In those, 43 patients (95.6% had right heart failure symptoms (edema of lower extremities, ascites, hepatic congestion, etc. and 40 patients (88.9% had atrial fibrillation. Twenty-six patients (57.8% were in New York Heart Association (NYHA functional class III, and 19 (42.2% in class IV. Previous operations included: 41 for mechanical mitral valve replacement (91.1%, 4 for bioprosthetic mitral valve replacement (8.9%, and 7 for tricuspid annuloplasty (15.6%. Results The tricuspid valves were repaired with Kay's (7 cases, 15.6% or De Vega technique (4 cases, 8.9%. Tricuspid valve replacement was performed in 34 cases (75.6%. One patient (2.2% died. Postoperative low cardiac output (LCO occurred in 5 patients and treated successfully. Postoperative echocardiography showed obvious reduction of right atrium and ventricle. The anterioposterior diameter of the right ventricle decreased to 25.5 ± 7.1 mm from 33.7 ± 6.2 mm preoperatively (P Conclusion TR after mitral valve replacement in rheumatic heart disease is a serious clinical problem. If it occurs or progresses late after mitral valve surgery, tricuspid valve annuloplasty or replacement may be performed with satisfactory results. Due to the serious consequence of untreated TR, aggressive treatment of existing TR during mitral valve surgery is recommended.

  6. Dendritic branching of olfactory bulb mitral and tufted cells: regulation by TrkB.

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    Fumiaki Imamura

    Full Text Available BACKGROUND: Projection neurons of mammalian olfactory bulb (OB, mitral and tufted cells, have dendrites whose morphologies are specifically differentiated for efficient odor information processing. The apical dendrite extends radially and arborizes in single glomerulus where it receives primary input from olfactory sensory neurons that express the same odor receptor. The lateral dendrites extend horizontally in the external plexiform layer and make reciprocal dendrodendritic synapses with granule cells, which moderate mitral/tufted cell activity. The molecular mechanisms regulating dendritic development of mitral/tufted cells is one of the unsolved important problems in the olfactory system. Here, we focused on TrkB receptors to test the hypothesis that neurotrophin-mediate mechanisms contributed to dendritic differentiation of OB mitral/tufted cells. PRINCIPAL FINDINGS: With immunohistochemical analysis, we found that the TrkB neurotrophin receptor is expressed by both apical and lateral dendrites of mitral/tufted cells and that expression is evident during the early postnatal days when these dendrites exhibit their most robust growth and differentiation. To examine the effect of TrkB activation on mitral/tufted cell dendritic development, we cultured OB neurons. When BDNF or NT4 were introduced into the cultures, there was a significant increase in the number of primary neurites and branching points among the mitral/tufted cells. Moreover, BDNF facilitated filopodial extension along the neurites of mitral/tufted cells. SIGNIFICANCE: In this report, we show for the first time that TrkB activation stimulates the dendritic branching of mitral/tufted cells in developing OB. This suggests that arborization of the apical dendrite in a glomerulus is under the tight regulation of TrkB activation.

  7. Cirurgia da insuficiência mitral no tratamento da insuficiência cardíaca avançada Mitral insufficiency surgery to treat advanced heart failure

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    João Victor Caprini Oliveira

    2009-12-01

    Full Text Available A cardiomiopatia dilatada caracteriza-se por disfunção miocárdica grave, progressiva e, quase sempre, irreversível. Essa síndrome cursa com remodelamento cardíaco e, em especial, por aumento do volume e da esfericidade do ventrículo esquerdo com dilatação do anel mitral. Como consequência ocorre deslocamento lateral dos músculos papilares, estiramento das cordas tendíneas e consequente restrição da excursão sistólica dos folhetos mitrais. Esse conjunto de alterações biomecânicas causa insuficiência mitral funcional, um indicador de mau prognóstico. A plastia ou a troca da valva mitral foram introduzidas como alternativas cirúrgicas coadjuvantes ao tratamento clínico convencional e têm se mostrado eficazes em combater os sintomas de insuficiência cardíaca. Resta, todavia, demonstrar, seu benefício sobre o aumento da sobrevida em longo prazo.Dilated cardiomyopathy is characterized by severe, progressive myocardial dysfunction that is, irreversible. That syndrome leads to cardiac remodeling with augmentation of left ventricle volume and sphericity, dilation of the mitral annulus and dislocation of papillary muscles that pulls up the mitral cords thereby restraining leaflet excursion. These biomechanical modifications generate functional mitral valve regurgitation, a dismal prognostic sign. Mitral valve plasty or replacement was introduced as surgical coadjuvants to conventional medical treatment, with good symptomatic improvement. The long term survival benefit is yet to be demonstrated.

  8. A ventriculotomia apical esquerda para tratamento cirúrgico da estenose mitral congênita The surgical treatment of congenital mitral stenosis through a left ventriculotomy

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    Miguel Barbero-Marcial

    1991-12-01

    Full Text Available Entre junho de 1987 e outubro de 1990, nove pacientes consecutivos, portadores de estenose mitral congênita (EMC foram submetidos a correção cirúrgica. Sete tinham valva mitral em paráquedas e dois, outras formas complexas de estenoses. Em todos, a via de abordagem foi a ventriculotomia apical esquerda, sendo dividido, primeiramente, o músculo papilar; depois, as cordas e, finalmente, as cúspides. As lesões associadas foram corrigidas prévia ou simultaneamente. Todos os pacientes tiveram boa evolução imediata. Houve um óbito tardio não relacionado. O estudo ecocardiográfico seriado pós-operatório mostrou adequada função ventricular esquerda. Conclui-se que esta via é de escolha para tratar lesões estenóticas congênitas complexas da valva mitral.From June 1987 to October 1990, nine patients with congenital mitral stenosis (CMS underwent surgical correction through an apical left ventriculotomy. Seven patients had parachute mitral valve and two had other forms of CMS. The surgical treatment of the mitral valve apparatus starts from below: first the papillary muscle is split and the cordae are divided and fenestrated. Then, the commissurotomies were performed through the ventricles aspect of the mitral valve. Associated anomalies were corrected simultaneously. There was no in-hospital death and only one late death (nonrelated. The echocardiography showed non significant residual stenosis and normal global function of the left ventricle. In conclusion, the appical left ventriculotomy is a good approach for treatment of CMS.

  9. [General Anesthesia Using Remifentanil for Cesarean Section in a Parturient with Marfan Syndrome Associated with Heart Failure due to Severe Mitral Regurgitation].

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    Fujita, Masahide; Satsumae, Tsuyoshi; Tanaka, Makoto

    2016-05-01

    A 24-year-old woman with Marfan syndrome was scheduled for cesarean section in order to avoid progression of heart failure due to severe mitral regurgitation and aortic dissection during labor. Cesarean section was performed under general anesthesia using remifentanil. Anesthesia was induced and maintained with remifentanil (0.1-0.3 μg x kg(-1) x min(-1)) and continuous administration of propofol (target-controlled infusion, 2-3 ng x ml(-1)). The trachea was intubated without a significant hemodynamic change. The patient's systolic blood pressure was maintained between 90 and 120 mmHg during surgery. Intraoperatively, we conducted a transesophageal echocardiography examination, and no remarkable change was seen in the severity of mitral regurgitation and the size of an ascending aorta. An infant was delivered 6 minutes after anesthesia induction. The Apgar scores were 4 at 1 min, 5 at 5 min and 8 at 10 min. Postoperative course was uneventful. We conclude that remifentanil can be used successfully to manage cesarean section of a parturient with Marfan syndrome associated with heart failure due to severe mitral regurgitation under general anesthesia. PMID:27319100

  10. Prevalence of mitral valve prolapse in primary fibromyalgia: a pilot investigation.

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    Pellegrino, M J; Van Fossen, D; Gordon, C; Ryan, J M; Waylonis, G W

    1989-07-01

    Fifty patients with primary fibromyalgia and a negative cardiovascular symptom history underwent echocardiography to determine the prevalence of mitral valve prolapse (MVP). The mean age of the population was 40 +/- 13 years (14 men, 36 women). Mitral valve prolapse was detected in 75%; 33% with myxomatous mitral valve leaflets. The prevalence of MVP in this population is significantly higher (p less than 0.0001) than in the general population. Primary fibromyalgia and MVP may be part of a more generalized connective tissue abnormality characterized by distinct genetically determined variants. PMID:2742471

  11. Color flow imaging of the vena contracta in mitral regurgitation: technical considerations.

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    Roberts, Brad J; Grayburn, Paul A

    2003-09-01

    Qualitative grading of mitral regurgitation severity has significant pitfalls secondary to hemodynamic variables, sonographic technique, blood pool entrainment, and the Coanda effect. Volumetric and proximal isovelocity surface area methods can be used to quantitate regurgitant orifice area, regurgitant volume, and regurgitant fraction, but have several limitations and can pose technical challenges. The vena contracta width method provides a rapid and accurate quantitative assessment of mitral regurgitation severity, but is clinically underused. This article is intended to generate an understanding of the flow mechanics of the vena contracta and the sonographic technique required to provide consistent and accurate measurements of vena contracta width in patients with mitral regurgitation. PMID:12931115

  12. Cardiac resynchronisation therapy after percutaneous trans-coronary-venous mitral annuloplasty.

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    Siminiak, Tomasz; Jerzykowska, Olga; Kalmucki, Piotr; Link, Rafał; Baszko, Artur

    2013-01-01

    We present a case of a 45-year-old man with symptomatic heart failure and ischaemic functional mitral regurgitation (FMR), who underwent a successful percutaneous trans-coronary venous mitral annuloplasty with the Carillon system. The procedure resulted in clinical improvement as well as in a decrease in the degree of MR as assessed by echocardiography. Fifteen months later, the patient underwent cardiac resynchronisation (CRT) device implantation, resulting in a further improvement in echocardiographic measures of FMR. This case not only confirms the feasibility of CRT after percutaneous trans-coronary-venous mitral annuloplasty, but also suggests a possible synergistic effect of both therapies, warranting future clinical trials. PMID:24399586

  13. Prevalence of calcification of the mitral valve annulus in patients undergoing surgical repair of mitral valve prolapse.

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    Fusini, Laura; Ghulam Ali, Sarah; Tamborini, Gloria; Muratori, Manuela; Gripari, Paola; Maffessanti, Francesco; Celeste, Fabrizio; Guglielmo, Marco; Cefalù, Claudia; Alamanni, Francesco; Zanobini, Marco; Pepi, Mauro

    2014-06-01

    Factors correlating to mitral annulus calcification (MAC) include risk factors predisposing to atherosclerosis. In patients with mitral valve (MV) prolapse (MVP), other anatomic or mechanical factors have been supposed to facilitate MAC. The aims of this study were, in patients with MVP undergoing MV repair, (1) to describe the prevalence and characteristics of MAC, (2) to correlate MAC with clinical risk factors, coronary involvement, and aortic valve disease, and (3) to describe prevalence, site, and extension of MAC in fibroelastic deficiency (FED) versus Barlow's disease (BD) and correlate MAC to surgical outcomes (repair vs replacement). In 410 consecutive patients with MVP suitable for surgical MV repair, detailed clinical and echocardiographic data were collected to characterize MAC in BD and FED. MAC was found in 99 patients (24%). Age, female gender, coronary artery disease, and cardiovascular risk factors were correlated with MAC. MAC was equally distributed in FED and BD groups despite patients with FED being older with more cardiovascular risk factors. The most common localization of MAC was annular involvement adjacent to P2 (75%), P1 (31%), and P3 (35%). The presence of MAC affected surgical outcomes in both groups (8% patients with MAC underwent replacement after a first attempt of repair vs 3% without MAC). MAC is a common finding in patients undergoing MV repair, and several clinical characteristics correlate with MAC either in FED or BD. In conclusion, despite very high percentage of repairability, MAC influences surgical outcomes and very detailed echo evaluation is advocated. PMID:24837266

  14. Mildly symptomatic chronic mitral regurgitation. Analysis of left ventricular systolic function and mitral regurgitant fraction under pharmacological influence: echocardiographic study

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    Rivera Ivan Romero

    2003-01-01

    Full Text Available OBJECTIVE: To study echocardiographic parameters of left ventricular systolic function and valvar regurgitation under pharmacological influence in mildly symptomatic patients with chronic mitral regurgitation (MR. METHODS: We carried out a double-blind placebo controlled study in 12 patients with MR, mean aged 12.5 years old, who were randomized in 4 phases: A digoxin; B enalapril; C digoxin + enalapril; D placebo. The medication was administered for 30 days in each phase, and the following variables were analyzed: shortening and ejection fractions, wall stress index of left ventricle, left ventricular meridional end-systolic wall stress, Doppler-derived mean rate of left ventricular pressure rise (mean dP/dt, stroke volume and MR jet area. The clinical variables analysed were heart rate and systemic arterial pressure. RESULTS: No significant variation was observed in the clinical variables analysed. The shortening and ejection fraction, the mean dP/dt and stroke volume significantly increased and the wall stress index of left ventricle, the meridional left ventricular end systolic wall stress and the mitral regurgitation jet area decreased in the phases with medication as compared with that in the placebo phase. CONCLUSION: The parameters of left ventricular systolic function improved significantly and the degree of MR decreased with the isolated administration of digoxin or enalapril in mildly symptomatic patients with chronic MR. The combination of the drugs, however, did not show better results.

  15. Investigation of SNPs in the porcine desmoglein 1 gene

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    Andresen Lars

    2007-03-01

    Full Text Available Abstract Background Desmoglein 1 (DSG1 is the target protein in the skin disease exudative epidermitis in pigs caused by virulent strains of Staphylococcus hyicus. The exfoliative toxins produced by S. hyicus digest the porcine desmoglein 1 (PIGDSG1 by a very specific reaction. This study investigated the location of single nucleotide polymorphisms (SNPs in the porcine desmoglein 1 gene (PIGDSG1 in correlation to the cleavage site as well as if the genotype of the SNPs is correlated to susceptibility or resistance to the disease. Results DNA from 32 affected and 32 unaffected piglets with exudative epidermitis were diagnosed clinically as affected or unaffected. Two regions of the desmoglein 1 gene were sequenced and genotypes of the SNPs were established. Seven SNPs (823T>C, 828A>G, 829A>G, 830A>T, 831A>T, 838A>C and 1139C>T were found in the analysed sequences and the allele frequencies were determined for the SNPs resulting in amino acid change. Four of the seven polymorphisms were situated in the motif known to be important for toxin cleavage. The distribution of the genotypes between affected and unaffected animals was analysed. Conclusion The study indicated a possible correlation between the genotypes of two out of seven SNPs found in the porcine desmoglein 1 gene and the susceptibility to exudative epidermitis.

  16. Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral Infected aneurysm of brachial artery after mitral valve infective endocarditis

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    Heraldo Guedis Lobo Filho

    2011-03-01

    Full Text Available Apresentamos um caso de aneurisma infectado de artéria braquial em paciente com endocardite infecciosa por Streptococcus bovis. Homem de 49 anos de idade se apresentou com febre, dispnéia e sopro regurgitativo em foco mitral com irradiação para axila. O ecocardiograma demonstrou vegetação em valva mitral nativa. Após troca valvar mitral com implante de prótese biológica, observou-se massa pulsátil de cinco centímetros de diâmetro em fossa antecubital direita. Foi feito o diagnóstico de aneurisma infectado de artéria braquial, e o tratamento cirúrgico foi realizado com sucesso. O objetivo desse relato de caso é apresentar uma complicação pouco comum após endocardite infecciosa.We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis.

  17. Deletion of collapsin response mediator protein 4 results in abnormal layer thickness and elongation of mitral cell apical dendrites in the neonatal olfactory bulb.

    Science.gov (United States)

    Tsutiya, Atsuhiro; Watanabe, Hikaru; Nakano, Yui; Nishihara, Masugi; Goshima, Yoshio; Ohtani-Kaneko, Ritsuko

    2016-05-01

    Collapsin response mediator protein 4 (CRMP4), a member of the CRMP family, is involved in the pathogenesis of neurodevelopmental disorders such as schizophrenia and autism. Here, we first compared layer thickness of the olfactory bulb between wild-type (WT) and CRMP4-knockout (KO) mice. The mitral cell layer (MCL) was significantly thinner, whereas the external plexiform layer (EPL) was significantly thicker in CRMP4-KO mice at postnatal day 0 (PD0) compared with WTs. However, differences in layer thickness disappeared by PD14. No apoptotic cells were found in the MCL, and the number of mitral cells (MCs) identified with a specific marker (i.e. Tbx21 antibody) did not change in CRMP4-KO neonates. However, DiI-tracing showed that the length of mitral cell apical dendrites was greater in CRMP4-KO neonates than in WTs. In addition, expression of CRMP4 mRNA in WT mice was most abundant in the MCL at PD0 and decreased afterward. These results suggest that CRMP4 contributes to dendritic elongation. Our in vitro studies showed that deletion or knockdown of CRMP4 resulted in enhanced growth of MAP2-positive neurites, whereas overexpression of CRMP4 reduced their growth, suggesting a new role for CRMP4 as a suppressor of dendritic elongation. Overall, our data suggest that disruption of CRMP4 produces a temporary alteration in EPL thickness, which is constituted mainly of mitral cell apical dendrites, through the enhanced growth of these dendrites. PMID:26739921

  18. EFFECT OF MAGNESIUM OROTATE ON CONNECTIVE TISSUE MATRIX AND CARDIAC INOTROPIC FUNCTION IN PATIENTS WITH MITRAL VALVE PROLAPSE. CLINICAL AND MORPHOLOGICAL STUDY

    Directory of Open Access Journals (Sweden)

    A. G. Avtandilov

    2015-09-01

    Full Text Available Aim. To study the morphological features of loose fibrous connective tissue (LFCT and myocardial contractility in patients with mitral valve prolapse before and after magnesium orotate course.Material and methods. Patients (n=59 with mitral valve prolapse and the phenotype of undifferentiated connective tissue dysplasia (UCTD were included into the study. A comprehensive morphological analysis of skin biopsy samples was performed to assess morphological and functional changes of LFCT. Standard echocardiography with the assessment of mitral flow was performed in all participants at baseline and after 8 weeks of magnesium orotate intake.Results. According to morphometry increase in proportion of amorphous matrix was found in LFCT sections after 8-week magnesium orotate course compared to baseline (38.6±0.4% and 23.9 ± 0.4%, respectively; p<0.001. According to the echocardiography increase in the end-diastolic (from 4.9±0.04 cm to 5.05±0.03 cm; p<0.05, and the end-sys- tolic (from 2.9±0.04 cm to 3.0±0.03 cm; p<0.01 left ventricular diameters was observed after 8 weeks of treatment as well as improvement of left ventricular diastolic func- tion (E/A raised from 1.42±0.02 to 1.79±0.04; p<0.01.Conclusion. In patients with mitral valve prolapse and UCTD the 8-week magnesium orotate course led to a significant increase in amorphous part of the matrix, improvement of diffusion ability and architectonics of the connective tissue that determines the improvement of flexibility and extensibility.

  19. Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: Role of transesophageal echocardiography

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    Shreedhar S Joshi

    2014-01-01

    Full Text Available Pseudoaneurysm of mitral-aortic intervalvular fibrosa (P-MAIVF is a rare cardiac surgical condition. P-MAIVF commonly occurs as a complication of aortic and mitral valve replacement surgeries. The surgical trauma during replacement of the valves weakens the avascular mitral and aortic intervalvular area. We present a case of P-MAIVF recurrence 5 years after a primary repair. Congestive cardiac failure was the presenting feature with mitral and aortic regurgitation. In view of the recurrence, the surgical team planned for a double valve replacement. The sewing rings of the two prosthetic-valves were interposed to close the mouth of the pseudoaneurysm and to provide mechanical reinforcement of the MAIVF. Intra-operative transesophageal echocardiography (TEE helped in delineating the anatomy, extent of the lesion, rupture of one of the pseudoaneurysm into left atrium and severity of the valvular regurgitation. Post-procedure TEE confirmed complete obliteration of the pseudoaneurysm and prosthetic valve function.

  20. Late calcific mitral stenosis after MitraClip procedure in a dialysis-dependent patient.

    Science.gov (United States)

    Pope, Nicolas H; Lim, Scott; Ailawadi, Gorav

    2013-05-01

    The EVEREST II trial investigated the MitraClip (Abbott Vascular, Menlo Park, CA) in patients with severe mitral regurgitation (MR) undergoing surgical procedures. Although mitral stenosis was not reported in this cohort, this trial excluded patients receiving dialysis. We report a case of a 43-year-old HIV-positive, dialysis-dependent patient with nonischemic cardiomyopathy and severe MR, who was considered at high operative risk because of frailty. She was treated with a MitraClip as part of the REALISM high-risk registry. Her symptomatic MR improved but severe symptomatic mitral stenosis developed 28 months after the MitraClip procedure. At that point, she was felt to be a better operative candidate but required open mitral valve replacement. Pathologic examination demonstrated significant calcification of the leaflets around the MitraClip devices.

  1. Perioperative management of patient with Bombay blood group undergoing mitral valve replacement

    Directory of Open Access Journals (Sweden)

    Shio Priye

    2015-01-01

    Full Text Available Bombay red blood cell phenotype is an extremely rare blood type for which patients can receive only autologous or Bombay phenotype red blood cells. We report a case of stenotic mitral valve with Bombay phenotype who underwent minimal invasive right lateral thoracotomy for the replacement of the mitral valve. A male patient from Bangladesh presented to the hospital with New York Heart Association III symptoms. His medical evaluation revealed severe mitral valve stenosis and mild aortic valve regurgitation. The patient received erythropoietin, intravenous iron succinate and folic acid tablets. Autologous blood transfusion was carried out. The mitral valve was replaced with a prosthetic valve successfully. After weaning off from cardiopulmonary bypass, heparinisation was corrected with protamine. Post-operatively, the patient received autologous red blood cells. The patient recovered after 1-day of inotropic support with adrenaline and milrinone, and diuretics and was discharged on the 5 th post-operative day.

  2. Mitral valvuloplasty without support in children - Modified De Vega technique: case reports

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    Coelho de Souza Magnus R.

    2002-01-01

    Full Text Available We report on three cases of mitral regurgitation in children at ages of 7 months, 5 months and 10 years old. In two of them, the etiology was congenital and the other it was rheumatic. The surgical technique used was valvuloplasty without support using the modified De Vega technique isolated or associated with other procedures. One of the children was re-operated seven years after the first surgery. All the patients were rated New York Association Class III before surgery. Following the surgery they were at Class I with good outcomes. All patients survived, without complications. According with the literature, mitral regurgitation can be treated with mitral valvuloplasty without support or using other surgical techniques, with excellent outcomes. We report here on one more option for its treatment especially in children and adolescents. This technique is easily performed and it permits growth of mitral valve during life.

  3. Enlargement of mitral valve ring in a young woman with severe prosthesis-patient mismatch.

    Science.gov (United States)

    Attisani, Matteo; Pellegrini, Augusto; Sorrentino, Paolo; Rinaldi, Mauro

    2014-04-01

    Mechanical prosthesis is the first choice for valve replacement at the mitral position in children. Replacement of the original prosthesis because of prosthesis-patient mismatch (PPM) is almost inevitable when prostheses are implanted in small children. The impact of PPM on long-term mortality becomes significant when the effective orifice area (EOA) is severely reduced. In these cases prosthesis replacement can be technically difficult, and it often requires extended enlargement of the mitral valve annulus ring. We report a case of a woman who underwent a mitral valve replacement with a 19-mm St. Jude mechanical prosthetic valve at the age of 3 years. At the age of 33 years, the patient underwent a successful minimally invasive mitral annulus ring enlargement and implantation of a 23-mm St. Jude mechanical prosthetic valve via a right minithoracotomy. PMID:24808442

  4. Perioperative management of patient with Bombay blood group undergoing mitral valve replacement.

    Science.gov (United States)

    Priye, Shio; Sathyanarayan, J; Shivaprakash, S; Reddy, Durgaprasad

    2015-12-01

    Bombay red blood cell phenotype is an extremely rare blood type for which patients can receive only autologous or Bombay phenotype red blood cells. We report a case of stenotic mitral valve with Bombay phenotype who underwent minimal invasive right lateral thoracotomy for the replacement of the mitral valve. A male patient from Bangladesh presented to the hospital with New York Heart Association III symptoms. His medical evaluation revealed severe mitral valve stenosis and mild aortic valve regurgitation. The patient received erythropoietin, intravenous iron succinate and folic acid tablets. Autologous blood transfusion was carried out. The mitral valve was replaced with a prosthetic valve successfully. After weaning off from cardiopulmonary bypass, heparinisation was corrected with protamine. Post-operatively, the patient received autologous red blood cells. The patient recovered after 1-day of inotropic support with adrenaline and milrinone, and diuretics and was discharged on the 5(th) post-operative day.

  5. Dextrocardia, situs inversus and severe mitral stenosis in a pregnant woman: successful closed commissurotomy.

    Science.gov (United States)

    Said, S A; Veerbeek, A; van der Wieken, L R

    1991-07-01

    A 16-weeks' pregnant woman with situs inversus and dextrocardia underwent successful closed commissurotomy for severe mitral stenosis. The electrocardiogram revealed sinus rhythm with right axis deviation and progressive diminishing of QRS amplitude towards the left precordial leads. The chest X-ray showed dextrocardia with situs inversus. Doppler echocardiography depicted severe mitral stenosis; the mitral valve area increased from 0.9 cm2 pre-operatively to 1.8 cm2 post-operatively with mild increase of mitral regurgitation from grade I to II post-valvotomy. She also had associated mild functional tricuspid insufficiency and moderate pulmonary hypertension. No thrombo-embolic complications occurred intra- or post-operatively. There was no evidence of either clinical or Doppler restenosis. The course of pregnancy was uneventful. At 39 weeks a healthy baby was vaginally delivered. The patient is still free of cardiac symptoms.

  6. The future of transcatheter mitral valve interventions: competitive or complementary role of repair vs. replacement?

    Science.gov (United States)

    Maisano, Francesco; Alfieri, Ottavio; Banai, Shmuel; Buchbinder, Maurice; Colombo, Antonio; Falk, Volkmar; Feldman, Ted; Franzen, Olaf; Herrmann, Howard; Kar, Saibal; Kuck, Karl-Heinz; Lutter, Georg; Mack, Michael; Nickenig, Georg; Piazza, Nicolo; Reisman, Mark; Ruiz, Carlos E; Schofer, Joachim; Søndergaard, Lars; Stone, Gregg W; Taramasso, Maurizio; Thomas, Martyn; Vahanian, Alec; Webb, John; Windecker, Stephan; Leon, Martin B

    2015-07-01

    Transcatheter mitral interventions has been developed to address an unmet clinical need and may be an alternative therapeutic option to surgery with the intent to provide symptomatic and prognostic benefit. Beyond MitraClip therapy, alternative repair technologies are being developed to expand the transcatheter intervention armamentarium. Recently, the feasibility of transcatheter mitral valve implantation in native non-calcified valves has been reported in very high-risk patients. Acknowledging the lack of scientific evidence to date, it is difficult to predict what the ultimate future role of transcatheter mitral valve interventions will be. The purpose of the present report is to review the current state-of-the-art of mitral valve intervention, and to identify the potential future scenarios, which might benefit most from the transcatheter repair and replacement devices under development.

  7. [Coronary sinus devices for treatment of functional mitral valve regurgitation. Solution or dead end?].

    Science.gov (United States)

    Degen, H; Schneider, T; Wilke, J; Haude, M

    2013-08-01

    In this article we review the currently available data on percutaneous mitral valve annulorrhaphy devices using the coronary sinus in patients with functional mitral valve regurgitation (MR). Of these devices the greatest clinical experience exists for the Carillon mitral contour system which has gained increasing application also outside trials in the last 2 years. The advantages include the ease of use with an effective reduction in functional MR and a subsequent improvement of echocardiographic and clinical parameters. A limitation is the compromise of flow in the circumflex artery in some patients especially with a crossing of the coronary sinus with this artery. Future investigations need to focus on the evaluation of this coronary sinus-based technology versus mitral valve clipping technology for the treatment of functional MR. PMID:23836012

  8. Designing innovative retractors and devices to facilitate mitral valve repair surgery.

    Science.gov (United States)

    Okamoto, Kazuma; Yozu, Ryohei

    2015-07-01

    Various devices have been developed to facilitate mitral valve surgery, including those that improve mitral valve exposure and assist surgeons with associated procedures. Choosing appropriate supporting devices when performing minimally invasive mitral valve surgery (MIMVS) through a minithoracotomy with endoscopic assistance is critical. Depending on the surgeon's preference, trans-thoracic or trans-working-port left atrial retractors can be utilized. Although the trans-thoracic retractors provide a simple and orderly working space around the minithoracotomy working port, the positioning of the shaft is difficult and there is an implicit risk of chest wall bleeding. On the other hand, the trans-working-port type provides excellent exposure, is easily handled and manipulated, and facilitates surgeries involving various anatomical structures without special training. A great deal of understanding and knowledge about retractors is necessary to achieve the optimal exposure required to facilitate surgical techniques, and to maintain a reproducible and safe surgical system during mitral valve surgery.

  9. Amplificação dos genes que codificam a endotelina-1 e seus receptores em valvas mitrais reumáticas Amplificación de los genes que codifican la endotelina-1 y sus receptores en válvulas mitrales reumáticas Amplification of the genes that codify endothelin-1 and its receptors in rheumatic mitral valves

    Directory of Open Access Journals (Sweden)

    Edmilson Bastos de Moura

    2010-07-01

    se asocian a la disfunción endotelial, con aumento de los niveles de endotelina-1 (ET-1 y consecuencias sobre la circulación pulmonar, muchas veces determinando la hipertensión pulmonar (HP. Mientras que, la presencia de ET-1 y sus receptores en la propia válvula mitral, promoviendo alteraciones vasculares pulmonares y aumentando la deformación valvar reumática, aún es un asunto no abordado en la literatura. OBJETIVO: Determinar, mediante técnicas moleculares, la expresión de los genes de la endotelina y de sus receptores en válvulas mitrales reumáticas. MÉTODOS: 27 pacientes sometidos a reemplazo valvular mitral tuvieron su tejido valvar analizado, a fin de determinar la presencia de genes de ET-1 y sus receptores A y B. Fueron hechos análisis histológico y molecular de las valvas (divididas en fragmentos M1, M2 y M3 y recogidos datos clínicos y epidemiológicos de los pacientes. Fueron divididos en tres grupos: valvopatía mitral, mitroaórtica y pacientes reoperados. RESULTADOS: El estudio mostró la manifestación del gen da ET-1 en 40,7% de los sujetos y de su receptor A en todas las muestras, con manifestación minoritaria del gen del receptor B (22,2%. CONCLUSIÓN: Todos los pacientes expresaron la presencia de gen del receptor A. No hubo diferencia estadística en cuanto a la gravedad de la enfermedad, expresada en clase funcional, y a los subgrupos estudiados (valvopatías mitrales, mitroaórticos y pacientes reoperados, o en cuanto a la expresión de los genes de la ET-1 y sus receptores entre los subgrupos estudiados (valvopatías mitrales, mitroaórticos y pacientes reoperados.BACKGROUND: Cardiopathies are high prevalence conditions. Among them, rheumatic carditis is of high relevance in developing countries. Left cardiac chamber changes are associated to endothelial dysfunction and ET-1 levels increase. Pulmonary circulation is then affected, and not seldom leading to pulmonary hypertension (PH. However, the presence of ET-1 and its

  10. Evaluation of cough in dogs with mitral valve insufficiency

    International Nuclear Information System (INIS)

    Distinguishing between respiratory and cardiac causes of coughing in dogs is critical to successful treatment. Such a distinction is especially important in older, small-breed dogs, which often experience both chronic respiratory disease and mitral valve insufficiency. Cough most commonly results from upper airway disease, tracheobronchial disease, pulmonary fibrosis, pulmonary neoplasia, pneumonia, and cardiac disease. Using historical and physical findings in conjunction with routinely available ancillary diagnostic procedures, the cause of cough can usually be determined and often effectively treated. Special diagnostic tests routinely available in general practice include conventional thoracic radiographs supplemented by expiratory lateral thoracic and inspiratory lateral cervical views to evaluate airway stability, electrocardiography, transtracheal aspiration with culture and sensitivity as well as cytologic evaluation, serology, specialized fecal examinations, and fine-needle aspiration of the lung

  11. Mitral and aortic valvular flow: quantification with MR phase mapping

    DEFF Research Database (Denmark)

    Søndergaard, Lise; Thomsen, C; Ståhlberg, F;

    1992-01-01

    of the flow-encoding gradient to 2.2 msec. Tested on a flow phantom simulating a severe valvular stenosis, the sequence was found to be robust for higher-order motion within the clinical velocity range. In eight healthy volunteers, mitral and aortic volume flow rates and peak velocities were quantified...... mapping is also valid for pathologic conditions. Phase mapping may be used as a noninvasive clinical tool for flow quantification in heart valve disease.......When magnetic resonance phase mapping is used to quantitate valvular blood flow, the presence of higher-order-motion terms may cause a loss of phase information. To overcome this problem, a sequence with reduced encoding for higher-order motion was used, achieved by decreasing the duration...

  12. Audit of radiation dose during balloon mitral valvuloplasty procedure

    Energy Technology Data Exchange (ETDEWEB)

    Livingstone, Roshan S [Department of Radiology, Christian Medical College, Vellore-632004, TN (India); Chandy, Sunil [Department of Cardiology, Christian Medical College, Vellore-632004, TN (India); Peace, B S Timothy [Department of Radiology, Christian Medical College, Vellore-632004, TN (India); George, Paul [Department of Cardiology, Christian Medical College, Vellore-632004, TN (India); John, Bobby [Department of Cardiology, Christian Medical College, Vellore-632004, TN (India); Pati, Purendra [Department of Cardiology, Christian Medical College, Vellore-632004, TN (India)

    2006-12-15

    Radiation doses to patients during cardiological procedures are of concern in the present day scenario. This study was intended to audit the radiation dose imparted to patients during the balloon mitral valvuloplasty (BMV) procedure. Thirty seven patients who underwent the BMV procedure performed using two dedicated cardiovascular machines were included in the study. The radiation doses imparted to patients were measured using a dose area product (DAP) meter. The mean DAP value for patients who underwent the BMV procedure from one machine was 19.16 Gy cm{sup 2} and from the other was 21.19 Gy cm{sup 2}. Optimisation of exposure parameters and radiation doses was possible for one machine with the use of appropriate copper filters and optimised exposure parameters, and the mean DAP value after optimisation was 9.36 Gy cm{sup 2}.

  13. [Minimally Invasive Mitral Valve Plasty;My Technique].

    Science.gov (United States)

    Ito, Toshiaki

    2016-07-01

    We perform minimally invasive mitral valve plasty under totally endoscopic view. Skin incisions are composed of a 3 to 5 cm of main wound along the right 4th intercostal space, 1 trocar port in the 3rd intercostal space, and a camera port in the 5th intercostal space. Matal rib spreader is not used. A 3-dimensional endoscope was recently introduced. Forceps controlled by the left hand are inserted through the independent trocar port in the 3rd intercostal space. Left atrial retractor, aortic clamp, and all the cannulae are inserted through the main incision. Cardio-pulmonary bypass is established through the right femoral artery and vein cannulation. No additional venous cannula through the right jugular vein is used. Posterior leaflet lesions are repaired by resection and suture technique. Anterior leaflet prolapse is repaired mainly using the loop technique. Bleeding from the chest wall is meticulously checked before closing the chest.

  14. Totally endoscopic set-up for mitral valve repair.

    Science.gov (United States)

    Walcot, Nicholas; Hohenberger, Wolfgang; Lakew, Fitsum; Batz, Gerhard; Diegeler, Anno; Perier, Patrick

    2015-01-01

    Minimally invasive mitral surgery is increasingly recognized as routine. We describe here the financially economical set-up for totally endoscopic surgery, which also represents currently the smallest surgical access, limited only by prosthesis and retractor size. This allows the full range of repairs to be performed. Cannulation for cardiopulmonary bypass is performed via the groin. A cosmetic, periareolar (in males) or inframammary fold (in females) incision is made and the chest entered on bypass. An aortic cross-clamp and crystalloid cardioplegia are used via the aortic root prior to atriotomy and surgical repair. This method gives the highest level of cosmesis available and minimal discomfort, without compromising on the extremely good published results.

  15. Unusual Giant Right Atrium in Rheumatic Mitral Stenosis and Tricuspid Insufficiency

    Directory of Open Access Journals (Sweden)

    Jean Baptiste Anzouan-Kacou

    2011-01-01

    Full Text Available Dilation and hypertrophy of the atria occur in patients with valvular heart disease especially in mitral regurgitation, mitral stenosis or tricuspid abnormalities. In sub-saharan Africa, rheumatic fever is still the leading cause of valvular heart disease. We report a case of an unusual giant right atrium in context of rheumatic stenosis and severe tricuspid regurgitation in a 58-year-old woman.

  16. TAVI in the case of preexisting mitral prosthesis: tips & tricks and literature review.

    Science.gov (United States)

    Vavuranakis, Manolis; Vrachatis, Dimitrios A; Kariori, Maria G; Moldovan, Carmen; Kalogeras, Konstantinos; Lavda, Maria; Aznaouridis, Konstantinos; Stefanadis, Christodoulos

    2014-11-01

    Very limited data exist on transcatheter aortic valve implantation (TAVI) in the setting of a preexisting mitral prosthesis regarding the technique, potential complications, and outcomes. Here, we report two cases of transfemoral TAVI with a self-expanding bioprosthesis (CoreValve; Medtronic, Inc) in patients who had previously undergone mitral valve replacement (one with an Omniscience and one with a St. Jude prosthesis). A brief literature review is also presented. PMID:25364003

  17. Age and gender-related differences in mitral cells of olfactory bulb

    International Nuclear Information System (INIS)

    To investigate the age and gender-related differences in mitral cells of the human cadaveric olfactory bulbs. Sixty olfactory bulbs, 30 each from male and female (age 20-76 years) human cadavers divided into six groups of age and gender-wise were collected from the mortuary of the King Edward Medical University, Lahore. Mitral cells were counted and their diameter was calculated from 10 micro m thick cresyl violet stained histological sections. Statistical analysis was done using ANOVA for age-related differences and independent t-test for gender-related differences. There was significant reduction in the number of mitral cells and diameter of their nuclei with age. There was significant decrease in the number of mitral cells in males, between groups I and II (p < 0.001); II and III (p < 0.001); and I and III (p < 0.001); statistically significant decrease also occurred in females, between groups IV and V (p < 0.001); V and VI (p < 0.001); and IV and VI (p < 0.001). In most cases, the distance between individual mitral cells was seen to be much greater than in younger group. In group VI, few mitral cells were observed in the cell layer. There was also significant decrease in the diameter of mitral cell nuclei in males, between groups I and III (p < 0.001); and II and III (p < 0.010); in females, between groups IV and VI (p < 0.001); and V and VI (p < 0.001). No gender-related differences were observed. The number of mitral cells and diameter of their nuclei decreased with advancing age. (author)

  18. Lumbar Discectomy of a Patient of Mitral Stenosis with Chronic Atrial Fibrillation Under Epidural Anaesthesia

    Directory of Open Access Journals (Sweden)

    Vinaya R Kulkarni

    2008-01-01

    Full Text Available A 60-year-old female patient posted for discectomy of lumbar region L 3 -L 4 was accidently diagnosed to have chronic atrial fibrillation of rheumatic aetiology.This is a case report of this patient of critical mitral stenosis with mild mitral regurgitation with chronic atrial fibrillation managed successfully under lower thoracic epidural anaesthesia,in prone position without any compli-cation.

  19. Echocardiography derived three-dimensional printing of normal and abnormal mitral annuli

    OpenAIRE

    Feroze Mahmood; Khurram Owais; Mario Montealegre-Gallegos; Robina Matyal; Peter Panzica; Andrew Maslow; Khabbaz, Kamal R.

    2014-01-01

    Aims and Objectives: The objective of this study was to assess the clinical feasibility of using echocardiographic data to generate three-dimensional models of normal and pathologic mitral valve annuli before and after repair procedures. Materials and Methods: High-resolution transesophageal echocardiographic data from five patients was analyzed to delineate and track the mitral annulus (MA) using Tom Tec Image-Arena software. Coordinates representing the annulus were imported into Solidworks...

  20. Dynamic heart phantom with functional mitral and aortic valves

    Science.gov (United States)

    Vannelli, Claire; Moore, John; McLeod, Jonathan; Ceh, Dennis; Peters, Terry

    2015-03-01

    Cardiac valvular stenosis, prolapse and regurgitation are increasingly common conditions, particularly in an elderly population with limited potential for on-pump cardiac surgery. NeoChord©, MitraClipand numerous stent-based transcatheter aortic valve implantation (TAVI) devices provide an alternative to intrusive cardiac operations; performed while the heart is beating, these procedures require surgeons and cardiologists to learn new image-guidance based techniques. Developing these visual aids and protocols is a challenging task that benefits from sophisticated simulators. Existing models lack features needed to simulate off-pump valvular procedures: functional, dynamic valves, apical and vascular access, and user flexibility for different activation patterns such as variable heart rates and rapid pacing. We present a left ventricle phantom with these characteristics. The phantom can be used to simulate valvular repair and replacement procedures with magnetic tracking, augmented reality, fluoroscopy and ultrasound guidance. This tool serves as a platform to develop image-guidance and image processing techniques required for a range of minimally invasive cardiac interventions. The phantom mimics in vivo mitral and aortic valve motion, permitting realistic ultrasound images of these components to be acquired. It also has a physiological realistic left ventricular ejection fraction of 50%. Given its realistic imaging properties and non-biodegradable composition—silicone for tissue, water for blood—the system promises to reduce the number of animal trials required to develop image guidance applications for valvular repair and replacement. The phantom has been used in validation studies for both TAVI image-guidance techniques1, and image-based mitral valve tracking algorithms2.

  1. Association between Body Mass Index and Mitral Valve Prolapse

    Directory of Open Access Journals (Sweden)

    Malihe Mojaver Borabadi

    2016-03-01

    Full Text Available Introduction: Body mass index (BMI can affect cardiac morphology; however, the relationship between BMI and valvular heart diseases has not been thoroughly evaluated. This study aimed to determine the relationship between BMI and mitral valve prolapse (MVP as one of the most common valve diseases worldwide. It can help us to better understand pathophysiology of this common disease. Materials and Methods: In this descriptive study we enrolled 200 patients with isolated MVP. This patient was referred from 2014 to 2015 to our cardiology clinic in Mashhad, Iran, with chief complaint of chest pain, dyspnea, and palpitation. patients underwent transthoracic echocardiography. We document the patients’ height, weight, and demographics data. BMI distribution was categorized as higher and lower than 18.5 kg/m2. Chi- square and independent samples t-test were performed using SPSS version 19 to analyze the data. Results: The results showed that 92 (46% and 108 (54% of the samples were male and female, respectively, and their mean age was 24.29±3.75 years. Most of the patients(n=110 had low BMI (55% of the patients had BMI lower than 18.5 kg/m2. Left atrial and ventricular diameters had a significant relationship with BMI of all the underweight patients(n=110 (P=0.026 and 0.032, respectively. The main complaints were chest pain (n=55,50% and dyspnea (n=58,64.44% in the patients with low and normal BMI, respectively. Conclusion: Symptoms and echocardiographic features in MVP patients vary with BMI. While mitral valve annulus diameter was the same in both BMI groups, the results showed that left atrial and ventricular diameters in the underweight patients were less than those with normal BMI.

  2. Molecular evolution of the porcine type I interferon family: subtype-specific expression and antiviral activity.

    Directory of Open Access Journals (Sweden)

    Yongming Sang

    Full Text Available Type I interferons (IFNs, key antiviral cytokines, evolve to adapt with ever-changing viral threats during vertebrate speciation. Due to novel pathogenic pressure associated with Suidae speciation and domestication, porcine IFNs evolutionarily engender both molecular and functional diversification, which have not been well addressed in pigs, an important livestock species and animal model for biomedical sciences. Annotation of current swine genome assembly Sscrofa10.2 reveals 57 functional genes and 16 pseudogenes of type I IFNs. Subfamilies of multiple IFNA, IFNW and porcine-specific IFND genes are separated into four clusters with ∼ 60 kb intervals within the IFNB/IFNE bordered region in SSC1, and each cluster contains mingled subtypes of IFNA, IFNW and IFND. Further curation of the 57 functional IFN genes indicates that they include 18 potential artifactual duplicates. We performed phylogenetic construction as well as analyses of gene duplication/conversion and natural selection and showed that porcine type I IFN genes have been undergoing active diversification through both gene duplication and conversion. Extensive analyses of the non-coding sequences proximal to all IFN coding regions identified several genomic repetitive elements significantly associated with different IFN subtypes. Family-wide studies further revealed their molecular diversity with respect to differential expression and restrictive activity on the resurgence of a porcine endogenous retrovirus. Based on predicted 3-D structures of representative animal IFNs and inferred activity, we categorized the general functional propensity underlying the structure-activity relationship. Evidence indicates gene expansion of porcine type I IFNs. Genomic repetitive elements that associated with IFN subtypes may serve as molecular signatures of respective IFN subtypes and genomic mechanisms to mediate IFN gene evolution and expression. In summary, the porcine type I IFN profile has

  3. Results of beating heart mitral valve surgery via the trans-septal approach Resultados da abordagem transeptal para a valva mitral com coração batendo

    Directory of Open Access Journals (Sweden)

    Tomas A Salerno

    2009-03-01

    Full Text Available OBJECTIVE: Mitral valve surgery can be performed through the trans-atrial or the trans-septal approach. Although the trans-atrial is the preferred method, the trans-septal approach has also been used recently and has a particular value in beating-heart mitral valve surgery. Herein we report our experience with beating-heart mitral valve surgery via trans-septal approach, and discuss its advantages and pitfalls. METHODS: Between 2000 and 2007, 214 consecutive patients were operated upon utilizing beating heart technique for mitral valve surgery. The operation was performed via transseptal approach with the aorta unclamped, the heart beating, with normal electrocardiogram and in sinus rhythm. RESULTS: Mean age was 56.03 ± 13.93 years (range: 19-86 years; median: 56 years. There were 131 (61.2% males and 83 (38.8% females. Of the prostheses used, 108 (50.5% were biological, and 39 (18.2% were mechanical. Mitral repairs were performed in 67 (31.3% patients. Mean hospital stay was 17.4 ± 20.0 days (range: 3-135 days; median: 11 days. Intra-aortic balloon pump (IABP utilization was required in 12 (5.6% of 214 patients. One-month mortality was 7.4%, and re-operation for bleeding was needed in 15 (7% patients. CONCLUSIONS: Beating-heart mitral valve surgery is an option for myocardial protection in patients undergoing mitral valve surgery. This technique is facilitated by the trans-septal approach due to reduced aortic insufficiency and improved visualization of the mitral apparatus.OBJETIVO: A cirurgia da valva mitral pode ser feita via transatrial ou transeptal. Embora a transatrial seja a preferida, a via transeptal tem sido utilizada mais recentemente e tido um grande valor nas operações com o coração batendo. Mostramos a nossa experiência na cirurgia da valva mitral via transeptal com coração batendo e discutimos seus benefícios e problemas. MÉTODOS: Entre 2000 e 2007, 214 pacientes consecutivos foram operados com o coração batendo. A

  4. LAS PRIMERAS VALVULOTOMÍAS MITRALES PERCUTÁNEAS EN EL CARDIOCENTRO ERNESTO CHE GUEVARA / The first percutaneous mitral valvotomies at the Ernesto Che Guevara Cardiology Hospital

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    Francisco L Moreno-Martínez

    2009-06-01

    Full Text Available Los avances en los procedimientos de cardiología intervencionista, unidos al desarrollo de las técnicas de imagen, han favorecido el diagnóstico y tratamiento de los pacientes con estenosis mitral. La valvulotomía o valvuloplastia mitral percutánea constituye una excelente opción terapéutica para estos pacientes. En este artículo presentamos los dos primeros casos sometidos a este procedimiento en la Unidad de Hemodinámica y Cardiología Intervencionista del Cardiocentro “Ernesto Che Guevara”. Ambas pacientes evolucionaron favorablemente y fueron egresadas al siguiente día de la valvulotomía. Con estas dos pacientes iniciamos la era de la valvulotomía mitral percutánea en el mencionado hospital, que representa un nuevo servicio de salud a la población.

  5. Mitral annular systolic velocity as a marker of preclinical systolic dysfunction among patients with arterial hypertension

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    Daskalov Ivaylo Rilkov

    2012-11-01

    Full Text Available Abstract Background The aim of this study was to investigate early changes in left ventricular longitudinal systolic function in patients with hypertension (HTN with and without concomitant diastolic dysfunction (DD and the clinical implications of these findings. Method We enrolled 299 patients with HTN and 297 age-matched patients with HTN and DD and compared both groups with an age-matched control group consisting of 100 healthy subjects. The long axis systolic function was investigated by determining the average peak systolic velocity of the septal and lateral mitral sites (Smavg using spectral pulsed wave tissue Doppler imaging (TDI. Results We found a strong negative trend toward the reduction of velocity, which is dependent on the grade of HTN, on the magnitude of DD, and also on the gender and age of the subjects (r=−0.891/-0.580; p Conclusion The strength of the study is the analysis of incremental changes in longitudinal contraction in patients with different stage of HTN but not so many the classification of the degree of systolic dysfunction. The importance of our results lies in the fact that these initial changes in systolic contraction could be used as an early sign that should prompt optimization of the treatment of HTN.

  6. A porcine model for teaching surgical cricothyridootomy

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    Fernando Antonio Campelo Spencer Netto

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the acceptability of an educational project using A porcine model of airway for teaching surgical cricothyroidotomy to medical students and medical residents at a university hospital in southern Brazil.METHODS: we developed a teaching project using a porcine model for training in surgical cricothyroidotomy. Medical students and residents received lectures about this surgical technique and then held practical training with the model. After the procedure, all participants filled out a form about the importance of training in airway handling and the model used.RESULTS: There were 63 participants. The overall quality of the porcine model was estimated at 8.8, while the anatomical correlation between the model and the human anatomy received a mean score of 8.5. The model was unanimously approved and considered useful in teaching the procedure.CONCLUSION: the training of surgical cricothyroidotomy with a porcine model showed good acceptance among medical students and residents of this institution.

  7. Characterization of an antigenically distinct porcine rotavirus.

    OpenAIRE

    Bridger, J C; Clarke, I. N.; McCrae, M A

    1982-01-01

    A porcine virus with rotavirus morphology, which was antigenically unrelated to previously described rotaviruses, is described. Particles with an outer capsid layer measured 75 nm and those lacking the outer layer were 63 nm in diameter. Particles which resembled cores were also identified. The virus was shown to be antigenically distinct from other rotaviruses as judged by immunofluorescence and immune electron microscopy, and it failed to protect piglets from challenge with porcine rotaviru...

  8. Conservative surgical management of mitral insufficiency: an alternative approach Tratamento cirúrgico conservador da insuficiência mitral: uma abordagem alternativa

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    Francisco Gregori Junior

    2012-06-01

    Full Text Available Mitral valve insufficiency is frequently the result of elongated or ruptured chordae tendineae. Several techniques have been described for its correction. However, when there is a severe elongation or rupture of the chordae, the most widely accepted treatment option has been valve replacement. The best long-term outcomes observed in conservative surgeries led us to choose this procedure rather than the correction of mitral valve insufficiency. We described three techniques for correction of mitral prolapse due to elongated and/or ruptured chordae tendineae. In addition, we developed mold pre built bovine pericardial chords (Braile-Gregori prosthesis for chordae replacement. Finally, since 1987, the rigid prosthetic semicircular ring (Gregori-Braile ring has been consistently used in our centre for correction of the posterior dilation of mitral annulus preferably in its portion close to the posteromedial commissure.A insuficiência mitral é frequentemente resultado do alongamento ou ruptura das cordas tendíneas. Várias técnicas foram descritas para sua correção. Entretanto, quando o comprometimento das cordas é mais intenso, a substituição valvar tem sido mais usualmente empregada. Os bons resultados a longo prazo observados na cirurgia conservadora têm nos levado a eleger esse procedimento como prioridade. Três técnicas foram por nós desenvolvidas para correção de alongamento e/ou ruptura de cordas tendíneas. Além disso, desenvolvemos uma prótese de pericárdio bovino para a substituição de cordas (prótese Braile-Gregori. Finalmente, desde 1987 empregamos o anel rígido semicircular (anel Gregori-Braile para a correção do alongamento posterior do anel mitral, com ênfase na sua porção junto à comissura póstero-medial.

  9. Management of the Congenital Aneurysm of the Left Ventricle Associated with Mitral Insufficiency in a Child: A Case Report

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    Mitsomoy Michel Francklyn

    2013-03-01

    Full Text Available The combination of congenital left ventricular aneurysm associated with mitral insufficiency is rare. We describe the case of a girl aged 11 years, bearing these two entities simultaneously. Aneurysmal resection of the left ventricle was performed with Dor technic to allow remodelation of the anatomy of the left ventricle. Mitral annuloplasty was performed through a transseptal approach. Three months after surgery, the child presents a good myocardial contractility without mitral regurgitation and normal ejection fraction.

  10. Off-pump transapical closure of a mitral periprosthetic leak: a new approach to a difficult problem

    OpenAIRE

    Gaia, Diego Felipe; Breda, João Roberto; Fischer, Claudio Henrique; Palma, José Honório

    2013-01-01

    A 60-year old male patient with multiple risk factors and two previous interventions over the mitral valve was admitted to the emergency unit with symptoms of cardiac failure. Initial examination revealed a competent mitral bioprosthesis with severe perivalvular mitral insufficiency. Based on previous experiences with transapical procedures, a transapical transcatheter closure of the perivalvular leak was performed. The apex was punctured with a 7 French introducer sheath, and a hydrophilic g...

  11. Local serotonin mediates cyclic strain-induced phenotype transformation, matrix degradation, and glycosaminoglycan synthesis in cultured sheep mitral valves.

    Science.gov (United States)

    Lacerda, Carla M R; Kisiday, John; Johnson, Brennan; Orton, E Christopher

    2012-05-15

    This study addressed the following questions: 1) Does cyclic tensile strain induce protein expression patterns consistent with myxomatous degeneration in mitral valves? 2) Does cyclic strain induce local serotonin synthesis in mitral valves? 3) Are cyclic strain-induced myxomatous protein expression patterns in mitral valves dependent on local serotonin? Cultured sheep mitral valve leaflets were subjected to 0, 10, 20, and 30% cyclic strain for 24 and 72 h. Protein levels of activated myofibroblast phenotype markers, α-smooth muscle actin (α-SMA) and nonmuscle embryonic myosin (SMemb); matrix catabolic enzymes, matrix metalloprotease (MMP) 1 and 13, and cathepsin K; and sulfated glycosaminoglycan (GAG) content in mitral valves increased with increased cyclic strain. Serotonin was present in the serum-free media of cultured mitral valves and concentrations increased with cyclic strain. Expression of the serotonin synthetic enzyme tryptophan hydroxylase 1 (TPH1) increased in strained mitral valves. Pharmacologic inhibition of the serotonin 2B/2C receptor or TPH1 diminished expression of phenotype markers (α-SMA and SMemb) and matrix catabolic enzyme (MMP1, MMP13, and cathepsin K) expression in 10- and 30%-strained mitral valves. These results provide first evidence that mitral valves synthesize serotonin locally. The results further demonstrate that tensile loading modulates local serotonin synthesis, expression of effector proteins associated with mitral valve degeneration, and GAG synthesis. Inhibition of serotonin diminishes strain-mediated protein expression patterns. These findings implicate serotonin and tensile loading in mitral degeneration, functionally link the pathogeneses of serotoninergic (carcinoid, drug-induced) and degenerative mitral valve disease, and have therapeutic implications.

  12. R-R interval variations influence the degree of mitral regurgitation in dogs with myxomatous mitral valve disease.

    Science.gov (United States)

    Reimann, M J; Møller, J E; Häggström, J; Markussen, B; Holen, A E W; Falk, T; Olsen, L H

    2014-03-01

    Mitral regurgitation (MR) due to myxomatous mitral valve disease (MMVD) is a frequent finding in Cavalier King Charles Spaniels (CKCSs). Sinus arrhythmia and atrial premature complexes leading to R-R interval variations occur in dogs. The aim of the study was to evaluate whether the duration of the R-R interval immediately influences the degree of MR assessed by echocardiography in dogs. Clinical examination including echocardiography was performed in 103 privately-owned dogs: 16 control Beagles, 70 CKCSs with different degree of MR and 17 dogs of different breeds with clinical signs of congestive heart failure due to MMVD. The severity of MR was evaluated in apical four-chamber view using colour Doppler flow mapping (maximum % of the left atrium area) and colour Doppler M-mode (duration in ms). The influence of the ratio between present and preceding R-R interval on MR severity was evaluated in 10 consecutive R-R intervals using a linear mixed model for repeated measurements. MR severity was increased when a short R-R interval was followed by a long R-R interval in CKCSs with different degrees of MR (Ptesting). The relationship was not significant in control dogs with minimal MR and in dogs with severe MR and clinical signs of heart failure. In conclusion, MR severity increases in long R-R intervals when these follow a short R-R interval in CKCSs with different degrees of MR due to asymptomatic MMVD. Thus, R-R interval variations may affect the echocardiographic grading of MR in CKCSs. PMID:24507881

  13. Hipermobilidade articular em pacientes com prolapso da valva mitral Hipermovilidad articular en pacientes con prolapso de la válvula mitral Joint hypermobility in patients with mitral valve prolapse

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    Simone Cavenaghi

    2009-09-01

    Full Text Available Estudos sobre hipermobilidade têm despertado grande interesse, nas últimas décadas, por estarem associados a disfunções músculo-esqueléticas, bem como a anormalidades em vários sistemas orgânicos - como, por exemplo, o prolapso da valva mitral. Neste contexto, buscou-se agrupar e atualizar os conhecimentos da relação entre a hipermobilidade articular e o prolapso da valva mitral. Segundo a literatura, estudos mostram que alterações genéticas na composição do colágeno parecem ser a principal causa desta relação.Studies on hypermobility have aroused great interest in the last decades, as they are associated to musculoskeletal disorders, as well as abnormalities in several organic systems, such as the mitral valve prolapse. Therefore, in this study, data on the association between joint hypermobility and the mitral valve prolapse were investigated and reviewed. Studies in the literature have shown that genetic alterations in the collagen composition seem to be the main cause of this association.

  14. Pulmonary hypertension in dogs with mitral regurgitation attributable to myxomatous valve disease.

    Science.gov (United States)

    Chiavegato, David; Borgarelli, Michele; D'Agnolo, Gino; Santilli, Roberto A

    2009-01-01

    Pulmonary hypertension has been associated with mitral insufficiency caused by chronic degenerative valve disease in dogs. Our aim was to search for associations between left atrial to aortic root ratio, end-systolic and end-diastolic volume indices, and changes in the right ventricular to right atrial pressure gradient as estimated by the peak velocity of tricuspid regurgitation in dogs with chronic degenerative valve disease and different classes of heart failure. Dogs, for which follow-up was available were evaluated for changes in the right ventricular to right atrial systolic pressure gradient over time. Three hundred and forty-four dogs were studied; 51 in the International Small Animal Cardiac Health Council class la, 75 in class 1b, 113 in class 2, 97 in class 3a, and 8 in class 3b. The mean values for right ventricular to right atrial systolic pressure gradient, end-systolic volume index, end-diastolic volume index, and left atrial to aortic ratio were 49.2 +/- 17.1 mmHg, 149.12 +/- 60.8 and 37.7 +/- 21.6 ml/m2, and 1.9 +/- 0.5, respectively. A weak positive correlation was found between the right ventricular to right atrial systolic pressure gradient and the left atrial to aorta ratio (r = 0.242, P dogs. Of these, 18 had an increased, 12 a decreased, and 19 a stable right ventricular to right atrial systolic pressure gradient despite therapy. The equivalence point between the sensitivity and specificity curves of about 80% in the coincident point corresponded to a right ventricular to right atrial systolic pressure gradient of 48 mmHg. Our results suggest an association between the progressive nature of chronic degenerative mitral valve disease and pulmonary hypertension. It is of clinical interest that, with a right ventricular to right atrial systolic pressure gradient pressure gradient at or above 48 mmHg, pulmonary hypertension does not appear to improve despite therapy targeted at lowering the left atrial load.

  15. PATIENT’S TOLERANCE OF PHYSICAL EFFORT AFTER MITRAL VALVE REPLACEMENT IN DURABLE POST-OPERATIVE PERIODS

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    S.I. Kitavina

    2008-06-01

    Full Text Available It is reasonable for the replacement findings of the mitral valve in case of durable post-operative periods, to evaluate patient’s tolerance of physical effort, which results, firstofall, in the condition of the cardio-vascular system. Taking into consideration the seriousness of patients' condition of understudy, data about physical tolerance maybe received with the help of dosed physical effort. A group of factors, also choice of mitral valve replacement method, influences on degree of patients' physical effort. The more preferable method of correction of mitral valve disease in case of prosthesis is a preservation of subvalvular structures of mitral valve.

  16. Sensitivity of partial carcass dissection for assessment of porcine cysticercosis at necropsy.

    Science.gov (United States)

    Lightowlers, M W; Assana, E; Jayashi, C M; Gauci, C G; Donadeu, M

    2015-11-01

    Many interventions against Taenia solium are evaluated by assessing changes in the prevalence of porcine cysticercosis ascertained by carcass dissection. Financial and logistical difficulties often prohibit dissection of entire pig carcasses. We assessed 209 pigs from rural areas of Cameroon and Peru for the presence of T. solium cysticerci and determined the distribution of parasites within the musculature of infected animals. Considering the presence of cysts in the tongue, masticatory muscles and heart, 31 of the 38 (81%) naturally infected animals were identified as having cysts. Dissection of only the tongue, masticatory muscles and heart provides a relatively sensitive and highly specific method for diagnosis of porcine cysticercosis. PMID:26385439

  17. Isolation, Culture and Induced Differentiation of Fetal Porcine Islet Derived Pancreatic Stem Cell

    Institute of Scientific and Technical Information of China (English)

    FENG Ruo-peng; ZHANG Hui-ru; WANG Yun; QIAO Hai; ZHAO Ting; SHEN Wen-zheng; DOU Zhong-ying

    2007-01-01

    To isolate and culture the porcine pancreatic stem cells and investigate their function, the fetal porcine pancreatic stem cells were isolated by the method of suspending plus adhering culture. The isolated cells were then identified by irnmunohistochemical staining, and their culture viability measured through the MTT method in vitro. This induced them to differentiate into endocrine cells and detect their function. The isolated IPSCS did not express nestin, but expressed CK-19, a marker of ductal epithelia cells and oc-actin, a smooth muscle marker, demonstrating the growth characteristics of ES-like cells, and strong proliferative ability, after 18 passages. They could excrete insulin, and showed ultrastructure changes after being induced. Porcine pancreatic stem cells can be isolated by this method, induced to form islet-like clusters, and can secret insulin.

  18. Geometria da valva mitral derivada da ressonância magnética cardiovascular na avaliação da gravidade da regurgitação mitral Cardiovascular magnetic resonance imaging-derived mitral valve geometry in determining mitral regurgitation severity

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    Andre Mauricio Fernandes

    2013-01-01

    Full Text Available FUNDAMENTO: A regurgitação mitral é a doença valvar cardíaca mais comum em todo o mundo. A ressonância magnética pode ser uma ferramenta útil para analisar os parâmetros da valva mitral. OBJETIVO: diferenciar padrões geométricos da valva mitral em pacientes com diferentes gravidades por regurgitação mitral (RM com base na ressonância magnética cardiovascular. MÉTODOS: Sessenta e três pacientes foram submetidos à ressonância magnética cardiovascular. Os parâmetros da valva mitral analisados foram: área (mm2 e ângulo (graus de tenting, altura do ventrículo (mm, altura do tenting (mm, folheto anterior, comprimento posterior do folheto (leaflet e diâmetro do anulo (mm. Os pacientes foram divididos em dois grupos, um incluindo pacientes que necessitaram de cirurgia da valva mitral e o outro os que não. RESULTADOS: Trinta e seis pacientes apresentaram de RM discreta a leve (1-2+ e 27 RM de moderada a grave (3-4+. Dez (15,9% dos 63 pacientes foram submetidos à cirurgia. Pacientes com RM mais grave tiveram maior diâmetro sistólico final do ventrículo esquerdo (38,6 ± 10,2 vs. 45,4 ± 16,8, p BACKGROUND: Mitral regurgitation is the most common valvular heart disease worldwide. Magnetic resonance may be a useful tool to analyze mitral valve parameters. OBJECTIVE: To distinguish mitral valve geometric patterns in patients with different severities of mitral regurgitation (MR based on cardiovascular magnetic resonance imaging. METHODS: Sixty-three patients underwent cardiovascular magnetic resonance imaging. Mitral valve parameters analyzed were: tenting area (mm2 and angle (degrees, ventricle height (mm, tenting height (mm, anterior leaflet, posterior leaflet length and annulus diameter (mm. Patients were divided into two groups, one including patients who required mitral valve surgery and another which did not. RESULTS: Thirty-six patients had trace to mild (1-2+ MR and 27 had moderate to severe MR (3-4+. Ten (15.9% out of

  19. Medical expertise of young people of military age with mitral valve prolapse

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    Kuznetsova M.A.

    2013-03-01

    Full Text Available The last decade is characterized by a sharp decrease in psychosomatic health of young people of military age and growth of level of cardiovascular pathology. It is promoted by social and economic transfor¬mations in the country, growth of a psychoemotional pressure, decrease in level of the material income of the population, food of non-full value, alcoholism and drug addiction, health system destruction. The special place in the structure of cardiovascular pathology of young men of military age is occupied by the prolapse of the mitral valve (PMV. In health system PMV is considered as pathology of young able-bodied age and most often is not treated as pathology in general, until cardiac violations (violations of heart rhythm and conductivity, clinically significant mitral regurgitation, etc. develop. This position is unacceptable relative to recruits, whose daily activity is entailed with influence of a complex of extreme factors of the military and professional environment. In specific conditions of military service (a strict regulation of mode of work and rest, high degree of a physical and psychoemotional pressure, elements of hypovitaminosis, etc., possibilities of adaptation of the young man with PMV are significantly complicated. Any minor changes of the environment can gain critical importance, lead to exhaustion of reserve potential of an organism, decompensation of bodies and systems responsible for adaptation. In the absence of a significant arrhythmic syndrome and/or signs of cardiac insufficiency, recruits with pathology of cardiovascular system (CCC, as a rule, are admitted fit for military service. However level of functional condition of an organism of this category of persons does not allow them to fulfill official duties in full measure. They lag behind in the program of educational battle training, differ in lowered ability to work, absence of motivation in performance of the official duties, constant complaints on a health

  20. Subvalvular apparatus and adverse outcome of balloon valvotomy in rheumatic mitral stenosis☆

    Science.gov (United States)

    Bhalgat, Parag; Karlekar, Shrivallabh; Modani, Santosh; Agrawal, Ashish; Lanjewar, Charan; Nabar, Ashish; Kerkar, Prafulla; Agrawal, Nandu; Vaideeswar, Pradeep

    2015-01-01

    Background Balloon mitral valvotomy (BMV) is a well-established therapeutic modality for rheumatic mitral stenosis (RMS). However, there are chances of procedural failure and the more ominous post-procedural severe mitral regurgitation. There are only a few prospective studies, which have evaluated the pathogenic mechanisms for these major complications of BMV, especially in relation to the subvalvular apparatus (SVA) pathology. Methods All symptomatic patients of RMS suitable for BMV by echocardiographic criteria in a span of 1 year were selected. In addition to the standard echocardiographic assessment of RMS (Wilkins score and score by Padial et al.), a separate grading and scoring system was assigned to evaluate the severity of the SVA pathology. The SVA score was ‘I’, when none of the two SVAs had severe disease, ‘II’ when one of the two SVAs has severe disease, and ‘III’ when both SVAs had severe disease. With these scoring systems, the outcomes of BMV (successful procedure, failure, and post-procedural mitral regurgitation) were analyzed. Emergency valve replacement was performed depending on clinical situation, and in cases of replacement, the pathology of the excised mitral valves were compared with echocardiographic findings. Results Of the 356 BMVs performed in a year, 43 patients had adverse outcomes in the form of failed procedure (14 patients) and mitral regurgitation (29 patients). Forty-one among these had a SVA score of III. The sensitivity and specificity of the MR score was lesser than the SVA score (sensitivity 0.34 vs. 1.00, specificity 0.92 vs. 0.99, respectively). The mitral valvular morphology in 39 patients who underwent post-procedural valve replacements correlated well with echocardiography findings. Conclusion It is important to assess the degree of SVA pathology in the conventional echocardiographic assessment for RMS, as BMV would have adverse events when both SVAs were severely diseased. PMID:26432729

  1. Mitral valve surgery in a patient with dextrocardia and 180° counter-clockwise rotated heart due to congenital agenesis of the right lung.

    Science.gov (United States)

    Atsumi, Yosuke; Tokunaga, Shigehiko; Yasuda, Shota; Fushimi, Kenichi; Masuda, Munetaka

    2013-11-01

    We report a case of severe mitral regurgitation (MR) with dextrocardia and 180° counterclockwise rotated situs solitus heart. We describe the technique for mitral valve surgery in a patient with dextrocardia and agenesis of the right lung.

  2. Mitral valve surgery for mitral regurgitation caused by Libman-Sacks endocarditis : a report of four cases and a systematic review of the literature

    NARCIS (Netherlands)

    Bouma, Wobbe; Klinkenberg, Theo J.; van der Horst, Iwan C. C.; Wijdh-den Hamer, Inez J.; Erasmus, Michiel E.; Bijl, Marc; Suurmeijer, Albert J. H.; Zijlstra, Felix; Mariani, Massimo A.

    2010-01-01

    Libman-Sacks endocarditis of the mitral valve was first described by Libman and Sacks in 1924. Currently, the sterile verrucous vegetative lesions seen in Libman-Sacks endocarditis are regarded as a cardiac manifestation of both systemic lupus erythematosus (SLE) and the antiphospholipid syndrome (A

  3. The spatial resolution of the porcine multifocal electroretinogram for detection of laser-induced retinal lesions

    DEFF Research Database (Denmark)

    Kyhn, Maria Voss; Kiilgaard, Jens Folke; Scherfig, Erik;

    2008-01-01

    This study aimed to investigate the spatial resolution of a porcine multifocal electroretinogram (mfERG) protocol by testing its ability to detect laser-induced retinal lesions. Furthermore, we wanted to describe time-dependent changes in implicit time and amplitude of the different mfERG peaks a...

  4. Staphylococcus aureus induces hypoxia and cellular damage in porcine dermal explants

    Science.gov (United States)

    Methicillin-resistant Staphylococcus aureus (MRSA) can infect wounds and produce difficult-to- treat biofilms. To determine the extent that MRSA biofilms can deplete oxygen, change pH and damage host tissue, we developed a porcine dermal explant model on which we cultured GFP-labeled MRSA biofilms. ...

  5. A model study on color and related structural properties of cured porcine batters.

    NARCIS (Netherlands)

    Palombo, R.

    1990-01-01

    Color, determined by tristimulus colorimeters, and related structural properties, i.e., microstructure, surface rheology, and bulk rheology, of cured porcine meat batters were studied.Effects of various processing factors (such as, temperature, air pressure during chopping, and cutter type) on chang

  6. Apical ballooning syndrome complicated by acute severe mitral regurgitation with left ventricular outflow obstruction – Case report

    Directory of Open Access Journals (Sweden)

    Celermajer David S

    2007-02-01

    Full Text Available Abstract Background Apical ballooning syndrome (or Takotsubo cardiomyopathy is a syndrome of transient left ventricular apical ballooning. Although first described in Japanese patients, it is now well reported in the Caucasian population. The syndrome mimicks an acute myocardial infarction but is characterised by the absence of obstructive coronary disease. We describe a serious and poorly understood complication of Takotsubo cardiomyopathy. Case Presentation We present the case of a 65 year-old lady referred to us from a rural hospital where she was treated with thrombolytic therapy for a presumed acute anterior myocardial infarction. Four hours after thrombolysis she developed acute pulmonary oedema and a new systolic murmur. It was presumed she had acute mitral regurgitation secondary to a ruptured papillary muscle, ischaemic dysfunction or an acute ventricular septal defect. Echocardiogram revealed severe mitral regurgitation, left ventricular apical ballooning, and systolic anterior motion of the mitral valve with significant left ventricular outflow tract gradient (60–70 mmHg. Coronary angiography revealed no obstructive coronary lesions. She had an intra-aortic balloon pump inserted with no improvement in her parlous haemodynamic state. We elected to replace her mitral valve to correct the outflow tract gradient and mitral regurgitation. Intra-operatively the mitral valve was mildly myxomatous but there were no structural abnormalities. She had a mechanical mitral valve replacement with a 29 mm St Jude valve. Post-operatively, her left ventricular outflow obstruction resolved and ventricular function returned to normal over the subsequent 10 days. She recovered well. Conclusion This case represents a serious and poorly understood association of Takotsubo cardiomyopathy with acute pulmonary oedema, severe mitral regurgitaton and systolic anterior motion of the mitral valve with significant left ventricular outflow tract obstruction. The

  7. Transesophageal echocardiography in surgical management of pseudoaneurysm of mitral-aortic intervalvular fibrosa with aneurysms of right sinus of Valsalva and left main coronary artery

    OpenAIRE

    Shreedhar S Joshi; Arkalgud Marigowda Jagadeesh; Arul Furtado; Seetharam Bhat

    2013-01-01

    Pseudoaneurysm of mitral-aortic intervalvular fibrosa (MAIVF) is a rare complication associated with aortic and/or mitral valve surgery complicated by infective endocarditis. We report pseudoaneurysm of MAIVF in a young adult without overt cardiac disease or previous cardiac surgery. The patient had a rare combination of pseudoaneurysm of MAIVF impinging on anterior mitral leaflet causing moderate mitral regurgitation, right sinus of Valsalva aneurysm extending into interventricular septum, a...

  8. Expression Profiling of Circulating MicroRNAs in Canine Myxomatous Mitral Valve Disease

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    Qinghong Li

    2015-06-01

    Full Text Available MicroRNAs (miRNAs are small non-coding RNAs that have shown promise as noninvasive biomarkers in cardiac disease. This study was undertaken to investigate the miRNA expression profile in dogs with myxomatous mitral valve disease (MMVD. 277 miRNAs were quantified using RT-qPCR from six normal dogs (American College of Veterinary Internal Medicine Stage A, six dogs with MMVD mild to moderate cardiac enlargement (ACVIM Stage B1/B2 and six dogs with MMVD and congestive heart failure (ACVIM Stage C/D. Eleven miRNAs were differentially expressed (False Discovery Rate < 0.05. Dogs in Stage B1/B2 or C/D had four upregulated miRNAs, including three cfa-let-7/cfa-miR-98 family members, while seven others were downregulated, compared to Stage A. Expression of six of the 11 miRNAs also were significantly different between dogs in Stage C/D and those in Stage B1/B2. The expression changes were greater as disease severity increased. These miRNAs may be candidates for novel biomarkers and may provide insights into genetic regulatory pathways in canine MMVD.

  9. Dynamic Heterogeneity of the Heart Valve Interstitial Cell Population in Mitral Valve Health and Disease

    Directory of Open Access Journals (Sweden)

    Tori E. Horne

    2015-08-01

    Full Text Available The heart valve interstitial cell (VIC population is dynamic and thought to mediate lay down and maintenance of the tri-laminar extracellular matrix (ECM structure within the developing and mature valve throughout life. Disturbances in the contribution and distribution of valve ECM components are detrimental to biomechanical function and associated with disease. This pathological process is associated with activation of resident VICs that in the absence of disease reside as quiescent cells. While these paradigms have been long standing, characterization of this abundant and ever-changing valve cell population is incomplete. Here we examine the expression pattern of Smooth muscle α-actin, Periostin, Twist1 and Vimentin in cultured VICs, heart valves from healthy embryonic, postnatal and adult mice, as well as mature valves from human patients and established mouse models of disease. We show that the VIC population is highly heterogeneous and phenotypes are dependent on age, species, location, and disease state. Furthermore, we identify phenotypic diversity across common models of mitral valve disease. These studies significantly contribute to characterizing the VIC population in health and disease and provide insights into the cellular dynamics that maintain valve structure in healthy adults and mediate pathologic remodeling in disease states.

  10. Lentiviral vector gene transfer to porcine airways.

    Science.gov (United States)

    Sinn, Patrick L; Cooney, Ashley L; Oakland, Mayumi; Dylla, Douglas E; Wallen, Tanner J; Pezzulo, Alejandro A; Chang, Eugene H; McCray, Paul B

    2012-01-01

    In this study, we investigated lentiviral vector development and transduction efficiencies in well-differentiated primary cultures of pig airway epithelia (PAE) and wild-type pigs in vivo. We noted gene transfer efficiencies similar to that observed for human airway epithelia (HAE). Interestingly, feline immunodeficiency virus (FIV)-based vectors transduced immortalized pig cells as well as pig primary cells more efficiently than HIV-1-based vectors. PAE express TRIM5α, a well-characterized species-specific lentiviral restriction factor. We contrasted the restrictive properties of porcine TRIM5α against FIV- and HIV-based vectors using gain and loss of function approaches. We observed no effect on HIV-1 or FIV conferred transgene expression in response to porcine TRIM5α overexpression or knockdown. To evaluate the ability of GP64-FIV to transduce porcine airways in vivo, we delivered vector expressing mCherry to the tracheal lobe of the lung and the ethmoid sinus of 4-week-old pigs. One week later, epithelial cells expressing mCherry were readily detected. Our findings indicate that pseudotyped FIV vectors confer similar tropisms in porcine epithelia as observed in human HAE and provide further support for the selection of GP64 as an appropriate envelope pseudotype for future preclinical gene therapy studies in the porcine model of cystic fibrosis (CF).Molecular Therapy - Nucleic Acids (2012) 1, e56; doi:10.1038/mtna.2012.47; published online 27 November 2012. PMID:23187455

  11. Existence of proviral porcine endogenous retrovirus in fresh and decellularised porcine tissues

    Directory of Open Access Journals (Sweden)

    Prabha S

    2008-01-01

    Full Text Available Purpose: Swine are expected to be utilized as xenograft donors for both whole organ and cellular transplantation. A major concern in using porcine organs for transplantation is the potential of transmission of porcine endogenous retrovirus (PERV. Tissue-engineered or decellularised heart valves have already been implanted in humans and have been marketed by certain companies after Food and Drug Administration (FDA approval. The aim of this study was to examine the existence of porcine endogenous retrovirus (PERV in fresh and decellularised porcine tissues. Methods: Porcine tissues (both fresh and decellularised were analysed using validated assays specific for PERV: polymerase chain reaction (PCR, reverse transcriptase polymerase chain reaction (RT-PCR. Results: PERV specific GAG sequences were found in the porcine heart tissue samples using PCR for DNA and RT- PCR for RNA. All tissue samples (both fresh and treated tissues like aortic valve, pulmonary valve and heart muscle showed the presence of PERV DNA. RT PCR for PERV was positive in all fresh tissues and was found to be negative in decellularised treated tissues. Conclusions: PCR is a rapid, specific test for the detection of PERV virus in xenografts. These findings have demonstrated that the presence of proviral DNA form of PERV in porcine tissues needs to be carefully considered when the infectious disease potential of xenotransplantation is being assessed.

  12. Porcine model of hemophilia A.

    Directory of Open Access Journals (Sweden)

    Yuji Kashiwakura

    Full Text Available Hemophilia A is a common X chromosome-linked genetic bleeding disorder caused by abnormalities in the coagulation factor VIII gene (F8. Hemophilia A patients suffer from a bleeding diathesis, such as life-threatening bleeding in the brain and harmful bleeding in joints and muscles. Because it could potentially be cured by gene therapy, subhuman animal models have been sought. Current mouse hemophilia A models generated by gene targeting of the F8 have difficulties to extrapolate human disease due to differences in the coagulation and immune systems between mice and humans. Here, we generated a porcine model of hemophilia A by nuclear transfer cloning from F8-targeted fibroblasts. The hemophilia A pigs showed a severe bleeding tendency upon birth, similar to human severe hemophiliacs, but in contrast to hemophilia A mice which rarely bleed under standard breed conditions. Infusion of human factor VIII was effective in stopping bleeding and reducing the bleeding frequency of a hemophilia A piglet but was blocked by the inhibitor against human factor VIII. These data suggest that the hemophilia A pig is a severe hemophilia A animal model for studying not only hemophilia A gene therapy but also the next generation recombinant coagulation factors, such as recombinant factor VIII variants with a slower clearance rate.

  13. Posterior cusp enlargement in mitral valve reconstructive surgery for restrictive valve insufficiency: Case report

    Directory of Open Access Journals (Sweden)

    Stojanović Ivan

    2007-01-01

    Full Text Available Introduction According to Carpentier classification, group III of mitral insufficiency is caused by the restrictive motion of the mitral valve. A rheumatic process and a coronary disease are the main causes. It is very important to examine the valve precisely, to define deformities and aetiology in order to make such a valve functional. In rheumatic disease, fibrosis and degeneration deform the entire mitral apparatus. A surgical principle is to re-establish mobility and pliability of the apparatus taking care of the functional anatomy at the same time. Cusp enlargement, chordal mobilization and ring remodeling are just some of the numerous surgical techniques that could be performed in these patients. Case outlineA 55-year old female patient was admitted to hospital with severe mitral regurgitaion. She belonged to NYHA, functional stage 2. Echocardiography revealed that both cusps, mostly posterior, were of reduced size and mobility, resulting in grade 3 regurgitation. We performed posterior cusp enlargement by using autologous pericardium treated in 0.6% of glutaraldehyde solution. Annulus remodeling was done using size 27 flexible Duran ring. Control echocardiography found trivial regurgitation. The patient was discharged on 12th postoperative day in sinus rhythm. Conclusion Surgical reconstruction of the rheumatic mitral valve back to the functional state is a demanding procedure, which, however, provides certain benefit for the successfully treated patient.

  14. Clinical trial experience with the MitraClip catheter based mitral valve repair system.

    Science.gov (United States)

    Maisano, Francesco; Godino, Cosmo; Giacomini, Andrea; Denti, Paolo; Arendar, Iryna; Buzzatti, Nicola; Canna, Giovanni La; Alfieri, Ottavio; Colombo, Antonio

    2011-12-01

    Severe mitral regurgitation (MR) confers a poor prognosis, in particular for patients with heart failure. Based on the results of the Euro Heart Survey, a large proportion of patients with mitral regurgitation is not referred to surgery and many other patients are rejected for cardiac surgery due to the high surgical risk or co-pathologies. Improving ventricular function with ACE inhibitors, beta-blockers and CRT may reduce mitral regurgitation, but for most patients a mechanical intervention is ultimately preferable. Mitral valve surgery is invasive and requires a long recovery period; therefore, less invasive and effective approaches are highly desirable, particularly in high risk patients. Therefore, new techniques have been recently developed to treat MR with percutaneous approach. The MitraClip device (Abbott Vascular, Menlo Park, CA) is used to treat both functional and degenerative mitral valve regurgitation. Its safety and efficacy has been initially tested in the Endovascular Valve Edge-to-Edge REpair Study (EVEREST), while MitraClip has been compared to surgery in the EVEREST II randomized trial. Besides EVEREST trials, safety and efficacy of the device as well as its health economic value is under evaluation in ongoing registries. Although the field of catheter based management of MR is at an early stage, initial clinical results have demonstrated that catheter based approaches can reduce MR, suggesting there is a great deal of potential for clinical benefit to patients with MR.

  15. Established interventions for mitral valve regurgitation. Current evidence.

    Science.gov (United States)

    Orban, Mathias; Braun, D; Orban, Martin; Gross, L; Näbauer, M; Hagl, C M; Massberg, S; Hausleiter, J

    2016-02-01

    Severe mitral regurgitation (MR) is a growing medical challenge in today's aging population, leading to increased health expenditure due to the resultant morbidity and mortality. Surgery, either replacement or repair, has been the mainstay of therapy for primary MR. In high-risk or inoperable patients, treatment was limited to medical therapy until 2008. Since then, alternative percutaneous therapies have been introduced and have proven to be safe and effective in patients with secondary MR. Edge-to-edge repair with the MitraClip system is applied worldwide for primary and secondary MR. Randomized data do not support its application in low-risk patients with primary MR. Results from ongoing and future randomized trials will clarify its impact on important clinical endpoints in high-risk and inoperable patients. The Carillon device is a percutaneous indirect annuloplasty technique introduced in 2009 for secondary MR. Clinical data for the novel Cardioband system, using a different intra-atrial annuloplasty technique, have been gathered from more than 40 patients and the system recently received CE mark approval. Other percutaneous repair devices and implantable valves are under development and may be introduced into clinical practice soon. The percutaneous interventional therapy of MR is a highly dynamic field of cardiovascular medicine and has the potential to improve quality of life as well as morbidity and mortality in selected patients. PMID:26659844

  16. Plasma proANP and SDMA and microRNAs are associated with chronic mitral regurgitation in a pig model

    DEFF Research Database (Denmark)

    Cirera Salicio, Susanna; Moesgaard, Sophia Gry; Zois, Nora Elisabeth;

    2013-01-01

    OBJECTIVE: NON-ISCHEMIC MITRAL REGURGITATION (MR) IS PRIMARILY CAUSED BY MYXOMATOUS MITRAL VALVE (MV) DISEASE LEADING TO ADAPTIVE REMODELING, ENLARGEMENT, AND DYSFUNCTION OF THE LEFT VENTRICLE. THE AIM OF THIS STUDY WAS TO EXAMINE THE REGULATION OF PLASMA MARKERS AND SEVERAL CARDIAC KEY GENES...

  17. The relationship between mitral regurgitation and ejection fraction as predictors for the prognosis of patients with heart failure

    DEFF Research Database (Denmark)

    Thune, Jens Jakob; Torp-Pedersen, Christian; Hassager, Christian;

    2011-01-01

    To study whether there is interaction between mitral regurgitation (MR) and left ventricular ejection fraction (LVEF) in the mortality risk of heart failure (HF) patients.......To study whether there is interaction between mitral regurgitation (MR) and left ventricular ejection fraction (LVEF) in the mortality risk of heart failure (HF) patients....

  18. Management and outcomes in patients with moderate or severe functional mitral regurgitation and severe left ventricular dysfunction

    DEFF Research Database (Denmark)

    Samad, Zainab; Shaw, Linda K; Phelan, Matthew;

    2015-01-01

    AIMS: The management and outcomes of patients with functional moderate/severe mitral regurgitation and severe left ventricular (LV) systolic dysfunction are not well defined. We sought to determine the characteristics, management strategies, and outcomes of patients with moderate or severe mitral...

  19. Flow-mediated vasodilation measurements in Cavalier King Charles Spaniels with increasing severity of myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Løwert, Charlotte Klostergaard; Zois, Nora Elisabeth;

    2012-01-01

    Cardiovascular disease is associated with endothelial dysfunction in humans and studies of plasma biomarkers suggest that dogs with myxomatous mitral valve disease (MMVD) might also have endothelial dysfunction.......Cardiovascular disease is associated with endothelial dysfunction in humans and studies of plasma biomarkers suggest that dogs with myxomatous mitral valve disease (MMVD) might also have endothelial dysfunction....

  20. Echocardiographic and clinical outcomes of central versus noncentral percutaneous edge-to-edge repair of degenerative mitral regurgitation

    DEFF Research Database (Denmark)

    Estévez-Loureiro, Rodrigo; Franzen, Olaf; Winter, Reidar;

    2013-01-01

    This study aimed to assess the clinical and echocardiographic results of MitraClip implantation in noncentral degenerative mitral regurgitation (dMR) compared with central dMR.......This study aimed to assess the clinical and echocardiographic results of MitraClip implantation in noncentral degenerative mitral regurgitation (dMR) compared with central dMR....

  1. Improved cell line IPEC-J2, characterized as a model for porcine jejunal epithelium.

    Directory of Open Access Journals (Sweden)

    Silke S Zakrzewski

    Full Text Available Cell lines matching the source epithelium are indispensable for investigating porcine intestinal transport and barrier properties on a subcellular or molecular level and furthermore help to reduce animal usage. The porcine jejunal cell line IPEC-J2 is established as an in vitro model for porcine infection studies but exhibits atypically high transepithelial resistances (TER and only low active transport rates so that the effect of nutritional factors cannot be reliably investigated. This study aimed to properly remodel IPEC-J2 and then to re-characterize these cells regarding epithelial architecture, expression of barrier-relevant tight junction (TJ proteins, adequate TER and transport function, and reaction to secretagogues. For this, IPEC-J2 monolayers were cultured on permeable supports, either under conventional (fetal bovine serum, FBS or species-specific (porcine serum, PS conditions. Porcine jejunal mucosa was analyzed for comparison. Main results were that under PS conditions (IPEC-J2/PS, compared to conventional FBS culture (IPEC-J2/FBS, the cell height increased 6-fold while the cell diameter was reduced by 50%. The apical cell membrane of IPEC-J2/PS exhibited typical microvilli. Most importantly, PS caused a one order of magnitude reduction of TER and of trans- and paracellular resistance, and a 2-fold increase in secretory response to forskolin when compared to FBS condition. TJ ultrastructure and appearance of TJ proteins changed dramatically in IPEC-J2/PS. Most parameters measured under PS conditions were much closer to those of typical pig jejunocytes than ever reported since the cell line's initial establishment in 1989. In conclusion, IPEC-J2, if cultured under defined species-specific conditions, forms a suitable model for investigating porcine paracellular intestinal barrier function.

  2. Immortalization of porcine placental trophoblast cells through reconstitution of telomerase activity.

    Science.gov (United States)

    Zhang, Hongling; Huang, Yong; Wang, Lili; Yu, Tingting; Wang, Zengguo; Chang, Lingling; Zhao, Xiaomin; Luo, Xiaomao; Zhang, Liang; Tong, Dewen

    2016-05-01

    Placental trophoblast cells (PTCs) play a critical role in histotrophic nutrient absorption, gaseous exchange, endocrine activities, and barrier function between the maternal and fetal systems. Establishment of immortalized porcine PTCs will help us to investigate the potential effects of different viruses on porcine trophoblast. In the present study, primary porcine PTCs were isolated from healthy gilts at Day 30 to Day 50 of gestation through collagenase digestion, percoll gradient centrifugation, and anti-CD9 immunomagnetic negative selection. To provide stable and long lifespan cells, primary PTCs were transfected with human telomerase reverse transcriptase (hTERT) gene. One porcine placental trophoblast cell line, named as hTERT-PTCs, was chosen for characterization. Human telomerase reverse transcriptase-PTCs achieved an extended replicative lifespan without exhibiting any neoplastic transformation signs in vivo or in vitro. The morphologic and key physiological characteristics of the immortalized PTCs were similar to primary PTCs. The immortalized PTCs retained original cell polarity and normal karyotype, expressed trophoblast-specific marker cytokeratin 7 and E-cadherin but did not express vimentin and major histocompatibility complex class I antigens as well as primary PTCs. Human telomerase reverse transcriptase-PTCs secreted low levels of chorionic gonadotrophin β-subunit and placental lactogen that were coincident with primary PTCs. Taken together, our results demonstrated that the porcine PTCs could be immortalized through reconstitution of telomerase activity. The immortalized PTCs maintained its original characteristics and can be used as a model cells line to study the pathologic changes of porcine placental trophoblast in viruses infectious diseases. PMID:26850465

  3. Gene Expression Profiling in Porcine Fetal Thymus

    Institute of Scientific and Technical Information of China (English)

    Yanjiong Chen; Shengbin Li; Lin Ye; Jianing Geng; Yajun Deng; Songnian Hu

    2003-01-01

    obtain an initial overview of gene diversity and expression pattern in porcinethymus, 11,712 ESTs (Expressed Sequence Tags) from 100-day-old porcine thymus(FTY) were sequenced and 7,071 cleaned ESTs were used for gene expressionanalysis. Clustered by the PHRAP program, 959 contigs and 3,074 singlets wereobtained. Blast search showed that 806 contigs and 1,669 singlets (totally 5,442ESTs) had homologues in GenBank and 1,629 ESTs were novel. According to theGene Ontology classification, 36.99% ESTs were cataloged into the gene expressiongroup, indicating that although the functional gene (18.78% in defense group) ofthymus is expressed in a certain degree, the 100-day-old porcine thymus still existsin a developmental stage. Comparative analysis showed that the gene expressionpattern of the 100-day-old porcine thymus is similar to that of the human infantthymus.

  4. Adaptações fisiológicas precoces e tardias após valvotomia mitral por cateter balão Early and late physiological effects of balloon mitral valvuloplasty

    Directory of Open Access Journals (Sweden)

    Japy Angelini Oliveira Fº

    1998-02-01

    class II and 56% were in class I (NYHA. The resting heart rate decreased (87±11bpm vs 85±7bpm vs 75±9bpm and the number of steps increased (4±1 steps vs 5±2 steps vs 6±1 steps; the peak oxygen uptake improved only in the late evaluation (16±3mL/kg/min vs 18±4mL/kg/min vs 22±7mL/kg/min. The anaerobic threshold, minute ventilation (VE and ventilatory equivalent for oxygen showed no change. The heart rate (1st step: 124±18bpm vs 112±13bpm vs 87±15bpm, O2 uptake (1st step: 10±2mL/kg/min vs 8±2mL/kg/min vs 8±2mL/kg/min and VE decreased during submaximal exercise in early and late phases. The mitral valve area decreased in the late evaluation (0.94cm² vs 1.66cm² vs 1.20cm². CONCLUSION: Although partial restenosis tended to occur in these patients, they improved the functional class and cardiorespiratory performance and cardiocirculatory load during submaximal exercise.

  5. Local intense mosaic pattern at site of flail mitral leaflet: report of a new color Doppler sign.

    Science.gov (United States)

    Khouzam, Rami N; D'Cruz, Ivan A; Minderman, Daniel; Kaiser, Jacqueline

    2005-10-01

    Color flow Doppler has been useful in diagnosing the presence and severity of mitral regurgitation (MR). We noted a hitherto unreported sign of MR due to flail mitral leaflet: intense local mosaic pattern at the site of the flail leaflet. This sign was seen well in 11 of 14 patients (79%) with the two-dimensional echocardiographic features of flail mitral leaflet, all with moderate or severe MR. In 3 other patients, the sign was absent; two of those had flail mitral leaflet with severe MR. No local mosaic pattern was seen on color Doppler in 20 other patients with MR but no flail mitral leaflet. We speculate that the focal intense mosaic color Doppler morphology may have been caused by intrusion of the flail leaflet into the MR stream, or to a Coanda-like effect of the MR jet "adhering" to the flail leaflet. PMID:16194168

  6. Simplified cryopreservation of porcine cloned blastocysts

    DEFF Research Database (Denmark)

    Du, Yutao; Zhang, Yunhai; Li, Juan;

    2007-01-01

    )â€"handmade cloning (HMC)â€"to establish a simplified and efficient cryopreservation system for porcine cloned embryos. In Experiment 1, zonae pellucidae of oocytes were partially digested with pronase, followed by centrifugation to polarize lipid particles. Ninety percent (173/192) oocytes were successfully......). Our results prove that porcine embryos produced from delipated oocytes by PA or HMC can be cryopreserved effectively by ultrarapid vitrification. Further experiments are required to assess the in vivo developmental competence of the cloned-vitrified embryos  ...

  7. Application of Percutaneous Balloon Mitral Valvuloplasty in Patients of Rheumatic Heart Disease Mitral Stenosis Combined with Tricuspid Regurgitation

    Institute of Scientific and Technical Information of China (English)

    Zhang-Qiang Chen; Lang Hong; Hong Wang; Lin-Xiang Lu; Qiu-Lin Yin; Heng-Li Lai; Hua-Tai Li

    2015-01-01

    Background:Tricuspid regurgitation (TR) is frequently associated with severe mitral stenosis (MS),the importance of significant TR was often neglected.However,TR influences the outcome of patients.The aim of this study was to investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV) procedure in rheumatic heart disease patients with mitral valve (MV) stenosis and tricuspid valve regurgitation.Methods:Two hundred and twenty patients were enrolled in this study due to rheumatic heart disease with MS combined with TR.Mitral balloon catheter made in China was used to expand MV.The following parameters were measured before and after PBMV:MV area (MVA),TR area (TRA),atrial pressure and diameter,and pulmonary artery pressure (PAP).The patients were followed for 6 months to 9 years.Results:After PBMV,the MVAs increased significantly (1.7 ± 0.3 cm2 vs.0.9 ± 0.3 cm2,P < 0.01);TRA significantly decreased (6.3 ± 1.7 cm2 vs.14.2 ± 6.5 cm2,P < 0.01),right atrial area (RAA) decreased significantly (21.5 ± 4.5 cm2 vs.25.4 ± 4.3 cm2,P < 0.05),TRA/RAA (%) decreased significantly (29.3 ± 3.2% vs.44.2 ± 3.6%,P < 0.01).TR velocity (TRV) and TR continue time (TRT) as well as TRV × TRT decreased significantly (183.4 ± 9.4 cm/s vs.254.5 ± 10.7 cm/s,P < 0.01;185.7 ± 13.6 ms vs.238.6 ± 11.3 ms,P < 0.01;34.2 ± 5.6 cm vs.60.7 ± 8.5 cm,P < 0.01,respectively).The postoperative left atrial diameter (LAD) significantly reduced (41.3 ± 6.2 mm vs.49.8 ± 6.8 mm,P < 0.01) and the postoperative right atrial diameter (RAD) significantly reduced (28.7 ± 5.6 mm vs.46.5 ± 6.3 mm,P < 0.01);the postoperative left atrium pressure significantly reduced (15.6 ± 6.1 mmHg vs.26.5 ± 6.6 mmHg,P < 0.01),the postoperative right atrial pressure decreased significantly (13.2 ± 2.4 mmHg vs.18.5 ± 4.3 mmHg,P < 0.01).The pulmonary arterial pressure decreased significantly after PBMV (48.2 ± 10.3 mmHg vs.60.6 ± 15.5 mmHg,P < 0.01).The

  8. Does exercise and the stress of clinical examination influence endothelial function in dogs with mitral regurgitation?

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Pedersen, Henrik Duelund; Holte, Andreas;

    2005-01-01

    to indicate endothelial function. As in man with heart failure, mitral regurgitation (MR) associated with mitral valve prolapse in dogs, has been found to be associated with a decreased plasma concentation of NOx early in the course of heart failure. Correction of such endothelial dysfunction in human...... subjects is regarded as being an important therapeutic target.An aim of this PhD project is to investigate the involvement of NO in mitral valve disease and explain possible reasons for the decrease in NOx seen in connection with MR.When dogs are examined under clinic conditions there is an inevitable...... amount of stress and agitation, which may affect the cardiovascular system and endothelial function. Plasma NOx measured in dogs with MR in their home environment was similar to that of dogs without MR which were measured in the clinic. However, the same dogs with MR showed a significant decrease...

  9. A novel mathematical technique to assess of the mitral valve dynamics based on echocardiography

    CERN Document Server

    Karvandi, Mersedeh; Hassantash, Seyed Ahmad; Foroughi, Mahnoosh

    2015-01-01

    Purpose: The mechanics of the mitral valve leaflet as a nonlinear, inelastic and anisotropic soft tissue results from an integrated response of many mathematical/physical indexes' that illustrate the tissue. In the past decade, finite element modeling of complete heart valves has greatly aided evaluation of heart valve surgery, design of bioprosthetic valve replacements, and general understanding of healthy and abnormal cardiac function. Such a model must be based on an accurate description of the mechanical behavior of the valve material. It is essential to calculate velocity/displacement and strain rate/strain at a component level that is to work at the cellular level. In this study we developed the first three-dimensional displacement vectors field in the characterization of mitral valve leaflets in continuum equations of inelasticity framework based on echocardiography. Method: Much of our knowledge of abnormal mitral valve function is based on surgical and post-mortem studies while these studies are quan...

  10. Atypical Early Aspergillus Endocarditis Post Prosthetic Mitral Valve Repair: A Case Report

    Directory of Open Access Journals (Sweden)

    Ahmed AbdulAziz Abuzaid

    2015-01-01

    Full Text Available A 64-year-old female operated 1 month previous for mitral valve repair presented with acute respiratory distress and dyspnea. Echocardiography showed large echogenic valvular mass measuring 2.3 × 1.3 cm with severe mitral regurgitation and dehiscence of the mitral ring posteriorly. The mass was attached subvalvularly to the ventricular septal-free wall and eroding through it, which required complete aggressive dissection of the infected tissues. Diagnosis was confirmed after resection of the valve by multiple negative blood cultures and positive valvular tissue for Aspergillus fumigatus endocarditis. She was treated with high dose of voriconazole for 3 months. Her postoperative period was complicated by acute-on-chronic renal failure. She responded very well to the management.

  11. Mitral valve repair after a right pneumonectomy: a minimally invasive approach.

    Science.gov (United States)

    Rose, David; Liew, Chee K; Zacharias, Joseph

    2015-10-01

    A 31-year old man was admitted to our unit with severe mitral regurgitation secondary to infective endocarditis on a background of a right pneumonectomy performed 8 years previously for a central carcinoid tumour. A previous right thoracotomy for lung resection is considered a contraindication to a minimal access approach to the mitral valve. Following the right pneumonectomy, a left-to-right displacement of the mediastinum had occurred. We report our experience on performing a mitral valve repair through a right mini-thoracotomy in a patient who had undergone a right pneumonectomy. In this case, three-dimensional computed tomography reconstructions were used to guide our surgical approach. We hope that this case presentation will help further broaden the applicability of a thru-port approach to this rare subgroup of patients.

  12. Mitral restenosis in the early postoperative period of a patient with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Pomerantzeff Pablo Maria Alberto

    1999-01-01

    Full Text Available A forty eight year old woman, who had undergone mitral comissurotomy and subsequently developed early restenosis, presented with major comissural fusion and verrucous lesions on the cuspid edges of the mitral valve, with normal subvalvar apparatus. Patient did well for the first six months after surgery when she began to present dyspnea on light exertion. A clinical diagnosis of restenosis was made, which was confirmed by an echocardiogram and cardiac catheterization. She underwent surgery, and a stenotic mitral valve with verrucous lesions suggesting Libman-Sacks' endocarditis was found. Because the diagnosis of systemic lupus erythematosus (SLE had not been confirmed at that time, a bovine pericardium bioprosthesis (FISICS-INCOR was implanted. The patient did well in the late follow-up and is now in NYHA Class I .

  13. Transcatheter Simultaneous Double-Transapical Access for Paravalvular Mitral Leak Closure Using the Occlutech PLD.

    Science.gov (United States)

    Pestrichella, Vincenzo; Pignatelli, Antonio; Alemanni, Rossella; Montesanti, Rosamaria; Braccio, Maurizio; Greco, Francesco; D'Ambruoso, Pierpaolo; Memmola, Cataldo Davide; Cassese, Mauro; Contegiacomo, Gaetano; Bagur, Rodrigo

    2016-07-01

    A 67-year-old patient with rheumatic heart valve disease had undergone two cardiac surgeries at the age of 30 years, then re-do with mitral valve replacement at 50 years. She presented with congestive heart failure and hemolytic anemia. Doppler echocardiography showed moderate-severe mitral regurgitation due to paravalvular mitral valve leak (PVML) and severe pulmonary hypertension. Transesophageal echocardiography demonstrated severe PVML secondary to a large 20 mm-long PVML defect. Due to comorbidities, the heart team deemed a third reoperation at very high surgical risk; therefore, the patient was considered most suitable for a transcatheter approach to PVML closure. Two Occlutech paravalvular leak devices were successfully delivered using a simultaneous double-transapical access with double-wire technique. PMID:27342208

  14. Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results

    Directory of Open Access Journals (Sweden)

    Lorier Gabriel

    2001-01-01

    Full Text Available OBJECTIVE: To analyze late clinical evolution after surgical treatment of children, with reparative and reconstructive techniques without annular support. METHODS: We evaluated 21 patients operated upon between 1975 and 1998. Age 4.67±3.44 years; 47.6% girls; mitral insufficiency 57.1% (12 cases, stenosis 28.6% (6 cases, and double lesion 14.3% (3 cases. The perfusion 43.10±9.50min, and ischemia time were 29.40±10.50min. The average clinical follow-up in mitral insufficiency was 41.52±53.61 months. In the stenosis group (4 patients was 46.39±32.02 months, and in the double lesion group (3 patients, 39.41±37.5 months. The echocardiographic follow-up was in mitral insufficiency 37.17±39.51 months, stenosis 42.61±30.59 months, and in the double lesion 39.41±37.51 months. RESULTS: Operative mortality was 9.5% (2 cases. No late deaths occurred. In the group with mitral insufficiency, 10 (83.3% patients were asymptomatic (p=0.04. The majorit y with mild reflux (p=0.002. In the follow-up of the stenosis group, all were in functional class I (NYHA; and the mean transvalve gradient varied between 8 and 12mmHg, average of 10.7mmHg. In the double lesion group, 1 patient was reoperated at 43 months. No endocarditis or thromboembolism were reported. CONCLUSION: Mitral stenosis repair has worse late results, related to the valve abnormalities and associated lesions. The correction of mitral insufficiency without annular support showed good long-term results.

  15. Echocardiographic findings and joint hypermobility: patients with mitral valve prolapse vs. healthy controls

    Directory of Open Access Journals (Sweden)

    Moradmand S

    2008-11-01

    Full Text Available "nBackground: Mitral valve prolapse is a relatively common valvular abnormality in most communities and joint hypermobility (JHM is also seen in many healthy people as well as in certain clinical disorders, such as Marfan syndrome. The present study was designed to investigate the association between joint hypermobility and mitral valve prolapse (MVP in an Iranian population sample. "nMethods: Fifty-seven patients with nonrheumatic and isolated mitral anterior leaflet prolapse (24 men and 33 women, mean age 23.5 +/-2.3 and 51 healthy subjects (20 men and 31 women, mean age 22.9+/-2.3 were studied. The presence of JHM was evaluated according to the Carter-Wilkinson & Beighton criteria. Echocardiographic examination was performed in all subjects and the correlation between the echocardiographic features of the mitral valve and the hypermobility score were investigated. "nResults: The frequency of JHM in patients with MVP was found to be significantly higher than that of controls (26.3% vs. 7.8%, with mean JHM scores of 3.1+/-2.2 and 1.9+/-1.7, respectively. The patients in the MVP group had significantly increased the anterior mitral leaflet thickness (AMLT, 3.4+/-0.4 mm vs. 3.0+/-0.3 mm; p<0.0005 and maximal leaflet displacement (MLD, 2.4+/-0.3 mm vs. 1.5+/-0.2 mm; p<0.0005 compared to the controls. "nConclusions: We detect a statistically significant relationship between isolated MVP and joint hypermobility as well as between the severity of JHM and echocardiographic features of the mitral leaflets. These results suggest a common etiology for MVP and JHM, which should be investigated in future well-conducted studies.

  16. Effectiveness of balloon valvuloplasty for palliation of mitral stenosis after repair of atrioventricular canal defects.

    Science.gov (United States)

    Robinson, Joshua D; Marx, Gerald R; Del Nido, Pedro J; Lock, James E; McElhinney, Doff B

    2009-06-15

    Closure of a mitral valve (MV) cleft, small left-sided cardiac structures, and ventricular imbalance all may contribute to mitral stenosis (MS) after repair of atrioventricular canal (AVC) defects. MV replacement is the traditional therapy but carries high risk in young children. The utility of balloon mitral valvuloplasty (BMV) in postoperative MS is not established and may offer alternative therapy or palliation. Since 1996, 10 patients with repaired AVC defects have undergone BMV at a median age of 2.5 years (range 8 months to 14 years), a median of 2 years after AVC repair. At catheterization, the median value of mean MS gradients was 16 mm Hg (range 12 to 22) and was reduced by 34% after BMV. Before BMV, there was mild mitral regurgitation in 9 of 10 patients, which increased to severe in 1 patient. All patients were alive at follow-up (median 5.4 years). Repeat BMV was performed in 4 patients, 10 weeks to 18 months after initial BMV. One patient underwent surgical valvuloplasty; 3 underwent MV replacement 2, 3, and 28 months after BMV. In the 6 patients (60%) with a native MV at most recent follow-up (median 3.2 years), the mean Doppler MS gradient was 9 mm Hg, the median weight had doubled, and weight percentile had increased significantly. In conclusion, BMV provides relief of MS in most patients with repaired AVC defects; marked increases in mitral regurgitation are uncommon. Because BMV can incompletely relieve obstruction and increase mitral regurgitation, it will not be definitive in most patients but will usually delay MV replacement to accommodate a larger prosthesis.

  17. Impact of prosthesis-patient mismatch on survival after mitral valve replacement: a systematic review

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian-feng; WU Yi-cheng; SHEN Wei-feng; KONG Ye

    2013-01-01

    Objective To determine whether the prosthesis-patient mismatch has a deleterious impact on survival after mitral valve replacement.Data sources A comprehensive literature search of PubMed,Embase,and ScienceDirect was carried out.References and cited papers of relevant articles were also checked.Study selection All articles published after January 1980 was initially considered.Non-English and non-human studies,case reports,and reviews were excluded from the initial search.References and cited papers of relevant articles were also checked.Results A total of 8 retrospective cohort studies were identified for this review.The overall incidence of prosthesis-patient mismatch (<1.3 to <1.2 cm2/m2) after mitral valve replacement ranged from 3.7% to 85.9% (moderate prosthesis-patient mismatch (0.9 to 1.2 cm2/m2) in 37.4% to 69.5%,severe prosthesis-patient mismatch (<0.9 cm2/m2) in 8.7% to 16.4%).Four studies demonstrated an association of prosthesis-patient mismatch with reduced long-term survival,but the other four studies found no significant deleterious impact of prosthesis-patient mismatch after mitral valve replacement.No definite conclusion could be derived from these conflicting results.Conclusions Current evidence is insufficient to derive a definite conclusion whether mitral prosthesis-patient mismatch affects long-term survival because of the biases and confounding factors that interfere with late clinical outcomes.Good-quality prospective studies are warranted to evaluate the impact of mitral prosthesis-patient mismatch after mitral valve replacement in the future.

  18. Surgical management of moderate ischemic mitral valve regurgitation: Where do we stand?

    Institute of Scientific and Technical Information of China (English)

    Khalil; Fattouch; Sebastiano; Castrovinci; Giacomo; Murana; Marco; Moscarelli; Giuseppe; Speziale

    2014-01-01

    Ischemic mitral regurgitation(IMR) represents a common complication after myocardial infarction. The valve is anatomically normal and the incompetence is the result of papillary muscles displacement and annular dilatation, causing leaflets tethering. Functionally the leaflets present a restricted systolic motion due to tethering forces that displaces the coaptation surface toward the left ventricle apex. The patients present poor left ventricular function at the time of surgery and the severity of the mitral regurgitation increases the risk of mortality. Currently there is general agreement to treat surgically severe IMR nevertheless strong evidences for patient with moderate insufficiency remains poor and proper treatment debated. The most effectivesurgical approach for the treatment of IMR remains debated. Some authors demonstrated that coronary artery bypass graft(CABG) alone is beneficial in patients with IMR. Conversely, in most patients, moderate IMR will persist or worsen after CABG alone which translate in higher long-term mortality as a function of residual mitral regurgitation severity. A probable reason for this unclear surgical management of functional MR is due to the contemporary suboptimal results of reparative techniques. The standard surgical treatment of chronic IMR is CABG associated with undersized annuloplasty using complete ring. Though, the recurrence of mitral regurgitation remains high(> 30%) because of continous left ventricle remodeling. To get better long term results, in the last decade, several subvalvular procedures in adjunct to mitral anuloplasty have been developed. Among them, surgical papillary muscle relocation represents the most appreciated option capable to restore normal left ventricle geometry. In the next future new preoperative predictors of increased mitral regurgitation recurrence are certainly needed to find an individual time period of treatment in each patient with moderate IMR.

  19. Interlaboratory testing of porcine sera for antibodies to porcine circovirus type 2

    DEFF Research Database (Denmark)

    McNair, I.; Marshall, M.; McNeilly, F.;

    2004-01-01

    A panel of 20 porcine sera was distributed to 5 laboratories across Europe and Canada. Each center was requested to test the sera for the presence of porcine circovirus type 2 antibodies using the routine assays, indirect immunofluorescence assay (IFA) and indirect immunoperoxidase monolayer assa...... than did IFA, and paraformaldehyde gave higher titers than did acetone or ethyl alcohol. This report highlights the need for standardized procedures and biologicals for this virus....

  20. Predictive value of natriuretic peptides in dogs with mitral valve disease

    DEFF Research Database (Denmark)

    Tarnow, Inge; Olsen, Lisbeth Høier; Kvart, Clarence;

    2009-01-01

    Natriuretic peptides are useful in diagnosing heart failure in dogs. However, their usefulness in detecting early stages of myxomatous mitral valve disease (MMVD) has been debated. This study evaluated N-terminal (NT) fragment pro-atrial natriuretic peptide (NT-proANP) and NT-pro-brain natriuretic...... peptide (NT-proBNP) in 39 Cavalier King Charles Spaniels (CKCS) with pre-clinical mitral valve regurgitation (MR), sixteen dogs with clinical signs of heart failure (HF) and thirteen healthy control dogs. Twenty seven CKCS and ten control dogs were re-examined 4 years after the initial examination and the...

  1. Antiphospholipid Syndrome and Libman-Sacks Endocarditis in a Bioprosthetic Mitral Valve.

    Science.gov (United States)

    Sladek, Eric H; Accola, Kevin D

    2016-02-01

    This report describes one the first cases of antiphospholipid syndrome and Libman-Sacks endocarditis in a bioprosthetic valve. A redo mitral valve replacement was carried out owing to early deterioration of the prior valve. Initially it was considered secondary to rheumatic heart disease; however, pathology analysis and autoimmune workup revealed antiphospholipid syndrome with Libman-Sacks endocarditis. We believe certain populations with mitral valve stenosis may have an underlying antiphospholipid syndrome. As a result, there needs to be a lower threshold for identifying this disease.

  2. Transient mitral regurgitation: An adjunctive sign of myocardial ischemia during dipyridamole-thallium imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lette, J.; Gagnon, A.; Lapointe, J.; Cerino, M.

    1989-07-01

    A patient developed transient exacerbation of a mitral insufficiency murmur and a reversible posterior wall perfusion defect during dipyridamole-thallium imaging. Coronary angiography showed significant stenoses of both the right and the circumflex coronary arteries that supply the posterior papillary muscle. Cardiac auscultation for transient mitral incompetence, a sign of reversible papillary muscle dysfunction, is a simple and practical adjunctive test for myocardial ischemia during dipyridamole-thallium imaging. It may confirm that an isolated reversible posterior wall myocardial perfusion defect is truly ischemic in nature as opposed to an artifact resulting from attenuation by the diaphragm.

  3. Doppler echocardiographic evaluation of Bjork-Shiley and St. Jude Medical prostheses in the mitral position.

    OpenAIRE

    Shigenobu,Masaharu; Nakayama,Hironobu; Hisamochi, Kunikazu; Yamamoto, Noriyoshi; Senoo,Yoshimasa; Teramoto,Shigeru

    1991-01-01

    The left ventricular studies by Doppler echocardiography were performed in 50 patients with a Bjork-Shiley (B-S) mitral valve and 50 patients after implantation of a St. Jude Medical (SJM) mitral valve; the effect of valve replacement on the hemodynamic performance at rest and during bicycle exercise was determined from serial echocardiographic data. Twenty-eight patients (56%) of the B-S group and 42 patients (84%) of the SJM group showed a good response to the exercise. There was no signifi...

  4. Concomitant Tricuspid Valve Surgery Affects Outcomes Following Mitral Operations: A multi-institutional, statewide analysis

    Science.gov (United States)

    LaPar, Damien J.; Mulloy, Daniel P.; Stone, Matthew L.; Crosby, Ivan K.; Lau, Christine L; Kron, Irving L.; Ailawadi, Gorav

    2012-01-01

    Background Mitral valve disease is often accompanied by concomitant tricuspid valve disease. The purpose of this study was to determine the influence of performing tricuspid procedures in the setting of mitral valve surgery within a multi-institutional patient population. Methods From 2001–2008, 5,495 mitral valve operations were performed at 17 different statewide centers. Patients underwent either mitral valve alone (MV alone, n=5,062, age=63.4±13.0 years) or mitral + tricuspid valve operations (MV+TV, n=433, age=64.0±14.2 years). Univariate and multivariate analyses were used to assess the influence of concomitant tricuspid procedures on operative mortality and the composite incidence of major complications. Results Patients undergoing MV+TV were more commonly female (62.7% vs. 45.5%, p<0.001), had higher rates of heart failure (73.7% vs. 50.9%, p<0.001), and more frequently underwent reoperations (17.1% vs. 7.4%, p<0.001) compared to MV alone patients. Other patient characteristics, including preoperative endocarditis (8.5% vs. 8.2%, p=0.78), were similar between groups. Mitral replacement (63.5%) was more common than repair (36.5%, p<0.001) in MV+TV operations, and MV+TV operations incurred longer median cardiopulmonary bypass (181 min. vs. 149 min, p<0.001) times. Unadjusted operative mortality (6.0% vs. 10.4%, p=0.001) and postoperative complications were higher following MV+TV compared to MV alone. Importantly, after risk adjustment, performance of concomitant tricuspid valve procedures proved an independent predictor of operative mortality (OR=1.50, p=0.03) and major complications (OR=1.39, p=0.004). Conclusions Concomitant tricuspid surgery is a proxy for more advanced valve disease. Compared to mitral operations alone, simultaneous mitral-tricuspid valve operations are associated with elevated morbidity and mortality even after risk adjustment. This elevated risk should be considered during preoperative patient risk stratification. PMID:22607786

  5. Impact of the learning curve on outcome after transcatheter mitral valve repair

    DEFF Research Database (Denmark)

    Ledwoch, Jakob; Franke, Jennifer; Baldus, Stephan;

    2014-01-01

    not decrease over time. CONCLUSION: A learning curve using the MitraClip(®) device does not appear to significantly affect acute MR reduction, hospital and 30-day mortality. Most likely, the proctor system leads to already high initial procedure success and relatively short procedure time.......AIMS: This analysis from the German Mitral Valve Registry investigates the impact of the learning curve with the MitraClip(®) technique on procedural success and complications. METHODS AND RESULTS: Consecutive patients treated since 2009 in centers that performed more than 50 transcatheter mitral...

  6. A Cranial-Sided Approach for Repeated Mitral Periprosthetic Leak After Right Pneumonectomy.

    Science.gov (United States)

    Takahashi, Yosuke; Shibata, Toshihiko; Sasaki, Yasuyuki; Kato, Yasuyuki; Motoki, Manabu; Morisaki, Akimasa; Nishimura, Shinsuke; Hattori, Koji

    2016-03-01

    A 72-year-old man presented with worsening dyspnea on effort. He underwent right pneumonectomy 40 years ago, then mitral valve replacement through a right thoracotomy 8 years ago with repeat surgery to repair a periprosthetic valve leak; the mediastinum was displaced to the right, and the heart was rotated counterclockwise. Transthoracic echocardiography showed periprosthetic valve leak recurrence near the left atrial appendage. We repaired the periprosthetic valve leak through a median sternotomy. Transecting the main pulmonary artery allowed us to widely open the cranial-sided left atrium. We obtained good exposure of the mitral valve, and repaired the periprosthetic valve leak using pledgeted sutures and a pericardial patch.

  7. Estudo do padrão respiratório e movimento toracoabdominal em valvopatia mitral

    Directory of Open Access Journals (Sweden)

    Satiko Shimada Franco

    2012-11-01

    Full Text Available FUNDAMENTO: pacientes com valvopatia mitral podem evoluir com congestão pulmonar, que aumenta o trabalho dos músculos respiratórios; essa sobrecarga pode alterar o padrão respiratório com predomínio do deslocamento torácico ou presença de movimentos paradoxais. OBJETIVO: a estudar o padrão respiratório e movimento toracoabdominal (MTA em pacientes com doença mitral b estudar o efeito do posicionamento nos parâmetros respiratórios c correlacionar hipertensão pulmonar com presença de incoordenação do MTA. MÉTODOS: o padrão respiratório e o MTA de pacientes com doença mitral foram avaliados por pletismografia respiratória por indutância, nas posições dorsal e sentada, durante dois minutos de respiração tranquila. Analisou-se volume corrente (Vc e tempos respiratórios e as variáveis do MTA. RESULTADOS: de 65 pacientes incluídos, 10 foram retirados, 29 participaram do grupo estenose mitral e 26 do grupo insuficiência mitral. O Vc, a ventilação pulmonar e o fluxo inspiratório médio aumentaram significantemente na posição sentada, sem diferenças entre os grupos. O MTA manteve-se coordenado entre os grupos e as posições; no entanto, cinco pacientes na posição dorsal apresentaram incoordenação (três no grupo estenose mitral; dois no grupo insuficiência mitral com correlação significante com valores de pressão de artéria pulmonar (r = 0,992, p = 0,007. CONCLUSÃO: o padrão respiratório e o MTA não apresentam diferenças entre pacientes com estenose ou insuficiência mitral. A posição sentada aumenta o Vc sem alterar os tempos respiratórios. A presença de incoordenação toracoabdominal na posição dorsal esteve associação à hipertensão pulmonar.

  8. Mitral valve repair in a patient with previous percutaneous annuloplasty with a CARILLON device.

    Science.gov (United States)

    Bartkowiak, Marek; Bugajski, Pawel; Jedlinski, Ireneusz; Kalawski, Ryszard

    2011-06-01

    A 67-year-old female patient was referred to our clinic for coronary artery bypass graft and severe mitral regurgitation (MR) treatment. The patient had a history of coronary disease and MR treated in 2007 with a CARILLON device. Left mammary and saphenous vein were used to graft the diseased coronaries. MR was corrected with a saddle ring; however, we had some difficulties anchoring ring sutures to the mitral annulus caused by the protruding CARILLON. The ring was finally stitched, and the patient was weaned from bypass. A transoesophageal echo showed a competent valve. The patient was transferred to the intensive care unit on moderate catecholamines. PMID:21422158

  9. Defeito do anel fibroso mitral posterior com aneurisma de átrio esquerdo e insuficiência mitral: tratamento cirúrgico com sucesso Defect of the posterior mitral fibrous ring with left atrial aneurysm and mitral insufficiency: successful surgical treatment

    Directory of Open Access Journals (Sweden)

    Ronaldo Machado BUENO

    1999-10-01

    Full Text Available Aneurismas em átrio esquerdo são pouco comuns, podendo ocorrer na aurícula ou na parede do átrio esquerdo. Freqüentemente, são assintomáticos, podendo ocorrer arritmias, fenômenos tromboembólicos ou insuficiência cardíaca como complicação da sua evolução. Apresentamos paciente de 39 anos, do sexo feminino, com defeito do anel posterior da valva mitral levando a grande dilatação aneurismática da parede posterior do átrio esquerdo com insuficiência mitral. O diagnóstico foi feito pela radiografia de tórax (abaulamento de silhueta cardíaca esquerda e ecocardiograma (grande aneurisma do átrio esquerdo posteriormente à parede posterior do ventrículo esquerdo com insuficiência mitral. O estudo hemodinâmico sugeriu pseudo-aneurisma de ventrículo esquerdo. Submetida a tratamento cirúrgico com auxílio da circulação extracorpórea, realizou-se anuloplastia mitral e exclusão do aneurisma com reconstrução do assoalho do átrio esquerdo com retalho de pericárdio bovino. A paciente apresentou boa evolução pós-operatória, recebendo alta hospitalar no oitavo dia em boas condições clínicas.Atrial aneurysm is a rare condition and can be found on the atrial appendage or on the atrial wall. Most patients are asymptomatic, but arrhythmias, thromboembolism, and heart failure are common complications. We present a 39 years old female patient with posterior mitral ring defect causing a great aneurysm of the left posterior atrial wall with mitral insufficiency. The diagnosis was achieved by chest roentgenogram (marked prominence of the upper left heart border and echocardiography (great left atrial aneurysm behind the left posterior ventricular wall with mitral insufficiency. Left ventricular cineangiogram suggested the presence of a false aneurysm of the left ventricle. The patient subsequently underwent surgical treatment with cardiopulmonary bypass. Posterior mitral valve annuloplasty was performed with aneurysm exclusion

  10. Production of recombinant porcine IGF-binding protein-5 and its effect on proliferation of porcine embryonic myoblast cultures in the presence and absence of IGF-I and Long-R3-IGF-I.

    Science.gov (United States)

    Pampusch, M S; Xi, G; Kamanga-Sollo, E; Loseth, K J; Hathaway, M R; Dayton, W R; White, M E

    2005-04-01

    IGF-binding protein-5 (IGFBP-5) is produced by porcine embryonic myogenic cell (PEMC) cultures and is secreted into the medium. IGFBP-5 may play some role in myogenesis and/or in changes in myogenic cell proliferation that accompany differentiation. IGFBP-5 reportedly may either suppress or stimulate proliferation or differentiation of cultured cells depending on cell type and culture conditions. Additionally, IGFBP-5 has been shown to possess both IGF-dependent and IGF-independent actions in some cell types. The goal of this study was to produce recombinant porcine IGFBP-5 (rpIGFBP-5) and assess its IGF-I-dependent and IGF-I-independent actions on the proliferation of PEMCs. To accomplish this, we have expressed porcine IGFBP-5 in the baculovirus system, purified and characterized the expressed rpIGFBP-5 and produced an anti-porcine IGFBP-5 antibody that neutralizes the biological activity of porcine IGFBP-5. rpIGFBP-5, purified to 98% homogeneity using nickel affinity chromatography and IGF-I affinity chromatography, suppressed IGF-I-stimulated proliferation of PEMCs in a concentration-dependent manner (P>0.05). rpIGFBP-5 also suppressed Long-R3-IGF-I-stimulated proliferation of PEMCs (P>0.05), even in the presence of significant molar excess of Long-R3-IGF-I compared with rpIGFBP-5, demonstrating the IGF-independent activity that rpIGFBP-5 possesses in PEMCs, since Long-R3-IGF-I is an IGF analog that has very low affinity for the IGFBPs but retains its ability to bind to the type I IGF receptor and thereby can stimulate proliferation. The anti-rpIGFBP-5 IgY produced against rpIGFBP-5 specifically recognized native porcine IGFBP-5 in PEMC media that also contained porcine IGFBP-2, -3, and -4. This antibody is capable of neutralizing the effects of both rpIGFBP-5 and endogenously produced porcine IGFBP-5 on PEMCs as well as detecting IGFBP-5 in Western blots. The production of rpIGFBP-5 and a neutralizing antibody to porcine IGFBP-5 provides a powerful tool to

  11. Porcine Reproductive and Respiratory Syndrome Virus (PRRSV)

    DEFF Research Database (Denmark)

    Kvisgaard, Lise Kirstine

    This PhD thesis presents the diversity of Porcine Reproductive and Respiratory Syndrome viruses (PRRSV) circulating in the Danish pig population. PRRS is a disease in pigs caused by the PRRS virus resulting in reproductive failures in sows and gilts and respiratory diseases in pigs . Due to genetic...

  12. Splicing variants of porcine synphilin-1

    Directory of Open Access Journals (Sweden)

    Knud Larsen

    2015-09-01

    Full Text Available Parkinson's disease (PD, idiopathic and familial, is characterized by degradation of dopaminergic neurons and the presence of Lewy bodies (LB in the substantia nigra. LBs contain aggregated proteins of which α-synuclein is the major component. The protein synphilin-1 interacts and colocalizes with α-synuclein in LBs. The aim of this study was to isolate and characterize porcine synphilin-1 and isoforms hereof with the future perspective to use the pig as a model for Parkinson's disease. The porcine SNCAIP cDNA was cloned by reverse transcriptase PCR. The spatial expression of SNCAIP mRNA was investigated by RNAseq. The presented work reports the molecular cloning and characterization of the porcine (Sus scrofa synphilin-1 cDNA (SNCAIP and three splice variants hereof. The porcine SNCAIP cDNA codes for a protein (synphilin-1 of 919 amino acids which shows a high similarity to human (90% and to mouse (84% synphilin-1. Three shorter transcript variants of the synphilin-1 gene were identified, all lacking one or more exons. SNCAIP transcripts were detected in most examined organs and tissues and the highest expression was found in brain tissues and lung. Conserved splicing variants and a novel splice form of synhilin-1 were found in this study. All synphilin-1 isoforms encoded by the identified transcript variants lack functional domains important for protein degradation.

  13. Occupational asthma due to porcine pancreatic amylase

    OpenAIRE

    1997-01-01

    A case of occupational asthma in a 41 year old histopathology laboratory technician attributable to a powder preparation of the porcine pancreatic enzyme amylase is reported. The diagnosis was confirmed by a double blind, placebo controlled, inhalation challenge study which showed immediate and late asthmatic reactions associated with a significant increase in airway responsiveness to methacholine.

  14. Porcine lung surfactant protein B gene (SFTPB)

    DEFF Research Database (Denmark)

    Cirera Salicio, Susanna; Fredholm, Merete

    2008-01-01

    The porcine surfactant protein B (SFTPB) is a single copy gene on chromosome 3. Three different cDNAs for the SFTPB have been isolated and sequenced. Nucleotide sequence comparison revealed six nonsynonymous single nucleotide polymorphisms (SNPs), four synonymous SNPs and an in-frame deletion of 69...

  15. Transcatheter, valve-in-valve transapical aortic and mitral valve implantation, in a high risk patient with aortic and mitral prosthetic valve stenoses

    Directory of Open Access Journals (Sweden)

    Harish Ramakrishna

    2015-01-01

    Full Text Available Transcatheter valve implantation continues to grow worldwide and has been used principally for the nonsurgical management of native aortic valvular disease-as a potentially less invasive method of valve replacement in high-risk and inoperable patients with severe aortic valve stenosis. Given the burden of valvular heart disease in the general population and the increasing numbers of patients who have had previous valve operations, we are now seeing a growing number of high-risk patients presenting with prosthetic valve stenosis, who are not potential surgical candidates. For this high-risk subset transcatheter valve delivery may be the only option. Here, we present an inoperable patient with severe, prosthetic valve aortic and mitral stenosis who was successfully treated with a trans catheter based approach, with a valve-in-valve implantation procedure of both aortic and mitral valves.

  16. One-year results from cryopreserved mitral allograft transplantation into the tricuspid position in a sheep experimental model.

    Science.gov (United States)

    Mokracek, A; Canadyova, J; Simunkova, Z; Fiala, R; Hmirak, M; Sulda, M; Burkert, J; Tintera, J; Kobylka, P; Spatenka, J

    2015-01-01

    Mitral allografts are still used only exceptionally in the mitral or tricuspid position. The main indication remains infectious endocarditis of atrioventricular valves for its flexibility and low risk of infection. The aim of our study was to evaluate 1-year results of mitral allografts transplantation into the tricuspid position in a sheep model. Mitral allografts were processed, cryopreserved, and transplanted into the tricuspid position anatomically (Group I - 11 animals) or antianatomically (Group II - 8 animals). All survivors (4 from Group I, and 3 from Group II) were checked at 3, 6, and 12 months by echocardiography with the exception of one survivor from Group II (which was examinated only visually). Examination throughout follow-up included for mitral allograft regurgitation and annuli dilatation. At postmortem, the papillary muscles were healed and firmly anchored to the right ventricular wall in all subjects. Transventricular fixation of the papillary muscles with buttressed sutures was proven to be a stable, reproducible, and safe method for anchoring mitral allograft leaflets. There were no significant differences between the two implantation methods. Annulus support of mitral allografts might be very useful in this type of operation and could prevent annular dilatation. PMID:26047374

  17. Myeloid zinc ifnger 1 (MZF1) is the most important transcriptional factor for porcine follistatin promoter

    Institute of Scientific and Technical Information of China (English)

    SUN Ya-meng; WANG Liang; YANG Xiu-qin; ZHANG Dong-jie; LIU Di

    2015-01-01

    Fol istatin (FS) is a secreted protein, which was original y isolated from porcine fol icular lfuid. Expression of fol istatin is tightly regulated during porcine growth and development. To study the essential transcriptional regions of the porcine FS promoter, ten primer pairs were designed to amplify segments with different lengths of the FS promoter from–1 800 to+16 bp. The products were then inserted into the pGL3-basic vector to analyze the relative luciferase activity. The results showed that the most remarkable changes of promoter activity were observed between constructs (–302/+16 bp)-FS and (–180/+16 bp)-FS (P<0.01). Further research showed that the reconstructed reporter plasmid lacking myeloid zinc ifnger 1 (MZF1) binding sequence had signiifcantly decreased luciferase activity (P<0.05). Furthermore, the FS protein expression was signiifcantly increased in PK15 cel s while the MZF1 was overexpressed, suggesting that the short sequence“TCCCCACC”(the recognition site of transcription factor MZF1) was the most important for FS transcription activation in the porcine.

  18. Dopaminergic modulation of mitral cell activity in the frog olfactory bulb: a combined radioligand binding-electrophysiological study

    International Nuclear Information System (INIS)

    Dopamine content in the amphibian olfactory bulb is supplied by interneurons scattered among mitral cells in the external plexiform/mitral cell layer. In mammals, dopamine has been found to be involved in various aspects of bulbar information processing by influencing mitral cell odour responsiveness. Dopamine action in the bulb depends directly on the localization of its receptor targets, found to be mainly of the D2 type in mammals. The present study assessed, in the frog, both the anatomical localization of D2-like, radioligand-labelled receptors of dopamine and the in vivo action of dopamine on unitary mitral cell activity in response to odours delivered over a wide range of concentrations. The [125I]iodosulpride-labelled D2 binding sites were visualized on frozen sagittal sections of frog brains by film radioautography. The sites were found to be restricted to the external plexiform/mitral cell layer; other layers of the olfactory bulb were devoid of specific labelling. Electrophysiological recordings of mitral unit activity revealed that dopamine or its agonist apomorphine induced a drastic reduction of spontaneous firing rate of mitral cells in most cases without altering odour intensity coding properties of these cells. Moreover, pre-treatment with the D2 antagonist eticlopride blocked the dopamine-induced reduction of mitral cell spontaneous activity.In the frog olfactory bulb, both anatomical localization of D2-like receptors and functional data on dopamine involvement in information processing differ from those reported in mammals. This suggests a phylogenetic evolution of dopamine action in the olfactory bulb. In the frog, anatomical data perfectly corroborate electrophysiological results, together strongly suggesting a direct action of dopamine on mitral cells. In a physiologically operating system, such an action would result in a global improvement of signal-to-noise ratio. (Copyright (c) 1997 Elsevier Science B.V., Amsterdam. All rights reserved.)

  19. Moderate ischemic mitral regurgitation (IMR and metabolic syndrome: where are we now and where are we going?

    Directory of Open Access Journals (Sweden)

    Ahmed Mohamed H

    2006-11-01

    Full Text Available Abstract Background The metabolic syndrome appears to affect 10% to 25% of adult population worldwide. Several studies have described the association between metabolic syndrome and ischaemic heart disease, however, none linked metabolic syndrome to ischemic mitral regurgitation, a serious clinical problem facing both the cardiologists and cardiac surgeons. Ischemic mitral regurgitation is mitral insufficiency caused by myocardial infarction. The myocardial ischemia can result in altered ventricular geometry, leading to mitral insufficiency. Interestingly metabolic syndrome showed more pronounced alteration of left ventricular geometry and function especially in obese subjects. Presentation of the hypothesis We have recently proposed that there is link between metabolic syndrome and ischemic mitral regurgitation and associated complications. Operative strategy for moderate ischaemic mitral regurgitation continues to be debated between revascularisation alone and concomitant valve repair at the time of coronary artery bypass surgery. Each of the above group has published studies, with results supporting each argument. Testing the hypothesis Generally speaking the treatments available for metabolic syndrome are based in both life style modification (dietary advice and advice to increase physical activity and medical treatment to enhance insulin sensitivity. Randomised controlled trials may show whether the current available treatment of metabolic syndrome may have an impact on moderate ischemic mitral regurgitation. Implications of the hypothesis Metabolic syndrome was shown to alter left ventricular geometry and therefore it is possible to postulate that the variation in the response of different patients with moderate ischemic mitral regurgitation to current management may be attributed to the absence and presence of metabolic syndrome. Research testing of this hypothesis in the future may reveal whether concomitant treatment of metabolic

  20. Dopaminergic modulation of mitral cell activity in the frog olfactory bulb: a combined radioligand binding-electrophysiological study

    Energy Technology Data Exchange (ETDEWEB)

    Duchamp, A.; Moyse, E.; Delaleu, J.-C.; Coronas, V.; Duchamp-Viret, P. [Laboratoire de Physiologie Neurosensorielle, Universite Claude Bernard and CNRS, F69622 Villeurbanne (France)

    1997-04-28

    Dopamine content in the amphibian olfactory bulb is supplied by interneurons scattered among mitral cells in the external plexiform/mitral cell layer. In mammals, dopamine has been found to be involved in various aspects of bulbar information processing by influencing mitral cell odour responsiveness. Dopamine action in the bulb depends directly on the localization of its receptor targets, found to be mainly of the D{sub 2} type in mammals. The present study assessed, in the frog, both the anatomical localization of D{sub 2}-like, radioligand-labelled receptors of dopamine and the in vivo action of dopamine on unitary mitral cell activity in response to odours delivered over a wide range of concentrations. The [{sup 125}I]iodosulpride-labelled D{sub 2} binding sites were visualized on frozen sagittal sections of frog brains by film radioautography. The sites were found to be restricted to the external plexiform/mitral cell layer; other layers of the olfactory bulb were devoid of specific labelling. Electrophysiological recordings of mitral unit activity revealed that dopamine or its agonist apomorphine induced a drastic reduction of spontaneous firing rate of mitral cells in most cases without altering odour intensity coding properties of these cells. Moreover, pre-treatment with the D{sub 2} antagonist eticlopride blocked the dopamine-induced reduction of mitral cell spontaneous activity.In the frog olfactory bulb, both anatomical localization of D{sub 2}-like receptors and functional data on dopamine involvement in information processing differ from those reported in mammals. This suggests a phylogenetic evolution of dopamine action in the olfactory bulb. In the frog, anatomical data perfectly corroborate electrophysiological results, together strongly suggesting a direct action of dopamine on mitral cells. In a physiologically operating system, such an action would result in a global improvement of signal-to-noise ratio. (Copyright (c) 1997 Elsevier Science B

  1. Factors related to sinus rhythm at discharge after radiofrequency ablation of permanent atrial fibrillation in patients undergoing mitral valve surgery.

    Science.gov (United States)

    Rostagno, Carlo; Gelsomino, Sandro; Capecchi, Irene; Rossi, Alessandra; Montesi, Gian Franco; Stefàno, Pier Luigi

    2016-04-01

    Late recovery of sinus rhythm is unusual in patients with permanent AF treated by (radiofrequency) RF maze procedure during mitral valve surgery. Identification of clinical and instrumental preoperative factors predictive of early success of RF ablation in patients with permanent AF undergoing mitral valve surgery may improve selection of subjects to obtain long-term results. Hundred and thirty consecutive patients with permanent AF and mitral valve disease underwent modified RF maze procedure during concomitant mitral valve surgery. Rheumatic valve disease (61 pts) and mitral valve prolapse (41 pts) were the more common aetiology of valve abnormalities. Mitral valve replacement was performed in 54 % of patients and mitral valve repair in the remaining 46 %. Four patients died after surgery. At discharge, 87 patients (69 %) were in sinus rhythm (group 1) and 43 patients in AF persisted (group 2). At an average 24-month follow-up, sinus rhythm was present in 67 % of patients, and 33 % were in atrial fibrillation. In this period, late recovery of sinus rhythm was observed only in five patients, while eight discharged in sinus rhythm developed again atrial fibrillation. Among preoperative parameters at univariate analysis female sex, atrial fibrillation >24 months, left atrial diameter >54 mm, left atrial area >24 cm(2), rheumatic valve disease and NYHA class were associated with persistence of AF. At Cox regression multivariate analysis, increased left atrial area (OR 1.07 per unit increase-95 % CI 1.01-1.131) and rheumatic aetiology of valve disease (OR 4.52, 95 % CI 1.65-12.4) were associated with persistence of AF at hospital discharge. Persistence of AF after RF ablation in patients undergoing mitral valve surgery is related to aetiology, e.g. rheumatic valve disease, and to increasing left atrial diameter. Due to low rate of late recovery of sinus rhythm, indication to RF ablation associated with MV surgery should be carefully considered in patients with large

  2. Left ventricular twist and circumferential strain in dogs with myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Zois, Nora Elisabeth; Olsen, N. T.; Moesgaard, S. G.;

    2013-01-01

    During the cardiac cycle, the ventricle undergoes a twisting motion because of the oblique orientation of the left ventricular (LV) myofibers. This can be quantified by speckle-tracking echocardiography (STE). In mitral regurgitation (MR) in humans, the short axis deformation has been suggested...

  3. Multiple modes of action potential initiation and propagation in mitral cell primary dendrite

    DEFF Research Database (Denmark)

    Chen, Wei R; Shen, Gongyu Y; Shepherd, Gordon M;

    2002-01-01

    to support the back-propagation of the evoked somatic action potential to produce the second dendritic spike. In summary, the balance of spatially distributed excitatory and inhibitory inputs can dynamically switch the mitral cell firing among four different modes: axo-somatic initiation with back...

  4. Procedural guidance using advance imaging techniques for percutaneous edge-to-edge mitral valve repair.

    Science.gov (United States)

    Quaife, Robert A; Salcedo, Ernesto E; Carroll, John D

    2014-02-01

    The complexity of structural heart disease interventions such as edge-to edge mitral valve repair requires integration of multiple highly technical imaging modalities. Real time imaging with 3-dimensional (3D) echocardiography is a relatively new technique that first, allows clear volumetric imaging of target structures such as the mitral valve for both pre-procedural diagnosis and planning in patients with degenerative or functional mitral valve regurgitation. Secondly it provides intra-procedural, real-time panoramic volumetric 3D view of structural heart disease targets that facilitates eye-hand coordination while manipulating devices within the heart. X-ray fluoroscopy and RT 3D TEE images are used in combination to display specific targets and movement of catheter based technologies in 3D space. This integration requires at least two different image display monitors and mentally fusing the individual datasets by the operator. Combined display technology such as this, allow rotation and orientation of both dataset perspectives necessary to define targets and guidance of structural disease device procedures. The inherently easy concept of direct visual feedback and eye-hand coordination allows safe and efficient completion of MitraClip procedures. This technology is now merged into a single structural heart disease guidance mode called EchoNavigator(TM) (Philips Medical Imaging Andover, MA). These advanced imaging techniques have revolutionized the field of structural heart disease interventions and this experience is exemplified by a cooperative imaging approach used for guidance of edge-to-edge mitral valve repair procedures.

  5. Fibroelastoma of the mitral valve as a cause of transient ischemic stroke

    Directory of Open Access Journals (Sweden)

    Alexandre Alessi

    2001-07-01

    Full Text Available A 44-year-old woman had a transient ischemic stroke, fibroelastoma of the mitral valve being the source of the embolus. The patient evolved with neutropenia induced by ticlopidine after 10 days of treatment. We report the major clinical features, therapeutical options, and medicamentous toxicity resulting from the use of antiplatelet drugs.

  6. Mural Papilloma of the Left Ventricle and Floppy Mitral Valve: Report of an Unusual Association

    OpenAIRE

    Stellin, Giovanni; Bortolotti, Uberto; Valfre, Carlo; Mazzucco, Alessandro; Thiene, Gaetano; Cavarzerani, Antonio; Gallucci, Vincenzo

    1983-01-01

    A 49-year-old man, with the diagnosis of floppy mitral valve and fibromyxomatous papilloma of the left ventricular outflow tract, underwent prosthetic valve replacement and excision of the tumor with good results. Although a left ventricular angiogram failed to visualize it, the intracardiac mass was diagnosed by two-dimensional echocardiography.

  7. Pseudoaneurysm of mitral-aortic intervalvular fibrosa in a child: Demonstration by MDCT and MRI

    International Nuclear Information System (INIS)

    Subaortic left ventricular outflow tract pseudoaneurysms are rare lesions that are associated with aortic valve diseases, infective endocarditis, trauma or surgery. We present dynamic multidetector computerized tomography and cine magnetic resonance imaging features of a case of subaortic aneurysm arising from interaortic-mitral valvular region in a child with past history of infective endocarditis

  8. Left ventricular pseudoaneurysm found after mitral valve replacement performed 30 years earlier.

    Science.gov (United States)

    Castilla, Elena; Gato, Manuel; Ruiz, José Ramón

    2010-03-01

    Pseudoaneurysm of the left ventricle (LV) is a rare cardiac disease that occurs after myocardial infarction or cardiac surgery. Because patients frequently present with nonspecific symptoms, a high index of suspicion is needed to make the diagnosis. This report describes an unusual case demonstrating a large LV pseudoaneurysm after mitral valve replacement performed 30 years earlier. PMID:20197588

  9. Severe Bioprosthetic Mitral Valve Stenosis and Heart Failure in a Young Woman with Systemic Lupus Erythematosus

    Science.gov (United States)

    Wartak, Siddharth; Sadiq, Adnan; Crooke, Gregory; Moskovits, Manfred; Frankel, Robert; Hollander, Gerald; Shani, Jacob

    2016-01-01

    A 23-year-old African American woman with a past medical history of systemic lupus erythematous (SLE), secondary hypertension, and end stage renal disease (ESRD) on hemodialysis for eight years was stable until she developed symptomatic severe mitral regurgitation with preserved ejection fraction. She underwent a bioprosthetic mitral valve replacement (MVR) at outside hospital. However, within a year of her surgery, she presented to our hospital with NYHA class IV symptoms. She was treated for heart failure but in view of her persistent symptoms and low EF was considered for heart and kidney transplant. This was a challenge in view of her history of lupus. We presumed that her stenosis of bioprosthetic valve was secondary to lupus and renal disease. We hypothesized that her low ejection fraction was secondary to mitral stenosis and potentially reversible. We performed a dobutamine stress echocardiogram, which revealed an improved ejection fraction to more than 50% and confirmed preserved inotropic contractile reserve of her myocardium. Based on this finding, she underwent a metallic mitral valve and tricuspid valve replacement. Following surgery, her symptoms completely resolved. This case highlights the pathophysiology of lupus causing stenosis of prosthetic valves and low ejection cardiomyopathy.

  10. In-Vivo Analysis of Selectively Flexible Mitral Annuloplasty Rings Using Three-Dimensional Echocardiography

    NARCIS (Netherlands)

    Owais, Khurram; Kim, Han; Khabbaz, Kamal R.; Bergman, Remco; Matyal, Robina; Gorman, Robert C.; Gorman, Joseph H.; Hess, Philip E.; Mahmood, Feroze

    2014-01-01

    Background. Selectively flexible rings, Colvin-Galloway (CG) Future and Carpentier-Edwards (CE) Physio II, are used for annuloplasty during mitral valve repair to facilitate dynamic annular motion while preventing annular dilation. In this study, we assessed the extent and nature of the flexibility

  11. Successful treatment of mitral valve endocarditis in a dog associated with 'Actinomyces canis-like' infection.

    Science.gov (United States)

    Balakrishnan, N; Alexander, K; Keene, B; Kolluru, S; Fauls, M L; Rawdon, I; Breitschwerdt, E B

    2016-09-01

    Infective endocarditis, an inflammation of the endocardial surface due to invasion by an infectious agent, is more common in middle sized to large breed dogs. We herein report a case of mitral valve endocarditis in a 9-year-old male-castrated Weimaraner caused by an Actinomyces canis-like bacterium, not previously reported in association with infection in dogs. PMID:27364088

  12. Hemorrhagic shock as a complication of anticoagulant therapy following the mitral valve replacement

    OpenAIRE

    Zah, Tajana; Ivančan, Višnja; TONKOVIĆ, DINKO; Krznarić, Željko; Klinar, Igor; Majerić Kogler, Višnja

    2007-01-01

    This report describes a case of the hemorrhagic shock in a patient on the anticoagulant therapy supplementing implanted mechanical prosthetic heart valve replacing the mitral valve. The association between hemorrhagic shock, mechanical prosthetic heart valve and anticoagulant therapy is briefly discussed.

  13. Characterization of biomechanical properties of aged human and ovine mitral valve chordae tendineae.

    Science.gov (United States)

    Zuo, Keping; Pham, Thuy; Li, Kewei; Martin, Caitlin; He, Zhaoming; Sun, Wei

    2016-09-01

    The mitral valve (MV) is a highly complex cardiac valve consisting of an annulus, anterior and posterior leaflets, chordae tendineae (chords) and two papillary muscles. The chordae tendineae mechanics play a pivotal role in proper MV function: the chords help maintain proper leaflet coaptation and rupture of the chordae tendineae due to disease or aging can lead to mitral valve insufficiency. Therefore, the aim of this study was to characterize the mechanical properties of aged human and ovine mitral chordae tendineae. The human and ovine chordal specimens were categorized by insertion location (i.e., marginal, basal and strut) and leaflet type (i.e., anterior and posterior). The results show that human and ovine chords of differing types vary largely in size but do not have significantly different elastic and failure properties. The excess fibrous tissue layers surrounding the central core of human chords added thickness to the chords but did not contribute to the overall strength of the chords. In general, the thinner marginal chords were stiffer than the thicker basal and strut chords, and the anterior chords were stiffer and weaker than the posterior chords. The human chords of all types were significantly stiffer than the corresponding ovine chords and exhibited much lower failure strains. These findings can be explained by the diminished crimp pattern of collagen fibers of the human mitral chords observed histologically. Moreover, the mechanical testing data was modeled with the nonlinear hyperelastic Ogden strain energy function to facilitate accurate computational modeling of the human MV. PMID:27315372

  14. Acute renal infarction secondary to calcific embolus from mitral annular calcification.

    Science.gov (United States)

    Bande, Dinesh; Abbara, Suhny; Kalva, Sanjeeva P

    2011-06-01

    We report a case of a 62-year-old man who presented with right groin pain who subsequently was found to have a renal infarct secondary to calcific embolus from mitral annular calcification on CT and angiography. We briefly review the literature and discuss the importance of this entity in clinical practice.

  15. Mitral valve disease with rheumatic appearance in the presence of left ventricular endomyocardial fibrosis

    Directory of Open Access Journals (Sweden)

    Lurildo R. Saraiva

    1999-03-01

    Full Text Available This is a report of a nine-year-old boy with both mitral stenosis and regurgitation and extensive endomyocardial fibrosis of the left ventricle. Focus is given to the singularity of the fibrotic process, with an emphasis on the etiopathogenic aspects.

  16. Transapical JenaValve in a patient with mechanical mitral valve prosthesis.

    LENUS (Irish Health Repository)

    O' Sullivan, Katie E

    2014-01-29

    We report the first case of transcatheter aortic valve replacement implantation using JenaValve™ in a patient with mechanical mitral valve prosthesis. We believe that the design features of this valve may be particularly suited for use in this setting. © 2014 Wiley Periodicals, Inc.

  17. Perforation of the Anterior Mitral Leaflet After Impella LP 5.0 Therapy in Cardiogenic Shock.

    Science.gov (United States)

    Eftekhari, Ashkan; Eiskjær, Hans; Terkelsen, Christian Juhl; Nielsen, Sten Lyager; Christiansen, Evald Høj; Poulsen, Steen Hvitfeldt

    2016-05-01

    A 52-year old man was admitted with out-of-hospital cardiac arrest, and he was resuscitated after 100 minutes. The initial hemodynamic condition was critical due to cardiogenic shock (left ventricular ejection fraction 10 % and mean arterial pressure 60 mmHg on inotropics). Acute coronary angiography did not reveal any new lesions. Due to persistent hemodynamic instability, mechanical support with Impella LP 5.0 was decided. The surgical procedure guided by fluoroscopy and transesophageal echocardiography was uncomplicated. The hemodynamic improved subsequently and after 17 days of intensive care, and additional 30 days of hospitalization, the patient was ready for discharge. Routine echocardiography prior to discharge revealed severe mitral regurgitation due to perforation of anterior mitral leaflet, a finding not observed in the previous echocardiograms. The patient was discharged to close follow up of the severe mitral regurgitation and future surgical intervention is likely. Therefore, close monitoring of mitral valve is necessary and explanation may be required if valve dysfunction is observed, as repositioning of the Impella system is not possible.

  18. A new surgical approach for treating dilated cardiomyopathy with mitral regurgitation

    Directory of Open Access Journals (Sweden)

    Buffolo Enio

    2000-01-01

    Full Text Available OBJECTIVE: To evaluate the early outcome of mitral valve prostheses implantation and left ventricular remodeling in 23 patients with end-stage cardiomyopathy and secondary mitral regurgitation (NYHA class III and IV. METHODS: Mitral valvular prosthesis implantation with preservation of papillary muscles and chordae tendinae, and plasty of anteriun cuspid for remodeling of the left ventricle. RESULTS: The surgery was performed in 23 patients, preoperative ejection fraction (echocardiography varied from 13% to 44% (median: 30%. In 13 patients associated procedures were performed: myocardial revascularization (9, left ventricle plicature repair (3 and aortic prosthese implantation (1. Early deaths (2 occurred on the 4th PO day (cardiogenic shock and on the 20th PO day (upper gastrointestinal bleeding, and a late death in the second month PO (ventricular arrhythmia. Improvement occurred in NYHA class in 82.6% of the patients (P<0.0001, with a survival rate of 86.9% (mean of 8.9 months of follow-up. CONCLUSION: This technique offers a promising therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy and secondary mitral regurgitation.

  19. Infarto de miocardio secundario a embolismo coronario en paciente con estenosis mitral

    Directory of Open Access Journals (Sweden)

    Edgar Fuentes-Molina

    2013-06-01

    Full Text Available El embolismo coronario se reconoce como una causa, aunque poco frecuente, del infarto de miocardio. Se reporta el caso de una paciente con estenosis mitral no identificada previamente, la cual presenta infarto de miocardio, en quien se documenta la presencia de un émbolo a nivel de la arteria coronaria derecha.

  20. Age-related decline in mitral peak diastolic velocities is unaffected in well-trained runners

    DEFF Research Database (Denmark)

    Olsen, Rasmus Huan; Couppé, Christian; Dall, Christian Have;

    2015-01-01

    (a') diastolic and systolic (s') annular longitudinal tissue Doppler velocities were measured by echocardiography during four stages (rest, supine bike exercise at 30% and 60% of maximal workload, and recovery). RESULTS: The athletes had marked cardiac remodeling, while overall differences in mitral...

  1. Estudo comparativo do anel valvar mitral e do ventrículo esquerdo na cardiomiopatia dilatada

    Directory of Open Access Journals (Sweden)

    HUEB Alexandre Ciappina

    2001-01-01

    Full Text Available OBJETIVO: O objetivo deste trabalho foi analisar o comportamento do anel valvar mitral e do ventrículo esquerdo na cardiomiopatia dilatada (CMD. MATERIAL E MÉTODOS: Analisaram-se 68 corações humanos adultos, fixados, sendo 48 portadores de CMD de etiologia isquêmica ou idiopática, e 20 corações sem cardiopatia. Obteve-se imagens digitalizadas do perímetro do anel mitral, inserção da cúspide anterior e posterior e da porção fibrosa e muscular. Obteve-se também o perímetro interno do VE, distância do septo ao músculo papilar anterior e posterior, distância entre os músculos papilares, e extensão do septo interventricular. RESULTADOS: A análise dos resultados demonstrou proporcionalidade, tanto da porção fibrosa (r²= 0.98, quanto da porção muscular (r²= 0.99 do anel em relação ao grau de dilatação da valva mitral. A regressão linear revelou que o perímetro de inserção das cúspides anterior (r²= 0.96 e posterior (r² =0.98 também guardam relação de proporcionalidade. Observou-se que a dilatação do VE ocorre de forma global e esférica em seus segmentos. Não se observou relação de proporcionalidade entre o grau de dilatação do anel mitral e do VE. CONCLUSÃO: Ao contrário do que se pensava, na CMD de etiologia isquêmica ou idiopática, a dilatação do anel mitral ocorre de forma proporcional e não apenas na sua porção posterior. Não é o grau de dilatação do VE que determina o grau de dilatação do anel mitral pois eles ocorrem de forma independente. Estas observações abrem novas perspectivas para as técnicas de correção da insuficiência valvar mitral na CMD.

  2. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2009-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  3. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2016-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  4. Extracellular matrix remodeling in wound healing of critical size defects in the mitral valve leaflet.

    Science.gov (United States)

    Stephens, Elizabeth H; Nguyen, Tom C; Blazejewski, Jack G; Vekilov, Dragoslava P; Connell, Jennifer P; Itoh, Akinobu; Ingels, Neil B; Miller, D Craig; Grande-Allen, K Jane

    2016-07-01

    The details of valvular leaflet healing following valvuloplasty and leaflet perforation from endocarditis are poorly understood. In this study, the synthesis and turnover of valvular extracellular matrix due to healing of a critical sized wound was investigated. Twenty-nine sheep were randomized to either CTRL (n = 11) or HOLE (n = 18), in which a 2.8-4.8 mm diameter hole was punched in the posterior mitral leaflet. After 12 weeks, posterior leaflets were harvested and histologically stained to localize extracellular matrix components. Immunohistochemistry was also performed to assess matrix components and markers of matrix turnover. A semi-quantitative grading scale was used to quantify differences between HOLE and CTRL. After 12 weeks, the hole diameter was reduced by 71.3 ± 1.4 % (p matrix turnover (prolyl 4-hydroxylase, metalloproteases, and lysyl oxidase, each p ≤ 0.025), along with fibrin accumulation. Two distinct remodeling regions were evident surrounding the hole, one directly bordering the hole rich in versican and hyaluronan and a second adjacent region with abundant collagen and elastic fiber turnover. The remodeling also caused reduced delineation between valve layers (p = 0.002), more diffuse staining of matrix components and markers of matrix turnover (p matrix composition and structure, resulting in partial wound closure. Because these changes could also affect leaflet mechanics and valve function, it will be important to determine their impact on healing wounds.

  5. Efeito da plástica mitral nas variáveis do teste cardiopulmonar em pacientes com insuficiência mitral crônica Effect of mitral valve repair on cardiopulmonary exercise testing variables in patients with chronic mitral regurgitation

    Directory of Open Access Journals (Sweden)

    Dorival Julio Della Togna

    2013-04-01

    Full Text Available FUNDAMENTO: A plástica valvar mitral é o procedimento cirúrgico de escolha para pacientes com Insuficiência Mitral (IM crônica. Os bons resultados imediatos e tardios permitem a indicação cirúrgica antes do início dos sintomas. O teste cardiopulmonar de exercício (TCPE pode avaliar objetivamente a capacidade funcional, mas pouco se conhece o efeito da cirurgia em suas variáveis. OBJETIVOS: Avaliar os efeitos da plástica mitral nas variáveis do TCPE em pacientes com IM crônica. MÉTODOS: Foram selecionados 47 pacientes com IM grave e submetidos plástica da valva mitral, sendo nestes, realizado TCPE ± 30 dias antes da cirurgia, e de seis a 12 meses após a cirurgia. RESULTADOS: Houve predominância da classe funcional I ou II pela NYHA em 30 pacientes (63,8% e 34 pacientes (72,3%, respectivamente. Após a cirurgia foi observado uma diminuição significativa do consumo de oxigênio (VO2, de 1.719 ± 571 para 1.609 ± 428 mL.min-1, p = 0,036. Houve redução do Oxygen Uptake Efficiency Slope (OUES, de 1.857 ± 594 para 1.763 ± 514, p = 0,073 e o pulso de oxigênio (O2 aumentou após a cirurgia, de 11,1 ± 3,2 para 11,9 ± 3,2 mL.bat-1 (p = 0,003. CONCLUSÃO: A plástica da valva mitral, não determinou aumento do VO2 pico e do OUES apesar do remodelamento cardíaco positivo observado após sete meses de cirurgia. Entretanto, o pulso de O2 aumentou no pós-operatório, sugerindo melhora do desempenho sistólico do VE. O TCPE é uma ferramenta útil, podendo auxiliar na conduta médica em pacientes com IM.BACKGROUND: Mitral valve repair is the surgical procedure of choice for patients with chronic Mitral Regurgitation (MR. The good early and late results allow surgical indication before symptom onset. The cardiopulmonary exercise test (CPET can objectively assess functional capacity, but little is known about the effect of surgery on their variables. OBJECTIVE: Evaluate the effects of mitral repair on CPET variables in patients with

  6. Efeito da plástica mitral nas variáveis do teste cardiopulmonar em pacientes com insuficiência mitral crônica

    Directory of Open Access Journals (Sweden)

    Dorival Julio Della Togna

    2013-04-01

    Full Text Available FUNDAMENTO: A plástica valvar mitral é o procedimento cirúrgico de escolha para pacientes com Insuficiência Mitral (IM crônica. Os bons resultados imediatos e tardios permitem a indicação cirúrgica antes do início dos sintomas. O teste cardiopulmonar de exercício (TCPE pode avaliar objetivamente a capacidade funcional, mas pouco se conhece o efeito da cirurgia em suas variáveis. OBJETIVOS: Avaliar os efeitos da plástica mitral nas variáveis do TCPE em pacientes com IM crônica. MÉTODOS: Foram selecionados 47 pacientes com IM grave e submetidos plástica da valva mitral, sendo nestes, realizado TCPE ± 30 dias antes da cirurgia, e de seis a 12 meses após a cirurgia. RESULTADOS: Houve predominância da classe funcional I ou II pela NYHA em 30 pacientes (63,8% e 34 pacientes (72,3%, respectivamente. Após a cirurgia foi observado uma diminuição significativa do consumo de oxigênio (VO2, de 1.719 ± 571 para 1.609 ± 428 mL.min-1, p = 0,036. Houve redução do Oxygen Uptake Efficiency Slope (OUES, de 1.857 ± 594 para 1.763 ± 514, p = 0,073 e o pulso de oxigênio (O2 aumentou após a cirurgia, de 11,1 ± 3,2 para 11,9 ± 3,2 mL.bat-1 (p = 0,003. CONCLUSÃO: A plástica da valva mitral, não determinou aumento do VO2 pico e do OUES apesar do remodelamento cardíaco positivo observado após sete meses de cirurgia. Entretanto, o pulso de O2 aumentou no pós-operatório, sugerindo melhora do desempenho sistólico do VE. O TCPE é uma ferramenta útil, podendo auxiliar na conduta médica em pacientes com IM.

  7. A Case of Mitral Valve Replacement with Neurologic Manifestations during Pregnancy

    Directory of Open Access Journals (Sweden)

    Kambiz Alizadeh

    2016-04-01

    Full Text Available Introduction: Cardiopulmonary bypass in pregnant patient is considered a high-risk procedure.  Maternal mortality is similar to that of the non-pregnant females about 1.5-5%. Variations in the timing of surgical intervention, gestational age, maternal health sta­­­­tus, perfusion protocol, and pharmacologic therapy are all factors that can influence fetomaternal outcome. Case Report: We present a case of 26- year- old pregnant woman (G1, Ab0, D0 in gestational age of 36 weeks with sudden CVA and neurological sequelae (disartheria, paresthesia of right side of face. In her past medical history, she had no positive history of neurologic problems, diabetes mellitus, hyperlipidemia or cardiovascular diseases. Left perisylvian encephalitis was reported in her brain MRI. In trans-thoracic echocardiography moderate Mitral Regurgitation (MR, severe mitral stenosis with gradient of 9mmHg, and valve surface of 1cm2 was observed. In obstetrics consultation, a healthy male fetus with approximate gestational age of 37 weeks was reported. Finally the pregnancy ended by caesarean section under general anesthesia, with presence of cardiologist and a healthy newborn was delivered at age of 37 weeks. Four days after caesarean section, Mitral Valve Replacement (MVR was measured which proceeded successfully. Conclusion:Due to the risk of further neurological complications in a pregnant mother who suffers from mitral valve stenosis, provided the gestational age permits harmless termination of pregnancy, it is possible to perform the mitral valve replacement procedure during the same hospital stay after termination of pregnancy.

  8. Model-driven physiological assessment of the mitral valve from 4D TEE

    Science.gov (United States)

    Voigt, Ingmar; Ionasec, Razvan Ioan; Georgescu, Bogdan; Houle, Helene; Huber, Martin; Hornegger, Joachim; Comaniciu, Dorin

    2009-02-01

    Disorders of the mitral valve are second most frequent, cumulating 14 percent of total number of deaths caused by Valvular Heart Disease each year in the United States and require elaborate clinical management. Visual and quantitative evaluation of the valve is an important step in the clinical workflow according to experts as knowledge about mitral morphology and dynamics is crucial for interventional planning. Traditionally this involves examination and metric analysis of 2D images comprising potential errors being intrinsic to the method. Recent commercial solutions are limited to specific anatomic components, pathologies and a single phase of cardiac 4D acquisitions only. This paper introduces a novel approach for morphological and functional quantification of the mitral valve based on a 4D model estimated from ultrasound data. A physiological model of the mitral valve, covering the complete anatomy and eventual shape variations, is generated utilizing parametric spline surfaces constrained by topological and geometrical prior knowledge. The 4D model's parameters are estimated for each patient using the latest discriminative learning and incremental searching techniques. Precise evaluation of the anatomy using model-based dynamic measurements and advanced visualization are enabled through the proposed approach in a reliable, repeatable and reproducible manner. The efficiency and accuracy of the method is demonstrated through experiments and an initial validation based on clinical research results. To the best of our knowledge this is the first time such a patient specific 4D mitral valve model is proposed, covering all of the relevant anatomies and enabling to model the common pathologies at once.

  9. Phenotypic and Functional Properties of Porcine Dedifferentiated Fat Cells during the Long-Term Culture In Vitro

    Directory of Open Access Journals (Sweden)

    Xuewu Peng

    2015-01-01

    Full Text Available It has been proved that terminally differentiated mature adipocytes possess abilities to dedifferentiate into fibroblast-like progeny cells with self-renewal and multiple differentiation, termed dedifferentiated fat (DFAT cells. However, the biological properties of DFAT cells during long-term culture in vitro have not been elucidated. Here, we obtained fibroblast-like morphology of porcine DFAT cells by ceiling culture. During the dedifferentiation process, round mature adipocytes with single large lipid droplets changed into spindle-shaped cells accompanied by the adipogenic markers PPARγ, aP2, LPL, and Adiponectin significant downregulation. Flow cytometric analysis showed that porcine DFAT cells displayed similar cell-surface antigen profile to mesenchymal stem cells (MSCs. Furthermore, different passages of porcine DFAT cells during long-term culture in vitro retained high levels of cell viabilities (>97%, efficient proliferative capacity including population doubling time ranged from 20 h to 22 h and population doubling reached 47.40±1.64 by 58 days of culture. In addition, porcine DFAT cells maintained the multiple differentiation capabilities into adipocytes, osteoblasts, and skeletal myocytes and displayed normal chromosomal karyotypes for prolonged passaging. Therefore, porcine DFAT cells may be a novel model of stem cells for studying the functions of gene in the different biological events.

  10. Purification, characterization and immunolocalization of porcine surfactant protein D

    DEFF Research Database (Denmark)

    Sørensen, C.M.; Nielsen, Ove Lilholm; Willis, A.;

    2005-01-01

    glycoconjugates on micro-organisms. This paper describes the tissue immunolocalization of porcine SP-D (pSP-D) in normal slaughter pigs using a monoclonal antibody raised against purified pSP-D. Porcine SP-D was purified from porcine bronchoalveolar lavage (BAL) by maltose-agarose and immunoglobulin M affinity...... chromatography. The purified protein appeared on sodium dodecyl sulphate-polyacrylamide gel electrophoresis as a band of similar to53 000 MW in the reduced state and similar to138 000 MW in the unreduced state. Porcine SP-D was sensitive to collagenase digestion and N-deglycosylation, which reduced the molecular...

  11. Sources of cumulus expansion enabling factor (CEEF) in porcine follicles

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    It was shown that expansion of porcine cumulus did not depend on oocyte-secreted factor(s), and it is therefore presumed that porcine CEEF may not be produced exclusively by the oocyte. In this experiment, we used mouse oocytectomized complexes (OOX), which were incapable of CEEF production, to assess the secretion of CEEF by evacuated zona, oocytes of different quality and somatic cells in the porcine follicles. The results showed that: (ⅰ) Evacuated zonae from both porcine and mouse oocytes did not produce CEEF. (ⅱ) Porcine oocytes of A, B and C types from 3 - 6 mm follicles were not significantly different in both production and activity of CEEF. (ⅲ) Both porcine OOX from 3 - 6 mm follicles and granulose cells from < 1 mm follicles secreted CEEF in a large quantity, independent of gonadotropins; mural granulose cells from 3-6 mm follicles, however, produced neglectable amount of CEEF. (ⅳ) The follicular fluid from 3-6 mm porcine follicles contained CEEF activity that was concentration-dependent, and thus it enabled cumulus expansion in 60% mouse OOX when used at 10% of concentration, but the expansion rate of mouse OOX decreased to 9% when the concentration was increased to 50%. (ⅴ) Mouse OOX cultured in porcine CEEF-containing M199 expanded only in the presence of gonadotropins, suggesting that the activity of porcine CEEF is hormone-de- pendent.

  12. Splicing variants of porcine synphilin-1

    DEFF Research Database (Denmark)

    Larsen, Knud Erik; Madsen, Lone Bruhn; Farajzadeh, Leila;

    2015-01-01

    %) and to mouse (84%) synphilin-1. Three shorter transcript variants of the synphilin-1 gene were identified, all lacking one or more exons. SNCAIP transcripts were detected in most examined organs and tissues and the highest expression was found in brain tissues and lung. Conserved splicing variants and a novel......RNA was investigated by RNAseq. The presented work reports the molecular cloning and characterization of the porcine (Sus scrofa) synphilin-1 cDNA (SNCAIP) and three splice variants hereof. The porcine SNCAIP cDNA codes for a protein (synphilin-1) of 919 amino acids which shows a high similarity to human (90...... splice form of synhilin-1 were found in this study. All synphilin-1 isoforms encoded by the identified transcript variants lack functional domains important for protein degradation....

  13. Porcine hokovirus in wild boar in Portugal.

    Science.gov (United States)

    Miranda, Carla; Coelho, Catarina; Vieira-Pinto, Madalena; Thompson, Gertrude

    2016-04-01

    Porcine hokovirus (PHoV), also referred to as porcine parvovirus 4 (P-PARV4), a recently discovered parvovirus of swine that is closely related to human parvovirus 4/5 (H-PARV4/5), was first described in Hong Kong. To evaluate the occurrence of P-PARV4 in Portuguese wild boars in the hunting season of 2011/2012, liver and serum samples were tested. P-PARV4 was detected in 24 % of the wild boars analyzed. Phylogenetic analysis showed a close relationship between the P-PARV4 isolates and other P-PARV4 reference strains. This virus appears to be emerging, with yet unknown implications for public health.

  14. Purification of tubulin from porcine brain.

    Science.gov (United States)

    Gell, Christopher; Friel, Claire T; Borgonovo, Barbara; Drechsel, David N; Hyman, Anthony A; Howard, Jonathon

    2011-01-01

    Microtubules, polymers of the heterodimeric protein αβ-tubulin, give shape to cells and are the tracks for vesicle transport and chromosome segregation. In vitro assays to study microtubule functions and their regulation by microtubule-associated proteins require the availability of purified αβ-tubulin. In this chapter, we describe the process of purification of heterodimeric αβ-tubulin from porcine brain.

  15. The evolution from surgery to percutaneous mitral valve interventions: the role of the edge-to-edge technique.

    Science.gov (United States)

    Maisano, Francesco; La Canna, Giovanni; Colombo, Antonio; Alfieri, Ottavio

    2011-11-15

    The edge-to-edge technique is a versatile procedure for mitral valve repair. Its technical simplicity has been the prerequisite for the development of a number of transcatheter technologies to perform percutaneous mitral valve repair. The evolution from a standard open heart surgical to percutaneous procedure involved the application of the technique in minimally invasive robotic surgery and direct access (transatrial) off-pump suture-based repair and finally in the fully percutaneous approach with either suture-based or device (clip)-based approach. The MitraClip (Abbott Vascular, Menlo Park, California) is currently available for clinical use in Europe, and it is mainly applied to treat high-risk patients with functional mitral regurgitation. A critical review of the surgical as well as the early percutaneous repair data is necessary to elucidate the clinical role and the potential for future developments of the edge-to-edge repair in the treatment of mitral regurgitation.

  16. How to do it: importance of left atrial side retraction in robotic and minimally invasive mitral valve surgery.

    Science.gov (United States)

    Ishikawa, Norihiko; Sun, You Su; Nifong, L Wiley; Watanabe, Go; Chitwood, W Randolph

    2008-01-01

    A customized transthoracic atrial retractor was previously developed for robotic and minimally invasive mitral valve surgery, but it has sometimes failed to provide sufficient exposure of the mitral valve because some atrial tissues push away the operative field from the right side. This report describes 3 new atrial side retractors (the foldaway retractor, the spoon retractor, and the wired retractor) and their use in performing robotic mitral valve repair in fresh frozen human cadavers. These retractors provided exceptional and consistent exposure of the left atrium in robotic and minimally invasive mitral valve surgery in human cadavers without causing traumatic injury, and these retractors should be useful in live patients because they will be used in arrested hearts.

  17. Tissue Sampling Guides for Porcine Biomedical Models.

    Science.gov (United States)

    Albl, Barbara; Haesner, Serena; Braun-Reichhart, Christina; Streckel, Elisabeth; Renner, Simone; Seeliger, Frank; Wolf, Eckhard; Wanke, Rüdiger; Blutke, Andreas

    2016-04-01

    This article provides guidelines for organ and tissue sampling adapted to porcine animal models in translational medical research. Detailed protocols for the determination of sampling locations and numbers as well as recommendations on the orientation, size, and trimming direction of samples from ∼50 different porcine organs and tissues are provided in the Supplementary Material. The proposed sampling protocols include the generation of samples suitable for subsequent qualitative and quantitative analyses, including cryohistology, paraffin, and plastic histology; immunohistochemistry;in situhybridization; electron microscopy; and quantitative stereology as well as molecular analyses of DNA, RNA, proteins, metabolites, and electrolytes. With regard to the planned extent of sampling efforts, time, and personnel expenses, and dependent upon the scheduled analyses, different protocols are provided. These protocols are adjusted for (I) routine screenings, as used in general toxicity studies or in analyses of gene expression patterns or histopathological organ alterations, (II) advanced analyses of single organs/tissues, and (III) large-scale sampling procedures to be applied in biobank projects. Providing a robust reference for studies of porcine models, the described protocols will ensure the efficiency of sampling, the systematic recovery of high-quality samples representing the entire organ or tissue as well as the intra-/interstudy comparability and reproducibility of results. PMID:26883152

  18. Posterior repair with perforated porcine dermal graft

    Directory of Open Access Journals (Sweden)

    G. Bernard Taylor

    2008-02-01

    Full Text Available OBJECTIVE: To compare postoperative vaginal incision separation and healing in patients undergoing posterior repair with perforated porcine dermal grafts with those that received grafts without perforations. Secondarily, the tensile properties of the perforated and non-perforated grafts were measured and compared. MATERIALS AND METHODS: This was a non-randomized retrospective cohort analysis of women with stage II or greater rectoceles who underwent posterior repair with perforated and non-perforated porcine dermal grafts (PelvicolTM CR Bard Covington, GA USA. The incidence of postoperative vaginal incision separation (dehiscence was compared. A secondary analysis to assess graft tensile strength, suture pull out strength, and flexibility after perforation was performed using standard test method TM 0133 and ASTM bending and resistance protocols. RESULTS: Seventeen percent of patients (21/127 who received grafts without perforations developed vaginal incision dehiscence compared to 7% (5/71 of patients who received perforated grafts (p = 0.078. Four patients with vaginal incision dehiscence with non-perforated grafts required surgical revision to facilitate healing. Neither tensile strength or suture pull out strength were significantly different between perforated and non-perforated grafts (p = 0.81, p = 0.29, respectively. There was no difference in the flexibility of the two grafts (p = 0.20. CONCLUSION: Perforated porcine dermal grafts retain their tensile properties and are associated with fewer vaginal incision dehiscences.

  19. A proteomic approach to porcine saliva.

    Science.gov (United States)

    Gutiérrez, Ana M; Cerón, José J; Fuentes-Rubio, María; Tecles, Fernando; Beeley, Josie A

    2014-02-01

    This paper reviews recent progress in salivary animal proteomics, with special reference to the porcine proteome. Until fairly recently, most studies on saliva as a diagnostic fluid have focused on humans, primates and rodents, and the development of salivary analysis in monitoring health in farm animals including pigs has received only limited consideration. The porcine salivary proteome has been characterised by 2D-electrophoresis followed by mass spectrometry. Major and minor proteins have been identified. The use of saliva as a non-invasive biological fluid in monitoring health and disease in pigs will be reviewed, together with the potential use of proteomics for the development of biomarkers. In this review, methods of collection and the composition of porcine saliva will be considered, together with saliva handling and analysis. The overall findings indicate that there is considerable potential for the development of salivary analysis as a non-invasive diagnostic fluid in the pig, and that it offers advantages over other body fluids in this animal.

  20. Cloning of Porcine Pituitary Tumor Transforming Gene 1 and Its Expression in Porcine Oocytes and Embryos

    Science.gov (United States)

    Liu, Shuai; Nong, Suqun; Ma, Qingyan; Chen, Baojian; Liu, Mingjun; Pan, Tianbiao; Liao, D. Joshua

    2016-01-01

    The maternal-to-embryonic transition (MET) is a complex process that occurs during early mammalian embryogenesis and is characterized by activation of the zygotic genome, initiation of embryonic transcription, and replacement of maternal mRNA with embryonic mRNA. The objective of this study was to reveal the temporal expression and localization patterns of PTTG1 during early porcine embryonic development and to establish a relationship between PTTG1 and the MET. To achieve this goal, reverse transcription-polymerase chain reaction (RT-PCR) was performed to clone porcine PTTG1. Subsequently, germinal vesicle (GV)- and metaphase II (MII)-stage oocytes, zygotes, 2-, 4-, and 8-cell-stage embryos, morulas, and blastocysts were produced in vitro and their gene expression was analyzed. The results revealed that the coding sequence of porcine PTTG1 is 609-bp in length and that it encodes a 202-aa polypeptide. Using qRT-PCR, PTTG1 mRNA expression was observed to be maintained at high levels in GV- and MII-stage oocytes. The transcript levels in oocytes were also significantly higher than those in embryos from the zygote to blastocyst stages. Immunohistochemical analyses revealed that porcine PTTG1 was primarily localized to the cytoplasm and partially localized to the nucleus. Furthermore, the PTTG1 protein levels in MII-stage oocytes and zygotes were significantly higher than those in embryos from the 2-cell to blastocyst stage. After fertilization, the level of this protein began to decrease gradually until the blastocyst stage. The results of our study suggest that porcine PTTG1 is a new candidate maternal effect gene (MEG) that may participate in the processes of oocyte maturation and zygotic genome activation during porcine embryogenesis. PMID:27058238

  1. Molecular and epidemiological studies of Porcine rubulavirus infection - an overview.

    Science.gov (United States)

    Cuevas-Romero, Julieta Sandra; Blomström, Anne-Lie; Berg, Mikael

    2015-01-01

    Porcine rubulavirus-La Piedad-Michoacan-Mexico virus (PorPV-LPMV) was identified as the causative agent of a viral disease that emerged spontaneously in Mexican swine in the 1980s. Since the report of the initial outbreak of the disease, only one full-length genome from a strain isolated in 1984 (PorPV-LPMV/1984) has been sequenced; sequence data are scarce from other isolates. The genetic variation of this virus that has spread throughout the main endemic region of Mexico is almost a complete mystery. The development of molecular techniques for improved diagnostics and to investigate the persistence, molecular epidemiology, and the possible reservoirs of PorPV are needed. Together, this will provide greater knowledge regarding the molecular genetic changes and useful data to establish new strategies in the control of this virus in Mexico.

  2. Characterization of the porcine carboxypeptidase E cDNA

    DEFF Research Database (Denmark)

    Hreidarsdôttir, G.E.; Cirera, Susanna; Fredholm, Merete

    2007-01-01

    Carboxypeptidase E (CPE) is an important enzyme responsible for the proteolytic processing of prohormone intermediates. A naturally occurring point mutation, leading to an accumulation of many neuroendocrine peptides has been characterized within exon 5 of the CPE gene in mice. In the present study...... the sequence of the cDNA for the porcine CPE gene including all the coding region and the 3'-UTR region was generated. Comparisons with bovine, human, mouse, and rat CPE cDNA sequences showed that the coding regions of the gene are highly conserved both at the nucleotide and at the amino acid level. A very low...... nonsynonymousl/synonymous substitution ratios between the proteins was found indicating that purifying selection os acting on the CPE gene. A nonsynonymous SNP identified at position 1272 in the transcript resulting in a codon change from TCA (Serine) to TTA (Leucine) was genotyped in the Danish pig populations...

  3. Cardiac dysfunction in a porcine model of pediatric malnutrition

    DEFF Research Database (Denmark)

    Fabiansen, Christian; Lykke, Mikkel; Nielsen, Anne-Louise Hother;

    2015-01-01

    and longitudinal changes in plasma pro-atrial natriuretic peptide and cardiac troponin-T in a pediatric porcine model. METHODS AND RESULTS: Five-week old piglets (Duroc-x-Danish Landrace-x-Yorkshire) were fed a nutritionally inadequate maize-flour diet to induce malnutrition (MAIZE, n = 12) or a reference diet......BACKGROUND: Half a million children die annually of severe acute malnutrition and cardiac dysfunction may contribute to the mortality. However, cardiac function remains poorly examined in cases of severe acute malnutrition. OBJECTIVE: To determine malnutrition-induced echocardiographic disturbances...... (AGE-REF, n = 12) for 7 weeks. Outcomes were compared to a weight-matched reference group (WEIGHT-REF, n = 8). Pro-atrial natriuretic peptide and cardiac troponin-T were measured weekly. Plasma pro-atrial natriuretic peptide decreased in both MAIZE and AGE-REF during the first 3 weeks but increased...

  4. Medial arterial calcification, calcific aortic stenosis and mitral annular calcification in a diabetic patient with severe autonomic neuropathy.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Medial arterial calcification (Monckeberg\\'s arteriosclerosis) is well described in diabetic patients with autonomic neuropathy. There is also a high prevalence of diabetes mellitus among subjects with calcific aortic stenosis and mitral annular calcification. We describe a diabetic patient with autonomic neuropathy and extensive medial arterial calcification who also had calcification of the aortic valve and of the mitral valve annulus. We propose that autonomic neuropathy may play a role in calcification of these structures at the base of the heart.

  5. Placement of Neochords in Mitral Valve Repair: Enhanced Exposure of the Papillary Muscles Using a Standard Valve Sizer.

    Science.gov (United States)

    Erlebach, Magdalena; Lange, Ruediger; Mazzitelli, Domenico

    2016-01-01

    Minimally invasive mitral valve repair with placement of artificial chordae for mitral valve regurgitation has become the standard of care. In some cases, such as Barlow's disease or bileaflet prolapse, papillary muscle exposure may be difficult. By using a valve sizer to retract both leaflets, visualization can be optimized, thus simplifying suture placement and thereby minimizing cross-clamp and cardiopulmonary bypass times. This technique is simple, is cost effective, and can be applied quickly. PMID:26694289

  6. Safety and Efficacy of Percutaneous Mitral Valve Repair Using the MitraClip® System in Patients with Diabetes Mellitus

    OpenAIRE

    Hellhammer, Katharina; Zeus, Tobias; Balzer, Jan; van Hall, Silke; Rammos, Christos; Wagstaff, Rabea; Kelm, Malte; Rassaf, Tienush

    2014-01-01

    Background Patients with diabetes mellitus show a negative outcome in percutaneous coronary intervention, aortic valve replacement and cardiac surgery. The impact of diabetes on patients undergoing treatment of severe mitral regurgitation (MR) using the MitraClip system is not known. We therefore sought to assess whether percutaneous mitral valve repair with the MitraClip system is safe and effective in patients with diabetes mellitus. Methods and Results We included 58 patients with severe a...

  7. Accuracy of 3-Dimensional Transoesophageal Echocardiography in Assessment of Prosthetic Mitral Valve Dehiscence with Comparison to Anatomical Specimens

    Directory of Open Access Journals (Sweden)

    Martin R. Brown

    2010-01-01

    Full Text Available The evolution of echocardiography from 2-Dimensional Transthoracic Echo through to real time 3-Dimensional Transoesophageal Echo has enabled more accurate visualisation and quantification of valvular disorders especially prosthetic mitral valve paravalvular regurgitation. However, validation of accuracy is rarely confirmed by surgical or post-mortem specimens. We present a case directly comparing different echocardiographic modality images to post mortem specimens in a patient with prosthetic mitral valve paravalvular regurgitation.

  8. How I do it: self-retaining atrial retractors for robotic and minimally invasive mitral valve surgery.

    Science.gov (United States)

    Ishikawa, Norihiko; Sun, You Su; Nifong, L Wiley; Watanabe, Go; Chitwood, W Randolph

    2007-01-01

    Successful surgery, particularly on the heart valves, is dependent on excellent and consistent exposure of the operative field. In this report, we describe 2 types of new atrial retractors designed for robotic and minimally invasive mitral valve surgery. These simple and easy-to-handle atrial retractors provide exceptional and consistent exposure of the left atrium in robotic and minimally invasive mitral valve surgery and prevent traumatic injury.

  9. Adiponectin Expression in the Porcine Ovary during the Oestrous Cycle and Its Effect on Ovarian Steroidogenesis

    OpenAIRE

    Anna Maleszka; Nina Smolinska; Anna Nitkiewicz; Marta Kiezun; Katarzyna Chojnowska; Kamil Dobrzyn; Hubert Szwaczek; Tadeusz Kaminski

    2014-01-01

    Adiponectin is an adipose-secreted hormone that regulates energy homeostasis and is also involved in the control of the reproductive system. The goal of the present study was to investigate changes in adiponectin gene and protein expression in porcine ovarian structures during the oestrous cycle and to examine the effects of in vitro administration of adiponectin on basal and gonadotrophin- and/or insulin-induced secretion of ovarian steroid hormones. Both gene and protein expression of adipo...

  10. Staphylococcus aureus Induces Hypoxia and Cellular Damage in Porcine Dermal Explants

    OpenAIRE

    Lone, Abdul G.; Atci, Erhan; Renslow, Ryan; Beyenal, Haluk; Noh, Susan; Fransson, Boel; Abu-Lail, Nehal; Park, Jeong-Jin; Gang, David R.; Douglas R. Call

    2015-01-01

    We developed a porcine dermal explant model to determine the extent to which Staphylococcus aureus biofilm communities deplete oxygen, change pH, and produce damage in underlying tissue. Microelectrode measurements demonstrated that dissolved oxygen (DO) in biofilm-free dermal tissue was 4.45 ± 1.17 mg/liter, while DO levels for biofilm-infected tissue declined sharply from the surface, with no measurable oxygen detectable in the underlying dermal tissue. Magnetic resonance imaging demonstrat...

  11. Metabolic rhythms in adolescents with diabetes during treatment with porcine or human insulin.

    OpenAIRE

    Hocking, M D; Crase, J; Rayner, P H; Nattrass, M

    1986-01-01

    Metabolic rhythms were studied over 24 hours in eight adolescent diabetic patients during treatment with porcine insulin and after transfer to human insulin. Despite an increase in dose with human insulin no significant changes were found in fasting blood glucose, 24h mean blood glucose, or glycosylated haemoglobin concentrations. Significantly higher 24h mean blood lactate concentrations and lower total ketone bodies and glycerol concentrations were observed during treatment with human insul...

  12. Endothelial 5-HT receptors mediate relaxation of porcine pulmonary arteries in response to ergotamine and dihydroergotamine.

    OpenAIRE

    Glusa, E; Roos, A. (Anna)

    1996-01-01

    1. The aim of the present study was to investigate whether antimigraine ergot compounds may act at endothelial 5-hydroxytryptamine (5-HT) receptors which trigger the release of endothelium-derived relaxing factor (EDRF). Changes in tone of porcine isolated pulmonary arteries were measured isometrically. The integrity of the endothelium was assessed by the bradykinin-induced relaxation of prostaglandin F2 alpha (PGF2 alpha, 3 microM)-precontracted vessels. 2. The ergot derivatives ergotamine, ...

  13. Substituição da valva mitral por aloenxerto valvar aórtico preservado em glutaraldeído Mitral valve replacement with glutaraldehyde preserved aortic allografts

    Directory of Open Access Journals (Sweden)

    Claudio A Salles

    1994-03-01

    valva natural. Ocorreram 15 óbitos tardios, representando uma mortalidade tardia de 2,1 % ± 0,5% por paciente-ano, porém apenas 3 óbitos estavam relacionados diretamente à alobioprótese, 10 à doença cardíaca (ICC, miocardiopatia e morte súbita e 2 a outras causas (tuberculose e diabetes. A sobrevida atuarial em 10 anos foi de 82,9% ± 4,8%. A sobrevida atuarial em 10 anos livre de disfunção valvar devido a fibrocalcificação foi de 62,1 % ± 8,4% sendo de 100% para pacientes acima de 15 anos e 34,2% ± 11,2% para pacientes com idade igual ou inferior a 15 anos. Embora a fibrocalcificação tenha representado a principal complicação tardia ocorrida com as alobiopróteses levando a disfunção valvar e representando a principal indicação para reoperações no grupo pediátrico, sua incidência foi significativamente menor que a incidência relatada na literatura para pacientes pediátricos portadores de xenobiopróteses.From September 1984 to December 1992, 145 selected patients underwent mitral valve replacement using cadaver aortic valves obtained during rotine autopsy, processed in glutaraldehyde and mounted into flexible stents made of Celcon and covered with Dacron fabric. Mean age was 22.5 years, ranging from 5 to 77 years and 54.5% (79 patients were 15 years old or younger. Twenty patients (13.8% had undergone previous mitral valve replacement using porcine, bovine pericardial and dura mater valves, which were calcified. Six patients had undergone a previous mitral valvuloplasty. Hospital mortality (30 days was 2.1% (3 patients. It was collected 709 patient-years of total follow-up, corresponding to a mean follow-up of 5 years per patient. The longest follow-up was 9 years and 5 months. Late complications related to the allograft were present in 48 patients, including fibrocalcification, thromboembolism, endocarditis and peri-valvular leak, corresponding to an incidence of 6.8% ± 0.9% per patient-year. Fibrocalcification was the most important

  14. In vitro development of preimplantation porcine embryos using alginate hydrogels as a three-dimensional extracellular matrix

    Science.gov (United States)

    Between day 10 and 12 of gestation, porcine embryos undergo a dramatic morphological change, known as elongation, with a corresponding increase in estrogen production for maternal recognition of pregnancy. Elongation deficiencies contribute to ~20% of embryonic loss, but exact mechanisms of elongati...

  15. Fatores de risco hospitalar para pacientes submetidos à substituição valvar com a bioprótese porcina em instituição universitária Risk factors for hospital mortality in valve replacement with porcine bioprosthesis at an universitary institution

    Directory of Open Access Journals (Sweden)

    Ana Carolina Tieppo Fornari

    2012-12-01

    Full Text Available OBJETIVO: Identificar fatores de risco hospitalar em pacientes submetidos ao implante de bioprótese porcina no Instituto de Cardiologia do Rio Grande do Sul. MÉTODOS: Estudo retrospectivo, com informações de prontuário, de 808 pacientes submetidos ao implante de pelo menos uma bioprótese porcina St. Jude Medical Biocor, no período entre 1994 e 2009. Foi analisada a relação entre mortalidade hospitalar e características clínicas e demográficas definidas em estudos reconhecidos, visando identificar fatores de risco. Foram utilizados testes qui-quadrado, t de Student e regressão logística uni e multivariável (P 1,4 mg/dL (OR 2,28; cirurgia cardíaca prévia (OR 2,17; hipertensão arterial sistêmica (OR 1,93; classe funcional III e IV (OR 1,92; revascularização miocárdica (OR 1,81; idade > 70 anos (OR 1,80; insuficiência cardíaca congestiva (OR 1,73; e sexo feminino (OR 1,68. Pela regressão logística multivariável, para fatores independentes, identificados: lesão mitral (OR 5,29; plastia tricúspide (OR 3,07; diabete melito (OR 2,72; idade > 70 anos (OR 2,62; revascularização miocárdica (OR 2,43; cirurgia cardíaca prévia (OR 1,82; e hipertensão arterial sistêmica (OR 1,79. CONCLUSÕES: A mortalidade observada nesta casuística é compatível com literatura. Fatores de risco preponderantes são reconhecidos e devem motivar programas específicos de neutralização.OBJECTIVE: Study designed to identify characteristics of patients related to increased hospital mortality after valve replacement, assumed as risk factors. METHODS: Retrospective study including 808 patients submitted to the implant of St. Jude Biocor porcine bioprosthesis between 1994 and 2009 at Instituto de Cardiologia do Rio Grande do Sul. Primary outcome was hospital death and hospital mortality was related to demographic and surgical characteristics. Statistics include t-test, qui-square test and logistical regression analysis. RESULTS: There were 80 (9

  16. Prostetik Kapaklı Hastada Nadir Kalp Yetmezliği Nedeni: Mitral Prostetik Kapak Endokardite Bağlı Dehisens

    OpenAIRE

    ERCAN, Süleyman; Davutoğlu, Vedat

    2014-01-01

    Mitral valve dehiscence due to prosthetic valve endocarditis is one of the most serious complications of infective endocarditis. If early diagnosis and treatment are not done it can lead to very serious results. A 49year-old male patient with St. Jude metallic mitral prosthetic valve replacement 3 years ago was admitted with fever, shortness of breath, and he admitted with a preliminary diagnosis of infective endocarditis. The vegetation of the mitral prosthetic valve dehiscence, echocardiogr...

  17. A Procedure of Combination of Sequential Internal Thoracic Artery Grafting and Cooley's Technique for Complicated Case With Multi-vessel Disease,Left Ventricular Aneurysm and Mitral Regurgitation

    Institute of Scientific and Technical Information of China (English)

    Meng-ya LIANG; Guang-xian CHEN; Zhong-kai WU; Xi ZHANG

    2009-01-01

    @@ INTRODUCTION Left ventricular aneurysm and ischemic mitral regurgitation are two of most common complications of acute myocardial infarction (AMI).Combination of both these two fatal complications is not rare and the management of these complicated cases is always a challenge to cardiac surgeon because of its relatively high mortality[1]. We reported a rare case of AMI in which a singlestage correction of mitral valve replacement with preservation of mitral apparatus, sequential left internal thoracic artery (ITA) grafting and Cooley's technique.

  18. Plastia da valva mitral com a técnica do "Duplo Teflon": resultados de 10 anos Mitral valve repair with "Double Teflon" technique: 10-year results

    Directory of Open Access Journals (Sweden)

    Carlos Manuel de Almeida Brandão

    2007-12-01

    Full Text Available OBJETIVO: O objetivo deste trabalho é apresentar os resultados clínicos tardios da plástica da valva mitral com a técnica do "Duplo Teflon". MÉTODOS: A plástica de "Duplo Teflon" consiste em técnica de reparo mitral com ressecção quadrangular da cúspide posterior, anuloplastia segmentar com plicatura do anel com de fios com "pledgets" sobre uma tira de Teflon, e sutura borda a borda da cúspide. Entre abril de 1994 e dezembro de 2003, 133 pacientes com diagnóstico de insuficiência mitral degenerativa com alongamento ou rotura de cordas da cúspide posterior foram submetidos à plástica com esta técnica. A idade média foi de 60,4 anos e 60,9% eram do sexo feminino. Quanto à avaliação clínica no pré-operatório, 29,3% dos pacientes estavam em classe funcional IV, 55,7% em classe III e 15,0% em classe II. Técnicas associadas de plástica mitral foram utilizadas em 15,2% dos pacientes, sendo a mais comum o encurtamento de cordas. Vinte e seis (19,5% pacientes foram submetidos a operações associadas. RESULTADOS: Houve um (0,75% óbito hospitalar. No período pós-operatório tardio, 95,5% dos sobreviventes estavam em classe funcional I. As taxas linearizadas de tromboembolismo, reoperação e óbito foram 0,9%, 0,3% e 0,6% pacientes/ano, respectivamente. A sobrevida atuarial em 10 anos foi de 94,1% ± 3,6%. As sobrevidas atuariais livre de tromboembolismo e reoperação foram de 97,3 ± 1,5% e 99,2 ± 0,8%, respectivamente. Não houve casos de endocardite ou hemólise. CONCLUSÃO: A plástica da valva mitral com a técnica do "Duplo Teflon" apresenta baixa morbi-mortalidade e boa evolução clínica tardia.OBJECTIVE: The purpose of this paper is to present the late clinical results of mitral valve repair with the "Double Teflon" technique. METHODS: "Double Teflon" technique consists of a quadrangular resection of the posterior leaflet, annulus plication with "pledgetted" stitches over a Teflon patch, and leaflet suture. Between

  19. Porcine skin as human body phantom at 60 GHz

    OpenAIRE

    Petrillo, Luca; Mavridis, Theodoros; De Doncker, Philippe; Sarrazin, Julien; Benlarbi-Delai, Aziz

    2015-01-01

    This communication presents the results of an experimental campaign carried out at 60 GHz to demonstrate that porcine skin can be used at 60 GHz as a phantom for the human body. Norton formulations above a flat human body are verified using porcine skin.

  20. Porcine artery elastin preparation reduces serum cholesterol level in rats

    OpenAIRE

    Liyanage, Ruvini; Nakamura, Yumi; Shimada, Ken-ichiro; SEKIKAWA, Mitsuo; Jayawardana, Barana Chaminda; HAN, Kyu-Ho; Tomoko, Okada; Ohba, Kiyoshi; Takahata, Yoshihisa; Morimatsu, Fumiki; FUKUSHIMA, Michihiro; 福島, 道広; 島田, 謙一郎; 関川, 三男; 韓, 圭鎬

    2009-01-01

    The effect of porcine artery elastin on serum cholesterol level was investigated in rats fed a cholesterol-free diet. Rats were fed for 4 weeks, with a diet (ED) containing 15% casein and 5% of porcine artery elastin in comparison with a diet (CD) containing 20% casein. The total serum and non-HDL-cholesterol concentrations were lower (P

  1. Growth of cultured porcine retinal pigment epithelial cells

    DEFF Research Database (Denmark)

    Wiencke, A.K.; Kiilgaard, Jens Folke; Nicolini, Jair;

    2003-01-01

    To establish and characterize cultures of porcine retinal pigment epithelial (pRPE) cells in order to produce confluent monolayers of cells for transplantation.......To establish and characterize cultures of porcine retinal pigment epithelial (pRPE) cells in order to produce confluent monolayers of cells for transplantation....

  2. COMPARISON OF BIAXIAL MECHANICAL PROPERTIES OF CORONARY SINUS TISSUES FROM PORCINE, OVINE AND AGED HUMAN SPECIES

    OpenAIRE

    Pham, Thuy Van; Sun, Wei

    2011-01-01

    Due to its proximity to the mitral valve, the coronary sinus (CS) vessel serves as a conduit for the deployment and implantation of the percutaneous transvenous mitral annuloplasty (PTMA) devices that can potentially reduce the mitral regurgitation. Because CS vessel is a venous tissue and seldom diseased, its mechanical properties have not been well studied. In this study, we performed the multi-axial mechanical test and histological analysis to characterize the mechanical and structural pro...

  3. Transesophageal echocardiography in surgical management of pseudoaneurysm of mitral-aortic intervalvular fibrosa with aneurysms of right sinus of Valsalva and left main coronary artery

    Directory of Open Access Journals (Sweden)

    Shreedhar S Joshi

    2013-01-01

    Full Text Available Pseudoaneurysm of mitral-aortic intervalvular fibrosa (MAIVF is a rare complication associated with aortic and/or mitral valve surgery complicated by infective endocarditis. We report pseudoaneurysm of MAIVF in a young adult without overt cardiac disease or previous cardiac surgery. The patient had a rare combination of pseudoaneurysm of MAIVF impinging on anterior mitral leaflet causing moderate mitral regurgitation, right sinus of Valsalva aneurysm extending into interventricular septum, and left main coronary artery aneurysm. Transesophageal echocardiography helped in confirming the lesions, delineating the anatomy of all the lesions, and assessing the adequacy of surgical repair.

  4. Beating Heart Mitral Valve Replacement Surgery without Aortic Cross-Clamping via Right Thoracotomy in a Patient with Compromised Left Ventricular Functions

    Directory of Open Access Journals (Sweden)

    Ahmet Baris-Durukan

    2015-10-01

    Full Text Available Global myocardial ischemia and ischemia-reperfusion injury are potential adverse events related with cardioplegic arrest. Beating heart surgery has avoided such complications and adapted to valve surgery following successful results published on myocardial revascularization. Difficulty in weaning from cardiopulmonary bypass may be lessened by using on-pump beating heart surgery for mitral valve interventions. Here we describe a 64-year-old male patient with severe mitral regurgitation and dilated cardiomyopathy. Beating heart mitral valve replacement surgery was performed without aortic cross-clamping through a right thoracotomy approach. We believe that, particularly in patients with poor left ventricular functions, beating heart mitral valve surgery may be advantageous

  5. Fibrinolytic Treatment after Transient Ischaemic Attack Caused by Prosthetic Mitral Valve Thrombosis

    Science.gov (United States)

    Neuß, Michael; Tambor, Grit; Hölschermann, Frank; Butter, Christian

    2016-01-01

    Prosthetic valve thrombosis is one of the most severe complications after surgical valve replacement. There are many possible presentations: from asymptomatic to life-threatening complications. We report on a 61-year-old female patient with prosthetic replacement of the aortic and mitral valve in the in-house department of cardiac surgery 3 months ago. The patient was suffering from aphasia during 5 minutes in domesticity. After her presentation in the emergency room, the echocardiographic examination revealed a thrombotic formation of the prosthetic mitral valve. At presentation, the anticoagulation was outside the effective range (INR: 1.7). A successful thrombolytic therapy with the plasminogen activator urokinase was begun with complete resolution of the thrombus. PMID:27313908

  6. Circulating cytokine concentrations in dogs with different degrees of myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Zois, Nora Elisabeth; Moesgaard, Sophia Gry; Kjelgaard-Hansen, Mads;

    2012-01-01

    Cytokines have been associated with the progression of congestive heart failure (CHF) in humans and may be implicated in the pathophysiology of myxomatous mitral valve disease (MMVD) in dogs. The aim of this study was to determine the serum concentrations of cytokines in dogs with MMVD. The study...... included 16 Cairn terriers with no or minimal mitral regurgitation (MR), 41 Cavalier King Charles Spaniels (CKCS) with different degrees of MR and 11 dogs of different breeds with CHF due to MMVD. Granulocyte–macrophage colony-stimulating factor, interferon-c, interleukin (IL)-2, IL-6, IL-7, IL-8, IL-10......, IL-15, IL-18, keratinocyte-derived chemokine, interferon-c-induced protein and monocyte chemoattractant protein-1 (MCP-1) were measured using a canine-specific multiplex immunoassay. CHF dogs had significantly higher MCP-1 concentrations than dogs with no or minimal MR. Among the CKCS, IL-2 and IL-7...

  7. Circulating concentrations of insulin-like growth factor-1 in dogs with naturally occurring mitral regurgitation

    DEFF Research Database (Denmark)

    Pedersen, Henrik Duelund; Falk, Bo Torkel; Häggström, Jens;

    2005-01-01

    Insulin-like growth factor-1 (IGF-1), which mediates most effects of growth hormone, has effects on cardiac mass and function, and plays an important role in the regulation of vascular tone. In humans, an inverse relationship between degree of heart failure (HF) and circulating IGF-1 concentrations...... has been found in several studies. In dogs with HF, few studies have focused on IGF-1. We examined circulating IGF-1 concentrations in dogs with mitral regurgitation (MR) caused by myxomatous mitral valve disease. Study 1 included 88 Cavalier King Charles Spaniels (CKCSs) with a broad range...... of asymptomatic MR (median serum IGF-1: 76.7 µg/L; 25-75 percentile, 59.8-104.9 µg/L). As expected, standard body weight and percentage under- or overweight correlated directly with IGF-1. MR (assessed in 4 different ways) did not correlate with IGF-1. In study 2, 28 dogs with severe MR and stable, treated...

  8. Efficacy and safety of percutaneous transvenous mitral commisurotomy (PTMC) performed through patent foramen ovale (PFO)

    International Nuclear Information System (INIS)

    Methodology: The aim of this study was to assess efficacy and safety of PTMC in patients with severe eitral stenosis (MS) perform throqgh patent foraman ovale. Methodology: All symptomatic patients with severe MS were included in the study from January 1998 to Decembeb 2010, at Cardiology department, Lady Readijg Hospital, Peshawar. Transthoracic and trans-esophageal echocardiogram was pdrformed to excLude left atrial appendage/left atrial clot and check pha anatomy of interatrial septum. Severely aalcified mitral valve and severe -Itral regurgitation were exaluded. Patent fnramen o6ala was cro3sed in majority of cases to reach left atriui. Stenosed mitral valve was dilated with Inoue balloon. Results: Total number of patients was 1818. Females were 74% (p0.05). Stroke was present in 1.5% patientr. Conclusion: PTMC through is a safe procedure, with few complications. (author)

  9. Intrapericardial rupture of a mitral subannular aneurysm: A case report and review of the literature.

    Science.gov (United States)

    Diop, I B; Leye, M; Diallo, A D; Sarr, E H M; Manga, S J; Diene, L L; Jobe, M

    2016-04-01

    Mitral subannular aneurysm is a rare heart disease that can have many different forms of clinical presentations. It was first described in young men of African descent and was later reported in other geographical areas of the world. The etiopathogenesis as per data from the literature can be congenital, acquired or idiopathic. We report the case of a 19-year-old male in whom we made the diagnosis of mitral subannular aneurysm. The evolution was fatal following a rupture of the aneurysm into the pericardium. Through this case report, we stress the importance of echocardiography in the diagnosis of this condition. In resource-limited countries, the prognosis is unfortunately often unfavorable especially the ruptured forms. Therefore, a high degree of suspicion is needed to make a prompt diagnosis and timely surgical intervention. PMID:25702237

  10. Valvuloplastia mitral y tricuspídea en una paciente con estenosis bivalvular

    Directory of Open Access Journals (Sweden)

    Neiva R. Maciel

    2006-01-01

    Full Text Available Se presenta el caso de una mujer de 43 años, con antecedentes de fiebre reumática, accidente vasculoencefálico isquémico, estenosis mitral y tricuspídea y disnea en CF III de 2 años de evolución. Se realizó ecocardiografia transesofágica que demostró estenosis mitral severa con área de 0,78 cm2 y estenosis tricuspídea severa, con índice de Wilkins de 9/16. Se realizó valvuloplastia bivalvular percutánea con balón, con resultado exitoso. A un año del procedimiento la paciente evoluciona asintomática.

  11. Control of Mitral/Tufted Cell Output by Selective Inhibition among Olfactory Bulb Glomeruli.

    Science.gov (United States)

    Economo, Michael N; Hansen, Kyle R; Wachowiak, Matt

    2016-07-20

    Inhibition is fundamental to information processing by neural circuits. In the olfactory bulb (OB), glomeruli are the functional units for odor information coding, but inhibition among glomeruli is poorly characterized. We used two-photon calcium imaging in anesthetized and awake mice to visualize both odorant-evoked excitation and suppression in OB output neurons (mitral and tufted, MT cells). MT cell response polarity mapped uniformly to discrete OB glomeruli, allowing us to analyze how inhibition shapes OB output relative to the glomerular map. Odorants elicited unique patterns of suppression in only a subset of glomeruli in which such suppression could be detected, and excited and suppressed glomeruli were spatially intermingled. Binary mixture experiments revealed that interglomerular inhibition could suppress excitatory mitral cell responses to odorants. These results reveal that inhibitory OB circuits nonlinearly transform odor representations and support a model of selective and nonrandom inhibition among glomerular ensembles. PMID:27346531

  12. Giant pulmonary artery aneurysm in a patient with rheumatic mitral stenosis

    Directory of Open Access Journals (Sweden)

    Vikas Singh

    2014-01-01

    Full Text Available Pulmonary artery (PA aneurysm is a rare condition, frequently associated with pulmonary hypertension. However, the evolution and treatment of this pathology is still not clear. We report a case of a 45-year-old female patient with giant PA aneurysm associated with rheumatic mitral stenosis and severe pulmonary arterial hypertension. The patient had undergone balloon mitral valvotomy around 7 years back; aneurysm was first identified 3 years back during routine follow-up. The PA aneurysm size, however, had remained almost unchanged with associated severe pulmonary regurgitation. Surgical correction was advised but denied by the patient. To our knowledge, this is the first case report of such a large PA aneurysm in association with rheumatic heart disease. Although medical therapy for pulmonary hypertension was started, surgical correction of the aneurysm was advised in order to prevent the future complications.

  13. A biophysical signature of network affiliation and sensory processing in mitral cells

    DEFF Research Database (Denmark)

    Angelo, Kamilla; Rancz, Ede A; Pimentel, Diogo;

    2012-01-01

    One defining characteristic of the mammalian brain is its neuronal diversity. For a given region, substructure, layer or even cell type, variability in neuronal morphology and connectivity persists. Although it is well known that such cellular properties vary considerably according to neuronal type......, the substantial biophysical diversity of neurons of the same morphological class is typically averaged out and ignored. Here we show that the amplitude of hyperpolarization-evoked sag of membrane potential recorded in olfactory bulb mitral cells is an emergent, homotypic property of local networks and sensory...... receptor is universally expressed. Population diversity in this intrinsic property therefore reflects differential expression between local mitral cell networks processing distinct odour-related information....

  14. [Incidentally detected bronchial artery aneurysm with combined operation for mitral regurgitation;report of a case].

    Science.gov (United States)

    Sato, Hisashi; Oteki, Hitoshi; Naito, Kozo; Yunoki, Junji

    2015-02-01

    A 77-year-old woman was admitted to the hospital for heart failure with orthopnea. Echocardiography revealed massive mitral regurgitation. During preoperative cardiac catheterization, an aneurysm was indentified incidentally just below the tracheal carina. Three dimensional computed tomography showed three bronchial artery aneurysms behind the pulmonary artery and the left atrium. The proximal aneurysm was the largest and was 22 mm in diameter. It was resected by retracting the ascending aorta to the left, the superior vana cava to the right and right pulmonary artery cranially under cardiopulmonary bypass, and mitral valve plasty was performed. We believed that resection of the proximal aneurysm would cause thrombotic occlusion of the other 2 aneurysms. Bronchial artery aneurysm is a rare entity that is observed in fewer than 1% of those who undergo selective bronchial arteriography. In addition, because bronchial artery aneurysm is a potentially life-threatening lesion, it should be treated promptly when diagnosed.

  15. Inhibition of Porcine Small Intestinal Sucrase by Validamine

    Institute of Scientific and Technical Information of China (English)

    郑裕国; 申屠旭萍; 沈寅初

    2005-01-01

    As an important medicinal intermediate with broad uses, validamine, an aminocyclitol, isolated from the enzymolysis broth of validamycins, has gained more and more attention. The absolute configuration of validamine is similar to that of α-D-glucose, and it demonstrates powerful inhibition activity on glycosidase. In this paper, the inhibitory effect of validamine on porcine small intestinal sucrase was investigated. Validamine was found to be a potent, competitive inhibitor to porcine small intestinal sucrase in vitro with an IC50 value of 6.85 × 10-4 mol·L-1. Validamine exhibited a dose-dependent inhibition effect on porcine small intestinal sucrase, whereby the inhibition interaction of validamine and porcine small intestinal sucrase was a fast binding process. The inhibition of validamine on porcine small intestinal sucrase was pH-dependent.

  16. Clinical evaluation of enalapril maleate and furosemide usage in dogs with degenerative myxomatous mitral valve, CHF functional class Ib

    Directory of Open Access Journals (Sweden)

    Rodrigo P. Franco

    2011-09-01

    Full Text Available Degenerative myxomatous mitral valve (DMMV is a heart disease of high incidence in small animal clinical medicine, affecting mainly older dogs and small breeds. Thus, a scientific investigation was performed in order to evaluate the clinical use of the medicines furosemide and enalapril maleate in dogs with this disease in CHF functional class Ib before and after the treatment was established. For this purpose 16 dogs with the given valve disease were used, separated into two groups: the first received furosemide (n=8 and the second received enalapril maleate (n=8 throughout 56 days. The dogs were evaluated in four stages (T0, T14, T28 and T56 day in relation to clinical signs, hematological, biochemical and serum assessment, which included serum angiotensin converting enzyme (ACE and aldosterone, as well as radiography, electrocardiography, Doppler-echocardiography and blood pressure. The results regarding the clinical, hematological and serum chemistry evaluations revealed no significant changes in both groups, but significant reductions in the values of ACE and aldosterone in the group receiving enalapril maleate were verified. The radiographic examination revealed reductions of VHS values and variable Pms wave of the electrocardiogram in both groups, but no changes in blood pressure values were identified. The echocardiogram showed a significant decrease of the variables LVDd/s in the studied groups and the FS% in animals that received only enalapril. Therefore, analysis of results showed that monotherapy based on enalapril maleate showed better efficiency of symptoms control in patients with CHF functional class Ib.

  17. Aflatoxin B1 is toxic to porcine oocyte maturation.

    Science.gov (United States)

    Liu, Jun; Wang, Qiao-Chu; Han, Jun; Xiong, Bo; Sun, Shao-Chen

    2015-07-01

    As a toxic secondary metabolite of Aspergillus species, Aflatoxin B1 (AFB1) is a major food and feed contaminant in tropical and sub-tropical regions with high temperature and humidity. It has been reported to be toxic to the female reproductive system in laboratory and domestic animals. In the present study, the influence of acute exposure to AFB1 (10 and 50 μM, 44h) on porcine oocyte maturation and its possible mechanism were investigated. The maturation rates of oocytes decreased significantly in the presence of 50 μM of AFB1. Cell cycle analysis showed that most oocytes were arrested at germinal vesicle breakdown or meosis I stage. However, actin assembly, spindle structure and chromosome alignment were not disrupted after exposure to 50 μM AFB1. Further study showed that DNA methylation levels increased in treated oocytes (50 μM). Histone methylation levels were also analysed after treatment (50 μM): H3K27me3 and H3K4me2 levels decreased, whereas H3K9me3 level increased, indicating that epigenetic modification was affected. AFB1 treatment (50 μM) also induced oxidative stress and further led to autophagy, as shown by accumulation of reactive oxygen species, up-regulated LC3 protein expression and increased mRNA levels of ATG3, ATG5 and ATG7. Annexin V-FITC staining assay revealed that AFB1 treatment (50 μM) resulted in oocyte early apoptosis, which was confirmed by increased Bak, Bax, Bcl-xl mRNA levels. Collectively, our results suggest that AFB1 disrupts porcine oocyte maturation through changing epigenetic modifications as well as inducing oxidative stress, excessive autophagy and apoptosis.

  18. Predictors and prognosis of early ischemic mitral regurgitation in the era of primary percutaneous coronary revascularisation

    OpenAIRE

    MacHaalany, Jimmy; Bertrand, Olivier F; O’Connor, Kim; Abdelaal, Eltigani; Voisine, Pierre; Larose, Éric; Charbonneau, Éric; Costerousse, Olivier; Déry, Jean-Pierre; Sénéchal, Mario

    2014-01-01

    Background Studies assessing ischemic mitral regurgitation (IMR) comprised of heterogeneous population and evaluated IMR in the subacute setting. The incidence of early IMR in the setting of primary PCI, its progression and clinical impact over time is still undetermined. We sought to determine the predictors and prognosis of early IMR after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Methods Using our primary PCI database, we screened for ...

  19. A Starr-Edwards mitral prosthesis after 44 years of good performance.

    Science.gov (United States)

    De Santo, Luca Salvatore; De Feo, Marisa; Della Corte, Alessandro; Cerasuolo, Flavio; Santé, Pasquale; Torella, Michele; Nappi, Gianantonio

    2010-06-01

    The Starr-Edwards caged-ball prosthesis has been widely used to replace cardiac valves. The Model 6120 mitral prosthesis was introduced on the market in 1965 to reduce the high incidence of ball variance and thromboembolism of the previous model. We report the case of a Starr-Edwards Model 6120 which had been in place for 44 years and was still well functioning with no apparent structural damage. PMID:20812436

  20. Diagnosis and treatment of early bioprosthetic malfunction in the mitral valve position due to thrombus formation.

    Science.gov (United States)

    Butnaru, Adi; Shaheen, Joseph; Tzivoni, Dan; Tauber, Rachel; Bitran, Daniel; Silberman, Shuli

    2013-11-01

    Bioprosthetic valve thrombosis is uncommon and the diagnosis is often elusive and may be confused with valve degeneration. We report our experience with mitral bioprosthetic valve thrombosis and suggest a therapeutic approach. From 2002 to 2011, 149 consecutive patients who underwent mitral valve replacement with a bioprosthesis at a single center were retrospectively screened for clinical or echocardiographic evidence of valve malfunction. Nine were found to have valve thrombus. All 9 patients had their native valve preserved, representing 24% of those with preserved native valves. Five patients (group 1) presented with symptoms of congestive heart failure at 16.4 ± 12.4 months after surgery. Echocardiogram revealed homogenous echo-dense film on the ventricular surface of the bioprosthesis with elevated transvalvular gradient, resembling early degeneration. The first 2 patients underwent reoperation: valve thrombus was found and confirmed by histologic examination. Based on these, the subsequent 3 patients received anticoagulation treatment with complete thrombus resolution: mean mitral gradient decreased from 23 ± 4 to 6 ± 1 mm Hg and tricuspid regurgitation gradient decreased from 83 ± 20 to 49 ± 5 mm Hg. Four patients (group 2) were asymptomatic, but routine echocardiogram showed a discrete mass on the ventricular aspect of the valve: 1 underwent reoperation to replace the valve and 3 received anticoagulation with complete resolution of the echocardiographic findings. In conclusion, bioprosthetic mitral thrombosis occurs in about 6% of cases. In our experience, onset is early, before anticipated valve degeneration. Clinical awareness followed by an initial trial with anticoagulation is warranted. Surgery should be reserved for those who are not responsive or patients in whom the hemodynamic status does not allow delay. Nonresection of the native valve at the initial operation may play a role in the origin of this entity.

  1. A Case of Piezogenic Pedal Papules Associated with Mitral Valve Insufficiency

    Directory of Open Access Journals (Sweden)

    Mualla Polat

    2012-09-01

    Full Text Available Piezogenic pedal papules are herniations of subcutaneous fat into the dermis. They are soft, skin-colored papules and nodules, which appear on the side of the heel when the subject is standing and disappear when weight is taken off the foot. Here, we present a 40-year-old male patient with mitral valve insufficiency and piezogenic pedal papules and discuss piezogenic pedal papules in the light of literature.

  2. Massive left atrial and interatrial septal calcification after mitral valve replacement

    Institute of Scientific and Technical Information of China (English)

    Yu-Shen Lin; Feng-Chun Tsai; Pao-Hsien Chu

    2008-01-01

    @@ Massive calcification of left atrium is an uncommon complication of long-standing rheumatic valvular disease, and is most often observed in patients with a previous operation on mitral valve.1 Most patients have experienced symptoms for more than 15 years.2 Massive calcification of the left atrium generally spared the interatrial septum in the previous studies.4 However, to our knowledge, fewer than five cases have presented as full left atrial calcification (Table).

  3. Spectrum of cardiac lesions associated with Isolated Cleft Mitral Valve and their impact on therapeutic choices

    Science.gov (United States)

    El hammiri, Ayoub; Drighil, Abdenasser; Benhaourech, Sanaa

    2016-01-01

    Background Isolated cleft mitral valve (ICMV) may occur alone or in association with other congenital heart lesions. The aim of this study was to describe the profile of cardiac lesions associated with ICMV and their potential impact on therapeutic management. Methods We conducted a descriptive study with data retrieved from the Congenital Heart Disease (CHD) single-center registry of our institution, including patients with ICMV registered between December 2008 and November 2014. Results Among 2177 patients retrieved from the CHD registry, 22 (1%) had ICMV. Median age at diagnosis was 5 years (6 days to 36 years). Nine patients (40.9%) had Down syndrome. Seventeen patients (77.3%) had associated lesions, including 11 (64.7%) with accessory chordae in the left ventricular outflow tract (LVOT) with no obstruction, 15 (88.2%) had ventricular septal defect (VSD), three had secundum atrial septal defect, and four had patent ductus arteriosus. Thirteen patients (59.1%) required surgical repair. The decision to proceed with surgery was mainly based on the severity of the associated lesion in eight patients (61.5%) and on the severity of the mitral regurgitation in four patients (30.8%). In one patient, surgery was decided based on the severity of both the associated lesion and mitral regurgitation. Conclusion Our study shows that ICMV is rare and strongly associated with Down syndrome. The most common associated cardiac abnormalities were VSD and accessory chordae in the LVOT. We conclude that cardiac lesions associated with ICMV are of major interest, since in this study patients with cardiac lesions were diagnosed earlier. The decision to operate on these patients must take into account the severity of both mitral regurgitation and associated cardiac lesions. PMID:27096525

  4. Complete Atrioventricular Block Complicating Mitral Infective Endocarditis Caused by Streptococcus Agalactiae.

    Science.gov (United States)

    Arai, Masaru; Nagashima, Koichi; Kato, Mahoto; Akutsu, Naotaka; Hayase, Misa; Ogura, Kanako; Iwasawa, Yukino; Aizawa, Yoshihiro; Saito, Yuki; Okumura, Yasuo; Nishimaki, Haruna; Masuda, Shinobu; Hirayama, Astushi

    2016-01-01

    BACKGROUND Infective endocarditis (IE) involving the mitral valve can but rarely lead to complete atrioventricular block (CAVB). CASE REPORT A 74-year-old man with a history of infective endocarditis caused by Streptococcus gordonii (S. gordonii) presented to our emergency room with fever and loss of appetite, which had lasted for 5 days. On admission, results of serologic tests pointed to severe infection. Electrocardiography showed normal sinus rhythm with first-degree atrioventricular block and incomplete right bundle branch block, and transthoracic echocardiography and transesophageal echocardiography revealed severe mitral regurgitation caused by posterior leaflet perforation and 2 vegetations (5 mm and 6 mm) on the tricuspid valve. The patient was initially treated with ceftriaxone and gentamycin because blood and cutaneous ulcer cultures yielded S. agalactiae. On hospital day 2, however, sudden CAVB requiring transvenous pacing occurred, and the patient's heart failure and infection worsened. Although an emergent surgery is strongly recommended, even in patients with uncontrolled heart failure or infection, surgery was not performed because of the Child-Pugh class B liver cirrhosis. Despite intensive therapy, the patient's condition further deteriorated, and he died on hospital day 16. On postmortem examination, a 2×1-cm vegetation was seen on the perforated posterior mitral leaflet, and the infection had extended to the interventricular septum. Histologic examination revealed extensive necrosis of the AV node. CONCLUSIONS This rare case of CAVB resulting from S. agalactiae IE points to the fact that in monitoring patients with IE involving the mitral valve, clinicians should be aware of the potential for perivalvular extension of the infection, which can lead to fatal heart block. PMID:27604147

  5. Enhanced expression of ROCK in left atrial myocytes of mitral regurgitation: a potential mechanism of myolysis

    OpenAIRE

    Chen, Huang-Chung; Chang, Jen-Ping; Chang, Tzu-Hao; Lin, Yu-Sheng; Huang, Yao-Kuang; Pan, Kuo-Li; Fang, Chih-Yuan; Chen, Chien-Jen; Ho, Wan-Chun; Chen, Mien-Cheng

    2015-01-01

    Background Severe mitral regurgitation (MR) may cause myolysis in the left atrial myocytes. Myolysis may contribute to atrial enlargement. However, the relationship between Rho-associated kinase (ROCK) and myolysis in the left atrial myocytes of MR patients remain unclear. Methods This study comprised 22 patients with severe MR [12 with atrial fibrillation (AF) and ten in sinus rhythm]. Left atrial appendage tissues were obtained during surgery. Normal left atrial tissues were purchased. Immu...

  6. CRITICAL MITRAL STENOSIS: A RARE PRESENTATION OF PEDIATRIC RHEUMATIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Balai Chandra

    2015-01-01

    Full Text Available Rheumatic fever (RF and rheumatic heart disease (RHD continue to be a major health hazard in most developing countries. Paediatric and juvenile mitral stenosis (MS, upto the age of 12 and 20yr respectively, severe enough to require operative treatment was documented. These negate the belief that patients of RHD become symptomatic ≥20 years after RF as well as the fact that congestive cardiac failure in childhood indicates active carditis and RF

  7. Characterisation of the gut microbiota in three porcine models of obesity and metabolic syndrome

    DEFF Research Database (Denmark)

    Pedersen, Rebecca

    by pre‐ and probiotics diet supplements. In order to investigate the impact of diet and obesity on gut microbiota and vice versa in humans, there is a need for translational animal models that can contribute to the understanding of obesity and its related diseases. Pigs are often used in intervention...... studies, primarily due to the close resemblance of their anatomy and physiology to that of humans. The main focus of this Ph.D. thesis was to elucidate the changes in gut microbiota during the course of diet induced obesity in three porcine models and to relate their microbial profiles to a physiological...... trait, namely lean or obese phenotype. Furthermore, these porcine models of obesity were evaluated for their potential as animal models that may be used in diet‐induced obesity‐gut micriobiota related studies in the future. In this Ph.D. thesis, the faecal and intestinal microbiota was investigated...

  8. Defining the clinical need and indications: who are the right patients for transcatheter mitral valve replacement.

    Science.gov (United States)

    Baumgarten, Heike; Squiers, John J; Arsalan, Mani; John, M; Dimaio, Michael J

    2016-06-01

    Mitral regurgitation (MR) can be divided into two major etiologies, primary and secondary MR. Primary MR, also termed degenerative or organic MR, is a disease of the valve itself and is treated routinely by surgical repair in all but prohibitive risk patients. In these patients, transcatheter repair techniques, including edge to edge repair with the MitraClip device have been largely successful and widely adopted. Transcatheter placement of artificial chords has also been performed. The potential role for transcatheter mitral valve replacement (TMVR) in primary MR will likely be quite limited. Secondary or functional MR is due to a disease of the left ventricle and not the valve itself. The MR is a result of dilation of the left ventricle causing distraction of the papillary muscles with tethering of the mitral leaflets and lack of leaflet coaptation. Medical therapy is the mainstay treatment, with resynchronization used in appropriate patients. Surgical repair, usually with an undersized annuloplasty, is used in a limited number of patients. Transcatheter edge to edge repair is used extensively outside the US in secondary MR and is the subject of a pivotal trial in the US. However, it is in this group of patients with secondary MR that there is the largest clinical unmet need and, hence, the greatest potential opportunity for TMVR. At least ten TMVR platforms are in early feasibility, first in human, or preclinical trial stages. Four devices have cumulative early human experience in selection. PMID:27028332

  9. CTS Trials Network: Surgical ablation of atrial fibrillation during mitral valve surgery - many questions unanswered.

    Science.gov (United States)

    Afifi, Ahmed

    2015-01-01

    A disease that is associated with stroke and mortality, atrial fibrillation (AF) complicates 30 to 50% of mitral valve disease patients admitted for surgery.(1) Since the introduction of the Cox maze III procedure in 1992 many efforts have been made to come up with modified lesion sets and/or energy sources to surgically treat AF. This lead to the recently published American Heart Association (AHA)- American College of Cardiology (ACC)-Heart Rhythm Society (HRS) guidelines(2) stating that it is reasonable to perform atrial fibrillation ablation in selected patients undergoing other types of cardiac surgery. The effectiveness of different techniques in conversion to sinus rhythm and the clinical impact of freedom from AF remain a question. The CTS Trials Network have undertaken a trial to answer these questions. The first year results of their randomized trial comparing AF ablation at the time of mitral valve surgery with mitral valve surgery alone were published recently in The New England Journal of Medicine.(3).

  10. A novel high temporal resolution phase contrast MRI technique for measuring mitral valve flows

    Science.gov (United States)

    Voorhees, Abram; Bohmann, Katja; McGorty, Kelly Anne; Wei, Timothy; Chen, Qun

    2005-11-01

    Mitral valve flow imaging is inherently difficult due to valve plane motion and high blood flow velocities, which can range from 200 cm/s to 700 cm/s under regurgitant conditions. As such, insufficient temporal resolution has hampered imaging of mitral valve flows using magnetic resonance imaging (MRI). A novel phase contrast MRI technique, phase contrast using phase train imaging (PCPTI), has been developed to address the high temporal resolution needs for imaging mitral valve flows. The PCPTI sequence provides the highest temporal resolution to-date (6 ms) for measuring in-plane and through-plane flow patterns, with each velocity component acquired in a separate breathhold. Tested on healthy human volunteers, comparison to a conventional retrogated PC-FLASH cine sequence showed reasonable agreement. Results from a more rigorous validation using digital particle image velocimetry technique will be presented. The technique will be demonstrated in vitro using a physiological flow phantom and a St. Jude Medical Masters Series prosthetic valve.

  11. Elevated transaortic valvular gradients after combined aortic valve and mitral valve replacement: an intraoperative dilemma.

    Science.gov (United States)

    Essandoh, Michael; Portillo, Juan; Zuleta-Alarcon, Alix; Castellon-Larios, Karina; Otey, Andrew; Sai-Sudhakar, Chittoor B

    2015-03-01

    High transaortic valvular gradients, after combined aortic valve and mitral valve replacement, require prompt intraoperative diagnosis and appropriate management. The presence of high transaortic valvular gradients after cardiopulmonary bypass, in this setting, can be secondary to the following conditions: prosthesis dysfunction, left ventricular outflow tract obstruction, supravalvular obstruction, prosthesis-patient mismatch, hyperkinetic left ventricle from administration of inotropes, left ventricular intracavitary gradients, pressure recovery phenomenon, and increased transvalvular blood flow resulting from hyperdynamic circulation or anemia. Transesophageal echocardiography is an extremely useful tool for timely diagnosis and treatment of this complication. We describe a case of a critically ill patient with endocarditis and acute lung injury, who presented for combined aortic valve and mitral valve replacement. Transesophageal echocardiographic assessment, post-cardiopulmonary bypass, revealed high transaortic valvular gradients due to encroachment of the mitral prosthesis strut on the left ventricular outflow tract, which was compounded by a small, hypertrophied, and hyperkinetic left ventricle. Discontinuation of inotropic support, administration of fluids, phenylephrine, and esmolol led to resolution of the high gradients and prevented further surgery. PMID:25549635

  12. Differential Axonal Projection of Mitral and Tufted Cells in the Mouse Main Olfactory System

    Directory of Open Access Journals (Sweden)

    Shin Nagayama

    2010-09-01

    Full Text Available In the past decade, much has been elucidated regarding the functional organization of the axonal connection of olfactory sensory neurons to olfactory bulb (OB glomeruli. However, the manner in which projection neurons of the OB process odorant input and send this information to higher brain centers remains unclear. Here, we report long-range, large-scale tracing of the axonal projection patterns of OB neurons using two-photon microscopy. Tracer injection into a single glomerulus demonstrated widely distributed mitral/tufted cell axonal projections on the lateroventral surface of the mouse brain, including the anterior/posterior piriform cortex (PC and olfactory tubercle (OT. We noted two distinct groups of labeled axons: PC-orienting axons and OT-orienting axons. Each group occupied distinct parts of the lateral olfactory tract. PC-orienting axons projected axon collaterals to a wide area of the PC but only a few collaterals to the OT. OT-orienting axons densely projected axon collaterals primarily to the anterolateral OT (alOT. Different colored dye injections into the superficial and deep portions of the OB external plexiform layer revealed that the PC-orienting axon populations originated in presumed mitral cells and the OT-orienting axons in presumed tufted cells. These data suggest that although mitral and tufted cells receive similar odor signals from a shared glomerulus, they process the odor information in different ways and send their output to different higher brain centers via the PC and alOT.

  13. 二尖瓣成形术在二尖瓣关闭不全中的应用%Application of mitral valvuloplasty in mitral insufficiency

    Institute of Scientific and Technical Information of China (English)

    陈红卫; 潘砚鹏; 陈文宽

    2015-01-01

    Objective To summarize and analyze the operation method and clinical effect of the mitral valvuloplas-ty. Methods The clinical data of 42 patients with mitral valvuloplasty from Jan. 2006 to Jun. 2013 were retrospectively analyzed. The operations were performed under low temperature during cardiopulmonary bypass. And among these ,8 cases adopted repairment of the cleft of the mitral leaflet,lobes rectangular resection and suture in 12 cases,chordate tendineae folded or transfer molding in 2 cases,valve annulus of the back lobe ring contraction and placation of the commeasure in 7 cases. Mitral valvuloplasty mitral valve perforation and repairmen in 4 cases. “ Edge-to-Edge”technique for method of double holes in 7 cases,prosthetic ring for mitral annuloplasty in 2 cases. The above method of forming at the same time the application of artificial valve ring annuloplasty in 28 cases,during the operation,to adopt water injection test and Tran esophageal echocardiography,after the operation,to ultrasound assessment of the forming effect. Results There was no death case,and after the operation,through ultrasonography showed no tricuspid regurgitation was in 27 cases(64. 29% ), mild reflux in 12 cases(28. 57% ),slight to middle degree in 3 cases(7. 14% ),and after the operation,due to hemoglo-binuria to have another operation in 1 case,the rate of re-resection was 2. 38% . The mean follow- up time was 1 - 6 (3. 5 ± 1. 6)years. All the patients return to normal life and work,I degree of NYHA in 32 cases,Ⅱ degree in 10 cases. Conclusions For the patients with mitral insufficiency with high quality leaflets,during the operation,according to the patient’s mitral morphology,to adopt corresponding operation forming and have good clinical results.%目的:总结分析二尖瓣成形术患者的手术方法和临床疗效。方法回顾性分析2006年1月至2013年6月行二尖瓣成形术患者42例,手术在体外循环中低温下施行,采用瓣叶裂缺修补8

  14. Cirurgia conservadora de próteses aórtica e mitral na endocardite infecciosa Conservative surgery for aortic and mitral prosthesis in infective endocarditis

    Directory of Open Access Journals (Sweden)

    Kanim Kalil KASSAB

    2001-03-01

    Full Text Available A endocardite infecciosa (EI acometendo próteses valvares é uma complicação freqüente, sendo tratada geralmente com cirurgia, devido ao seu difícil controle clínico e má resposta à antibioticoterapia. Este relato descreve o caso de uma paciente com EI, acometendo simultaneamente as biopróteses aórtica (Ao e mitral (Mi após vinte e quatro meses de cirurgia de implantes valvares, submetida a tratamento cirúrgico conservador, e com resultado favorável. Discutem-se as vantagens deste procedimento em situações específicas.Infective endocarditis is a frequent complication for valvar prosthesis currently treated with surgery, orving to its difficult control and poor response to therapy with antibiotics. Although conservative surgery for infective endocarditis of prosthesis is not a procedure of choice, this report shows a case of infective endocarditis of aortic and mitral prosthesis, after 24 months of implantation, treated by conservative surgery with favorable outcome.

  15. Real time three-dimensional transesophageal echocardiography guided coronary sinus cannulation during CARILLON mitral annuloplasty device therapy for a patient with chronic severe mitral regurgitation.

    Science.gov (United States)

    Mahmoud, Hani M; Al-Ghamdi, Mohammed A; Ghabashi, Abdullah E

    2015-01-01

    The coronary sinus (CS) has become a clinically important structure especially through its role in providing access for different cardiac procedures such as arrhythmia ablation, biventricular pacing and recently, percutaneous valvular interventions. Fluoroscopy with or without two-dimensional transesophageal echocardiography is the widely used method for guidance. A 78-year-old female patient undergoing percutaneous CARILLON mitral annuloplasty device therapy for chronic severe symptomatic mitral regurgitation. After insertion of the CS catheter through the right internal jugular vein, multiple trials for CS cannulation guided by fluoroscopy and two-dimensional transesophageal echocardiography were unsuccessful. So, real time three-dimensional zoom mode was used. Then, the volume was rotated to have the anatomically oriented enface view of the interatrial septum from the right atrial perspective. The CS ostium was identified adjacent to the eustachian valve. Then the catheter was reintroduced through the superior vena cava into the right atrium then easily navigated to cannulate the CS ostium. The position was confirmed by the fluoroscopically known course of the CS plus the pattern of the invasive pressure wave form. CS cannulation is not always feasible using fluoroscopy and/or two-dimensional Echocardiography guidance. Real time three-dimensional transesophageal echocardiography can be used to guide CS cannulation as it provides an anatomically oriented and informative enface view of the CS ostium. It can help reducing fluoroscopic radiation time. PMID:25231878

  16. Effects of the Sheep Polyclonal Antibodies Against the Porcine Adipocyte Plasma Membrane Proteins on Porcine Carcass Composition and Meat Quality

    Institute of Scientific and Technical Information of China (English)

    GAO Shi-zheng; HU Hong-mei; LIU Ling-yun; ZHANG Xi; LIU Yong-gang; GE Chang-rong

    2007-01-01

    To detect the effects of the polyclonal antibodies raised in sheep against porcine adipocyte plasma membranes on the porcine carcass composition and meat quality, 30 pigs assigned into 6 treatment groups were given intraperitoneal injections of sheep antipig adipocyte plasma membrane immunoglobulin (ASIg) or sheep nonimmune serum immunoglobulin (NSIg). At the end of the experiment, the pigs were slaughtered at 90 kg body weight, and carcasses and meat quality were evaluated. The results showed that when pigs intraperitoneally immunized with 20 or 30 mg ASIg at 15 kg body weight, 20 mg purified ASIg twice at 15 and 60 kg body weight, or 20 mg purified ASIg at 60 kg body weight, respectively, their lean meat percentage, fat meat percentage, backfat thickness, loin eye area leaf fat weight, caul fat weight, heart weight, liver weight, and kidney weight were significantly affected. However, the kidney weight, lung weight, dressing percentage,and spleen weight did not remarkably change. Our results indicated that pigs intraperitoneally immunized with 20 or 30 mg ASIg at 15 kg body weight, and 20 mg ASIg twice at 15 and 60 kg body weight, have significantly different drip loss rate,cooked meat ratio, tenderness, storage loss rate, muscle fiber diameter, moisture content, dry matter content, crude protein content, and crude fat content from the control group that received 20 mg NSIg at 15 kg body weight. However, meat pH,meat color value, meat marbling score, inosinate, and myohemoglobin were not significantly affected. Our results indicated ASIg could not significantly affect the content of most muscular amino acids and intramuscular fatty acids.

  17. Lipid characterization of individual porcine oocytes by dual mode DESI-MS and data fusion

    International Nuclear Information System (INIS)

    Highlights: • Repeated analysis by DESI(±)-MS of intact single oocytes for lipid characterization. • Deployment of a data fusion strategy to merge positive and negative ion mode data. • Enhanced interpretation of metabolic changes by more efficient analysis of spectral data. • Discovery of increased fatty acid metabolism and membrane complexity during maturation. • Assistance in the improvement of in vitro embryo production for porcine species. - Abstract: The development of sensitive measurements to analyze individual cells is of relevance to elucidate specialized roles or metabolic functions of each cell under physiological and pathological conditions. Lipids play multiple and critical roles in cellular functions and the application of analytical methods in the lipidomics area is of increasing interest. In this work, in vitro maturation of porcine oocytes was studied. Two independent sources of chemical information (represented by mass spectra in the positive and negative ion modes) from single oocytes (immature oocytes, 24-h and 44-h in vitro matured oocytes) were acquired by using desorption electrospray ionization-mass spectrometry (DESI-MS). Low and mid-level data fusion strategies are presented with the aim of better exploring the large amount of chemical information contained in the two mass spectrometric lipid profiles. Data were explored by principal component analysis (PCA) within the two multi-block approaches to include information on free fatty acids, phospholipids, cholesterol-related molecules, di- and triacylglycerols. After data fusion, clearer differences among immature and in vitro matured porcine oocytes were observed, which provide novel information regarding lipid metabolism throughout oocyte maturation. In particular, changes in TAG composition, as well as increase in fatty acid metabolism and membrane complexity were evidenced during the in vitro maturation process. This information can assist the improvement of in vitro embryo

  18. Lipid characterization of individual porcine oocytes by dual mode DESI-MS and data fusion

    Energy Technology Data Exchange (ETDEWEB)

    Pirro, Valentina, E-mail: valentina.pirro@unito.it [Department of Chemistry, University of Turin, Via Pietro Giuria 7, Turin 10125 (Italy); Oliveri, Paolo [Department of Pharmacy, University of Genoa, Via Brigata Salerno 13, Genoa 16147 (Italy); Ferreira, Christina Ramires [Department of Chemistry, Purdue University, 560 Oval Drive, West Lafayette, IN 47907 (United States); González-Serrano, Andrés Felipe [Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Hoeltystrasse 10, 31535 Neustadt, Mariensee (Germany); Machaty, Zoltan [Department of Animal Sciences, Purdue University, 915 W. State St., West Lafayette, IN 47907 (United States); Cooks, Robert Graham [Department of Chemistry, Purdue University, 560 Oval Drive, West Lafayette, IN 47907 (United States)

    2014-10-27

    Highlights: • Repeated analysis by DESI(±)-MS of intact single oocytes for lipid characterization. • Deployment of a data fusion strategy to merge positive and negative ion mode data. • Enhanced interpretation of metabolic changes by more efficient analysis of spectral data. • Discovery of increased fatty acid metabolism and membrane complexity during maturation. • Assistance in the improvement of in vitro embryo production for porcine species. - Abstract: The development of sensitive measurements to analyze individual cells is of relevance to elucidate specialized roles or metabolic functions of each cell under physiological and pathological conditions. Lipids play multiple and critical roles in cellular functions and the application of analytical methods in the lipidomics area is of increasing interest. In this work, in vitro maturation of porcine oocytes was studied. Two independent sources of chemical information (represented by mass spectra in the positive and negative ion modes) from single oocytes (immature oocytes, 24-h and 44-h in vitro matured oocytes) were acquired by using desorption electrospray ionization-mass spectrometry (DESI-MS). Low and mid-level data fusion strategies are presented with the aim of better exploring the large amount of chemical information contained in the two mass spectrometric lipid profiles. Data were explored by principal component analysis (PCA) within the two multi-block approaches to include information on free fatty acids, phospholipids, cholesterol-related molecules, di- and triacylglycerols. After data fusion, clearer differences among immature and in vitro matured porcine oocytes were observed, which provide novel information regarding lipid metabolism throughout oocyte maturation. In particular, changes in TAG composition, as well as increase in fatty acid metabolism and membrane complexity were evidenced during the in vitro maturation process. This information can assist the improvement of in vitro embryo

  19. In vitro manipulation techniques of porcine embryos

    DEFF Research Database (Denmark)

    Liu, Ying; Li, Juan; Løvendahl, Peter;

    2015-01-01

    insemination. Therefore, a review of the overall efficiency for the developmental competence of embryos produced by these in vitro methods would be useful in order to obtain a more thorough overview of this growing area with respect to its development and present status. In this review a meta-analysis was used...... to analyse data collected from all published articles with a focus on zygotes and embryos for transfer, pregnancy, full-term development and piglets born. It was generally concluded that an increasing level of in vitro manipulation of porcine embryos decreased the overall efficiency for production of piglets...

  20. Porcine dentin sialoprotein glycosylation and glycosaminoglycan attachments

    Directory of Open Access Journals (Sweden)

    Yamakoshi Fumiko

    2011-02-01

    Full Text Available Abstract Background Dentin sialophosphoprotein (Dspp is a multidomain, secreted protein that is critical for the formation of tooth dentin. Mutations in DSPP cause inherited dentin defects categorized as dentin dysplasia type II and dentinogenesis imperfecta type II and type III. Dentin sialoprotein (Dsp, the N-terminal domain of dentin sialophosphoprotein (Dspp, is a highly glycosylated proteoglycan, but little is known about the number, character, and attachment sites of its carbohydrate moieties. Results To identify its carbohydrate attachment sites we isolated Dsp from developing porcine molars and digested it with endoproteinase Glu-C or pronase, fractionated the digestion products, identified fractions containing glycosylated peptides using a phenol sulfuric acid assay, and characterized the glycopeptides by N-terminal sequencing, amino acid analyses, or LC/MSMS. To determine the average number of sialic acid attachments per N-glycosylation, we digested Dsp with glycopeptidase A, labeled the released N-glycosylations with 2-aminobenzoic acid, and quantified the moles of released glycosylations by comparison to labeled standards of known concentration. Sialic acid was released by sialidase digestion and quantified by measuring β-NADH reduction of pyruvic acid, which was generated stoichiometrically from sialic acid by aldolase. To determine its forms, sialic acid released by sialidase digestion was labeled with 1,2-diamino-4,5-methyleneoxybenzene (DMB and compared to a DMB-labeled sialic acid reference panel by RP-HPLC. To determine the composition of Dsp glycosaminoglycan (GAG attachments, we digested Dsp with chondroitinase ABC and compared the chromotagraphic profiles of the released disaccharides to commercial standards. N-glycosylations were identified at Asn37, Asn77, Asn136, Asn155, Asn161, and Asn176. Dsp averages one sialic acid per N-glycosylation, which is always in the form of N-acetylneuraminic acid. O-glycosylations were