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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. 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...

  3. In vitro assessment of mitral valve function in cyclically pressurized porcine hearts.

    Science.gov (United States)

    Vismara, Riccardo; Leopaldi, Alberto M; Piola, Marco; Asselta, Chiara; Lemma, Massimo; Antona, Carlo; Redaelli, Alberto; van de Vosse, Frans; Rutten, Marcel; Fiore, Gianfranco B

    2016-04-01

    Recent approaches to the in vitro experimental study of cardiac fluid mechanics involve the use of whole biological structures to investigate in the lab novel therapeutic approaches for the treatment of heart pathologies. To enhance reliability and repeatability, the influence of the actuation strategy of the experimental apparatuses on the biomechanics of biological structures needs to be assessed. Using echography and intracardiac high-speed imaging, we compared the mitral valve (MV) anatomo-functional features (coaptation areas/lengths, papillary muscles-valvular plane distances) in two passive-beating-heart mock loops with internal (IPML) or external (EPML) pressurization of the ventricular chamber. Both apparatuses showed fluid dynamic conditions that closely resembled the physiology. The MVs analyzed in the EPML presented coaptation areas and lengths that were systematically higher, and exhibited greater variability from early-to peak-systole, as compared to those in the IPML. Moreover, in the EPML, the MV leaflets exhibited a convexity with high curvature toward the atrium. With the IPML, MV coaptation lengths ranged similar to available clinical data and the papillary muscles-valve plane distances were more stable throughout systole. In conclusion, both the apparatuses allow for reproducing in vitro the left heart hemodynamics, in terms of flow rates and pressures, with proper mitral valve continence. Results suggest that the IPML is more suitable for replicating the physiological MV functioning, while the EPML may have more potential as a model for the study of MV pathologies. PMID:26908180

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

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    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

  5. Changes in enzyme activities of porcine erythrocytes exposed to radiation

    International Nuclear Information System (INIS)

    Changes in activities of superoxide dismutase, catalase, peroxidase and acetylcholinesterase were observed in porcine erythrocytes for doses of 5 - 30 kGy. These enzymes are capable of performing their functions also in irradiated porcine erythrocytes, which seem to be more radioresistant in this respect than bovine erythrocytes investigated previously. (author)

  6. 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.

  7. 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 ...

  8. Mitral stenosis

    Science.gov (United States)

    ... fluid may then collect in the lung tissue (pulmonary edema), making it hard to breathe. In adults, mitral ... intestines, kidneys, or other areas Congestive heart failure Pulmonary edema Pulmonary hypertension

  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. 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...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. Deoxynivalenol exposure induces autophagy/apoptosis and epigenetic modification changes during porcine oocyte maturation.

    Science.gov (United States)

    Han, Jun; Wang, Qiao-Chu; Zhu, Cheng-Cheng; Liu, Jun; Zhang, Yu; Cui, Xiang-Shun; Kim, Nam-Hyung; Sun, Shao-Chen

    2016-06-01

    Deoxynivalenol (DON) is a widespread trichothecene mycotoxin which contaminates agricultural staples and elicits a complex spectrum of toxic effects on humans and animals. It has been shown that DON impairs oocyte maturation, reproductive function and causes abnormal fetal development in mammals; however, the mechanisms remain unclear. In the present study, we investigate the possible reasons of the toxic effects of DON on porcine oocytes. Our results showed that DON significantly inhibited porcine oocyte maturation and disrupted meiotic spindle by reducing p-MAPK protein level, which caused retardation of cell cycle progression. In addition, up-regulated LC3 protein expression and aberrant Lamp2, LC3 and mTOR mRNA levels were observed with DON exposure, together with Annexin V-FITC staining assay analysis, these results indicated that DON treatment induced autophagy/apoptosis in porcine oocytes. We also showed that DON exposure increased DNA methylation level in porcine oocytes through altering DNMT3A mRNA levels. Histone methylation levels were also changed showing with increased H3K27me3 and H3K4me2 protein levels, and mRNA levels of their relative methyltransferase genes, indicating that epigenetic modifications were affected. Taken together, our results suggested that DON exposure reduced porcine oocytes maturation capability through affecting cytoskeletal dynamics, cell cycle, autophagy/apoptosis and epigenetic modifications. PMID:26988607

  15. 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.

  16. Obestatin changes proliferation, differentiation and apoptosis of porcine preadipocytes.

    Science.gov (United States)

    Tang, Shengqiu; Dong, Xiaoying; Zhang, Wei

    2014-02-01

    Obestatin, originally identified and purified from rat stomach extracts, was reported to bind to orphan G protein-coupled receptor, GPR39, and inhibit appetite and gastric motility. This study was conducted to investigate the effects of porcine obestatin on proliferation, differentiation and apoptosis of porcine preadipocytes isolated from subcutaneous fat of piglets. At indicated times of culture, morphology of preadipocytes and accumulated lipid droplets within the cells were identified by invert microscope. After treating with obestatin (0, 0.1, 1, 10 and 100nM), cell proliferation was measured by MTT method and protein expression of CCAAT/enhancer binding protein-α (C/EBPα), peroxisome proliferator-activated receptor-γ (PPARγ), Caspase-7 and Caspase-9 was determined by Western Blot, mRNA expression of GPR39 and Caspase-3 was analyzed by RT-PCR, and the activity of Caspase-3 was measured by spectrophotometric method. The results showed that obestatin had no effect on GPR39 expression, while promotes the optical density (OD) value of cells, enhanced protein expression of PPARγ and C/EBPa, decreased mRNA expression and activity of Caspase-3, and inhibited protein expression of Caspase-7 and Caspase-9 in a dose-dependent manner. These results suggested that obestatin enhances proliferation and differentiation of preadipocytes promoting PPARγ and C/EBPa expression, and inhibiting preadipocyte apoptosis by decreasing expression of Caspase-3, Caspase-7 and Caspase-9. PMID:24534601

  17. 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

  18. Double orifice mitral valve: A case report

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    Musić Ljilja

    2016-01-01

    Full Text Available Introduction. Double orifice mitrol valve (DOMV is a very rare congenital heart defect. Case report. We reported 20-year-old male referred to our center due to evaluation of his cardiologic status. He was operated on shortly after birth for a tracheoesophageal fistula. Accidentally, echocardiography examination at the age of 4 years revealed double orifice mitral valve (DOMV without the presence of mitral regurgitation, as well as mitral stenosis, with normal dimensions of all cardiac chambers. The patient was asymptomatic, even more he was a kick boxer. His physical finding was normal. Electrocardiography showed regular sinus rhythm, incomplete right bundle branch block. Transthoracic echocardiography (TTE examination revealed the normal size of the left atrial, mitral leaflets were slightly more redundant. The left and right heart chambers, aorta, tricuspid valve and pulmonary artery valve were normal. During TTE examination on a short axis view two asymmetric mitral orifices were seen as a double mitral orifice through which we registered normal flow, without regurgitation and mitral stenosis. Transesophageal echocardiography (TEE examination from the transgastric view at the level of mitral valve, showed 2 single asymmetric mitral orifices separated by fibrous tissue, mitral leaflet with a separate insertion of hordes for each orifice. Conclusion. The presented patient with DOMV is the only one recognized in our country. The case is interesting because during 16-year a follow-up period there were no functional changes despite the fact that he performed very demanded sport activities. This is very important because there is no information in the literature about that.

  19. Protein Profile Changes during Porcine Oocyte Aging and Effects of Caffeine on Protein Expression Patterns

    OpenAIRE

    Jiang, Guang-Jian; Wang, Ke; Miao, De-Qiang; Guo, Lei; Hou, Yi; Schatten, Heide; Sun, Qing-Yuan

    2011-01-01

    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 1...

  20. [Modern mitral valve surgery].

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    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

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

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    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. Mitral stenosis and pregnancy: Current concepts in anaesthetic practice

    OpenAIRE

    Kannan, M.; Vijayanand, G

    2010-01-01

    The incidence of rheumatic mitral stenosis is grossly reduced in India. Still, among heart disease complicating pregnancy, rheumatic mitral stenosis occupies a greater segment. The unique physiological changes in pregnancy and the pathological impact of mitral stenosis over pregnancy and labour are discussed in detail. A multidisciplinary approach in the diagnosis and management reduces the mortality and morbidity during peripartum. The labour analgesia technique and the evidence-based region...

  3. 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)

  4. 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

  5. "Malignant" mitral stenosis

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    Auer Johann

    2012-03-01

    Full Text Available Abstract Symptomatic mitral stenosis caused by a left atrial mass as the first sign of metastasis of a malignant tumor is extremely rare and frequently associated with poor prognosis. We report a case of a 59-year-old man with a history of grade 3 malignant fibrous histiocytoma on his left tigh treated by limb-sparing surgery 17 months earlier, who was admitted with 10-days of worsening dyspnea. Imaging revealed a left atrial mass protruding through the mitral valve that resulted in severe mitral stenosis. Biopsy confirmed metastasis of malignant fibrous histiocytoma.

  6. 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...

  7. 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 ...

  8. 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

  9. Changes in acid-phosphate content in enamel mineral during porcine amelogenesis.

    Science.gov (United States)

    Shimoda, S; Aoba, T; Moreno, E C

    1991-12-01

    The present study was undertaken to investigate changes in the acid-phosphate content of porcine enamel mineral during its development and to assess separately the HPO4(2-) pools in labile and stable forms. Enamel samples at the secretory and maturing stages of amelogenesis were obtained from the permanent incisors of five- to six-month-old slaughtered piglets. Human enamel from erupted, extracted teeth, synthetic hydroxyapatite, and carbonatoapatite containing acid phosphate were included as references. The acid-phosphate content of each sample was determined chemically through its pyrolytic conversion to pyrophosphate. The assessment of HPO4(2-) in labile forms was made by analysis of samples preequilibrated with solutions containing 3 mmol/L phosphate at pH11 (to de-protonate the HPO4(2-) species on crystal surfaces). The analytical results of porcine enamel samples showed that: (a) the outermost secretory (youngest) enamel contained the highest HPO4(2-), corresponding to about 16% of the total phosphate; (b) the acid-phosphate content decreased gradually to 10% in the inner (older) secretory and to 6% in the maturing tissue; (c) a substantial part of the HPO4(2-) in developing enamel tissue (50-60% of the HPO4(2-) for the secretory enamel) was in labile forms; and (d) the pool of the labile HPO4(2-) decreased with the growth of enamel mineral. In parallel studies with mature human enamel, it was ascertained that the total acid phosphate was only about 3% of the total phosphate, much lower than in developing porcine enamel, and that the labile pool of HPO4(2-) was also small, corresponding to about 15% of the total acid phosphate determined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1774383

  10. 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

  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. 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

  13. 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.

  14. Does Down-Sized Ring Annuloplasty Induce Papillary Muscle Relocation in Ischemic Mitral Regurgitation?

    DEFF Research Database (Denmark)

    Jensen, Henrik; Jensen, Morten O; Smerup, Morten H; Ringgaard, Steffen; Andersen, Niels T; Wierup, Per; Hasenkam, J Michael; Nielsen, Sten L

    2010-01-01

    Down-sized ring annuloplasty has been shown to induce left ventricular remodeling in patients with functional ischemic mitral regurgitation (FIMR). To determine if this remodeling comprised papillary muscle (PM) relocation, a chronic FIMR porcine model was used to assess the impact on three......-dimensional (3D) PM positioning, by implanting a down-sized rigid ring annuloplasty....

  15. 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

  16. [Immune state in athletes with mitral valve prolapse].

    Science.gov (United States)

    Maslennikova, O M; Reznichenko, T A; Firsakova, V Iu

    2013-01-01

    The authors evaluated immune state in 541 professional athletes. The athletes with vitral valve prolapse (132 subjects) appeared to have immune changes - lower immunoglobulines levels, general leucocytes count, if compared to the athletes without mitral valve prolapse. PMID:24340766

  17. Mitral stenosis and pregnancy: Current concepts in anaesthetic practice

    Directory of Open Access Journals (Sweden)

    M Kannan

    2010-01-01

    Full Text Available The incidence of rheumatic mitral stenosis is grossly reduced in India. Still, among heart disease complicating pregnancy, rheumatic mitral stenosis occupies a greater segment. The unique physiological changes in pregnancy and the pathological impact of mitral stenosis over pregnancy and labour are discussed in detail. A multidisciplinary approach in the diagnosis and management reduces the mortality and morbidity during peripartum. The labour analgesia technique and the evidence-based regional and general anaesthesia techniques are discussed at length in this article.

  18. 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.

  19. Changes of porcine growth hormone and pituitary nitrogen monoxide production as a response to cadmium toxicity.

    Science.gov (United States)

    Han, Xin-Yan; Huang, Qi-Chun; Liu, Bo-Jing; Xu, Zi-Rong; Wang, Yi-Zhen

    2007-11-01

    The present study was designed to investigate the effects of various cadmium concentrations on porcine growth hormone (GH) secretion in serum and cultured pituitary cells and to explore the possible mechanisms of cadmium toxicity. In feeding trial, 192 barrows (Duroc x Landrace x Yorkshire), with similar initial body weights, were randomly divided into four different treatment groups with three replicates for each treatment. The diets were supplemented for 83 days with 0, 0.5, 5.0, and 10.0 mg/kg cadmium (as CdCl2). For the cell culture trial, dispersed pituitary cells were incubated with graded doses of cadmium (0, 5, 10, 15, or 20 microM) for 24 h. Pigs treated with 10 mg/kg cadmium had significantly decreased serum GH content. 3-(4,5-dimethyl-2-yl)-2,5-diphenyl tetrazolium bromide assay showed that Cd toxicity was dose-dependent. Cell viability was reduced to 50% at 15 microM concentration. Administration of cadmium significantly reduced GH secretion, whereas cellular NO content and inducible nitric oxide synthase activity increased to a certain extent. These findings suggest that the decrease of GH might be related to NO production and to a change of NO signal pathway caused by cadmium. PMID:17916936

  20. 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.

  1. 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.

  2. 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

  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. 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

  5. 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...

  6. Changes in cellular microRNA expression induced by porcine circovirus type 2-encoded proteins

    OpenAIRE

    Hong, Jae-Sang; Kim, Nam-Hoon; Choi, Chang-Yong; Lee, Jun-Seong; Na, Dokyun; Chun, Taehoon; Lee, Young Sik

    2015-01-01

    Porcine circovirus type 2 (PCV2) is the primary causative agent of postweaning multisystemic wasting syndrome, which leads to serious economic losses in the pig industry worldwide. While the molecular basis of PCV2 replication and pathogenicity remains elusive, it is increasingly apparent that the microRNA (miRNA) pathway plays a key role in controlling virus-host interactions, in addition to a wide range of cellular processes. Here, we employed Solexa deep sequencing technology to determine ...

  7. 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.

  8. 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.

  9. 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.

  10. Temporal changes in glycogenolytic enzyme mRNAs during myogenesis of primary porcine satellite cells

    DEFF Research Database (Denmark)

    Henckel, Poul; Theil, Peter Kappel; Sørensen, Inge Lise; Oksbjerg, Niels

    2007-01-01

    , phosphorylase kinase, phosphorylase and glycogen debranching enzyme, and no alterations of the transporter molecule GLUT4, clearly indicate that glycogenolytic enzymes of potential importance to meat quality development are regulated at the gene level during myogenesis, and are heavily involved in muscle cell...... and muscle fibre development. The genes, however, are not influenced by insulin, and the lack of response to insulin of expression of gene-encoding enzymes involved in the formation and degradation of glycogen may question the applicability of porcine cell culture systems, like the one applied, as a...

  11. Modified Surgical Intervention for Extensive Mitral Valve Endocarditis and Posterior Mitral Annular Calcification

    Science.gov (United States)

    Kim, Gwan Sic; Beom, Min Sun; Kim, Sung Ryong; Kim, Na Rae; Jang, Ji Wook; Jang, Mi Hee; Ryu, Sang Wan

    2016-01-01

    The concomitant presence of posterior mitral annular calcification and infectious mitral valve lesions poses a technical challenge with considerable perioperative risk when using previously proposed techniques for mitral valve surgery. Herein, we report a case of the use of a modified surgical technique to successfully treat a patient with mitral infective endocarditis complicated by a subendocardial abscess and extensive posterior mitral annular calcification. PMID:26889447

  12. Estimation of mitral stenosis by using digital perfusion images (DPI)

    International Nuclear Information System (INIS)

    Pulmonary perfusion images were modified by computer system to digital perfusion images (DPI) to estimate the distribution of pulmonary blood flow of the patients with mitral stenosis and 27 patients admitted at the Heart Institute Japan were selected and DPI were obtained by using standard method (Tc-99m MAA were injected in sitting state). DPI of the patients were classified into 6 types according to the hemodynamics and the patterns of DPI, i.e. mitral stenosis with sinus rhythm, without regurgitation, with regurgitation (10), with regurgitation (20-) with giant atrium, and with low output state. In each type the pattern of DPI changed gradually according to the hemodynamic changes and eventually showed its own characteristic patterns. Right lateral DPI (r-DPI) showed characteristic patterns which could not be suspected from both anterior and posterior DPI. Patterns of DPI changed after exercise and the postexercise DPI were similar to patterns of DPI with more pulmonary hypertensive state. From these findings it might be suspected as followings. The classification of mitral stenosis into 6 types might be reasonable from the stand point of distribution of pulmonary blood flow. The distribution of pulmonary blood flow might change according to the pulmonary hemodynamic changes. In each type there might be critical pulmonary pressure. R-DPI might be one of the best DPI to estimate the distribution of pulmonary blood flow. By using DPI it might be possible to estimate the pulmonary hemodynamics and severity of the patients with mitral stenosis. (author)

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

    OpenAIRE

    Shamoun, Fadi E.; Ryan C Craner; Rita Von Seggern; Gerges Makar; Harish Ramakrishna

    2015-01-01

    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 v...

  14. Changes in cellular microRNA expression induced by porcine circovirus type 2-encoded proteins.

    Science.gov (United States)

    Hong, Jae-Sang; Kim, Nam-Hoon; Choi, Chang-Yong; Lee, Jun-Seong; Na, Dokyun; Chun, Taehoon; Lee, Young Sik

    2015-01-01

    Porcine circovirus type 2 (PCV2) is the primary causative agent of postweaning multisystemic wasting syndrome, which leads to serious economic losses in the pig industry worldwide. While the molecular basis of PCV2 replication and pathogenicity remains elusive, it is increasingly apparent that the microRNA (miRNA) pathway plays a key role in controlling virus-host interactions, in addition to a wide range of cellular processes. Here, we employed Solexa deep sequencing technology to determine which cellular miRNAs were differentially regulated after expression of each of three PCV2-encoded open reading frames (ORFs) in porcine kidney epithelial (PK15) cells. We identified 51 ORF1-regulated miRNAs, 74 ORF2-regulated miRNAs, and 32 ORF3-regulated miRNAs that differed in abundance compared to the control. Gene ontology analysis of the putative targets of these miRNAs identified transcriptional regulation as the most significantly enriched biological process, while KEGG pathway analysis revealed significant enrichment for several pathways including MAPK signaling, which is activated during PCV2 infection. Among the potential target genes of ORF-regulated miRNAs, two genes encoding proteins that are known to interact with PCV2-encoded proteins, zinc finger protein 265 (ZNF265) and regulator of G protein signaling 16 (RGS16), were selected for further analysis. We provide evidence that ZNF265 and RGS16 are direct targets of miR-139-5p and let-7e, respectively, which are both down-regulated by ORF2. Our data will initiate further studies to elucidate the roles of ORF-regulated cellular miRNAs in PCV2-host interactions. PMID:25885539

  15. [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

  16. 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...

  17. Balloon mitral valvotomy in youngest documented rheumatic mitral stenosis patient.

    Science.gov (United States)

    Sarkar, Achyut; Patil, Shailesh; Ahmed, Imran

    2015-11-01

    Juvenile rheumatic mitral stenosis (MS) is common in the Indian subcontinent. Early recognition and management is essential. Rarely rheumatic MS may occur in saving intervention in these cases unless contraindicated, although the procedure entails considerable technical issues in this age group. Herein, we report a successful balloon mitral valvotomy in a 4-year-old child with severe rheumatic MS (documented since 2 years 6 months of age) presenting with repeated pulmonary edema. To the best of our knowledge, this child is the youngest documented case of established rheumatic heart disease and also one of the youngest PTMC procedure performed. This report supports the clinical usefulness of PTMC in childhood MS; however, pertinent technical issues are raised, which needs a proper consensus. PMID:26012486

  18. Acute thrombosis of bioprosthetic mitral valve

    OpenAIRE

    Kwon, Jin-Tae; Jung, Tae-Eun; Lee, Dong-Hyup

    2013-01-01

    We report a case of acute thrombosis of bioprosthetic mitral valve in a 59 year–old Korean female, who underwent a mitral valve replacement with a 25 mm Carpentier - Edwards PERIMOUNT Plus bioprosthesis (Edwards Lifesciences, Inc.; Irvine, CA, USA) and a mini-Maze procedure for correction of mitral stenosis (MS) and atrial fibrillation (AF). On the 10th postoperative day, the patient began to complain of increasing dyspnea and general malaise. Her symptoms worsened and developed into pulmonar...

  19. 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.

  20. 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.

  1. [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

  2. 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.

  3. 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.

  4. 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. PMID:26483167

  5. Anatomical challenges for transcatheter mitral valve intervention.

    Science.gov (United States)

    DE Backer, Ole; Luk, Ngai H; Søndergaard, Lars

    2016-06-01

    Following the success of transcatheter aortic and pulmonary valve implantation, there is a large interest in transcatheter mitral valve interventions to treat severe mitral regurgitation (MR). With the exception for the MitraClipTM (Abbott, Abbott Park, IL, USA) edge-to-edge leaflet plication system, most of these transcatheter mitral valve interventions are still in their early clinical or preclinical development phase. Challenges arising from the complex anatomy of the mitral valve and the interplay of the mitral apparatus with the left ventricle (LV) have contributed to a more difficult development process and mixed clinical results with these novel technologies. This review aims to discuss the several anatomical aspects and challenges related to transcatheter mitral valve intervention - the relevant anatomy will be reviewed in relation to specific requirements for device design and procedural aspects of transcatheter mitral valve interventions. To date, experience with these novel therapeutic modalities are still limited and resolution of many challenges are pending. Future studies have to evaluate for whom the transcatheter approach is a feasible and preferred treatment and which patients will benefit from either transcatheter mitral valve repair or replacement. Nevertheless, technological developments are anticipated to drive the transcatheter approach forward into a clinically feasible alternative to surgery for selected patients with severe MR. PMID:27028333

  6. 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.

  7. 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

    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 ra...... proteins may be related to the meat rigor mortis and quality development. --------------------------------------------------------------------------------...

  8. 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

  9. 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. PMID:26416815

  10. 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.

  11. Liquefaction necrosis of mitral annulus calcification.

    Science.gov (United States)

    Mallisho, Maram; Hwang, Inyong; Alsafwah, Shadwan F

    2014-01-01

    Liquefaction necrosis of the mitral annulus is a rare form of peri-annular calcification that the cardiologist must be able to differentiate from other cardiac masses. It classically looks like a round or semilunar hyperdense mass with a denser peripheral rim, located mainly in the posterior mitral annulus. The case we report here was diagnosed in a 78-year-old female patient who presented with an embolic cerebral vascular accident, which raises the question of its etiopathogenic responsibility. PMID:24420234

  12. Regurgitation Hemodynamics Alone Cause Mitral Valve Remodeling Characteristic of Clinical Disease States In Vitro.

    Science.gov (United States)

    Connell, Patrick S; Azimuddin, Anam F; Kim, Seulgi E; Ramirez, Fernando; Jackson, Matthew S; Little, Stephen H; Grande-Allen, K Jane

    2016-04-01

    Mitral valve regurgitation is a challenging clinical condition that is frequent, highly varied, and poorly understood. While the causes of mitral regurgitation are multifactorial, how the hemodynamics of regurgitation impact valve tissue remodeling is an understudied phenomenon. We employed a pseudo-physiological flow loop capable of long-term organ culture to investigate the early progression of remodeling in living mitral valves placed in conditions resembling mitral valve prolapse (MVP) and functional mitral regurgitation (FMR). Valve geometry was altered to mimic the hemodynamics of controls (no changes from native geometry), MVP (5 mm displacement of papillary muscles towards the annulus), and FMR (5 mm apical, 5 mm lateral papillary muscle displacement, 65% larger annular area). Flow measurements ensured moderate regurgitant fraction for regurgitation groups. After 1-week culture, valve tissues underwent mechanical and compositional analysis. MVP conditioned tissues were less stiff, weaker, and had elevated collagen III and glycosaminoglycans. FMR conditioned tissues were stiffer, more brittle, less extensible, and had more collagen synthesis, remodeling, and crosslinking related enzymes and proteoglycans, including decorin, matrix metalloproteinase-1, and lysyl oxidase. These models replicate clinical findings of MVP (myxomatous remodeling) and FMR (fibrotic remodeling), indicating that valve cells remodel extracellular matrix in response to altered mechanical homeostasis resulting from disease hemodynamics. PMID:26224524

  13. Porcine retrovirus: hybridization studies

    International Nuclear Information System (INIS)

    Tritium-labeled porcine retrovirus (PoRV) was isolated and purified, and kinetics of hybridization of this RNA with DNA from various sources was determined. Results indicate that PoRV is an endogenous porcine virus

  14. 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)

  15. 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.

  16. 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 ...

  17. 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

  18. 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

  19. Percutaneous balloon mitral valvuloplasty by the Inoue balloon technique: the procedure of choice for treatment of mitral stenosis.

    Science.gov (United States)

    Cheng, T O; Holmes, D R

    1998-03-01

    The Inoue technique of percutaneous balloon mitral valvuloplasty, introduced in 1984, is a truly startling advance in cardiology in modern times. It is time to reeducate our colleagues that when they hear the opening snap in patients with mitral stenosis, they should automatically open these stenotic mitral valves with an Inoue balloon catheter rather than submit these patients to surgical correction. PMID:9514461

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. 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

    2016-01-01

    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.

  5. 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; Gøtze, Jens Peter; Hassager, Christian; Køber, Lars

    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)....

  6. Mitral valve apparatus: echocardiographic features predicting the outcome of percutaneous mitral balloon valvotomy

    OpenAIRE

    du Toit, R; Brice, EAW; Van Niekerk, JD; Doubell, AF

    2007-01-01

    Summary Objectives To evaluate the significance of involvement of subvalvular apparatus in the outcome of percutaneous mitral balloon valvotomy (PMBV) in patients with mitral stenosis (MS) and to determine the predictive value of chordal length compared with current echocardiographic scores. Methods Patients with significant MS were selected according to the Massachusetts General Hospital score (MGHS). Chordal lengths were assessed as additional markers of disease. Standard percutaneous valvo...

  7. 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...

  8. Predictors of Very Late Events After Percutaneous Mitral Valvuloplasty in Patients With Mitral Stenosis.

    Science.gov (United States)

    Jorge, Elisabete; Pan, Manuel; Baptista, Rui; Romero, Miguel; Ojeda, Soledad; Suárez de Lezo, Javier; Faria, Henrique; Calisto, João; Monteiro, Pedro; Pêgo, Mariano; Suárez de Lezo, José

    2016-06-15

    Data on long-term outcomes of percutaneous mitral valvuloplasty (PMV) are still scarce. In addition, the persistence of pulmonary hypertension (PH) after PMV is a complication for which mechanisms and prognostic implications are unclear. Our aims were (1) to report the long-term outcomes of patients with rheumatic mitral stenosis treated with PMV; (2) to determine the risk factors for long-term poor outcomes; and (3) to analyze the prevalence and predictors of persistent PH. We prospectively enrolled 532 patients who underwent PMV from 1987 to 2011 at 2 hospitals. The following end points were assessed after PMV: all-cause mortality, mitral reintervention, a composite end point of all-cause mortality and mitral reintervention, and PH persistence. Survival status was available for 97% patients; the median follow-up was 10 years (interquartile range 4 to 18 years). Procedural success was achieved in 85% patients. During the follow-up, 21% patients died and 27% required mitral reintervention. Before PMV, 74% patients had PH that persisted after PMV in 45% of patients (p 8) and post-PMV mean pulmonary arterial pressure (PAP) were independent predictors of all-cause mortality, mitral reintervention, and the composite end point. Post-PMV mean PAP was significantly correlated with a mitral valve area (MVA) PAP (p <0.001). In conclusion, PMV represents an advantageous therapeutic option for patients with mitral stenosis in terms of long-term outcomes. Unfavorable valve anatomy and persistent PH were the most important predictors of long-term outcomes. The persistence of PH is associated with the MVA obtained after PMV. PMID:27131615

  9. 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.

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

    Science.gov (United States)

    Shamoun, Fadi E; Craner, Ryan C; Seggern, Rita Von; Makar, Gerges; Ramakrishna, Harish

    2015-01-01

    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. PMID:26440239

  11. 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.

  12. Transcatheter mitral valve implantation via transapical approach

    DEFF Research Database (Denmark)

    Sondergaard, Lars; Brooks, Matthew; Ihlemann, Nikolaj; Jonsson, Anders; Holme, Susanne; Tang, Mariann; Terp, Kim; Quadri, Arshad

    2015-01-01

    coronary artery 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...

  13. Timing in resolution of left heart dilation according to the degree of mitral regurgitation in children with ventricular septal defect after surgical closure

    Directory of Open Access Journals (Sweden)

    Hwa Jin Cho

    2014-01-01

    Full Text Available OBJECTIVE: Children with ventricular septal defects (VSD can have chronic volume overload, which can result in changes of left heart echocardiographic parameters. To evaluate the changes before and after surgical closure, the children were divided into three groups according to the degree of mitral regurgitation (MR, and their echocardiographic characteristics were reviewed at serial follow-up after surgical closure. METHODS: The preoperative, and one-, three-, and 12-month postoperative echocardiographic data of 40 children who underwent surgical closure of VSD were retrospectively reviewed. Left ventricular end-diastolic volume (LVEDV, left ventricular end-diastolic dimension (LVEDD, left ventricular end-systolic dimension (LVESD, mitral valvular characteristics, including degree of MR and mitral valve annulus, and left atrial (LA characteristics, including volume and dimensions, were observed. RESULTS: Preoperative LVEDV, LVEDD, LVESD, mitral valvular annulus, LA volume, and LA dimensions were significantly larger in children with MR. Additionally, there were significant decreases in LVEDV, LVEDD, LA volume, and LA dimensions at one, three, and 12 months postoperatively. The degree of MR also improved to a lower grade after surgical closure of the VSD without additional mitral valve repair. CONCLUSION: The echocardiographic parameters of left heart dilation and MR in children with VSD improved within the first year after surgical closure without additional mitral valve repair. Furthermore, in all of the patients with VSD, regardless of MR, LA dilation was reduced within three months after surgical closure of the VSD; however, LV and mitral valve annular dilatation decreased within 12 months.

  14. Physiologic Changes in the Heart Following Cessation of Mechanical Ventilation in a Porcine Model of Donation After Circulatory Death: Implications for Cardiac Transplantation.

    Science.gov (United States)

    White, C W; Lillico, R; Sandha, J; Hasanally, D; Wang, F; Ambrose, E; Müller, A; Rachid, O; Li, Y; Xiang, B; Le, H; Messer, S; Ali, A; Large, S R; Lee, T W; Dixon, I M C; Lakowski, T M; Simons, K; Arora, R C; Tian, G; Nagendran, J; Hryshko, L V; Freed, D H

    2016-03-01

    Hearts donated following circulatory death (DCD) may represent an additional source of organs for transplantation; however, the impact of donor extubation on the DCD heart has not been well characterized. We sought to describe the physiologic changes that occur following withdrawal of life-sustaining therapy (WLST) in a porcine model of DCD. Physiologic changes were monitored continuously for 20 min following WLST. Ventricular pressure, volume, and function were recorded using a conductance catheter placed into the right (N = 8) and left (N = 8) ventricles, and using magnetic resonance imaging (MRI, N = 3). Hypoxic pulmonary vasoconstriction occurred following WLST, and was associated with distension of the right ventricle (RV) and reduced cardiac output. A 120-fold increase in epinephrine was subsequently observed that produced a transient hyperdynamic phase; however, progressive RV distension developed during this time. Circulatory arrest occurred 7.6±0.3 min following WLST, at which time MRI demonstrated an 18±7% increase in RV volume and a 12±9% decrease in left ventricular volume compared to baseline. We conclude that hypoxic pulmonary vasoconstriction and a profound catecholamine surge occur following WLST that result in distension of the RV. These changes have important implications on the resuscitation, preservation, and evaluation of DCD hearts prior to transplantation. PMID:26663659

  15. Surgical treatment of functional ischemic mitral regurgitation.

    Science.gov (United States)

    Jensen, Henrik

    2015-03-01

    In many ways we are at a crossroad in terms of what constitutes optimal FIMR treatment: is CABG combined with mitral valve ring annuloplasty better than CABG alone in moderate FIMR? Is mitral valve repair really better than replacement? And does adding a valvular repair or subvalvular reverse remodeling procedure shift that balance? In the present thesis I aim to shed further light on these questions by addressing the current status and future perspectives of the surgical treatment of FIMR. CURRENT SURGICAL TREATMENT FOR FIMR. CABG alone: The overall impression from the literature is that patients are left with a high grade of persistent/recurrent FIMR from isolated CABG. CABG is most effective to treat FIMR in patients with viable myocardium (at least five viable segments) and absence of dyssynchrony between papillary muscles (risk factors to develop recurrent FIMR were identified, e.g. LVEDD > 65-70 mm, coaptation depth > 10 mm, anterior leaflet angle > 27-39.5°, posterior leaflet angle > 45° and interpapillary muscle distance > 20 mm. CABG alone vs. combined CABG and mitral valve ring annuloplasty: The current available literature, including three randomized studies and a meta analysis, indicate that combined CABG and mitral valve ring annuloplasty has no late survival difference compared with CABG alone, and early mortality might even be higher. Meanwhile, adding a mitral valve ring annuloplasty results in a lower NYHA functional class, most likely as a consequence of a lower incidence of persistent or recurrent FIMR. More randomized studies are being conducted to further address this topic. Mitral valve ring annuloplasty vs. mitral valve replacement. The early survival may be higher after repair compared with replacement, meanwhile, the literature is more ambiguous in terms of late survival advantages, and recent reports find no late survival advantage from repair over replacement. The recurrence rates after ring annuloplasty addressed above were also

  16. frequency of severe mitral stenosis in young female patients having pure mitral stenosis secondary to rheumatic heart disease

    International Nuclear Information System (INIS)

    High morbidity and mortality due to Rheumatic heart disease (RHD) associated with females is mainly because of late diagnosis on one hand and socioeconomic reasons on the other hand. Poor referral to tertiary care centres leads to delayed diagnosis which results in complications. The objectives of this cross-sectional descriptive study was to assess the frequency of severe mitral stenosis in woman of child bearing age, having pure mitral stenosis (MS) secondary to rheumatic heart disease. Methods: Two hundred and fifty women of child bearing age with RHD were enrolled in the study using consecutive non-probability sampling technique. Out of these 250 patients, cases of pure MS were selected. Patients with associated mitral regurgitation and aortic valve disease were excluded. After admission, assessment of mitral valve stenosis was done with 2D colour Doppler echocardiography. Results: Out of 250 consecutive patients of rheumatic carditis, 110 (44%) patients had pure mitral valve stenosis, 85 (34%) had stenosis with mitral regurgitation and 55 (22%) patients had both mitral and aortic valve problem of varying severity. Among 110 patients with pure mitral valve stenosis, 48 (43.6%) had severe mitral valve stenosis. Severe mitral valve gradient (MVG) and high pulmonary artery pressure (PAP) was observed in 66 (60%) and 49 (44.5%) of the patients respectively. Conclusion: This high frequency can be linked to lack of early detection of the disease at primary level, poor management of throat infections and poor rheumatic fever prophylaxis at community level. (author )

  17. [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

  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. 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...

  20. 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).

  1. 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

  2. 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

    INTRODUCTION: Staphylococcus aureus sequence type ST398 has recently gained attention due to the spread of methicillin-resistant strains among people exposed to livestock. The aim of this study was to explore temporal changes in the population structure of S. aureus in pigs over the last 40 years...... historical isolates from 1973-1974 (n = 19) and from 1991-2003 (n = 13), and 59 contemporary isolates from 2004-2009. The latter isolates represented the most common MLST types (ST1, ST9, ST97 and ST433) and spa types isolated from pigs in Europe. RESULTS AND DISCUSSION: S. aureus sequence type ST398...... isolates are occasionally reported in pigs today (ST8, ST30, ST97, ST387, ST1092, ST2468) or have never been described in this animal host (ST12, ST133, ST1343). These results indicate that the population structure of porcine S. aureus has changed over the last 40 years and confirm the current theory...

  3. 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...

  4. 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...

  5. Effect of obstructive sleep apnea on mitral valve tenting.

    Science.gov (United States)

    Pressman, Gregg S; Figueredo, Vincent M; Romero-Corral, Abel; Murali, Ganesan; Kotler, Morris N

    2012-04-01

    Obstructive apneas produce high negative intrathoracic pressure that imposes an afterload burden on the left ventricle. Such episodes might produce structural changes in the left ventricle over time. Doppler echocardiograms were obtained within 2 months of attended polysomnography. Patients were grouped according to apnea-hypopnea index (AHI): mild/no obstructive sleep apnea (OSA; AHI <15) and moderate/severe OSA (AHI ≥15). Mitral valve tenting height and area, left ventricular (LV) long and short axes, and LV end-diastolic volume were measured in addition to tissue Doppler parameters. Comparisons of measurements at baseline and follow-up between and within groups were obtained; correlations between absolute changes (Δ) in echocardiographic parameters were also performed. After a mean follow-up of 240 days mitral valve tenting height increased significantly (1.17 ± 0.12 to 1.28 ± 0.17 cm, p = 0.001) in moderate/severe OSA as did tenting area (2.30 ± 0.41 to 2.66 ± 0.60 cm(2), p = 0.0002); Δtenting height correlated with ΔLV end-diastolic volume (rho 0.43, p = 0.01) and Δtenting area (rho 0.35, p = 0.04). In patients with mild/no OSA there was no significant change in tenting height; there was a borderline significant increase in tenting area (2.20 ± 0.44 to 2.31 ± 0.43 cm(2), p = 0.05). Septal tissue Doppler early diastolic wave decreased (8.04 ± 2.49 to 7.10 ± 1.83 cm/s, p = 0.005) in subjects with moderate/severe OSA but not in in those with mild/no OSA. In conclusion, in patients with moderate/severe OSA, mitral valve tenting height and tenting area increase significantly over time. This appears to be related, at least in part, to changes in LV geometry. PMID:22264596

  6. 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.

  7. 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...

  8. 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...

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

    OpenAIRE

    Zhang-Qiang Chen; Lang Hong; Hong Wang; Lin-Xiang Lu; Qiu-Lin Yin; Heng-Li Lai; Hua-Tai Li; Xiang Wang

    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 thi...

  10. 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...

  11. 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

  12. 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.

  13. 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

  14. 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

  15. [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

  16. MR imaging evaluation for percutaneous balloon valvuloplasty of mitral stenosis

    International Nuclear Information System (INIS)

    This paper discusses MR imaging performed in 23 patients undergoing percutaneous balloon valvuloplasty (PBV) of mitral stenosis to evaluate cardiac anatomy and postprocedural changes. A 2.0-T MR system was used (Spectro-20000, Gold Star, Korea). The valvuloplasty procedure was successful in all cases. MR imaging was performed 1--2 days before and atrium decreased from 8.5 cm ± 1.2 to 8.2 cm ± 1.1 (P < .01) and from 4.9 cm ± 1.0 to 4.3 cm ± 0.9 (P < .01), respectively. The high signal due to slow flow in the left atrial cavity completely disappeared in 13 cases and decreased in intensity in four cases. Pericardial effusion was detected in one case

  17. 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...

  18. Myxomatous Mitral Valve with Prolapse and Flail Scallop

    Science.gov (United States)

    Fan, Jerry; Timbrook, Alexa; Said, Sarmad; Babar, Kamran; Teleb, Mohamed; Mukherjee, Debabrata; Abbas, Aamer

    2016-01-01

    Summary Background Myxomatous mitral valve with prolapse are classically seen with abnormal leaflet apposition during contraction of the heart. Hemodynamic disorders can result from eccentric mitral regurgitation usually caused by chordae tendinae rupture or papillary muscle dysfunction. Echocardiography is the gold standard for evaluation of leaflet flail and prolapse due to high sensitivity and specificity. Though most mitral valve prolapse are asymptomatic those that cause severe regurgitation need emergent surgical intervention to prevent disease progression. Case Report We report a 54 year old Hispanic male who presented with progressively worsening dyspnea and palpitations. Initial evaluation was significant for atrial fibrillation on electrocardiogram with subsequent echocardiography revealing myxomatous mitral valve with prolapse. Following surgical repair of the mitral valve, the dyspnea and palpitations resolved. Conclusions Mitral valve prolapse is a common valvular abnormality but the pathogenic cause of myxomatous valves has not been elucidated. Several theories describe multiple superfamilies of proteins to be involved in the process. Proper identification of these severe mitral regurgitation due to these disease valves will help relieve symptomatic mitral valve prolapse patients. PMID:27279924

  19. 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.

  20. Immunohistochemistry of porcine skin.

    Science.gov (United States)

    Wollina, U; Berger, U; Mahrle, G

    1991-01-01

    The present paper reports immunohistological findings in porcine skin, which were obtained by use of mono- and polyclonal antihuman antibodies and either alkaline phosphatase anti-alkaline phosphatase (APAAP) or peroxidase (POX) technique. Epidermal staining was observed with antibodies to keratins (K 8.12, RSKE 60), filaggrin, and calmodulin (ACAM). Staining of connective tissue and vessels was achieved using antibodies to vimentin (V9(1)), collagen type IV, and fibronectin. In general, these antibodies gave a staining pattern similar to that of normal human skin. The similarities of immunoreactivity to poly- and monoclonal antihuman antibodies in porcine and human skin render porcine skin a reliable model in biomedical research. PMID:1710864

  1. Evaluation of plain radiograph in mitral stenosis related to hemodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Ku Ok; Suh, Jung Ho; Park, Chang Yun; Choi, Byung So [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1973-04-15

    Mitral stenosis, the most frequent heart disease in adult, showed relatively characteristic pulmonary findings in plain chest X-ray. In recent years the knowledge of the altered physiology of hemodynamics could offer considerable amount of hemodynamic barrier in plain chest. But the value of several parameters was still controversial. In this study a variety of roentgen signs were related to physiologic data and those were acquired by the cardiac catheterization in total of 67 cases of mitral stenosis. 1. Correlation of DPA/DHT ratio (Diameter of pulmonary arterial segment/ Diameter of hemithorax X 100) to hemodynamic data; The pulmonary arterial segments was dilated by two factors, the one was pulmonary blood flow and the other the blood pressure within it. In mitral stenosis, the cardiac output was decreased to quite uniform level, hence measurement of pulmonary arterial segment might be valuable. The correlation coefficient of DPA/ DHT ratio to hemodynamic data were as follows: 0.54 to mean pulmonary artery pressure, 0.32 to pulmonary capillary wedge pressure, -0.37 to mitral valvular area and 0.07 to pulmonary vascular resistance. No significant difference was noted in between pure mitral stenosis and mitral stenosis associated with other valvular disease. 2. Correlation of diameter of right descending pulmonary artery to hemodynamic data: The measurement was made near the first bifurcation of right descending pulmonary artery at its widest point. Pulmonary vascular pattern was best correlated (r=0.71). Another had rough correlation: 0.05 to mean pulmonary artery pressure, 0.31 to pulmonary capillary wedge pressure, -0.44 to mitral valvular area in correlation coefficient. No pulmonary arterial hypertension was observed in the cases diameter of less than 12 mm, but all except two cases had pulmonary hypertension in which diameter exceeded 16 mm. According to increase of the mean pulmonary arterial pressure, the same increment in pressure increased change

  2. Evaluation of plain radiograph in mitral stenosis related to hemodynamics

    International Nuclear Information System (INIS)

    Mitral stenosis, the most frequent heart disease in adult, showed relatively characteristic pulmonary findings in plain chest X-ray. In recent years the knowledge of the altered physiology of hemodynamics could offer considerable amount of hemodynamic barrier in plain chest. But the value of several parameters was still controversial. In this study a variety of roentgen signs were related to physiologic data and those were acquired by the cardiac catheterization in total of 67 cases of mitral stenosis. 1. Correlation of DPA/DHT ratio (Diameter of pulmonary arterial segment/ Diameter of hemithorax X 100) to hemodynamic data; The pulmonary arterial segments was dilated by two factors, the one was pulmonary blood flow and the other the blood pressure within it. In mitral stenosis, the cardiac output was decreased to quite uniform level, hence measurement of pulmonary arterial segment might be valuable. The correlation coefficient of DPA/ DHT ratio to hemodynamic data were as follows: 0.54 to mean pulmonary artery pressure, 0.32 to pulmonary capillary wedge pressure, -0.37 to mitral valvular area and 0.07 to pulmonary vascular resistance. No significant difference was noted in between pure mitral stenosis and mitral stenosis associated with other valvular disease. 2. Correlation of diameter of right descending pulmonary artery to hemodynamic data: The measurement was made near the first bifurcation of right descending pulmonary artery at its widest point. Pulmonary vascular pattern was best correlated (r=0.71). Another had rough correlation: 0.05 to mean pulmonary artery pressure, 0.31 to pulmonary capillary wedge pressure, -0.44 to mitral valvular area in correlation coefficient. No pulmonary arterial hypertension was observed in the cases diameter of less than 12 mm, but all except two cases had pulmonary hypertension in which diameter exceeded 16 mm. According to increase of the mean pulmonary arterial pressure, the same increment in pressure increased change

  3. 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.)

  4. 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...

  5. 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...

  6. Comparison of high temporal resolution left ventricular volume curves before and after mitral valve replacement

    International Nuclear Information System (INIS)

    A patient with severe mitral insufficiency was studied preoperatively by conventional cardiac catheterization, including left ventricular contrast angiography, and also by ECG-gated scintigraphic angiocardiography. Following mitral valve replacement the patient was again studied both by cardiac catheterization and by the scintigraphic procedure. A comparison of preoperative left ventricular volume curves derived from a frame-by-frame analysis of the contrast angiogram, and from the scintigraphic procedure, showed good agreement. A major feature of both preoperative volume curves was a large, early diastolic filling rate. The postoperative scintigraphic volume curve exhibited a marked reduction in early filling rate and a much reduced end-diastolic volume. This study suggests that the scintigraphic procedure is capable of closely following diastolic and systolic changes in left ventricular volume

  7. 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

  8. 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.

  9. 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...

  10. Percutaneous mitral valve repair with MitraClip for severe functional mitral regurgitation.

    Science.gov (United States)

    Yeo, Khung Keong; Ding, Zee Pin; Chua, Yeow Leng; Lim, Soo Teik; Sin, Kenny Yoong Kong; Tan, Jack Wei Chieh; Chiam, Paul Toon Lim; Hwang, Nian Chih; Koh, Tian Hai

    2013-01-01

    A 67-year-old Chinese woman with comorbidities of chronic obstructive lung disease, hypertension and prior coronary artery bypass surgery presented with severe functional mitral regurgitation (MR) and severely depressed left ventricular function. She was in New York Heart Association (NYHA) Class II-III. Due to high surgical risk, she was referred for percutaneous treatment with the MitraClip valve repair system. This procedure is typically performed via the femoral venous system and involves a transseptal puncture. A clip is delivered to grasp the regurgitant mitral valve leaflets and reduce MR. This was performed uneventfully in our patient, with reduction of MR from 4+ to 1+. She was discharged on post-procedure Day 2 and her NYHA class improved to Class I. This was the first successful MitraClip procedure performed in Asia and represents a valuable treatment option in patients with severe MR, especially those with functional MR or those at high surgical risk. PMID:23338929

  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. 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.

  13. Development of mitral stenosis after single MitraClip insertion for severe mitral regurgitation.

    Science.gov (United States)

    Cockburn, James; Fragkou, Paraskevi; Hildick-Smith, David

    2014-02-01

    We report the first case of mitral stenosis following Mitra-Clip insertion in a patient with symptomatic NYHA IV heart failure, secondary to severe mitral regurgitation (MR). A 79-year-old female with a history of prior aortic valve replacement underwent percutaneous mitral valve (MV) repair. A single clip was advanced coaxially down onto the MV under TOE guidance, with the anterior and posterior leaflets clipped together between A2 and P2. TOE confirmed a significant reduction in MR (grade 4 to grade 1). Despite initial symptomatic relief, she represented 3 months later with similar symptoms. Repeat TOE confirmed a well positioned Mitra-Clip with mild residual MR. However, the possibility of significant mitral stenosis was raised due to the presence of significant turbulence through the bi-orifice valve, with a peak gradient of 25 mm Hg. In addition there was evidence of severe functional tricuspid valve (TV) regurgitation with elevated pulmonary artery pressures (PAP 90 mm Hg), confirmed on subsequent right heart catheterization. After repeated heart team discussions and a failure of optimal medical therapy, and despite a logistic EuroScore of 35.5, minimally invasive surgical replacement of the MV and simultaneous TV repair was undertaken via a right thoracotomy. Despite procedural success and initial good postoperative response, the patient died subsequently from a combination of hospital-acquired pneumonia and significant gastrointestinal bleeding (post operative day 35). Mitra-Clip is a promising novel approach to MV repair. The establishment of further clinical and echocardiographic based selection criteria will help identify the correct patients for this treatment. PMID:23703973

  14. 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.

    2016-01-01

    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 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 cm2; 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 cm2. During nearly 17 years of follow-up, the Mosaic bioprosthesis has shown good overall clinical and hemodynamic performance after mitral valve replacement. PMID:27047280

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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.

  20. Dengue myocarditis presenting with mitral valve involvement

    Directory of Open Access Journals (Sweden)

    Arvind Mishra

    2015-01-01

    Full Text Available We admitted a case of dengue fever who was positive for dengue serotype 2 in the Department of Medicine, King George′s Medical University (K.G.M.U., Lucknow, Uttar Pradesh, India. The patient had developed erythematous rashes with thrombocytopenia and bleeding manifestation in the form of microscopic hematuria. While he was recovering from the illness, he developed a sudden onset of breathlessness. On examination, his chest was full of crepitation bilaterally and his x-ray was suggestive of pulmonary edema. His troponin T (Trop T and prohormone brain natriuretic peptide (proBNP levels were elevated. Two-dimensional echo showed global left ventricular (LV hypokinesia with mitral regurgitation (MR and tricuspid regurgitation (TR. A diagnosis of myocarditis was made and the patient was managed in an intensive care unit (ICU setting. The patient recovered from the illness and after a follow-up period of 6 weeks, showed no residual cardiac abnormality.

  1. 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...

  2. 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...

  3. 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.

  4. The Predictive Value of Mitral Leaflet Motion and Thickness Index Scores on Early Restenosis after Mitral Balloon Valvuloplasty

    Science.gov (United States)

    Akin, Mustafa; Sagcan, Abdi; Nalbantgil, Sanem; Ozerkan, Filiz; Akilli, Azem; Yavuzgil, Oguz; Zoghi, Mehdi

    2004-01-01

    The purpose of this study was to investigate whether there is any association between mitral leaflet motion (LMI) and leaflet thickness index (LTI) scores and the rate of restenosis 3 months after successful mitral balloon valvuloplasty. The study population consisted of 46 patients with symptomatic rheumatic mitral stenosis who underwent balloon valvuloplasty (37 women, 9 men; mean age, 36 ± 9 years). Two-dimensional and Doppler echocardiography were performed in all patients on the day before, immediately after, and 3 months after valvuloplasty. The severity of restriction of leaflet motion and the severity of leaflet thickening were classified into grades of mild (a score of 0), moderate (a score of 1), and severe (a score of 2). Subvalvular disease and commissural involvement were homogeneous in all patients. Before and immediately after mitral balloon valvuloplasty, there were no significant differences in mitral valve area among the groups with different LMI and LTI scores. However, at 3 months after valvuloplasty, reduction in mitral valve area was more significant in patients who had higher pre-procedural LMI and LTI scores (P < 0.05). The rates of early restenosis were 0 with a total score of 0, 14.2% with a total score of 1–2, and 32% with a total score of 3. In conclusion, quantitative assessment of LMI and LTI scores by 2-dimensional echocardiography may be helpful in predicting early restenosis after mitral balloon valvuloplasty. Early reduction in mitral valve area is significant in patients who have higher total LMI and LTI scores. PMID:15562845

  5. 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...

  6. 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...

  7. 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.

  8. 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).

  9. Heart rate, heart rate variability, and arrhythmias in dogs with myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Rasmussen, Caroline Elisabeth; Falk, Bo Torkel; Zois, Nora Elisabeth; Moesgaard, Sophia Gry; Häggström, J.; Pedersen, H. D.; Åblad, B.; Nilsen, H. Y.; Olsen, Lisbeth Høier

    2012-01-01

    Autonomic modulation of heart rhythm is thought to influence the pathophysiology of myxomatous mitral valve disease (MMVD).......Autonomic modulation of heart rhythm is thought to influence the pathophysiology of myxomatous mitral valve disease (MMVD)....

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

    DEFF Research Database (Denmark)

    Ravn, Nathja; Zois, Nora Elisabeth; Moesgaard, Sophia Gry;

    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...

  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. 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.

  13. 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,...

  14. 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.

  15. 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...

  16. 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...

  17. 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

  18. 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...

  19. Evaluation of mitral regurgitation by cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    Valvular regurgitation can be detected as a region of signal loss ('flow void') by cardiac cine magnetic resonance (MR) imaging. Cine MR images of 36 patients with mitral regurgitation caused by mitral valve prolapse (MVP) and non-MVP were evaluated and compared with color Doppler flow images. The direction, distance, area and timing of flow void were detected in all patients in several different planes at mitral level with a 0.5 Tesla superconducting magnet by an ECG-gated fast field echo technique. In 23 of the 36 patients contiguous multiple transaxial images were also obtained to calculate the volumes of flow void and the left atrium. The direction of flow void tended to deviate to the opposite side within the left atrium in MVP. The frame showing maximal area of flow void was demonstrated in mid-systole in 24 of the 36 patients (67%). The distance, area and volume of flow void were concordant with the grade from color Doppler flow images. The volumes of flow void and the left atrium correlated (n=19, r=0.74, p<0.05) in MVP. In conclusion, cine MR images in several different planes or contiguous multiple slices are useful in determining spatial orientation and the extent and timing of mitral regurgitation noninvasively. Furthermore, calculation of the volume of flow void enables the assessment of the semiquantitation of mitral regurgitation. (author)

  20. 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

  1. 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

  2. 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.

  3. 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

  4. [National registry of percutaneous mitral commissurotomy. 8-year's experience].

    Science.gov (United States)

    Ledesma Velasco, M; Treviño Treviño, A; Delgado Caro, G; Martínez Ríos, M A; Murillo Márquez, H; Munayer Calderón, J; de Zatarain Rivero, R; Encarnación Muñoz, B

    1996-01-01

    From April 1986 to June 1994 we performed percutaneous transvenous mitral commissurotomy in 689 patients with rheumatic mitral stenosis in a multicenter study. Mean age was 40 +/- 11 years, of then 84.9% female, 2.7% to had previous surgical treatment and in 1.4% the procedure was performed during pregnancy. Inoue balloon was used in 89.4%, double balloon 9.7% and monoballoon 0.9%. Mitral valve area (MVA) increased from 0.93 +/- 0.20 to 1.85 +/- 0.37 cm2 (p TVG) from 15.4 +/- 6.4 to 3.4 +/- 3.1 mmHg (p 1 cm2) and good predilatation NYHA class were predictors of optimal results. Severe MR were more frecuently in patients with atrial fibrillation and with high score (> 8). Our results were similar the international experience. We conclude that the technique of PTMC is a safe and effective technique. PMID:8967819

  5. 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

  6. 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

  7. Association of Keratoconus and Mitral Valve Prolapse

    Directory of Open Access Journals (Sweden)

    Mohammad-Ali Javadi

    2008-12-01

    Full Text Available

    PURPOSE: To compare the prevalence of mitral valve prolapse (MVP in patients with keratoconus (KCN with that of normal subjects. METHODS: This study includes 62 individuals with KCN diagnosed by clinical findings and topographic criteria, and 167 age and sex matched controls with no clinical or topographic evidence of KCN. All participants were evaluated by two-dimensional M-mode and color doppler echocardiography. Perloff's criteria were used for diagnosis of definite MVP. RESULTS: Definite MVP was diagnosed in 22.6% of subjects with KCN and 6.6% of the control group (OR= 4.2; 95% CI, 1.93-11.3; P= 0.009. MVP was more prevalent in patients with KCN based on age and sex stratification. Odds ratio for MVP increased from 2.67 before the third decade of life to 33.44 in the third decade and slightly decreased to 16.52 in the fourth decade and above. CONCLUSION: This study disclosed an increased prevalence of MVP in individuals with keratoconus suggesting the necessity of cardiovascular evaluation in these patients.

  8. 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.

  9. Comparing measurements of mitral valve area by two-dimensional planimetry and continuity equation in patients with mitral stenosis

    Directory of Open Access Journals (Sweden)

    B Khosravi

    2012-11-01

    Full Text Available Background: Measurements of mitral valve area (MVA are essential to determine the severity of mitral stenosis (MS and adopt the best management strategies. The aim of the present study was to compare MVA determined by two-dimensional (2D planimetry to MVA measured by continuity equation (CE in patients with moderate to severe MS. Methods: We evaluated 73 consecutive patients with the diagnosis of MS scheduled for balloon mitral valvuloplasty or with moderate to severe rheumatic MS admitted at the echocardiography clinic of Imam Khomeini Hospital in 2010. Using 2D images of mitral valve obtained from paraesternal short axis view, 2D planimetry of the mitral orifice area was performed by an experienced cardiologist. MVA by CE was calculated from aortic forward stroke volume divided by transmitral time-velocity integral.Results: The mean value of MVA by 2-D planimetry was 1.0±0.3 cm2. The average values of MVA measured by PHT and CE were 1.0±0.3 cm2 and 0.9±0.4 cm2, respectively. The MVA determined by planimetry correlated well with CE (r=0.832, standard error of estimation [SEE]= 0.166, P<0.001. The mean values of MVA calculated by CE highly correlated with those calculated by 2-D planimetry in patients presenting with both non-significant (r=0.701 and significant (r=0.761 AIs. Conclusion: When planimetry is not feasible, such as in severe calcification of mitral valve or after percutaneous balloon valvuloplasty, CE could be an alternative method for MVA measurement in comparison with PHT.

  10. 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.

  11. Functional impact of transmitral gradients at rest and during exercise after restrictive annuloplasty for ischemic mitral regurgitation.

    OpenAIRE

    Bertrand, Philippe; Gutermann, Herbert; SMEETS, Christophe; Van Kerrebroeck, Christiaan; Verhaert, David; VANDERVOORT, Pieter; Dion, Robert

    2014-01-01

    OBJECTIVES: Restrictive mitral valve annuloplasty combined with coronary artery bypass grafting is the treatment of choice for ischemic mitral regurgitation. Postoperative functional mitral stenosis and its potential impact on functional capacity remain the object of debate. The aim of this study was to assess functional and hemodynamic outcome at rest and during exercise in a population with ischemic mitral regurgitation after a standardized restrictive mitral valve annuloplasty. METHO...

  12. 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.

  13. 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.

  14. MRI planimetry for diagnosis and follow-up of valve area in mitral stenosis treated with valvuloplasty

    Energy Technology Data Exchange (ETDEWEB)

    Djavidani, B.; Lipke, C.; Nitz, W.; Feuerbach, S. [Inst. fuer Roentgendiagnostik, Universitaetsklinikum Regensburg (Germany); Debl, K.; Buchner, S.; Riegger, G.; Luchner, A. [Klinik und Poliklinik fuer Innere Medizin II, Universitaetsklinikum Regensburg (Germany)

    2006-08-15

    Purpose: we sought to determine whether noninvasive planimetry by magnetic resonance imaging (MRI) is suitably sensitive and reliable for visualizing the mitral valve area (MVA) and for detecting increases in the MVA after percutaneous balloon mitral valvuloplasty (PBMV). Materials and methods: in 8 patients with mitral valve stenosis, planimetry of the MVA was performed before and after PBMV with a 1.5 T MR scanner using a breath-hold balanced gradient echo sequence (true FISP). The data was compared to the echocardiographically determined MVA (ECHO-MVA) as well as to the invasively calculated MVA by the Gorlin formula at catheterization (CATH-MVA). Results: PBMV was associated with an increase of 0.79 {+-} 0.30 cm{sup 2} in the MVA ({delta} MRI-MVA). The correlation between {delta} MRI-MVA and {delta} CATH-MVA was 0.92 (p < 0.03) and that between {delta} MRI-MVA and {delta} ECHO-MVA was 0.90 (p < 0.04). The overall correlation between MRI-MVA and CATH-MVA was 0.95 (p < 0.0001) and that between MRI-MVA and ECHO-MVA was 0.98 (p < 0.0001). MRI-MVA slightly overestimated CATH-MVA by 8.0% (1.64 {+-} 0.45 vs. 1.51 {+-} 0.49 cm{sup 2}, p < 0.01) and ECHO-MVA by 1.8% (1.64 {+-} 0.45 vs. 1.61 {+-} 0.43 cm{sup 2}, n.s.). Conclusion: magnetic resonance planimetry of the mitral valve orifice is a sensitive and reliable method for the noninvasive quantification of mitral stenosis and visualization of small relative changes in the MVA. This new method is therefore capable of diagnosing as well as following the course of mitral stenosis. It must be taken into consideration that planimetry by MRI slightly overestimates the MVA as compared to cardiac catheterization. (orig.)

  15. 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...

  16. 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...... leaflet. Echocardiographic follow up is recommended after a complicated course of left-sided catheter ablation....

  17. 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.

  18. 'P' mitrale and left atrial enlargement: comparison with echocardiography

    International Nuclear Information System (INIS)

    This study was carried out to determine the sensitivity and specificity of 'P' Mitrale in diagnosing left atrial enlargement by comparing it with the Gold Standard of echocardiography. The study was carried out at the department of Physiology, Army Medical College, Rawalpindi and department of Cardiology at Armed Forces Institute of Cardiology / National Institute of Heart Diseases. 50 clinically diagnosed cases of left atrial enlargement were included in the study. ECG of the patients was recorded and 'P' Mitrale observed. This was followed by echocardiography and using 2-D echocardiogram as a guideline M-mode recording was obtained and left atrial size was calculated. 'P' Mitrale has a sensitivity of 22.5% and specificity of 100%. The positive and negative predictive value and diagnostic efficacy of the test were also calculated. Sensitivity of ECG is low in detecting left atrial enlargement. However its sensitivity can be increased by combining 'P' Terminal Force in lead V1 and P/P-R ratio to 'P' Mitrale. ECG is however still recommended as a routine investigation because of its cost effectiveness and easy availability. (author)

  19. 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.

  20. Novel porcine repetitive elements

    Directory of Open Access Journals (Sweden)

    Nonneman Dan J

    2006-12-01

    Full Text Available Abstract Background Repetitive elements comprise ~45% of mammalian genomes and are increasingly known to impact genomic function by contributing to the genomic architecture, by direct regulation of gene expression and by affecting genomic size, diversity and evolution. The ubiquity and increasingly understood importance of repetitive elements contribute to the need to identify and annotate them. We set out to identify previously uncharacterized repetitive DNA in the porcine genome. Once found, we characterized the prevalence of these repeats in other mammals. Results We discovered 27 repetitive elements in 220 BACs covering 1% of the porcine genome (Comparative Vertebrate Sequencing Initiative; CVSI. These repeats varied in length from 55 to 1059 nucleotides. To estimate copy numbers, we went to an independent source of data, the BAC-end sequences (Wellcome Trust Sanger Institute, covering approximately 15% of the porcine genome. Copy numbers in BAC-ends were less than one hundred for 6 repeat elements, between 100 and 1000 for 16 and between 1,000 and 10,000 for 5. Several of the repeat elements were found in the bovine genome and we have identified two with orthologous sites, indicating that these elements were present in their common ancestor. None of the repeat elements were found in primate, rodent or dog genomes. We were unable to identify any of the replication machinery common to active transposable elements in these newly identified repeats. Conclusion The presence of both orthologous and non-orthologous sites indicates that some sites existed prior to speciation and some were generated later. The identification of low to moderate copy number repetitive DNA that is specific to artiodactyls will be critical in the assembly of livestock genomes and studies of comparative genomics.

  1. 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.

  2. 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.

  3. 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).

  4. The Prevalence of Hypomagnesaemia in Pediatric Patients with Mitral Valve Prolapse Syndrome and the Effect of Mg Therapy

    Directory of Open Access Journals (Sweden)

    Hamid Amoozgar

    2012-09-01

    Full Text Available Background: A paucity of data exists regarding the prevalence and relationship of hypomagnesaemia with clinical symptoms of mitral valve prolapse (MVP in pediatric patients. Objective: In this study we evaluated the prevalence of magnesium (Mg deficiency in pediatric patients with MVP syndrome and attempted to clarify the effect of Mg therapy on alleviating their symptoms. Methods: The present study was conducted from April 2010 to January 2012, and included 230 patients (90 males and 140 females with symptoms of mitral valve prolapse and mean age of 11.6±3.66. Serum magnesium (Mg level less than 1.5 mg/dl was defined as hypomagnesaemia. Patients with 2 mm leaflet displacement and maximum leaflet thickness of 5 mm in echocardiography were considered to have classic MVP, while those with leaflet thickness less than 5 mm were considered as non-classic MVP. Patients with hypomagnesaemia were orally treated with 4.5 mg/kg/day Mg chloride for 5 weeks followed by re-evaluation of symptoms of chest pain, palpitation, fatigue and dyspnea. Results: Hypomagnesaemia was found in 19 (8.2 % of 230 patients with mitral valve prolapse. The re-evaluation of patients with Hypomagnesaemia after 5 weeks of Mg therapy, showed statistically significant relief of chest pain (P=0.01. However, no significant changes was detected in regard to palpitation (P=0.06, fatigue (P= 0.5 and dyspnea (P=0.99. Conclusion: This study revealed that the prevalence of hypomagnesaemia in pediatric patients with mitral valve prolapse is relatively low compared to adults, but treatment with oral Mg in patient with hypomagnesaemia decreases chest pain.

  5. Hemodynamic efficacy of E-1020 in comparison with dopamine on acute mitral regurgitation in anesthetized dogs.

    Science.gov (United States)

    Tanio, H; Kumada, T; Hayashi, M; Himura, Y; Nakamura, Y; Kawai, C

    1991-11-01

    To evaluate the effects of a new phosphodiesterase inhibitor, E-1020 (1, 2-dihydro-6-methyl-2-oxo-5-(imidazo [1, 2-a] pyridin-6-yl)-3-pyridine carbonitrile hydrochloride monohydrate), on cardiovascular hemodynamics in acute heart failure, we compared its effects with those of dopamine on experimentally produced acute mitral regurgitation in dogs. After the production of mitral regurgitation by transmyocardial chordal sectioning and obtaining a stable state, dopamine (5 micrograms/kg/min) was infused until the peak positive dP/dt (peak (+) dP/dt) increased to about 50% of the predopamine value. After complete recovery, E-1020 (30 micrograms/kg) was infused over 5 min and the data were obtained 10 min later. Both drugs equally increased peak (+) dP/dt, decreased systemic vascular resistance, and increased cardiac output. Left ventricular (LV) end-diastolic pressure, LV end-diastolic segment length (EDL), and mean left atrial (LA) pressure decreased with both drugs. The changes in EDL and mean LA pressure were larger with E-1020 than with dopamine (p less than .01 and p less than .05). Although mean inferior vena caval blood flow volume (mIVCF) increased and mean inferior vena caval pressure decreased with both drugs, the increment of mIVCF was smaller with E-1020 (p less than .001). Thus, E-1020 had not only a positive inotropic effect but also a vasodilatory action both on resistance vessels and on capacitance vessels. PMID:1749068

  6. [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

  7. 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

  8. Failed Percutaneous Mitral Commisurotomy due to congenital anomaly of inferior vena cava

    International Nuclear Information System (INIS)

    Since its inception in 1982, percutaneous transvenous mitral commissurotomy (PTMC) has gained increasingly wide use internationally in patients with Rheumatic Mitral stenosis. PTMC offers an alternative to surgery in patients who have pliable mitral valve. Very few reasons were reported to abort the procedure when patient lies on the table. This study presents two case reports in which congenital venous anomalies were one of the reasons to terminate the procedure. (author)

  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. 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...

  12. Computed tomography assessment for transcatheter mitral valve interventions.

    Science.gov (United States)

    Narang, Akhil; Guerrero, Mayra; Feldman, Ted; Pursnani, Amit

    2016-06-01

    Multidetector cardiac computerized tomography (CT) is a robust advanced imaging modality with high spatial resolution that has emerged as an essential tool for the planning of structural heart and electrophysiology interventions. The most notable example has been its important role in the pre-procedural planning of transcatheter aortic valve replacement (TAVR), which has developed to the point that commercial software packages are commonly used for this application. More recently several novel approaches and devices have been developed for transcatheter mitral valve replacement (TMVR). Given the greater complexity of mitral valve anatomy, CT has at least an equally important role for preprocedural planning of TMVR. Similar to TAVR assessment, its utility in TMVR is multi-fold, including assessment of valve and adjacent anatomical structures, determination of accurate annulus dimensions for prosthesis sizing, vascular access planning, and prediction of fluoroscopic angles. PMID:27028331

  13. 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.

  14. 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...

  15. Mitral valve replacement in systemic lupus erythematosus associated Libman-Sacks endocarditis.

    Science.gov (United States)

    Akhlaq, Anam; Ali, Taimur A; Fatimi, Saulat H

    2016-04-01

    Libman-Sacks endocarditis, first discovered in 1924, is a cardiac manifestation of systemic lupus erythematosus (SLE). Valvular involvement has been associated with SLE and antiphospholipid syndrome (APS). Mitral valve, especially its posterior leaflet, is most commonly involved. We report a case of a 34 year old woman with antiphospholipid antibody syndrome and SLE, who presented with mitral valve regurgitation. The patient underwent a prosthetic mitral valve replacement, with no followup complications. We suggest mechanical valve replacement employment in the management of mitral regurgitation in Libman-Sacks endocarditis, in view of the recent medical literature and our own case report. PMID:27053904

  16. Antiphospholipid syndrome associated with non-infective mitral valve endocarditis: a case report

    Directory of Open Access Journals (Sweden)

    Dragan Stevanović

    2014-04-01

    Full Text Available We present a rare case of antiphospholipid syndrome associated with non-infectious thrombotic endocarditis of the mitral valve. The patient was admitted to hospital for examination because of skin lesions manifested through a discoid skin rash. During the hospitalization antiphospholipid syndrome was diagnosed along with ultrasound verification of vegetations on the mitral valve, including both leaflets, with moderate to severe mitral regurgitation. Adequate and opportunely introduced therapy led to regression of all symptoms, including endocarditis of the mitral valve on checkup ultrasound verifications, with a prevention of arterial and/or venous thrombosis in patient's future.

  17. Cardiac dysfunction in a porcine model of pediatric malnutrition

    DEFF Research Database (Denmark)

    Fabiansen, Christian; Lykke, Mikkel; Nielsen, Anne-Louise Hother; Koch, Jørgen; Nielsen, Ole Bækgaard; Hunter, Ingrid; Goetze, Jens P.; Friis, Henrik; Thymann, Thomas

    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...... across the three groups. The myocardial performance index was 86% higher in MAIZE vs AGE-REF (p<0.001) and 27% higher in MAIZE vs WEIGHT-REF (p = 0.025). CONCLUSIONS: Malnutrition associates with cardiac dysfunction in a pediatric porcine model by increased myocardial performance index and pro...

  18. Managing mitral regurgitation: focus on the MitraClip device

    OpenAIRE

    Magruder JT; Crawford TC; Grimm JC; Fredi JL; Shah AS

    2016-01-01

    J Trent Magruder,1 Todd C Crawford,1 Joshua C Grimm,1 Joseph L Fredi,2 Ashish S Shah3 1Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 2Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 3Department of Cardiac Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA Abstract: Based on the principle of surgical edge-to-edge mitral valve repair (MVR), the MitraClip percutaneous MVR technique h...

  19. 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...

  20. Pulmonary hemosiderosis due to mitral valvular heart disease

    International Nuclear Information System (INIS)

    We report a case of biopsy-proven secondary hemosiderosis of the lung in a 58-year-old patient with mitral valvular heart disease. Both chest radiography and high-resolution CT demonstrated patchy areas of ground-glass opacity ; the former indicated that it was in both lungs, while the latter showed inter-and intralobular septal thickening. These findings were reversible when pulmonary venous hypertension was corrected

  1. Pulmonary hemosiderosis due to mitral valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Yeop; Kim, Tae Sung; Han, Joung Ho; Lee, Kyung Soo [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    We report a case of biopsy-proven secondary hemosiderosis of the lung in a 58-year-old patient with mitral valvular heart disease. Both chest radiography and high-resolution CT demonstrated patchy areas of ground-glass opacity ; the former indicated that it was in both lungs, while the latter showed inter-and intralobular septal thickening. These findings were reversible when pulmonary venous hypertension was corrected.

  2. [Mitral valve endocarditis after Turkish "Festival of Sacrifice"].

    Science.gov (United States)

    Blaich, A; Fasel, D; Kaech, C; Frei, R

    2011-09-01

    Erysipelothrix rhusiopathiae is the causative agent of swine erysipelas. Systemic infections caused by E. rhusiopathiae are rare, but often (90%) associated with endocarditis. In about 60% of cases endocarditis develops on normal heart valves, and despite appropriate antibiotic therapy about one-third of the patients requires valve replacement. We report the case of a housewife, who developed a mitral valve endocarditis due to E. rhusiopathiae after preparing meat for the Turkish "Festival of Sacrifice". PMID:21152883

  3. 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

  4. 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.

  5. Serotonin concentrations in platelets, plasma, mitral valve leaflet, and left ventricular myocardial tissue in dogs with myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Cremer, Signe Emilie; Singletary, G.E.; Olsen, Lisbeth Høier; Wallace, K.; Häggström, J.; Ljungvall, I.; Höglund, K.; Reynolds, C.A.; Pizzinat, N.; Oyama, M.A.

    2014-01-01

    [5HT] in platelet-rich plasma (PRP), platelet-poor plasma (PPP), mitral valve leaflets (MV), and left ventricular myocardium (LV). ANIMALS: Forty-five dogs comprised 4 plasma groups of Cavalier King Charles Spaniels (CKCS) or non-CKCS, either healthy (CON) or MMVD affected: CKCS CON (n = 12); non......-CKCS CON (n = 8); CKCS MMVD (n = 14); non-CKCS MMVD (n = 11). Twenty-four dogs comprised 3 tissue groups: MMVD (n = 8); other-HD (heart disease) (n = 7); non-HD, extracardiac disease (n = 9). METHODS: High-performance liquid chromatography measured PRP, PPP, MV, and LV [5HT]. RESULTS: Platelet-rich plasma......HYPOTHESIS/OBJECTIVES: Altered serotonin (5-hydroxytryptamine, 5HT) signaling is postulated in development and progression of canine myxomatous mitral valve disease (MMVD). Little is known regarding platelet, plasma, valvular, or myocardial 5HT concentration ([5HT]) in affected dogs. We quantified...

  6. 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

  7. 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

  8. 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...

  9. 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

  10. The role of the transesofagic echocardiography in the study of the patients with mitral stenosis programmed for mitral valvuloplastia with balloon of Inoue

    International Nuclear Information System (INIS)

    Balloon valvuloplasty (BVP) is the treatment of choice in patients with mitral stenosis (MS) who are not otherwise counter indicated. Trans-esophageal echocardiography (TEE) before a BVP complements the information obtained by trans-thoracic echocardiography (TTE) and allows the diagnosis of counter indications, which may pass unnoticed in the latter. Seven years' experience with TEE in the study of patients with mitral stenosis about to under go BVP is presented. New counter indications are found for this procedure in 30 % of the cases. In the rest of the patients the exam complements the morphological and hemodynamic valuation of the mitral valve

  11. 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...

  12. 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.

  13. 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

    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...

  14. 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.

  15. A controlled evaluation of the risk of bacterial endocarditis in persons with mitral-valve prolapse.

    Science.gov (United States)

    Clemens, J D; Horwitz, R I; Jaffe, C C; Feinstein, A R; Stanton, B F

    1982-09-23

    The absence of controlled evidence and the high prevalence of mitral-valve prolapse have created substantial uncertainty about whether this condition is an important risk factor for bacterial endocarditis. We evaluated this risk in a case-control study of hospital inpatients who had undergone echocardiography and who lacked any known cardiovascular risk factors for endocarditis, apart from mitral-valve prolapse and isolated mitral-regurgitant murmurs. Thirteen (25 per cent) of 51 patients with endocarditis had mitral-valve prolapse, as compared with 10 (seven per cent) of the 153 matched controls without endocarditis. For the 51 matched case-control sets, the odds ratio (8.2; 95 per cent confidence interval, 2.4 to 28.4) indicated a substantially higher risk of endocarditis for people with mitral-valve prolapse than for those without it. This association remained statistically significant when parenteral drug abuse and routine antibiotic prophylaxis preceding dental work and other forms of instrumentation were taken into account. Furthermore, the risk may be higher than is indicated by this study, since 46 per cent of the controls underwent echocardiography for clinically suspected mitral-valve prolapse, suggesting an overrepresentation of mitral prolapse in the control group. The results support the contention that mitral-valve prolapse is a significant risk factor for bacterial endocarditis. PMID:7110242

  16. PREDICTION OF BLOOD FLOW VELOCITY AND LEAFLET DEFORMATION VIA 2D MITRAL VALVE MODEL

    Directory of Open Access Journals (Sweden)

    M.A.H. Mohd Adib

    2012-06-01

    Full Text Available In the mitral valve, regional variations in structure and material properties combine to affect the biomechanics of the entire valve. From previous studies, we know that the mitral valve leaflet tissue is highly extensible. A two-dimensional model of the mitral valve was generated using an Arbitrary Lagrangian-Eulerian (ALE mesh. A simple approximation of the heart geometry was used and the valve dimensions were based on actual measurements made. Valve opening and closure was simulated using contact equations. The objective of this study was to investigate and predict flow and leaflet phenomena via a simple 2D mitral valve model based on the critical parameter of blood. Two stages of mitral valves analysis were investigated: the systolic and diastolic stages. The results show a linear correlation between the mitral valve leaflet rigidity and the volume of backflow. Additionally, the simulation predicted mitral valve leaflet displacement during closure, which agreed with the results of our previous data analysis and the results for blood flow velocity during systole condition through the mitral valve outlet, as reported in the medical literature. In conclusion, these computational techniques are very useful in the study of both degenerative valve disease and failure of prostheses and will be further developed to investigate heart valve failure and subsequent surgical repair.

  17. 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.

  18. 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 release...... and the effects of substance P and neurokinin A infusion on insulin, glucagon, somatostatin, and exocrine secretion were studied using the isolated perfused porcine pancreas with intact vagal innervation. NK-1 and NK-2 receptor antagonists were used to investigate receptor involvement. Substance P immunoreactive...

  19. Mitral valve regurgitation due to annular dilatation caused by a huge and floating left atrial myxoma

    Science.gov (United States)

    Ersoy, Burak; Yeniterzi, Mehmet

    2015-01-01

    We describe a case of mitral valve annular dilatation caused by a huge left atrial myxoma obstructing the mitral valve orifice. A 50-year-old man presenting with palpitation was found to have a huge left atrial myxoma protruding into the left ventricle during diastole, causing severe mitral regurgitation. The diagnosis was made with echocardiogram. Transoesophageal echocardiography revealed a solid mass of 75 × 55 mm. During operation, the myxoma was completely removed from its attachment in the atrium. We preferred to place a mechanical heart valve after an annuloplasty ring because of severely dilated mitral annulus and chordae elongation. The patient had an uneventful recovery. Our case suggests that immediate surgery, careful evaluation of mitral valve annulus preoperatively is recommended. PMID:26702283

  20. 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

    OpenAIRE

    Andre Mauricio Fernandes; Vikas Rathi; Biederman, Robert W; Mark Doyle; Yamrozik, June A; Ronald B. Willians; Vinayak Hedge; Saundra Graunt; Roque Aras Jr.

    2013-01-01

    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 f...

  1. The Mitral Valve in Obstructive Hypertrophic Cardiomyopathy: A Test in Context.

    Science.gov (United States)

    Sherrid, Mark V; Balaram, Sandhya; Kim, Bette; Axel, Leon; Swistel, Daniel G

    2016-04-19

    Mitral valve abnormalities were not part of modern pathological and clinical descriptions of hypertrophic cardiomyopathy in the 1950s, which focused on left ventricular (LV) hypertrophy and myocyte fiber disarray. Although systolic anterior motion (SAM) of the mitral valve was discovered as the cause of LV outflow tract obstruction in the M-mode echocardiography era, in the 1990s structural abnormalities of the mitral valve became appreciated as contributing to SAM pathophysiology. Hypertrophic cardiomyopathy mitral malformations have been identified at all levels. They occur in the leaflets, usually elongating them, and also in the submitral apparatus, with a wide array of malformations of the papillary muscles and chordae, that can be detected by transthoracic and transesophageal echocardiography and by cardiac magnetic resonance. Because they participate fundamentally in the predisposition to SAM, they have increasingly been repaired surgically. This review critically assesses imaging and measurement of mitral abnormalities and discusses their surgical relief. PMID:27081025

  2. 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

  3. 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

  4. 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

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

    DEFF Research Database (Denmark)

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

    1992-01-01

    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 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 by...

  6. 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.

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

    OpenAIRE

    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 changes in color of porcine lean meat batters (PLMBs) during processing were characterized, analyzed, and predicted using graphical analysis, kinetic analysis, and mathematical modeling respectively. "A...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Chimeric viruses containing the N-terminal ectodomains of GP5 and M proteins of porcine reproductive and respiratory syndrome do not change the cellular tropism of equine arteritis virus

    Science.gov (United States)

    Equine arteritis virus (EAV) and porcine reproductive and respiratory syndrome virus (PRRSV) are members of family Arteriviridae; they share many biological properties but differ significantly in cellular tropism. Using an infectious cDNA clone of EAV, we engineered a panel of six chimeric viruses b...

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

    Science.gov (United States)

    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

  11. Kingella kingae endocarditis: A rare case of mitral valve perforation

    Directory of Open Access Journals (Sweden)

    Anthony A Holmes

    2011-01-01

    Full Text Available Kingella kingae , a HACEK (Haemophilus parainfluenzae, Aggregatibacter actinomycetemcomitans, Aggregatibacter aphrophilus, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae organism, is a common resident of the upper airway in children; it has been associated with endocarditis in children with pre-existing heart conditions. This case report describes K. kingae endocarditis leading to valvular damage in a previously healthy 18-month-old child. Our patient developed a K. kingae bacteremia that was later complicated by meningitis, septic embolic stroke, and endocarditis of the mitral valve, leading to perforation of the posterolateral leaflet. The patient was initially treated conservatively with cefotaxime but, subsequently, required a mitral valve repair with a pericardial patch and annuloplasty. This report draws attention to the need for clinicians to be aware of the potentially serious complications of K. kingae infection in young children. If K. kingae infection is suspected then therapy should be initiated promptly with a β-lactam, followed by early echocardiographic assessment. This case also highlights the lack of specific guidelines available for K. kingae endocarditis.

  12. Methods of estimation of mitral valve regurgitation for the cardiac surgeon

    Directory of Open Access Journals (Sweden)

    Baikoussis Nikolaos G

    2009-07-01

    Full Text Available Abstract Mitral valve regurgitation is a relatively common and important heart valve lesion in clinical practice and adequate assessment is fundamental to decision on management, repair or replacement. Disease localised to the posterior mitral valve leaflet or focal involvement of the anterior mitral valve leaflet is most amenable to mitral valve repair, whereas patients with extensive involvement of the anterior leaflet or incomplete closure of the valve are more suitable for valve replacement. Echocardiography is the recognized investigation of choice for heart valve disease evaluation and assessment. However, the technique is depended on operator experience and on patient's hemodynamic profile, and may not always give optimal diagnostic views of mitral valve dysfunction. Cardiac catheterization is related to common complications of an interventional procedure and needs a hemodynamic laboratory. Cardiac magnetic resonance (MRI seems to be a useful tool which gives details about mitral valve anatomy, precise point of valve damage, as well as the quantity of regurgitation. Finally, despite of its higher cost, cardiac MRI using cine images with optimized spatial and temporal resolution can also resolve mitral valve leaflet structural motion, and can reliably estimate the grade of regurgitation.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. The kinetics of interaction of porcine - alpha-, and porcine - beta -trypsin with intact and modified soybean trypsin inhibitor (kunitz)

    International Nuclear Information System (INIS)

    The association of porcine trypsin with soybean trypsin inhibitor (Kunitz) resulted in characteristic changes in absorption spectrum, indicating an alteration of the micro environments of the enzyme chromophores as a consequence of the interaction. The rates of formation of the stable trypsin - inhibitor complexes from porcine - alpha - trypsin and soybean trypsin inhibitor and from porcine - beta - trypsin and either intact or modified soybean trypsin inhibitor were measured by mixing the equimolar concentration of the reactants in a Stopped - Flow apparatus at pH (4.5 to 10.0). The reaction of trypsin with soybean trypsin inhibitor was of first order with respect to the concentration of the reactants used. The rates of dissociation of the stable complexes, alpha - trypsin - soybean trypsin inhibitor, beta -trypsin - soybean trypsin inhibitor and beta -trypsin modified soybean trypsin inhibitor were also measured at pH (1.92 to 3.58). The values of first order rate constant, k/sub D/ obtained for the dissociation of all the three complexes were identical with one another. The kinetics results obtained for the porcine trypsin were compared with those of bovine trypsin system and it was suggested that the reaction mechanisms in both these systems were identical. (author)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

  17. Post-mortem changes in porcine M. longissimus studied by solid-state 13C cross-polarization magic-angle spinning nuclear magnetic resonance spectroscopy.

    Science.gov (United States)

    Bertram, Hanne Christine; Jakobsen, Hans Jørgen; Andersen, Henrik Jørgen; Karlsson, Anders Hans; Engelsen, Søren Balling

    2003-03-26

    Solid-state (13)C cross-polarization (CP) magic-angle spinning (MAS) nuclear magnetic resonance (NMR) experiments are carried out for the first time on rapidly frozen muscle biopsies taken in M. longissimus in vivo and at 1 min, 45 min, and 24 h post-mortem from three pigs. Two of the pigs were CO(2)-stunned (control animals), and one was pre-slaughter-stressed (treadmill exercise) followed by electrical stunning to induce difference in metabolism post-mortem. (13)C resonance signals from saturated and unsaturated carbons in fatty acids, carboxylic carbons, and carbons in lactate and glycogen are identified in the solid-state NMR spectra. The (13)C CP MAS spectra obtained for post-mortem samples of the stressed, electrically stunned pig differ significantly from the post-mortem control samples, as the intensity of a resonance line appearing at 30 ppm, assigned to carbons of the methylene chains, is reduced for the stressed pig. This spectral difference is probably due to changes in lipid mobility and indicates altered membrane properties in the muscle of the stressed/electrically stunned animal when compared with the control animals already 1 min post-mortem. In addition, the post-mortem period changes in glycogen carbons can be estimated from the (13)C CP MAS spectra, yielding a correlation of r = 0.74 to subsequent biochemical determination of the glycogen content. PMID:12643674

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

    Science.gov (United States)

    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

  19. Transcatheter Aortic and Mitral Valve Implantation (TAMVI) in Native Rheumatic Valves.

    Science.gov (United States)

    Akujuo, Adanna C; Dellis, Sophia L; Britton, Lewis W; Bennett, Edward V

    2015-11-01

    A 68-year-old female with moderate to severe aortic stenosis and severe mitral stenosis, deemed too high risk for surgery (STS mortality risk = 12.3%) with a porcelain aorta, was successfully treated with a transcatheter aortic and mitral valve implantation (TAMVI) via a transapical approach. A 23 mm Sapien valve (Edwards Lifesciences, Irvine, CA, USA) was placed in the aortic position and a 29 mm inverted Sapien valve (Edwards Lifesciences) in the mitral position. PMID:26347492

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  3. The interferon sensitivity of selected porcine viruses.

    OpenAIRE

    Derbyshire, J. B.

    1989-01-01

    The objective of this study was to compare the sensitivity of 11 porcine viruses to the antiviral effects of porcine interferon-alpha in serum from piglets which had been infected 19 h previously with transmissible gastroenteritis virus, and of porcine interferon-beta prepared in PK-15 cells by induction with polyinosinic:polycytidylic acid, in yield reduction assays in pig kidney cells which were treated with interferon before virus challenge, and both before and after virus challenge. The m...

  4. 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...

  5. 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

  6. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.

  9. Exercise-induced changes in left ventricular filling pressure after myocardial infarction assessed with simultaneous right heart catheterization and Doppler echocardiography

    DEFF Research Database (Denmark)

    Andersen, Mads J; Ersbøll, Mads; Gustafsson, Finn; Axelsson, Anna; Hassager, Christian; Køber, Lars; Boesgaard, Søren; Pellikka, Patricia A; Møller, Jacob E

    2013-01-01

    To assess whether changes in E/e´ (the ratio between peak early mitral inflow velocity (E) and peak early mitral annulus velocity (e´)) during exercise reflect changes in filling pressure in patients with a recent myocardial infarction (MI) and mild to moderate diastolic dysfunction at rest. A lo...

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Papillary fibroelastoma of the anterior leaflet of the mitral valve mimicking vegetation

    Directory of Open Access Journals (Sweden)

    Edvin Prifti

    2015-01-01

    Conclusion: To summarize, we report a PFE of the anterior leaflet of the mitral valve. The diagnosis was confirmed by histopathological examination after surgical removal. Finally, careful echocardiographic analyses during evaluation of valvular masses are strongly recommended for differential diagnosis.

  12. Heart murmurs audible across the room in children with mitral valve prolapse.

    OpenAIRE

    Fiddler, G I; Scott, O

    1980-01-01

    Three children are described in whom an unusual heart murmur was intermittently audible in the same room without a stethoscope. Subsequent investigations disclosed mitral valve prolapse in all three patients.

  13. [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

  14. 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. PMID:26903676

  15. 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.

  16. Isolated parachute mitral valve in a 29 years old female; a case report

    Directory of Open Access Journals (Sweden)

    Mehrnoush Toufan

    2016-03-01

    Full Text Available A 29-year old female patient was referred to our hospital for evaluation of dyspnea NYHA class I which begun from several months ago. The only abnormal sign found on physical examination was a grade 2/6 systolic murmur at the apex position without radiation. Echocardiography revealed normal left and right ventricular sizes and systolic function, and only one papillary muscle in left ventricular (LV cavity which all chordae tendineae inserted into that muscle. The mitral valve orifice was eccentrically located at the lateral side with mild to moderate mitral regurgitation but without significant mitral stenosis. No other congenital heart anomalies were identified. Thus, the final diagnosis was isolated parachute mitral valve (IPMV. She was one of the very rare IPMV cases have ever been reported in adults

  17. Isolated parachute mitral valve in a 29 years old female; a case report

    Science.gov (United States)

    Toufan, Mehrnoush; Mahmoudi, Seyed Sajjad

    2016-01-01

    A 29-year old female patient was referred to our hospital for evaluation of dyspnea NYHA class I which begun from several months ago. The only abnormal sign found on physical examination was a grade 2/6 systolic murmur at the apex position without radiation. Echocardiography revealed normal left and right ventricular sizes and systolic function, and only one papillary muscle in left ventricular (LV) cavity which all chordae tendineae inserted into that muscle. The mitral valve orifice was eccentrically located at the lateral side with mild to moderate mitral regurgitation but without significant mitral stenosis. No other congenital heart anomalies were identified. Thus, the final diagnosis was isolated parachute mitral valve (IPMV). She was one of the very rare IPMV cases have ever been reported in adults PMID:27069567

  18. 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

  19. 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

  20. 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

  1. Biphasic 201thallium scintgraphy after dipyridamole in mitral valve diseases

    International Nuclear Information System (INIS)

    The results of biphasic 201thallium scintigraphy after dipyridamole i.v. could neither prove nor exclude the presence of small focal lesions in the myocardium of 17 patients with mitral valve diseases. The frequent finding of a decrease in activity in the anterolateral myocardium is probably due to a relative increase in activity in the region of the inferior wall with superimposed areas of the papillary muscle and right ventricular myocardium. If the right ventricle is visualized in stress- or redistribution images, an increase in mean pulmonary artery pressure can be accepted. According to Cohen's criteria, a grade 2 or 3 virtually proves the existence of pulmonary hypertension, a grade 1 makes this finding rather probable. The possibility of pulmonary hypertension can not be excluded if the right ventricular myocardium is not visualized. (orig.)

  2. Mitral valve mechanics following posterior leaflet patch augmentation

    DEFF Research Database (Denmark)

    Rahmani, Azadeh; Rasmussen, Ann Qvist; Hønge, Jesper Langhoff; Ostli, Bjorn; Levine, Robert A.; Hagège, Albert; Nygaard, Hans; Nielsen, Sten L; Jensen, Morten Ølgaard Jegstrup

    2013-01-01

    tendineae emanating from the posterior papillary muscle in a FIMR-simulated valve, following posterior leaflet patch augmentation. Methods: Mitral valves were obtained from 12 pigs (body weight 80 kg). An in vitro test set-up simulating the left ventricle was used to hold the valves. The left ventricular...... pressure was regulated with water to simulate different static pressures during valve closure. A standardized oval pericardial patch (17 × 29 mm) was introduced into the posterior leaflet from mid P2 to the end of the P3 scallop. Dedicated miniature transducers were used to record the forces exerted on the...... chordae tendineae. Data were acquired before and after 12 mm posterior and 5 mm apical posterior papillary muscle displacement to simulate the effect from one of the main contributors of FIMR, before and after patch augmentation. Results: The effect of displacing the posterior papillary muscle induced...

  3. Association of mitral annulus calcification, aortic valve calcification with carotid intima media thickness

    OpenAIRE

    Scuteri Angelo; Sgorbini Luca; Leggio Massimo; Leggio Francesco

    2004-01-01

    Abstract Background Mitral annular calcification (MAC) and aortic annular calcification (AVC) may represent a manifestation of generalized atherosclerosis in the elederly. Alterations in vascular structure, as indexed by the intima media thickness (IMT), are also recognized as independent predictors of adverse cardiovascular outcomes. Aim To examine the relationship between the degree of calcification at mitral and/or aortic valve annulus and large artery structure (thickness). Methods We eva...

  4. The Carpentier-Edwards Perimount Magna mitral valve bioprosthesis: intermediate-term efficacy and durability

    OpenAIRE

    Loor, Gabriel; Schuster, Andres; Cruz, Vincent; Rafael, Aldo; Stewart, William J.; Diaz, James; McCurry, Kenneth

    2016-01-01

    Background The Carpentier-Edwards Perimount Magna mitral valve bioprosthesis (Edwards Lifesciences, Irvine, CA) is a low-profile version of the earlier Perimount valve that uses the ThermaFix process for enhanced calcium removal. The Magna valve has been in use since 2008, yet no publication, until now, has verified its intermediate-term safety and efficacy. Methods From 2008 through 2011 (our 4-year study period), 70 Magna valves were implanted in the mitral position at a single institution ...

  5. 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...

  6. 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 a...... being pivotal to LV function. Decreased and delayed LV twist has been described in experimental MR, but has not been studied in myxomatous mitral valve disease (MMVD)....

  7. 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

  8. 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)

  9. 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.

  10. 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.

  11. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

  14. Quantitative analysis of 3D mitral complex geometry using support vector machines

    International Nuclear Information System (INIS)

    Quantitative analysis of 3D mitral complex geometry is crucial for a better understanding of its dysfunction. This work aims to characterize the geometry of the mitral complex and utilize a support-vector-machine-based classifier from geometric parameters to support the diagnosis of congenital mitral regurgitation (MR). The method has the following steps: (1) description of the 3D geometry of the mitral complex and establishment of its local reference coordinate system, (2) calculation of geometric parameters and (3) analysis and classification of these parameters. With a control group of 20 normal young children (11 boys, 9 girls, mean age 5.96 ± 3.12 years) and with the normal structure of mitral apparatus, 20 patients (9 boys, 11 girls, mean age 5.59 ± 3.30 years) suffering from severe congenital MR are studied in this study. The average classification accuracy is up to 90.0% of the present population, with the possibility of exploring quantitative association between the mitral complex geometry and the mechanism of congenital MR. (paper)

  15. 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

  16. 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

  17. 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...

  18. 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

    Directory of Open Access Journals (Sweden)

    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.

  19. Constitutive Androstane Receptor is Upregulated during Porcine Primary Preadipocyte Differentiation

    Directory of Open Access Journals (Sweden)

    Xuewei Li

    2012-01-01

    Full Text Available Constitutive Androstane Receptor (CAR is one of members of the nuclear receptors superfamily which is involved in induction of drug metabolism and lipogenic pathway. In this study, the reseachers investigated whether the mRNA expression pattern of CAR in porcine preadipocyte is changed during the process of induced differentiation. Preadipocytes were aseptically taken from 3 days old piglet under general anesthesia and grown to near confluence. Postconfluent cells (Day 0 were further cultured in differentiation medium for 3 days. From day 3 onward, the cells were cultured in maintain-medium based on differentiation medium without roglitazone and IBMX until day 15. The total RNA was isolated on seven time points (i.e., days 0, 2, 4, 6, 8, 10 and 15. The mRNA expression changes of the CAR before and after porcine primary preadipocytes differentiation that acorss seven time points (i.e., days 0, 2, 4, 6, 8, 10 and 15 were measured using the quantitative RT-PCR method. In addition, the researchers also examined lipid accumulation and the mRNA expression of adpocyte differentiation markers (Such as PPARγ and RXRα which confirmed the differentiation of preadipocytes to adipocytes. The results showed that the mRNA expression of CAR was up-regulated during porcine primary preadipocyte differentiation. There is the reason that the CAR may be involved in the process of preadipocyte differentiation and is a potential drug target for the treatment of obesity and diabetes.

  20. 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; Teerlink, T.; Molin, M.; Falk, Bo Torkel; Rasmussen, Caroline Elisabeth; Fuentes, V. Luis; Jones, I.D.; Olsen, Lisbeth Høier

    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....

  1. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  3. 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

  4. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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...

  7. Detection of porcine circovirus type 1 in commercial porcine vaccines by loop-mediated isothermal amplification

    OpenAIRE

    Wang, Chun; Pang, Victor Fei; Jeng, Chian-Ren; LEE, Fan; Huang, Yu-Wen; Lin, Yeou-Liang; Hsiao, Shih-Hsuan; Lai, Shiow-Suey

    2011-01-01

    A loop-mediated isothermal amplification (LAMP) method with a real-time monitoring system was developed for the detection of porcine circovirus type 1 (PCV1) in commercial swine vaccines. This method was highly specific for PCV1. No cross-reaction to porcine circovirus type 2, porcine parvovirus, pseudorabies virus, classical swine fever virus, and porcine reproductive and respiratory syndrome virus was observed. The analytical sensitivity of the LAMP for PCV1 DNA was 10 copies/μl in the case...

  8. 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

  9. Distribution of Mitral Annular and Aortic Valve Calcium as Assessed by Unenhanced Multidetector Computed Tomography.

    Science.gov (United States)

    Koshkelashvili, Nikoloz; Codolosa, Jose N; Goykhman, Igor; Romero-Corral, Abel; Pressman, Gregg S

    2015-12-15

    Aging is associated with calcium deposits in various cardiovascular structures, but patterns of calcium deposition, if any, are unknown. In search of such patterns, we performed quantitative assessment of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a broad clinical sample. Templates were created from gated computed tomography (CT) scans depicting the aortic valve cusps and mitral annular segments in relation to surrounding structures. These were then applied to CT reconstructions from ungated, clinically indicated CT scans of 318 subjects, aged ≥65 years. Calcium location was assigned using the templates and quantified by the Agatston method. Mean age was 76 ± 7.3 years; 48% were men and 58% were white. Whites had higher prevalence (p = 0.03) and density of AVC than blacks (p = 0.02), and a trend toward increased MAC (p = 0.06). Prevalence of AVC was similar between men and women, but AVC scores were higher in men (p = 0.008); this difference was entirely accounted for by whites. Within the aortic valve, the left cusp was more frequently calcified than the others. MAC was most common in the posterior mitral annulus, especially its middle (P2) segment. For the anterior mitral annulus, the medial (A3) segment calcified most often. In conclusion, AVC is more common in whites than blacks, and more intense in men, but only in whites. Furthermore, calcium deposits in the mitral annulus and aortic valve favor certain locations. PMID:26517948

  10. Geometria da valva mitral derivada da ressonância magnética cardiovascular na avaliação da gravidade da regurgitação mitral

    OpenAIRE

    Andre Mauricio Fernandes; Vikas Rathi; Biederman, Robert W; Mark Doyle; Yamrozik, June A; Ronald B. Willians; Vinayak Hedge; Saundra Graunt; Roque Aras Jr.

    2013-01-01

    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 f...

  11. A Case of Microangiopathic Hemolytic Anemia after Myxoma Excision and Mitral Valve Repair Presenting as Hemolytic Uremic Syndrome

    Science.gov (United States)

    Park, Young Joo; Kim, Sang Pil; Shin, Ho-Jin

    2016-01-01

    Microangiopathic hemolytic anemia occurs in a diverse group of disorders, including thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and prosthetic cardiac valves. Hemolytic anemia also occurs as a rare complication after mitral valve repair. In this report, we describe a case of microangiopathic hemolytic anemia following myxoma excision and mitral valve repair, which was presented as hemolytic uremic syndrome. PMID:27081450

  12. Quantitative assessment of mitral and aortic insufficiency from effective systemic ejection fraction measured by radiocardiography and cardiac chambers scanning

    International Nuclear Information System (INIS)

    Comparison between the effective systemic ejection fraction defined by radiocardiography and cardiac chambers scanning, and the whole left ventricular ejection fraction calculated by cineangiocardiography allows an accurate assessment of mitral and aortic regurgitation extent. In case of both mitral and aortic insufficiency, each regurgitation can be quantitatively dissociated by means of the aortic isotopic dilution curve recorded at the same time as the radiocardiogram

  13. 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

  14. 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...

  15. 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

  16. 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

  17. 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...

  18. Chronic mitral regurgitation and Doppler estimation of left ventricular filling pressures in patients with heart failure

    Science.gov (United States)

    Temporelli, P. L.; Scapellato, F.; Corra, U.; Eleuteri, E.; Firstenberg, M. S.; Thomas, J. D.; Giannuzzi, P.

    2001-01-01

    Previous studies relating Doppler parameters and pulmonary capillary wedge pressures (PCWP) typically exclude patients with severe mitral regurgitation (MR). We evaluated the effects of varying degrees of chronic MR on the Doppler estimation of PCWP. PCWP and mitral Doppler profiles were obtained in 88 patients (mean age 55 +/- 8 years) with severe left ventricular (LV) dysfunction (mean ejection fraction 23% +/- 5%). Patients were classified by severity of MR. Patients with severe MR had greater left atrial areas, LV end-diastolic volumes, and mean PCWPs and lower ejection fractions (each P <.01). In patients with mild MR, multiple echocardiographic parameters correlated with PCWP; however, with worsening MR, only deceleration time strongly related to PCWP. From stepwise multivariate analysis, deceleration time was the best independent predictor of PCWP overall, and it was the only predictor in patients with moderate or severe MR. Doppler-derived early mitral deceleration time reliably predicts PCWP in patients with severe LV dysfunction irrespective of degree of MR.

  19. [New approach in the surgical treatment of mitral regurgitation: beating heart transapical neochord implantation].

    Science.gov (United States)

    Ruttkay, Tamás; Jancsó, Gábor; Gombocz, Károly; Gasz, Balázs

    2016-05-01

    Severe mitral regurgitation due to prolapse of the valve demands early surgical intervention. Recently artificial chord implantation is the prefered solution, which requires cardioplegia and application of cardiopulmonary bypass using the left atrial approach. Transoesophageal echocardiography guided transapical neochord implantation is an emerging new technique for the treatment of mitral regurgitation. It enables the operation through left minithoracotomy on beating heart using a special instrument introduced into the left ventricle. Acute procedural success rates in different centres vary between 86 and 100%. According to reports, 92% of the patients do not require additional intervention at the 3-month follow-up. Continuous integration of data resulting improved outcomes supports the hope that this novel, less-invasive technique will be applied widely for the treatment of mitral regurgitation. PMID:27106725

  20. 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 .

  1. Management of cardiac perforation and pericardial tamponade complicating percutaneous balloon mitral valvuloplasty

    International Nuclear Information System (INIS)

    Objective: To determine the diagnostic and therapeutic approach of cute cardiac perforation and tamponade complicating percutaneous balloon mitral valvuloplasty. Methods and Results: Percutaneous balloon mitral valvuloplasty was performed in 772 patients with rheumatic mitral stenosis from May 1992 to Dec. 2001, 9 were diagnosed cardiac perforation, 2 which developed pericardial tamponade which was successfully controlled by contrast and X-ray guided pericardiocentesis using a sub-xiphoid approach. Conclusions: Only a minority of cardiac perforation resulted from PBMV developed pericardial tamponade. The latter could be controlled safely and effectively by contrast and X-ray guided pericardiocentesis using a sub-xiphoid approach. The diagnosis of pericardial tamponade during or after PBMV relies on a strong clinical suspicion, and contrast and X-ray guided pericardiocentesis should be carried out without echocardiography for patients in unstable state

  2. 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.

  3. 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.

  4. 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.

  5. Interlaboratory testing of porcine sera for antibodies to porcine circovirus type 2

    DEFF Research Database (Denmark)

    McNair, I.; Marshall, M.; McNeilly, F.; Bøtner, Anette; Ladekjær-Mikkelsen, A.S.; Vincent, I.; Herrmann, Brigitte; Sanchez, R.; Rhodes, C.

    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 assay...

  6. 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

  7. 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...

  8. 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.

  9. Hydatid cyst confined to the papillary muscle: a very rare cause of mitral regurgitation.

    Science.gov (United States)

    Apaydin, Anil Z; Oguz, Emrah; Ayik, Fatih; Nalbantgil, Sanem; Ceylan, Naim

    2009-01-01

    Cardiac involvement of hydatid cysts is rare. Hydatidosis of the valvular apparatus can be treated successfully by the careful application of valvular surgical procedures. To the best of our knowledge, cardiac hydatidosis confined to the anterolateral papillary muscle has not been reported. Herein, we present a case involving a hydatid cyst that was located in a cardiac papillary muscle and that caused mitral regurgitation in a 37-year-old woman. The cyst was removed by papillary muscle incision, and the mitral valve was repaired. The patient experienced an uneventful recovery. PMID:20069089

  10. 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

  11. MITRAL MECHANICAL PROSTHETIC VALVE THROMBOSIS FOUR YEARS AFTER DISCONTINUING ANTICOAGULATION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Ravi Venkatachelam

    2015-04-01

    Full Text Available A 40 year s lady who underwent a mitral valve replacement with a mechancial prosthesis nine years ago, stopped oral anticoagulants totally. She was asymptomatic and doing her field job with good exercise tolerance for 4 years without any anticoagulation or follow - up and presented now with acute pulmonary edema due to prosthetic valve thrombosis. Echocardiography revealed a large clot on the mitral valve and increased Doppler gradients across the valve. She was given intravenous streptokinase for 28 hours with relief o f symptoms, re - appearance of prosthetic valve click and normalisation of flow velocities. She was prescribed oral acenocoumarol and discharged in a stable condition.

  12. Mitral valve restoration using the No-React(R MitroFix™: a novel concept

    Directory of Open Access Journals (Sweden)

    Oertel Frank

    2012-09-01

    Full Text Available Abstract Background Mitral Valve Repair (MVRP has been shown to be significantly superior to Mitral Valve Replacement (MVR. Since the majority of repairs involve the Posterior Mitral Leaflet (PML and not the Anterior Mitral Leaflet (AML, the monocuspidalisation of the Mitral Valve (MV can be achieved with a bio-posterior leaflet that imitates a closed PML. This approach may have the benefit of restoring the competence of the MV without reducing its effective orifice area. Methods We have used a new concept and device, the MitroFixTM, to correct MV regurgitation due to pathology of the PML. The device comes with functional sizers both of which have identical shape and size. This allows the surgeon to pre-test the success of the restoration. From December 2006 to October 2011, 51 MitroFixTM devices were implanted at three institutions. Results The mean age of the patients (32 males and 19 females was 67.7 years. 37 of them were in NYHA class III or IV and all patients suffered from severe mitral valve regurgitation (MR. 31 patients underwent combined surgery. Successful implantation of the MitroFix™ device was performed in 51/53 patients.Mean cross-clamp time was 63.6 min (range: 29-118 min. Six patients had additional reconstructive procedures of the AML (chordae transfer, neo-chordae, triangular resection. At discharge, 33 patients showed no MR in the TTE and 17 patients exhibited trivial (I or moderate (II MR. The mean gradient was 4.0 mmHg and mean EOA was 2.52cm^2 (range: 1.5-4.0cm2. All patients were classified as being in NYHA class I or II. Conclusion The MitroFixTM Mitral Valve Restoration Device is a new concept that offers an effective treatment of MR. The restoration of the mitral valve with the MitroFix™ device offers the advantage of preserving the AML and providing good coaptation with a prosthetic PML. Importantly, this preliminary evaluation indicates a mean effective orifice area ( EOA of 2.5cm2 in MV receiving a Mitro

  13. 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...

  14. Effect of varying ventricular function by extrasystolic potentiation on closure of the mitral valve.

    Science.gov (United States)

    Vandenberg, R. A.; Williams, J. C. P.; Sturm, R. E.; Wood , E. H.

    1971-01-01

    Mitral regurgitant indexes were measured by roentgen videodensitometry in anesthetized dogs without thoracotomy before, during and after extrasystolic potentiation of ventricular contraction while the atria and ventricles were driven in normal temporal sequence simultaneously or in such a way as to induce atrial fibrillation. Small amounts of mitral reflux were observed with simultaneous atrial and ventricular driving and with atrial fibrillation in the control measurements before initiation of extrasystolic potentiation. Reflux became negligible during extrasystolic potentiation and increased beyond control levels after termination of extrasystolic potentiation.

  15. [Giant Left Atrium with Mitral Regurgitation in Williams Syndrome: Report of a Case].

    Science.gov (United States)

    Suzuki, Ryusuke; Sakaguchi, Takeshi; Uekihara, Kenta; Mouri, Masaharu; Yoshioka, Yuki; Miyamoto, Tomoya; Hirayama, Ryo; Watanabe, Toshiaki; Matsukawa, Mai; Nakajima, Masamichi

    2016-02-01

    A 43-year-old woman with a history of mitral regurgitation and Williams syndrome was admitted for the treatment of congestive heart failure. A computed tomography scan showed a giant left atrium. No other cardiac abnormalities were observed. She received mitral valve replacement with a mechanical valve prosthesis and underwent left atrium volume reduction with a suture technique and modified Maze procedure. After the operation, the cardiac rhythm returned to sinus rhythm and chest radiography showed normal cardiothoracic ratio. Congestive heart failure did not recur. PMID:27075158

  16. 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.

  17. Transient mitral regurgitation: An adjunctive sign of myocardial ischemia during dipyridamole-thallium imaging

    International Nuclear Information System (INIS)

    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

  18. 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...

  19. 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

  20. 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.

  1. Assessment of cardiac remodeling in asymptomatic mitral regurgitation for surgery timing: a comparative study of echocardiography and magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Ozdogan Oner

    2010-08-01

    Full Text Available Abstract Background Early surgery is recommended for asymptomatic severe mitral regurgitation (MR, because of increased postoperative left ventricular (LV dysfunction in patients with late surgery. On the other hand, recent reports emphasized a "watchful waiting" process for the determination of the proper time of mitral valve surgery. In our study, we compared magnetic resonance imaging (MRI and transthoracic echocardiography to evaluate the LV and left atrial (LA remodeling; for better definitions of patients that may benefit from early valve surgery. Methods Twenty-one patients with moderate to severe asymptomatic MR were evaluated by echocardiography and MRI. LA and LV ejection fractions (EFs were calculated by echocardiography and MRI. Pulmonary veins (PVs were measured from vein orifices in diastole and systole from the tangential of an imaginary circle that completed LA wall. Right upper PV indices were calculated with the formula; (Right upper PV diastolic diameter- Right upper PV systolic diameter/Right upper PV diastolic diameter. Results In 9 patients there were mismatches between echocardiography and MRI measurements of LV EF. LV EFs were calculated ≥60% by echocardiography, meanwhile 0.05. However, both right upper PV indices (0.16 ± 0.06 vs. 0.24 ± 0.08, p: 0.024 and LA EFs (0.19 ± 0.09 vs. 0.33 ± 0.14, p: 0.025 were significantly decreased in patients with depressed EFs when compared to patients with normal EFs. Conclusions MRI might be preferred when small changes in functional parameters like LV EF, LA EF, and PV index are of clinical importance to disease management like asymptomatic MR patients that we follow up for appropriate surgery timing.

  2. 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...

  3. 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.

  4. 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

  5. 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

  6. 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.)

  7. 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

  8. 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.

  9. 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

    The mitral cell primary dendrite plays an important role in transmitting distal olfactory nerve input from olfactory glomerulus to the soma-axon initial segment. To understand how dendritic active properties are involved in this transmission, we have combined dual soma and dendritic patch recordi...

  10. Cardiac remodeling following percutaneous mitral valve repair - initial results assessed by cardiovascular magnetic resonance imaging

    DEFF Research Database (Denmark)

    Radunski, U K; Franzen, O; Barmeyer, A;

    2014-01-01

    PURPOSE: Percutaneous mitral valve repair with the MitraClip device (Abbott Vascular, Redwood City, California, USA) is a novel therapeutic option in patients with mitral regurgitation. This study evaluated the feasibility of cardiac volume measurements by cardiovascular magnetic resonance imaging...... mitral valve repair results in reverse LV but not in RV or LA remodeling. KEY POINTS: • Volume measurements by cardiovascular magnetic resonance imaging are feasible following percutaneous mitral valve repair despite device-related artifacts.• A significant reduction of left ventricular volume was found...... end-systolic (48 [42 - 80] vs. 51 [40 - 81] ml/m(2); p = 0.48), and LA (87 [55 - 124] vs. 92 [48 - 137] ml/m(2); p = 0.20) volume indices between BL and FU. CONCLUSION: CMR enables the assessment of cardiac volumes in patients after MitraClip implantation. Our CMR findings indicate that percutaneous...

  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. 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.

  13. Structural organization of normally located mitral valve chordae tendineae of the human heart

    Directory of Open Access Journals (Sweden)

    Fedonyuk L.Ya.

    2014-09-01

    Full Text Available Background. The mitral valve complex of the human heart consists of: the fibrous annulus, valve leaflets, chordae tendineae and papillary muscles. Deficiency or degeneration one of these structures may result in the dysfunction of the valvular apparatus. Topography and structure of the chordae tendineae effect to the normal functioning of heart valve complex and its hemodynamics, due to the aim of our research was to examine the peculiarities of the structural organization normally located mitral valve chordae tendineae of the human heart. Methods. The investigation was made on sectional material. We used light microscopy and immunohistochemistry methods. Results. The chordae tendineae are cord-like tendons that connect the papillary muscles to the valve leaflets in the heart. The chordeae tendineae were covered by endocardium which contained superficial layer of endothelium. Subendocardial layer includes loosely located collagen and elastic fibers which were interwoven with each other. Cor of the chordae are composed of bundles of densely packed collagen fibrils with few elastic fibers. Conclusion. The investigations allowed to receive a new objective data on some structural peculiarities of chordae tendineae of the human mitral valve that later can become the basis for the differential diagnosis of disease, including valvular heart pathology. Citation: Fedonyuk LYa, Malyk YuYu. [Structural organization of normally located mitral valve chordae tendineae of the human heart]. Morphologia. 2014;8(3:61-6. Ukrainian.

  14. Mitral valve prolapse is associated with altered extracellular matrix gene expression patterns.

    Science.gov (United States)

    Greenhouse, David G; Murphy, Alison; Mignatti, Paolo; Zavadil, Jiri; Galloway, Aubrey C; Balsam, Leora B

    2016-07-15

    Mitral valve prolapse (MVP) is the leading indication for isolated mitral valve surgery in the United States. Disorganization of collagens and glycosaminoglycans in the valvular extracellular matrix (ECM) are histological hallmarks of MVP. We performed a transcriptome analysis to study the alterations in ECM-related gene expression in humans with sporadic MVP. Mitral valve specimens were obtained from individuals undergoing valve repair for MVP (n=7 patients) and from non-beating heart-tissue donors (n=3 controls). Purified RNA was subjected to whole-transcriptome microarray analysis. Microarray results were validated by quantitative reverse transcription polymerase chain reaction (RT-qPCR). Gene ontology enrichment analysis was performed. 2046 unique genes showed significant differential expression (false discovery rate Functional annotation clustering calculated enrichment of ECM-related ontology groups (enrichment score=4.1). ECM-related gene expression is significantly altered in MVP. Our study is consistent with the histologically observed alterations in collagen and mucopolysaccharide profiles of myxomatous mitral valves. Furthermore, whole-transcriptome analyses suggest dysregulation of multiple pathways, including TGF-beta signaling. PMID:27063507

  15. Differential MicroRNA Expression Profile in Myxomatous Mitral Valve Prolapse and Fibroelastic Deficiency Valves

    Science.gov (United States)

    Chen, Yei-Tsung; Wang, Juan; Wee, Abby S. Y.; Yong, Quek-Wei; Tay, Edgar Lik-Wui; Woo, Chin Cheng; Sorokin, Vitaly; Richards, Arthur Mark; Ling, Lieng-Hsi

    2016-01-01

    Myxomatous mitral valve prolapse (MMVP) and fibroelastic deficiency (FED) are two common variants of degenerative mitral valve disease (DMVD), which is a leading cause of mitral regurgitation worldwide. While pathohistological studies have revealed differences in extracellular matrix content in MMVP and FED, the molecular mechanisms underlying these two disease entities remain to be elucidated. By using surgically removed valvular specimens from MMVP and FED patients that were categorized on the basis of echocardiographic, clinical and operative findings, a cluster of microRNAs that expressed differentially were identified. The expressions of has-miR-500, -3174, -17, -1193, -646, -1273e, -4298, -203, -505, and -939 showed significant differences between MMVP and FED after applying Bonferroni correction (p < 0.002174). The possible involvement of microRNAs in the pathogenesis of DMVD were further suggested by the presences of in silico predicted target sites on a number of genes reported to be involved in extracellular matrix homeostasis and marker genes for cellular composition of mitral valves, including decorin (DCN), aggrecan (ACAN), fibromodulin (FMOD), α actin 2 (ACTA2), extracellular matrix protein 2 (ECM2), desmin (DES), endothelial cell specific molecule 1 (ESM1), and platelet/ endothelial cell adhesion molecule 1 (PECAM1), as well as inverse correlations of selected microRNA and mRNA expression in MMVP and FED groups. Our results provide evidence that distinct molecular mechanisms underlie MMVP and FED. Moreover, the microRNAs identified may be targets for the future development of diagnostic biomarkers and therapeutics. PMID:27213335

  16. Carnitine Deficiency as the Possible Etiology of Idiopathic Mitral Valve Prolapse

    OpenAIRE

    Trivellato, Mario; De Palo, Elio; Gatti, Rosalba; Parenti, Anna; Piazza, Mario

    1984-01-01

    Idiopathic mitral valve prolapse (IMVP) is a very common cardiac abnormality that may be linked to carnitine deficit (inadequate nutritional intake or absorption). One patient with IMVP and related symptoms that were resistant to drug therapy was fully studied. Free plasma carnitine and 24-hour free urine carnitine were measured twice, 10 days apart, after an overnight fast.

  17. Aspergillus Flavus Endocarditis of the Native Mitral Valve in a Bone Marrow Transplant Patient

    OpenAIRE

    Demir, Tolga; Ergenoglu, Mehmet Umit; Ekinci, Abdurrahman; Tanrikulu, Nursen; Sahin, Mazlum; Demirsoy, Ergun

    2015-01-01

    Patient: Male, 36 Final Diagnosis: Aspergillus flavus endocarditis Symptoms: Malaise • fatigue and dyspnea Medication: — Clinical Procedure: Mitral vale replacemnet Specialty: Cardiology Objective: Rare disease Background: Infective endocarditis due to Aspergillus species is an uncommon infection with a high mortality rate. It mostly occurs after the implantation of prosthetic heart valves. Parenteral nutrition, immunosuppression, broad-spectrum antibiotic regimens, and illegal intravenous dr...

  18. 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

  19. 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.

  20. 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

  1. 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

    function. DESIGN: The study comprised 17 senior athletes (age: 59-75 years, running distance: 30-70 km/week), 10 young athletes (age: 20-36 years, matched for running distance), and 11 senior and 12 young weight-matched sedentary controls. Peak early (E) and late (A) mitral inflow and early (e') and late...

  2. Early postpartum mitral valve thrombosis requiring extra corporeal membrane oxygenation before successful valve replacement.

    Science.gov (United States)

    Halldorsdottir, H; Nordström, J; Brattström, O; Sennström, M M; Sartipy, U; Mattsson, E

    2016-05-01

    Pregnancy is associated with an increased risk of thrombosis in women with mechanical prosthetic heart valves. We present the case of a 29-year-old woman who developed early postpartum mitral valve thrombus after an elective cesarean delivery. The patient had a mechanical mitral valve and was treated with warfarin in the second trimester, which was replaced with high-dose dalteparin during late pregnancy. Elective cesarean delivery was performed under general anesthesia at 37weeks of gestation. The patient was admitted to the intensive care unit for postoperative care and within 30min she developed dyspnea and hypoxia requiring mechanical ventilation. She deteriorated rapidly and developed pulmonary edema, worsening hypoxia and severe acidosis. Urgent extra corporeal membrane oxygenation was initiated. Transesophageal echocardiography revealed a mitral valve thrombus. The patient underwent a successful mitral valve replacement after three days on extra corporeal membrane oxygenation. This case highlights the importance of multidisciplinary care and frequent monitoring of anticoagulation during care of pregnant women with prosthetic heart valves. PMID:26775895

  3. 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.

  4. 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.

  5. 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

  6. 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.

  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. 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

  9. 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.

  10. 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

  11. 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.

  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. Coincidental detection of genomes of porcine parvoviruses and porcine circovirus type 2 infecting pigs in Japan

    OpenAIRE

    Saekhow, Prayuth; KISHIZUKA, Shingo; SANO, Natsuha; MITSUI, HIROKO; AKASAKI, Hajime; MAWATARI, Takahiro; Ikeda, Hidetoshi

    2015-01-01

    The infection status of 15 viruses in 120 pigs aged about 6 months was investigated based on tonsil specimens collected from a slaughterhouse. Only 5 species of porcine parvoviruses and porcine circovirus type 2 (PCV2) were detected at high frequencies; 67% for porcine parvovirus (PPV) (PPV-Kr or -NADL2 as the new abbreviation), 58% for PPV2 (CnP-PARV4), 39% for PPV3 (P-PARV4), 33% for PPV4 (PPV4), 55% for PBo-likeV (PBoV7) and 80% for PCV2. A phylogenetic analysis of PPV3 suggested that Japa...

  14. First identification of porcine parvovirus 6 in North America by viral metagenomic sequencing of serum from pigs infected with porcine reproductive and respiratory syndrome virus

    OpenAIRE

    Schirtzinger, Erin E.; Suddith, Andrew W.; Hause, Benjamin M.; Hesse, Richard A.

    2015-01-01

    Background Currently, eight species in four genera of parvovirus have been described that infect swine. These include ungulate protoparvovirus 1 (classical porcine parvovirus, PPV), ungulate tetraparvovirus 2 (PPV3), ungulate tetraparvovirus 3 (which includes PPV2, porcine hokovirus, porcine partetravirus and porcine PARV4), ungulate copiparvovirus 2 (which includes PPV4 and PPV5), ungulate bocaparvovirus 2 (which includes porcine bocavirus 1, 2 and 6), ungulate bocaparvovirus 3 (porcine boca...

  15. 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.

  16. Cholecystokinin: an excitatory modulator of mitral/tufted cells in the mouse olfactory bulb.

    Directory of Open Access Journals (Sweden)

    Jie Ma

    Full Text Available Cholecystokinin (CCK is widely distributed in the brain as a sulfated octapeptide (CCK-8S. In the olfactory bulb, CCK-8S is concentrated in two laminae: an infraglomerular band in the external plexiform layer, and an inframitral band in the internal plexiform layer (IPL, corresponding to somata and terminals of superficial tufted cells with intrabulbar projections linking duplicate glomerular maps of olfactory receptors. The physiological role of CCK in this circuit is unknown. We made patch clamp recordings of CCK effects on mitral cell spike activity in mouse olfactory bulb slices, and applied immunohistochemistry to localize CCKB receptors. In cell-attached recordings, mitral cells responded to 300 nM-1 µM CCK-8S by spike excitation, suppression, or mixed excitation-suppression. Antagonists of GABAA and ionotropic glutamate receptors blocked suppression, but excitation persisted. Whole-cell recordings revealed that excitation was mediated by a slow inward current, and suppression by spike inactivation or inhibitory synaptic input. Similar responses were elicited by the CCKB receptor-selective agonist CCK-4 (1 µM. Excitation was less frequent but still occurred when CCKB receptors were blocked by LY225910, or disrupted in CCKB knockout mice, and was also observed in CCKA knockouts. CCKB receptor immunoreactivity was detected on mitral and superficial tufted cells, colocalized with Tbx21, and was absent from granule cells and the IPL. Our data indicate that CCK excites mitral cells postsynaptically, via both CCKA and CCKB receptors. We hypothesize that extrasynaptic CCK released from tufted cell terminals in the IPL may diffuse to and directly excite mitral cell bodies, creating a positive feedback loop that can amplify output from pairs of glomeruli receiving sensory inputs encoded by the same olfactory receptor. Dynamic plasticity of intrabulbar projections suggests that this could be an experience-dependent amplification mechanism for

  17. Comparison of Right Anterolateral Thorocotomy with Standard Median Steronotomy for Mitral Valve Replacement

    Directory of Open Access Journals (Sweden)

    Zamir Ahmad Shah

    2013-03-01

    Full Text Available Obejectives: The objectives of this study were to compare and analyze the results of right anterolateral thoracotomy and median sternotomy approach for primary mitral valve replacement with reference to the exposure during Valve Replacement , length of surgical incision, mean cross clamp time, mean bypass time, intensive care unit (ICU stay, hospitalization, overall comorbidity with sternotomy; sepsis, dehiscence, healing cosmetic issues and cost effectiveness. Methods: The present study comprised 68 patients with rheumatic mitral valve disease who underwent mitral valve replacement in the Department ofCardiovascular and Thoracic Surgery at Sher‑i‑Kashmir Institute of Medical Sciences from September 2009 to August 2011. Results: This study comprised 64 patients with 23 (35.9% males and 41 (64.1% females. Sternotomy group had 10 males (31.3% and 22 females (68.7%. Thoracotomy group had 13 males (40.6% and 19(59.4% females. The length of incision between the two groups was statistically significant (P<0.0001. Mean incision length were 24.6±2.1 cm and 14.8±2.3 cm in sternotomy and thoracotomy respectively. Statistically significant difference regarding duration of ICU stay was found between the two groups (P<0.0001. Scar visibility was 100% in sternotomy and around 25% in thoracotomy( P<0.0001. Conclusions: Thoracotomy through a right anterolateral aspect was easy to perform while maintaining maximum security for the patients. Besides its satisfactory cosmetic result especially in female patients, this approach proved to have several advantages. It offers a better exposure to the mitral apparatus even in patients with small left, allowing easy mitral valve replacement which is apparent from the lower cross‑clamp time in the test group. The invaluable advantage of the above- mentioned thoracotomy is total eradication of the risk of deep sternal infection. The shorter hospital stay and cost effectiveness of thoracotomy approach are additional

  18. 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  ...

  19. Porcine Circovirus Diseases: A review of PMWS

    DEFF Research Database (Denmark)

    Baekbo, P.; Kristensen, C. S.; Larsen, L. E.

    2012-01-01

    This article is a review on post‐weaning multisystemic wasting syndrome (PMWS), the first described disease among the porcine circovirus diseases (PCVD). Post‐weaning multisystemic wasting syndrome has, since its appearance in Canada in 1991, been seen in all major pig producing countries. To...... vaccines against Porcine Circo Virus type 2 have been coming on the market and many studies have shown great benefits of these to control PMWS. Today, sow vaccines as well as piglet vaccines are available in most countries. An extensive meta‐analysis of many of the vaccines has shown a comparable good...

  20. 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

  1. Hygienic aspects of porcine gullets.

    Science.gov (United States)

    Bijker, P G; Mossel, D A; van Logtestijn, J G

    1985-01-01

    In an attempt to elaborate good manufacturing practices, including the collection, processing and storage of porcine gullets, their bacterial condition immediately after collection (100 samples), as well as that of deep frozen gullets just before incorporation into meat products (40 samples), was assessed. Fresh gullets were found to be contaminated to a high degree: poured plate colony count at 30°C (PPCC) approximately 10(6) to 10(7) and Enterobacteriaceae approximately 10(3) to 10(4) cfu g(-1). Deep frozen gullets showed even higher counts: PPCC approximately 10(7) to 10(8) and Enterobacteriaceae approximately 10(4) to 10(5) cfu g(-1). Hygiene during collection was visually assessed in six abattoirs and found to be satisfactory in two, moderate in three and poor in one. The effects of processing, by cleaning or removal of the mucus membrane, on bacterial condition, pH, colour and odour were assessed before and during storage at 4°C and 20°C. Both cleaning and removal of the mucus membrane resulted in up to approximately a tenfold reduction of colony counts. After 7 days' storage at 4°C these were significantly lower than those of unprocessed gullets (P < 0·01). Processed gullets stored at 4°C were no longer fit for consumption after 4 days' storage. It being impossible to achieve a marked improvement in the bacteriological condition of gullets, the incorporation of these products into sausages should be discouraged and their use in petfoods only allowed under reasonable conditions of hygiene and chilling. PMID:22055164

  2. Transcription analysis of the porcine alveolar macrophage response to porcine circovirus type 2

    OpenAIRE

    Li, Wentao; Liu, Shuqing; Wang, Yang; Deng, Feng; Yan, Weidong; YANG Kun; Chen, Huanchun; He, Qigai; Charreyre, Catherine; Audoneet, Jean-Christophe

    2013-01-01

    Background Porcine circovirus type 2 (PCV2) is the causal agent of postweaning multisystemic wasting syndrome (PMWS), which has severely impacted the swine industry worldwide. PCV2 triggers a weak and atypical innate immune response, but the key genes and mechanisms by which the virus interferes with host innate immunity have not yet been elucidated. In this study, genes that control the response of primary porcine alveolar macrophages (PAMs), the main target of PCV2, were profiled in vitro. ...

  3. The ventricular function after operative correction of chronic mitral insufficiency. Non-invasive study with technetium-99m pertechnetate. First passage technique

    International Nuclear Information System (INIS)

    14 patients (age 49.6 ± 13.3 years) with pure mitral insufficiency of the second to fourth degree underwent an operative intervention on the mitral valve, whereby in 12 cases the valve was replaced and two times the insufficiency could be cleared up with a plastic reconstruction. On the average of 21.6 ± 11 months after the operation a non-invasive study was done with the help of heart scintigraphy 'first passage technique' with Tc 99m pertechnetate at rest and at maximum ergometeric stress. With this method pre- and postoperative end-diastolic volumes (227/ 114 ml), end-systolic volumes (69/ 46 ml), heart minute volumes (4.5/ 5.7 l/min), total output fraction of the left ventricle (61/ 69%), diastolic filling speed and emptying speed of the ventricle were determined as well as the measuring of the lung flow time. The speed of the rapid filling phase gave no indication of a hindrance as a result of an implanted valve or a plastic reconstruction. The changes under stress indicate a normal reaction of the ventricle. This ability to react corresponds clinically to the improvement of the patients on the average of 1.1 degrees according to the NYHA classification. (orig./TRV)

  4. Clinical Application of Cine-MRI in the Visual Assessment of Mitral Regurgitation Compared to Echocardiography and Cardiac Catheterization

    OpenAIRE

    Heitner, John; Bhumireddy, Geetha P; Crowley, Anna Lisa; Weinsaft, Jonathan; Haq, Salman A.; Klem, Igor; Kim, Raymond J; Jollis, James G.

    2012-01-01

    Background Detecting and quantifying the severity of mitral regurgitation is essential for risk stratification and clinical decision-making regarding timing of surgery. Our objective was to assess specific visual parameters by cine-magnetic resonance imaging (MRI) in the determination of the severity of mitral regurgitation and to compare it to previously validated imaging modalities: echocardiography and cardiac ventriculography. Methods The study population consisted of 68 patients who unde...

  5. Conservative approach to mitral valve replacement in hypertrophic cardiomyopathy with systolic anterior motion – a case report

    Science.gov (United States)

    Suder, Bogdan; Szymoński, Krzysztof; Wasilewski, Grzegorz; Sadowski, Jerzy; Kapelak, Boguslaw

    2015-01-01

    The authors report the case of a 60-year-old patient with hypertrophic cardiomyopathy (HCM), systolic anterior motion (SAM), and high gradient in the left ventricular outflow tract (LVOT) who underwent surgical treatment. During the surgery, myomectomy of the septum was performed using the Morrow method: despite the persisting SAM and increased LVOT gradients, the mitral valve was not replaced. The case study presents a conservative approach to mitral valve replacement during HCM surgery. PMID:26855652

  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. 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.

  9. 7 CFR 1230.18 - Porcine animal.

    Science.gov (United States)

    2010-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE PORK PROMOTION, RESEARCH, AND CONSUMER INFORMATION Pork Promotion, Research, and Consumer Information Order Definitions § 1230.18 Porcine... purposes as seed stock and included in the breeding herd; and (c) a market hog, slaughtered by the...

  10. 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.

  11. 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.

  12. The Porcine Immunology and Nutrition Resource Database

    Science.gov (United States)

    Diverse genomics-based databases have been developed to facilitate research with human and rodent models. Current porcine gene databases, however, lack the nutritional and immunological orientation and robust annotation to design effective molecular tools to study relevant pig models. To address t...

  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. 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.

  15. 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

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

    OpenAIRE

    Álvaro Villela de Moraes; Caio César Jorge Medeiros; Pablo M. A. Pomerantzeff; João César Sbano; Miriam Magalhães Pardi; Henry Abensur; Tamara Cortez Martins; Giovani Guido Cerri; Geraldo Verginelli; Giovani Bellotti; Fúlvio Pileggi; JATENE Adib D.

    1992-01-01

    A ecodopplercardiografia ocupa posição de destaque no diagnóstico das valvopatias, pois fornece dados sobre a anatomia valvar, a área estenótica, os gradientes pressóricos e o grau da regurgitação. Seu uso na cirurgia cardíaca, com a abordagem epicárdica, é bastante conhecido. O advento da abordagem transesofágica, por não interferir no campo operatório, facilitou a sua utilização. O objetivo deste trabalho foi estudar a utilidade da ETE nacirurgiada valva mitral. De julho de 1991 a janeiro d...

  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. 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...

  19. 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

  20. 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)

  1. 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.

  2. Primary Cardiac Synovial Sarcoma Originating From the Mitral Valve Causing Left Ventricular Outflow Tract Obstruction.

    Science.gov (United States)

    Prifti, Edvin; Veshti, Altin; Ikonomi, Majlinda; Demiraj, Aurel

    2015-10-01

    An 11-year-old boy was admitted with complaints of syncope and convulsion. Echocardiogram revealed a mass measuring 2 × 4 cm related to the mitral subvalvular apparatus. The mass, which appeared to be attached to the anterolateral papillary muscle, protruded into the left ventricular outflow tract causing intermittent obstruction. The patient underwent surgical excision of the mass. Pathology confirmed the diagnosis of primary synovial sarcoma. At six months following the operation, a small mass measuring 1 × 1 cm was detected in the left ventricle. The patient underwent reoperation consisting of radical resection of the subvalvular apparatus and mitral valve replacement. Histology confirmed that the mass was cardiac synovial sarcoma. One year after surgery, the patient is doing well. PMID:26467881

  3. Heart Rate Variability in Cavalier King Charles Spaniels with Different Degree of Myxomatous Mitral Valve Disease

    DEFF Research Database (Denmark)

    Rasmussen, Caroline Elisabeth; Falk, Bo Torkel; Zois, Nora Elisabeth; Moesgaard, Sophia Gry; Häggström, Jens; Pedersen, Henrik Duelund; Olsen, Lisbeth Høier

    2010-01-01

    variability (HRV). Reduced HRV is seen in dogs with heart failure secondary to myxomatous mitral valve disease (MMVD). However, HRV is suggested to increase with disease progression in dogs with early stages of MMVD. Comparable results are found in people with primary mitral valve prolapse, a disease...... resembling canine MMVD. Aim: To associate progression of MMVD in dogs with time and frequency domain HRV, analysed from 24-hour electrocardiography. Materials and Methods: Eighty-one Cavalier King Charles Spaniels (CKCS) were examined by echocardiography and 24-hour electrocardiography. CKCS were divided...... responsiveness. Results: Ten out of 13 HRV variables decreased with increasing MMVD severity. In group 1, 10 HRV variables were increased compared to group 3 and 4 (P<0.05) and 2 HRV variables were increased compared to group 2 (P<0.04). Eight and 10 HRV variables were increased in group 2 compared to group 3 (P...

  4. 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

  5. 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

  6. 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....

  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

    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.

  8. 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.

  9. 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

  10. 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...

  11. 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 ...

  12. Aortic Periannular Abscess Invading into the Central Fibrous Body, Mitral Valve, and Tricuspid Valve

    OpenAIRE

    Oh, Hyun Kong; Kim, Nan Yeol; Kang, Min-Woong; Kang, Shin Kwang; Yu, Jae Hyeon; Lim, Seung Pyung; Choi, Jae Sung; Na, Myung Hoon

    2014-01-01

    A 61-year-old man was diagnosed with aortic stenoinsufficiency with periannular abscess, which involved the aortic root of noncoronary sinus (NCS) that invaded down to the central fibrous body, whole membranous septum, mitral valve (MV), and tricuspid valve (TV). The open complete debridement was executed from the aortic annulus at NCS down to the central fibrous body and annulus of the MV and the TV, followed by the left ventricular outflow tract reconstruction with implantation of a mechani...

  13. [Severe left ventricular outflow tract obstruction as a complication of mitral valve repair: case report].

    Science.gov (United States)

    Rodrigues, Bruno; Santos, Luís Ferreira; Correia, Emanuel; Faria, Rita; Moreira, Davide; Gama, Pedro; Cabral, Costa; Pipa, João; Santos, Oliveira

    2011-11-01

    Systolic anterior motion (SAM) is a postoperative complication of mitral valve repair, with an incidence of 5 to 10%. Early recognition of the signs and symptoms of SAM is essential for the management of these patients. This article focuses on the pathophysiology and dynamics of SAM and the treatment strategies described in the literature. The authors present a case study and echocardiographic images illustrating the clinical relevance of the mechanism involved, in order to clarify whether surgical reintervention is necessary. PMID:22032955

  14. 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

  15. 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

  16. Genetic Stability of a Genetically-Engineered Chimeric Porcine Circovirus (PCV) Vaccine, PCV1-2

    OpenAIRE

    Gillespie, Jennifer Ann

    2009-01-01

    Porcine circovirus type 2 (PCV2) is the primary causative agent of porcine circovirus associated disease (PCVAD), an economically important swine disease that causes wasting in pigs 5-18 weeks of age. There exist two different types of porcine circoviruses: porcine circovirus type 1 (PCV1) was discovered as a contaminant of porcine kidney (PK-15) cells and was determined to be nonpathogenic in swine; whereas porcine circovirus type 2 (PCV2) is pathogenic. A recently released vaccine for PCVA...

  17. Pre-clinical Experience with a Multi-Chordal Patch for Mitral Valve Repair.

    Science.gov (United States)

    Chawla, Surendra K; Shi, Weiwei; McIver, Bryant V; Vinten-Johansen, Jakob; Frater, Robert W M; Padala, Muralidhar

    2016-04-01

    Surgical repair of flail mitral valve leaflets with neochordoplasty has good outcomes, but implementing it in anterior and bi-leaflet leaflet repair is challenging. Placing and sizing individual neochordae is time consuming and error prone, with persistent localized flail if performed incorrectly. In this study, we report our pre-clinical experience with a novel multi-chordal patch for mitral valve repair. The device was designed based on human cadaver hearts, and laser cut from expanded polytetrafluoroethylene. The prototypes were tested in: (stage 1) ex vivo hearts with leaflet flail (N = 6), (stage 2) acute swine induced with flail (N = 6), and (stage 3) two chronic swine survived to 23 and 120 days (N = 2). A2 and P2 prolapse were successfully repaired with coaptation length restored to 8.1 ± 2.2mm after posterior repair and to 10.2 ± 1.3mm after anterior repair in ex vivo hearts. In vivo, trace regurgitation was seen after repair with excellent patch durability, healing, and endothelialization at euthanasia. A new device for easier mitral repair is reported, with good early pre-clinical outcomes. PMID:26801477

  18. 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.

  19. Mitral and aortic valve sclerosis/calcification and carotid atherosclerosis: results from 1065 patients.

    Science.gov (United States)

    Rossi, Andrea; Faggiano, Pompilio; Amado, Alexandra E; Cicoira, Mariantonietta; Bonapace, Stefano; Franceschini, Lorenzo; Dini, Frank L; Ghio, Stefano; Agricola, Eustachio; Temporelli, Pier Luigi; Vassanelli, Corrado

    2014-11-01

    This study assesses whether aortic valve sclerosis (AVS) and mitral annulus calcification (MAC) are associated with carotid artery atherosclerosis, independently of traditional cardiovascular risk factors. A total of 1065 patients underwent both echocardiography and carotid artery ultrasound scanning. AVS and MAC were defined as focal areas of increased echogenicity and thickening of the aortic leaflets or mitral valve annulus. Carotid artery atherosclerosis was defined as presence/absence of any atherosclerotic plaque or presence/absence of plaque >50 %. Of 1065 patients (65 ± 9 years; 38 % female) who comprised the study population, 642 (60 %) had at least one atherosclerotic plaque. AVS, but not mitral valve sclerosis; was associated with the presence of carotid atherosclerosis (odds ratio (OR) 1.9, 95 % confidence interval (CI) 1.2-3.9; P = 0.005) and the degree of carotid atherosclerosis (OR 2.1, 95 % CI 1.2-3.9; P = 0.01) in a multivariate model including age, gender, previous ischemic heart disease, hypertension, dyslipidemia, smoking, diabetes, family cardiovascular history, left ventricular size, mass, and ejection fraction, and left atrial size. AVS is a significant predictor of carotid atherosclerosis, independently of other cardiovascular clinical and echocardiographic risk factors. PMID:24196525

  20. Tag1 deficiency results in olfactory dysfunction through impaired migration of mitral cells.

    Science.gov (United States)

    Bastakis, George G; Savvaki, Maria; Stamatakis, Antonis; Vidaki, Marina; Karagogeos, Domna

    2015-12-15

    The olfactory system provides mammals with the abilities to investigate, communicate and interact with their environment. These functions are achieved through a finely organized circuit starting from the nasal cavity, passing through the olfactory bulb and ending in various cortical areas. We show that the absence of transient axonal glycoprotein-1 (Tag1)/contactin-2 (Cntn2) in mice results in a significant and selective defect in the number of the main projection neurons in the olfactory bulb, namely the mitral cells. A subpopulation of these projection neurons is reduced in Tag1-deficient mice as a result of impaired migration. We demonstrate that the detected alterations in the number of mitral cells are well correlated with diminished odor discrimination ability and social long-term memory formation. Reduced neuronal activation in the olfactory bulb and the corresponding olfactory cortex suggest that Tag1 is crucial for the olfactory circuit formation in mice. Our results underpin the significance of a numerical defect in the mitral cell layer in the processing and integration of odorant information and subsequently in animal behavior. PMID:26525675

  1. 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

  2. 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.

  3. Minimal access mitral valve repair in a patient with a right pneumonectomy for Scimitar syndrome.

    Science.gov (United States)

    Sinha, Shantanu; Morgan-Hughes, Nick; O'Toole, Laurence; Hunter, Steven

    2016-06-01

    A 61-year old man known with chronic atrial fibrillation was referred to our unit via the multidisciplinary team meeting, with severe mitral regurgitation secondary to prolapse of anterior mitral leaflet. In 1968, he had undergone right pneumonectomy due to Scimitar syndrome. Dense adhesions due to previous interventions, such as thoracotomy, make it difficult to insert ports, and this is therefore considered a relative contraindication to port access approach to the mitral valve. The anatomical position of the heart in the mediastinum was completely distorted due to the shift of the mediastinum to the right following previous surgery. Our report illustrates the operative success that can be achieved in such complex situations. Computed tomography scanning and on table transoesophageal and transthoracic echocardiography were the tools used in conjunction to achieve the best possible approach. This case promotes the use of minimal access approach in the experienced hands so that such complex procedures can be carried out without any complication and yield good results. PMID:26979655

  4. 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

  5. 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

  6. 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.

  7. 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

  8. Coincidental detection of genomes of porcine parvoviruses and porcine circovirus type 2 infecting pigs in Japan.

    Science.gov (United States)

    Saekhow, Prayuth; Kishizuka, Shingo; Sano, Natsuha; Mitsui, Hiroko; Akasaki, Hajime; Mawatari, Takahiro; Ikeda, Hidetoshi

    2016-01-01

    The infection status of 15 viruses in 120 pigs aged about 6 months was investigated based on tonsil specimens collected from a slaughterhouse. Only 5 species of porcine parvoviruses and porcine circovirus type 2 (PCV2) were detected at high frequencies; 67% for porcine parvovirus (PPV) (PPV-Kr or -NADL2 as the new abbreviation), 58% for PPV2 (CnP-PARV4), 39% for PPV3 (P-PARV4), 33% for PPV4 (PPV4), 55% for PBo-likeV (PBoV7) and 80% for PCV2. A phylogenetic analysis of PPV3 suggested that Japanese PPV3s showed a slight variation, and possibly, there were farms harboring homogeneous or heterogeneous PPV3s. Statistical analyses indicated that the detection of PCV2 was significantly coincidental with each detection of PPV, PPV2 and PPV3, and PPV and PPV4 were also coincidentally detected. The concurrent infection with PCV2 and porcine parvoviruses in the subclinically infected pigs may resemble the infection status of pigs with the clinical manifestations of porcine circovirus associated disease which occurs in 3-5 months old pigs and is thought to be primarily caused by the PCV2 infection. PMID:26166811

  9. Early and Mid-Term Outcome of Pediatric Congenital Mitral Valve Surgery

    Science.gov (United States)

    Baghaei, Ramin; Tabib, Avisa; Jalili, Farshad; Totonchi, Ziae; Mahdavi, Mohammad; Ghadrdoost, Behshid

    2015-01-01

    Background: Congenital lesions of the mitral valve are relatively rare and are associated with a wide spectrum of cardiac malformations. The surgical management of congenital mitral valve malformations has been a great challenge. Objectives: The aim of this study was to evaluate the early and intermediate-term outcome of congenital mitral valve (MV) surgery in children and to identify the predictors for poor postoperative outcomes and death. Patients and Methods: In this retrospective study, 100 consecutive patients with congenital MV disease undergoing mitral valve surgery were reviewed in 60-month follow-up (mean, 42.4 ± 16.4 months) during 2008 - 2013. Twenty-six patients (26%) were under one-year old. The mean age and weight of the patients were 41.63 ± 38.18 months and 11.92 ± 6.12 kg, respectively. The predominant lesion of the mitral valve was MV stenosis (MS group) seen in 21% and MR (MR group) seen in 79% of the patients. All patients underwent preoperative two-dimensional echocardiography and then every six months after surgery Results: Significant improvement in degree of MR was noted in all patients with MR during postoperative and follow-up period in both patients with or without atrioventricular septal defect (AVSD) (P = 0.045 in patients with AVSD and P = 0.008 in patients without AVSD). Decreasing trend of mean gradient (MG) in MS group was statistically significant (P = 0.005). In patients with MR, the mean pulmonary artery pressure (PAP) had improved postoperatively (P < 0.001). Although PAP in patients with MV stenosis was reduced, this reduction was not statistically significant (P = 0.17). In-hospital mortality was 7%. Multivariate analysis demonstrated that age (P < 0.001), weight (P < 0.001), and pulmonary stenosis (P = 0.03) are strong predictors for mortality. Based on the echocardiography report at the day of discharge from hospital, surgical results were optimal (up to moderate degree for MR group and up to mild degree for MS group) in

  10. Genomic analysis of porcine circovirus type-2 isolates in Alberta pigs demonstrating clinical porcine circovirus associated disease (PCVAD)

    OpenAIRE

    McIntyre, Leila; Chaiyakul, Mark; Clark, Edward G.; Marshall, Frank; Czub, Markus

    2010-01-01

    Nineteen pigs with clinical signs of porcine circovirus associated diseases (PCVAD) on 5 Alberta pig farms were examined pathologically, including gross pathology, histopathology, and immunohistochemistry. Polymerase chain reaction (PCR) for porcine circovirus type-2 (PCV-2) and sequence analysis was performed on tissue samples of 12 animals. Results showed that new strains of porcine circovirus type-2 genogroup b were present in most pigs that were positive for PCV-2. Furthermore, a mixed in...

  11. Echocardiographic Assessment of Ischaemic Mitral Regurgitation, Mechanism, Severity, Impact on Treatment Strategy and Long Term Outcome

    Science.gov (United States)

    Naser, Nabil; Dzubur, Alen; Kusljugic, Zumreta; Kovacevic, Katarina; Kulic, Mehmed; Sokolovic, Sekib; Terzic, Ibrahim; Haxihibeqiri-Karabdic, Ilirijana; Hondo, Zorica; Brdzanovic, Snjezana; Miseljic, Sanja

    2016-01-01

    Introduction: The commonest mitral regurgitation etiologies are degenerative (60%), rheumatic post-inflammatory, 12%) and functional (25%). Due to the large number of patients with acute MI, the incidence of ischaemic MR is also high. Ischaemic mitral regurgitation is a complex multifactorial disease that involves left ventricular geometry, the mitral annulus, and the valvular/subvalvular apparatus. Ischaemic mitral regurgitation is an important consequence of LV remodeling after myocardial infarction. Research Objectives: The objective of this study is to determine the role of echocardiography in detecting and assessment of mitral regurgitation mechanism, severity, impact on treatment strategy and long term outcome in patients with myocardial infarction during the follow up period of 5 years. Also one of objectives to determine if the absence or presence of ischaemic MR is associated with increased morbidity and mortality in patients with myocardial infarction. Patients and methods: The study covered 138 adult patients. All patients were subjected to echocardiography evaluation after acute myocardial infarction during the period of follow up for 5 years. The patients were examined on an ultrasound machine Philips iE 33 xMatrix, Philips HD 11 XE, and GE Vivid 7 equipped with all cardiologic probes for adults and multi-plan TEE probes. We evaluated mechanisms and severity of mitral regurgitation which includes the regurgitant volume (RV), effective regurgitant orifice area (EROA), the regurgitant fraction (RF), Jet/LA area, also we measured the of vena contracta width (VC width cm) for assessment of IMR severity, papillary muscles anatomy and displacement, LV systolic function ± dilation, LV regional wall motion abnormality WMA, LV WMI, Left ventricle LV remodeling, impact on treatment strategy and long term mortality. Results: We analyzed and follow up 138 patients with previous (>16 days) Q-wave myocardial infarction by ECG who underwent TTE and TEE

  12. 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. PMID:26711454

  13. Porcine SLITRK1: Molecular cloning and characterization

    Directory of Open Access Journals (Sweden)

    Knud Larsen

    2014-01-01

    Full Text Available 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 introns, as does its human and mouse counterparts. RT-PCR cloning revealed two SLITRK1 transcripts: a full-length mRNA and a transcript variant that results in a truncated protein. The encoded SLITRK1 protein, consisting of 695 amino acids, displays a very high homology to human SLITRK1 (99%. The porcine SLITRK1 gene is expressed exclusively in brain tissues.

  14. Splicing variants of porcine synphilin-1

    DEFF Research Database (Denmark)

    Larsen, Knud Erik; Madsen, Lone Bruhn; Farajzadeh, Leila;

    2015-01-01

    (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......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...... 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....

  15. Regulation of spike timing-dependent plasticity of olfactory inputs in mitral cells in the rat olfactory bulb.

    Directory of Open Access Journals (Sweden)

    Teng-Fei Ma

    Full Text Available The recent history of activity input onto granule cells (GCs in the main olfactory bulb can affect the strength of lateral inhibition, which functions to generate contrast enhancement. However, at the plasticity level, it is unknown whether and how the prior modification of lateral inhibition modulates the subsequent induction of long-lasting changes of the excitatory olfactory nerve (ON inputs to mitral cells (MCs. Here we found that the repetitive stimulation of two distinct excitatory inputs to the GCs induced a persistent modification of lateral inhibition in MCs in opposing directions. This bidirectional modification of inhibitory inputs differentially regulated the subsequent synaptic plasticity of the excitatory ON inputs to the MCs, which was induced by the repetitive pairing of excitatory postsynaptic potentials (EPSPs with postsynaptic bursts. The regulation of spike timing-dependent plasticity (STDP was achieved by the regulation of the inter-spike-interval (ISI of the postsynaptic bursts. This novel form of inhibition-dependent regulation of plasticity may contribute to the encoding or processing of olfactory information in the olfactory bulb.

  16. Investigation of SNPs in the porcine desmoglein 1 gene

    DEFF Research Database (Denmark)

    Daugaard, L.; Andresen, Lars Ole; Fredholm, M.

    2007-01-01

    the location of single nucleotide polymorphisms (SNPs) in the porcine desmoglein I gene (PIG)DSGI 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 I 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 wre 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...

  17. Simultaneous transfemoral transcatheter mitral and tricuspid valve edge-to-edge repair (using MitraClip system) completed by atrial septal defect occlusion in a surgically inoperable patient. First-in-human report

    OpenAIRE

    Kowalski, Marek; Franz, Norbert; Ritter, Frank; Hofmann, Steffen; Stabel-Mahassine, Chourok; Warnecke, Henning; Thale, Joachim

    2015-01-01

    Transcatheter transfemoral mitral valve repair using the MitraClip system (Abbott Vascular, USA) is used in high-risk or inoperable patients with severe mitral regurgitation. We report the first-in-human simultaneous transfemoral clipping of the mitral and tricuspid valve completed by occlusion of an atrial septal defect (ASD). The procedure was performed in an 84-year-old patient in October 2015. After effective reduction of mitral and tricuspid regurgitations using the MitraClip system a PF...

  18. The ontogeny of the porcine immune system

    Czech Academy of Sciences Publication Activity Database

    Šinkora, Marek; Butler, J. E.

    2009-01-01

    Roč. 33, č. 3 (2009), s. 273-283. ISSN 0145-305X R&D Projects: GA ČR GA524/07/0087; GA ČR GA523/07/0088 Institutional research plan: CEZ:AV0Z50200510 Keywords : ontogeny of the porcine immune system * swine adaptive immunity * development of alpha beta and gamma delta T cells Subject RIV: EC - Immunology Impact factor: 3.290, year: 2009

  19. Studies on genetic properties of porcine parvoviruses

    OpenAIRE

    Streck, André Felipe

    2013-01-01

    Porcine parvovirus (PPV) is considered to be one of the most important causes of reproductive failure in swine. Fetal death, mummification, stillbirths and delayed return to estrus are some of the clinical signs commonly associated with PPV infection in a herd. The virus genome is considered to be conservative, with substitution rates near to that of their host. However, it has been shown that some parvoviruses exhibit a substitution rate close to that commonly determined for RNA viruses. In ...

  20. KBSH parvovirus: comparison with porcine parvovirus.

    OpenAIRE

    Molitor, T W; Joo, H S; Collett, M S

    1985-01-01

    We compared the molecular, antigenic, and pathogenic properties of KBSH parvovirus to those of porcine parvovirus (PPV) isolate NADL-8. KBSH, propagated in swine testes cells in culture, possessed two major capsid polypeptides of 83 and 64 kilodaltons that were similar in size to those of PPV. KBSH-infected cells also contained an 86-kilodalton nonstructural polypeptide that was identical in size to the PPV nonstructural polypeptide (NS-1). The KBSH polypeptides were structurally similar but ...

  1. Pathogenicity of porcine respiratory coronavirus isolated in Québec.

    OpenAIRE

    Jabrane, A; Girard, C; Elazhary, Y

    1994-01-01

    Porcine respiratory coronavirus (PRCV) is present in many countries, including Canada, but controversy still exists concerning its pathogenicity. Eight-week-old piglets were inoculated intratracheally with a Quebec PRCV isolate (1Q90). Two contact piglets were kept with the inoculated animals. Three animals served as control. Polypnea and dyspnea were the main clinical signs observed. Diffuse bronchioloalveolar damage occurred 24 hours postinoculation. Changes compatible with bronchointerstit...

  2. 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...

  3. 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, ...

  4. Retrospective study on the occurrence of porcine circovirus 2 infection and associated entities in Northern Germany

    OpenAIRE

    Jacobsen, Bjoern; KRUEGER, Lars; Seeliger, Frank; Bruegmann, Michael; Segalés, Joaquim; Baumgaertner, Wolfgang

    2009-01-01

    Abstract Porcine circovirus type 2 (PCV 2) represents a widespread, globally occurring pathogen with an increasing number of associated entities. To further elucidate the origin, spread and pathogenesis of PCV2 and associated changes archived material of pigs originating from Northern Germany and submitted for necropsy between 1961 to 1998 were investigated by using in situ hybridisation and polymerase chain reaction. PCV2 was first detected in a pig from 1962. However, incidence o...

  5. 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...

  6. Specific detection of Lawsonia intracellularis in porcine proliferative enteropathy inferred from fluorescent rRNA in situ hybridization

    DEFF Research Database (Denmark)

    Boye, Mette; Jensen, Tim Kåre; Møller, Kristian; Leser, T.D.; Jorsal, Sven Erik Lind

    1998-01-01

    probe was determined by simultaneous comparison with indirect immunofluorescence assay for detection of L. intracellularis in formalin-fixed tissue samples from 15 pigs affected by porcine proliferative enteropathy. We used 10 tissue samples from pigs without proliferative mucosal changes as negative...

  7. 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

  8. 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.

  9. Studies on porcine pancreatic elastase activity, 1

    International Nuclear Information System (INIS)

    An improved method of radioimmunoassay was devised to offer a successful formula for determining blood concentration of elastase. With porcine pancreatic elastase as the antigen, rabbits were immunized to obtain antiserum. Iodinated elastase labeled by the chloramine-T procedure using 131I (or 125I) had a specific activity of 200 - 300 mCi/mg. The double antibody method was used for BF separation. While the usual method of radioimmunoassay was not always successful in obtaining accurate serum concentration of elastase, the use of diisopropyl fluorophosphate (DFP) was able to eliminate the disturbing influence of intra-serous inhibitors, α1-AT and α2-M, eventually producing satisfactory results. With the use of DFP, the elastase standard curve and the porcine serum dilution curve had a statistically significant correlation; precision and recovery were both satisfactory; cross-reactivity of the antiserum with trypsin and chymotrypsin was less than 0.001%. The minimal detectable concentration of elastase was 5 ng/ml, and the range of normal fasting porcine serum level was 70 - 100 ng/ml. (author)

  10. Fluid–Structure Interaction Analysis of Papillary Muscle Forces Using a Comprehensive Mitral Valve Model with 3D Chordal Structure

    Energy Technology Data Exchange (ETDEWEB)

    Toma, Milan; Jensen, Morten Ø.; Einstein, Daniel R.; Yoganathan, Ajit P.; Cochran, Richard P.; Kunzelman, Karyn S.

    2015-07-17

    Numerical models of native heart valves are being used to study valve biomechanics to aid design and development of repair procedures and replacement devices. These models have evolved from simple two-dimensional approximations to complex three-dimensional, fully coupled fluid-structure interaction (FSI) systems. Such simulations are useful for predicting the mechanical and hemodynamic loading on implanted valve devices. A current challenge for improving the accuracy of these predictions is choosing and implementing modeling boundary conditions. In order to address this challenge, we are utilizing an advanced in-vitro system to validate FSI conditions for the mitral valve system. Explanted ovine mitral valves were mounted in an in vitro setup, and structural data for the mitral valve was acquired with *CT. Experimental data from the in-vitro ovine mitral valve system were used to validate the computational model. As the valve closes, the hemodynamic data, high speed lea et dynamics, and force vectors from the in-vitro system were compared to the results of the FSI simulation computational model. The total force of 2.6 N per papillary muscle is matched by the computational model. In vitro and in vivo force measurements are important in validating and adjusting material parameters in computational models. The simulations can then be used to answer questions that are otherwise not possible to investigate experimentally. This work is important to maximize the validity of computational models of not just the mitral valve, but any biomechanical aspect using computational simulation in designing medical devices.

  11. 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...

  12. Interlaboratory testing of porcine sera for antibodies to porcine circovirus type 2

    DEFF Research Database (Denmark)

    McNair, I.; Marshall, M.; McNeilly, F.; Bøtner, Anette; Ladekjær-Mikkelsen, A.S.; Vincent, I.; Herrmann, Brigitte; Sanchez, R.; Rhodes, C.

    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 assay...... (IPMA), and to determine the titer of each serum. Results from all centers were then compiled and correlated. They demonstrate a wide variation in the titers obtained between laboratories. These differences were dependent on the assay used and the choice of fixative. In general, IPMA gave higher titers...

  13. Differential expression of micrornas in porcine parvovirus infected porcine cell line

    OpenAIRE

    Li, Xinqiong; Zhu, Ling; Liu, Xiao; Sun, Xiangang; Zhou, Yuanchen; Lang, Qiaoli; Li, Ping; Cai, Yuhan; Qiao, Xiaogai; XU, ZHIWEN

    2015-01-01

    Background Porcine parvovirus (PPV), a member of the Parvoviridae family, causes great economic loss in the swine industry worldwide. MicroRNAs (miRNAs) are a class of non-protein–coding genes that play many diverse and complex roles in viral infections. Finding Aiming to determine the impact of PPV infections on the cellular miRNAome, we used high-throughput sequencing to sequence two miRNA libraries prepared from porcine kidney 15 (PK-15) cells under normal conditions and during PPV infecti...

  14. Genetic Characterization of Porcine Circovirus Type 2 from Pigs with Porcine Circovirus Associated Diseases in Argentina

    OpenAIRE

    Pereda, Ariel; Piñeyro, Pablo; Bratanich, Ana; Quiroga, María Alejandra; Bucafusco, Danilo; Craig, María Isabel; Cappuccio, Javier; Machuca, Mariana; Rimondi, Agustina; Dibárbora, Marina; Sanguinetti, Hector Ramón; Perfumo, Carlos Juan

    2011-01-01

    Porcine circovirus type 2 (PCV-2) has been associated with syndromes grouped by the term porcine circovirus associated diseases (PCVAD). The PCV-2 isolates have been grouped into two major groups or genotypes according to their nucleotide sequence of whole genomes and/or ORF-2: PCV-2b, which have, in turn, been subdivided into three clusters (1A–1C), and PCV-2a, which has been subdivided into five clusters (2A–2E). In the present study, we obtained 16 sequences of PCV-2 from different farms f...

  15. Mixoma de la válvula mitral en un niño.Presentación de un caso y revisión de la literatura.

    Directory of Open Access Journals (Sweden)

    Rafael Gutiérrez A

    2005-05-01

    Full Text Available Niño de 11 años de edad con historia de dolor torácico intermitente de 6 meses de evolución y soplo cardíaco.El ecocardiograma mostró una masa tumoral en la válvula mitral con insuficiencia valvular moderada.Se intervino quirúrgicamente con resección extensa del tumor de la válvula mitral y de los músculos papilares al cual estaba adherido,se colocó una válvula mitral protésica.El diagnóstico patológico fue de mixoma de la válvula mitral.Este tumor es raro en la infancia,con una localización pocas veces descrita,de carácter benigno,pero potencialmente fatal.An 11 year old boy came in with a 6 months history of intermittent chest pain and a cardiac murmur.An echocardiogram showed a mitral valve mass and mild insufficiency.He underwent an extensive resection of the mitral valve and its papillary muscles,since it was attached to them.A prosthetic mitral valve was implanted.The pathological report was mitral valve myxoma.This type of tumor is unusual during infancy,its location is seldom described,although benign in nature it is potentially fatal.

  16. Surgical Treatment of Mitral-Aortic Incompetence and Aneurysm of the Ascending Aorta in a Child with Marfan's Syndrome: Case Report

    OpenAIRE

    Stellin, Giovanni; Bortolotti, Uberto; Faggian, Giuseppe; Livi, Ugolino; Mazzucco, Alessandro; Frigo, Giuseppe; Gallucci, Vincenzo

    1983-01-01

    A 7-year-old girl with Marfan's syndrome developed severe mitral and aortic valve incompetence and aneurysmatic dilatation of the ascending aorta. She underwent successful replacement of the mitral valve, aortic valve, and ascending aorta with coronary reimplantation. After 3 months of follow-up, she continues to be asymptomatic.

  17. Cardiogenic shock as a complication of acute mitral valve regurgitation following posteromedial papillary muscle infarction in the absence of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Frati Giacomo

    2008-11-01

    Full Text Available Abstract A 48 year old man was transferred to our department with cardiogenic shock, pyrexia, a high white cell count and significant serum troponin T level. Clinical evaluation revealed severe mitral regurgitation secondary to a flail of both mitral valve leaflets. An emergency cardiac catheterisation did not reveal any significant coronary artery disease. Left ventricular angiogram and echocardiography demonstrated a good left ventricular function and massive mitral regurgitation. Blood cultures were negative for aerobics, anaerobics and fungi. The patient underwent emergency mitral valve replacement with a mechanical valve. Intraoperatively, the posteromedial papillary muscle was found to be ruptured. Histology of the papillary muscle revealed myocardial necrosis with no signs of infection. Cultures obtained from a mitral valve specimen were negative. The patient's recovery was uneventful and he was discharged on the 6th postoperative day.

  18. The effect of vaccination against Porcine reproductive and respiratory syndrome virus (PRRSV) on the Porcine circovirus-2 (PCV-2) load in porcine circovirus associated disease (PCVAD) affected pigs

    OpenAIRE

    Genzow, Marika; Schwartz, Kent; Gonzalez, Glenda; Anderson, Gail; Chittick, Wayne

    2009-01-01

    A diagnostic project was initiated across the United States in 2006 to improve the understanding of porcine circovirus associated diseases (PCVAD) as well as to identify co-factors in PCVAD-affected farms. A Porcine circovirus-2 (PCV-2) DNA real-time polymerase chain reaction quantitation (qPCR) was established according to a published method and sera from a total of 23pig farms across the United States were examined for viral loads for PCV-2 and analyzed for any possible effects of Porcine r...

  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. Percutaneous transvenous mitral commissurotomy (PTMC) and percutaneous coronary intervention (PCI) successfully applied in one patient in same sitting.

    Science.gov (United States)

    Sial, Jawaid Akbar; Farman, Muhammad Tariq; Saghir, Tahir; Zaman, Khan Shah

    2011-01-01

    Sixty years old male with severe rheumatic mitral stenosis (MS), presented with dyspnoea New York Heart Association (NHYA) class III to IV. Coronary angiogram revealed severe occlusive coronary artery disease in left anterior coronary artery (LAD). Percutaneous Transvenous Mitral Commissurotomy (PTMC) and Percutaneous Coronary Intervention (PCI) of Left Anterior Descurery (LAD) were done in same sitting. Both procedures were successful and ended without complication. After, half an hour while shifting to coronary care unit (CCU) patient developed cardiac tamponade, which was managed successfully. Patient was followed up for three month, he is doing well and recent echocardiogram showed mild mitral stenosis with normal left ventricular function. This case demonstrates the feasibility of the combined appliance on interventional techniques in selected patients as an alternative to cardiac surgery. PMID:22368914

  3. 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.

  4. miR-375 negatively regulates porcine preadipocyte differentiation by targeting BMPR2.

    Science.gov (United States)

    Liu, Siyuan; Sun, Guangjie; Yuan, Bao; Zhang, Lianjiang; Gao, Yan; Jiang, Hao; Dai, Lisheng; Zhang, Jiabao

    2016-05-01

    The differentiation of preadipocytes into adipose tissues is tightly regulated by various factors including miRNAs and cytokines. In this study, taking advantage of isolated porcine primary preadipocytes, we showed that ectopic expression of miR-375 could change preadipocyte differentiation. In addition, bone morphogenetic protein receptor 2 (BMPR2) was identified as a direct target of miR-375. Silencing BMPR2 had the same inhibition effects as overexpressing miR-375 on the preadipocyte differentiation. Together, we demonstrated that miR-375 is a negative regulator of adipogenic differentiation using porcine primary preadipocytes. These results clarified the role of miR-375 in ex vivo adipogenic differentiation. PMID:27059117

  5. Estudo da reatividade vascular induzida pelo estresse mental na gravidez de mulheres portadoras de estenose mitral Vascular reactivity response to mental stress in pregnant women with mitral stenosis

    Directory of Open Access Journals (Sweden)

    Walkiria Samuel Avila

    2006-08-01

    Full Text Available OBJETIVO: Estudar a reatividade vascular mediante a análise do fluxo sangüíneo e da resistência vascular periférica em repouso e estresse mental na gravidez de mulheres com estenose mitral. MÉTODOS: Foram estudadas 22 mulheres portadoras de estenose mitral, 13 grávidas (GE e 9 não-grávidas (EM, e 9 gestantes saudáveis voluntárias (GN. Na gestação, 9 (GEB das 13 do GE necessitaram de betabloqueador e 4 restantes (GESB evoluíram sem medicação. A plestimografia em repouso e sob estresse mental analisou o fluxo sangüíneo muscular, resistência vascular periférica (RVP, pressão arterial média (PAM e freqüência cardíaca (FC na gestação e no puerpério. RESULTADOS: Na gestação do GESB, os valores do fluxo sangüíneo muscular e da FC foram maiores em 1,6% e 20,5% (p = 0,05, e os da RVP e da PAM foram menores em 19,3% e 4,4%, respectivamente, em comparação ao puerpério; no estresse mental, o fluxo sangüíneo muscular aumentou em 55,9%, a FC reduziu em 30,2% e houve semelhança da RVP e PAM. No GEB, os valores do fluxo e da FC foram maiores em 5,9% e 14,9% (p = 0,001 e os da PAM e da RVP menores em 10,3% e 9,1%, respectivamente, quando comparados ao puerpério; no estresse mental o fluxo e a PAM aumentaram em 69,8% e 174,1%, respectivamente, a FC foi semelhante e a RVP reduziu em 53,7%. O estudo comparativo mostrou que no grupo GN o fluxo sangüíneo muscular foi maior, a RVP menor e houve semelhança na PAM e FC em relação ao grupo GE e que os grupos GE, GN, EM apresentaram semelhança na resposta ao estresse mental. CONCLUSÕES: A reatividade vascular na gestação de mulheres com estenose mitral foi preservada e a análise das medidas mostrou valores menores de fluxo sangüíneo muscular e maiores da RVP quando comparados às gestantes saudáveis.OBJECTIVE: To study vascular reactivity according to the analysis of blood flow and peripheral vascular resistance at rest and during mental stress in pregnant women with

  6. Synthesis of biologically active porcine secretin and [ITyr10] porcine secretin

    DEFF Research Database (Denmark)

    Kofod, Hans

    1991-01-01

    Porcine secretin, [Tyr10] secretin, and [Tyr13] secretin were synthesized by solid phase methodology and purified by stepwise gradient elution from a short reversed-phase column with ethanol and acetic acid as organic modifiers. [Tyr10] secretin and [Tyr13] secretin were iodinated by the chloramine...

  7. Analysis of immunostaining and western blotting of endothelin 1 and its receptors in mitral stenosis

    Directory of Open Access Journals (Sweden)

    Sydney Correia Leão

    2015-04-01

    Full Text Available AbstractIntroduction:Rheumatic Fever represents a serious public health problem in developing countries, with thousands of new cases each year. It is an autoimmune disease, which occurs in response to infection by streptococcus A.Objective:The aim of this study was to evaluate the immunolabeling and protein expression for endothelin-1 and 3 (ET-1, ET-3 and its receptors (ETA, ETB in rheumatic mitral valves.Methods:Immunohistochemistry was used to identify ET-1/ET-3 and ETA/ETB receptors in rheumatic and control mitral valves. Quantitative analysis of immunostaining for ET-1/ET-3 and ETA/ETB receptors was performed. In addition, western blot analysis was carried out to assess protein levels in tissue samples.Results:ET-1 and ETA receptor immunostaining predominated in stenotic valves, mainly associated with fibrotic regions, inflammatory areas and neovascularization. Quantitative analysis showed that the average area with positive expression of ET-1 was 18.21±14.96%. For ETA and ETB, the mean expressed areas were respectively 15.06±13.13% and 9.20±11.09%. ET-3 did not have a significant expression. The correlation between the expression of both endothelin receptors were strongly positive (R=0.74, P=0.02, but the correlation between ET-1 and its receptor were negative for both ETA (R=-0.37, P=0.25, and ETB (R=-0.14, P=0.39. This data was supported by western blot analysis.Conclusion:The strong correlation between ET-1 and its receptors suggests that both play a role in the pathophysiology of rheumatic mitral valve stenosis and may potentially act as biomarkers of this disease.

  8. Cardiac remodeling following percutaneous mitral valve repair. Initial results assessed by cardiovascular magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Radunski, U.K [University Heart Center, Hamburg (Germany). Cardiology; Franzen, O. [Rigshospitalet, Copenhagen (Denmark). Cardiology; Barmeyer, A. [Klinikum Dortmund (Germany). Kardiologie; and others

    2014-10-15

    Percutaneous mitral valve repair with the MitraClip device (Abbott Vascular, Redwood City, California, USA) is a novel therapeutic option in patients with mitral regurgitation. This study evaluated the feasibility of cardiac volume measurements by cardiovascular magnetic resonance imaging (CMR) to assess reverse myocardial remodeling in patients after MitraClip implantation. 12 patients underwent CMR at baseline (BL) before and at 6 months follow-up (FU) after MitraClip implantation. Cine-CMR was performed in short- and long-axes for the assessment of left ventricular (LV), right ventricular (RV) and left atrial (LA) volumes. Assessment of endocardial contours was not compromised by the device-related artifact. No significant differences in observer variances were observed for LV, RV and LA volume measurements between BL and FU. LV end-diastolic (median 127 [IQR 96-150] vs. 112 [86-150] ml/m{sup 2}; p=0.03) and LV end-systolic (82 [54-91] vs. 69 [48-99] ml/m{sup 2}; p=0.03) volume indices decreased significantly from BL to FU. No significant differences were found for RV end-diastolic (94 [75-103] vs. 99 [77-123] ml/m{sup 2}; p=0.91), RV end-systolic (48 [42-80] vs. 51 [40-81] ml/m{sup 2}; p=0.48), and LA (87 [55-124] vs. 92 [48-137]R ml/m{sup 2}; p=0.20) volume indices between BL and FU. CMR enables the assessment of cardiac volumes in patients after MitraClip implantation. Our CMR findings indicate that percutaneous mitral valve repair results in reverse LV but not in RV or LA remodeling.

  9. 3D printed cardiac phantom for procedural planning of a transcatheter native mitral valve replacement

    Science.gov (United States)

    Izzo, Richard L.; O'Hara, Ryan P.; Iyer, Vijay; Hansen, Rose; Meess, Karen M.; Nagesh, S. V. Setlur; Rudin, Stephen; Siddiqui, Adnan H.; Springer, Michael; Ionita, Ciprian N.

    2016-03-01

    3D printing an anatomically accurate, functional flow loop phantom of a patient's cardiac vasculature was used to assist in the surgical planning of one of the first native transcatheter mitral valve replacement (TMVR) procedures. CTA scans were acquired from a patient about to undergo the first minimally-invasive native TMVR procedure at the Gates Vascular Institute in Buffalo, NY. A python scripting library, the Vascular Modeling Toolkit (VMTK), was used to segment the 3D geometry of the patient's cardiac chambers and mitral valve with severe stenosis, calcific in nature. A stereolithographic (STL) mesh was generated and AutoDesk Meshmixer was used to transform the vascular surface into a functioning closed flow loop. A Stratasys Objet 500 Connex3 multi-material printer was used to fabricate the phantom with distinguishable material features of the vasculature and calcified valve. The interventional team performed a mock procedure on the phantom, embedding valve cages in the model and imaging the phantom with a Toshiba Infinix INFX-8000V 5-axis Carm bi-Plane angiography system. Results: After performing the mock-procedure on the cardiac phantom, the cardiologists optimized their transapical surgical approach. The mitral valve stenosis and calcification were clearly visible. The phantom was used to inform the sizing of the valve to be implanted. Conclusion: With advances in image processing and 3D printing technology, it is possible to create realistic patientspecific phantoms which can act as a guide for the interventional team. Using 3D printed phantoms as a valve sizing method shows potential as a more informative technique than typical CTA reconstruction alone.

  10. Análise multivariada dos fatores preditivos de mortalidade hospitalar em reoperação valvar mitral

    OpenAIRE

    Lima Júnior, José Dantas de

    2010-01-01

    Resumo: Introdução: Grande número de pacientes submetidos a procedimentos cirúrgicos sobre a valva mitral deverá requerer nova cirurgia em algum período tardio de sua sobrevida. A abordagem cirúrgica na reoperação valvar mitral necessita grande habilidade da técnica operatória e outros cuidados na abordagem clínica para identificar e tratar os fatores de risco, obtendo, dessa forma, bons resultados. Objetivo: Identificar os fatores preditivos de mortalidade hospitalar em reoperação valvar mit...

  11. First pass radionuclide studies in evaluation of mitral valve replacement in chronic insufficiency using Bjork-Shiley tilting disc valves

    International Nuclear Information System (INIS)

    First pass radionuclide ventriculography is a non-invasive, convenient and safe procedure which may be performed repeatedly. Like invasive heart catheriterization it yields objective data on both right and left ventricular performance as well as on implanted valve function. Therefore, this method can be used to obtain long term follow-up controls in patients with mitral prosthesis. Very important is the technique's objectivity as opposed to the method of classification according to the NYHA. Furthermore, first pass radionuclide ventriculography helps to demonstrate that valve replacement for chronic mitral insufficiency may lead to restoration of normal left ventricular function in many cases

  12. Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Aplin, Mark; Kyhl, Kasper; Bjerre, Jenny;

    2016-01-01

    AIMS: Evaluation of patients with primary mitral valve insufficiency (MI) is best supported by quantitative measures. Cardiovascular magnetic resonance imaging (CMR) offers flow and cardiac chamber volume quantification. We studied cardiac remodelling with CMR to determine MI regurgitation volumes...... (P < 0.05). In surgical patients, the MIVol correlated to the decrease in LV dimension after valve surgery (P < 0.02). CONCLUSION: CMR provides a reproducible quantitative technique for evaluation of MI, as MIVol and cardiac chamber volumes can be held against diagnostic cut-off values. The Aoflow...

  13. Papillary fibroelastoma of the anterior leaflet of the mitral valve mimicking vegetation.

    Science.gov (United States)

    Prifti, Edvin; Ademaj, Fadil; Ikonomi, Majlinda; Demiraj, Aurel

    2015-01-01

    The papillary fibroelastoma (PFE) is a rare and benign primary cardiac tumor, and the most frequently found tumor occurring in the cardiac valves. With the introduction of echocardiography, the diagnosis of these tumors in living patients has been reported sporadically. The PFEs have been found most often on valve leaflets, chordae tendineae, and both ventricles. We describe an interesting case of the PFE originating from the anterior leaflet of the mitral valve mimicking vegetation. The patient underwent successful surgical removal of the PFE. PMID:26187170

  14. Swan ganz catheter for diagnosis of transient central diabetes insipidus after mitral valve replacement

    International Nuclear Information System (INIS)

    Transient Diabetes Insipidus (DI) occurring in a patient undergoing open heart surgery is a rare occurrence. In this case report, we are presenting a 30 years old female patient with past history of stroke who underwent redo mitral valve replacement developed polyuria. The diagnosis of hypovolemia was made with the help of swan ganz catheter. The patient responded to desmopressin and completely recovered seven days after surgery. It is possible that transient cerebral ischemia given her history of Stroke resulted in the dysfunction of osmotic receptors in the hypothalamus or hypothalamus - pituitary axis during Cardiopulmonary Bypass (CPB). Therefore, we concluded that central DI is a probable cause of polyuria after CPB. (author)

  15. Secondary abdominal compartment syndrome required decompression laparotomy during minimally invasive mitral valve repair.

    Science.gov (United States)

    Nishi, Hiroyuki; Toda, Koichi; Miyagawa, Shigeru; Yoshikawa, Yasushi; Fukushima, Satsuki; Yoshioka, Daisuke; Saito, Tetsuya; Sawa, Yoshiki

    2016-12-01

    We treated a 77-year-old patient with secondary abdominal compartment syndrome that caused failure to maintain cardiopulmonary bypass while undergoing elective minimally invasive right mini-thoracotomy mitral valve and tricuspid valve repair procedures. During the operation, a decompression laparotomy was needed to relieve elevated intraabdominal pressure that caused instability of the cardiopulmonary bypass. Due to poor oxygenation and the long cardiopulmonary bypass time, the patient required peripheral extracorporeal membrane oxygenation before recovery. We alert surgeons to this rare complication that can occur even in patients undergoing minimally invasive surgery with a right mini-thoracotomy. PMID:26943679

  16. Utilization of artificial neural networks and autoregressive modeling in diagnosing mitral valve stenosis.

    Science.gov (United States)

    Kara, Sadik; Güven, Ayşegül; Okandan, Mustafa; Dirgenali, Fatma

    2006-05-01

    This research is concentrated on the diagnosis of mitral heart valve stenosis through the analysis of Doppler Signals' AR power spectral density graphic with the help of ANN. Multilayer feedforward ANN trained with a Levenberg Marquart backpropagation algorithm was implemented in the MATLAB environment. Correct classification of 94% was achieved, whereas 4 false classifications have been observed for the test group of 68 subjects in total. The designed classification structure has about 97.3% sensitivity, 90.3% specifity and positive prediction is calculated to be 92.3%. The stated results show that the proposed method can make an effective interpretation. PMID:15890326

  17. 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

  18. 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

  19. 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.

  20. Ortner Syndrome due to Concomitant Mitral Stenosis and Bronchiectasis

    OpenAIRE

    Islam, AKM Monwarul; Zaman, Shahana; Doza, Fatema

    2012-01-01

    Ortner syndrome or cardiovocal syndrome is a rare condition characterized by hoarseness of voice associated with cardiovascular pathology. Compression of the left recurrent laryngeal nerve by the pulmonary artery or left atrium is usually responsible. Recurrent aspiration pneumonia may cause significant morbidity and mortality. Early recognition and treatment along with removal of the underlying cause, if possible, may change an otherwise poor prognosis of the condition. The case presented he...

  1. Studies on Electrical Activation of Porcine Oocytes Matured in vitro and Embryo Culture Systems

    Institute of Scientific and Technical Information of China (English)

    WU Zhong-hong; XING Feng-ying; LIU Guo-shi; ZENG Shen-ming; ZHU Shi-en; ZHANG Zhong-cheng; FU Peng-hui

    2002-01-01

    Conditions for electrical parthenogenetic activation of porcine oocytes matured in vitro and in vitro culture systems of porcine embryo were studied. The best results were achieved under the conditions of electrical field strength and the pulse duration at 130Vmm-1/80 μs, with a blastocyst development rate of (20.12 ± 8.18)% (P > 0.05). No significant difference was found between treatments of multiple pulses and a single pulse ( P > 0.05). Parthenogenetic embryos were cultured with different methods and air conditions for 7 days in vitro, blastocyst development rate of embryos with changed culture media [ (26.44 ± 8.35)% ] or changed media with 10% fetal bovine serum (FBS) [ (17.68 ± 5.39)% ] on the fifth day showing no significant difference from that of embryos without change of culture media [ (25.30 ± 7.55) %, P > 0.05 ], while cell numbers of blastocysts from embryos with changed culture media (15.78 ± 5.46 and 14.55 ± 4.81) were significantly lower than number of blastocysts from embryos without change of culture media (18.01 ± 6.79,P < 0.01 ). Blastocyst development rate and blastocyst cell number of embryos cultured in lower O2 (5 % CO2:7%O2:88%N2) also showed no significant difference from those in high O2 (5% CO2 in air) [ (20.78 ± 8.80) % and 17.00 ± 6.12 vs. (25.30 ± 7.55) % and 18.01 ± 6.79, P > 0.05 ]. It is concluded that change of culture media with the same new one or changing over to media with 10% fetal bovine serum (FBS) on the fifth day and low O2 environment are not necessary for porcine embryos development.

  2. Endoscopic feature tracking for augmented-reality assisted prosthesis selection in mitral valve repair

    Science.gov (United States)

    Engelhardt, Sandy; Kolb, Silvio; De Simone, Raffaele; Karck, Matthias; Meinzer, Hans-Peter; Wolf, Ivo

    2016-03-01

    Mitral valve annuloplasty describes a surgical procedure where an artificial prosthesis is sutured onto the anatomical structure of the mitral annulus to re-establish the valve's functionality. Choosing an appropriate commercially available ring size and shape is a difficult decision the surgeon has to make intraoperatively according to his experience. In our augmented-reality framework, digitalized ring models are superimposed onto endoscopic image streams without using any additional hardware. To place the ring model on the proper position within the endoscopic image plane, a pose estimation is performed that depends on the localization of sutures placed by the surgeon around the leaflet origins and punctured through the stiffer structure of the annulus. In this work, the tissue penetration points are tracked by the real-time capable Lucas Kanade optical flow algorithm. The accuracy and robustness of this tracking algorithm is investigated with respect to the question whether outliers influence the subsequent pose estimation. Our results suggest that optical flow is very stable for a variety of different endoscopic scenes and tracking errors do not affect the position of the superimposed virtual objects in the scene, making this approach a viable candidate for annuloplasty augmented reality-enhanced decision support.

  3. Brain 'Embolism' Detected by Magnetic Resonance Imaging During Percutaneous Mitral Balloon Commissurotomy

    International Nuclear Information System (INIS)

    Purpose: The common finding of thrombi between the bifoil balloons when they were extracted after mitral dilation prompted us to look for evidence of minor brain embolisms using the sensitive technique of BMRI (brain magnetic resonance T2-weighted imaging). Methods: BMRI was performed within 48 hr before and after a percutaneous mitral balloon commissurotomy (PMBC) in each of the 63 patients in this study. Results: There was evidence (hyperintensity foci: HI) of a previous asymptomatic brain embolism in 38 of 63 patients before PMBC and a new HI appeared in 18 of 63 patients after the procedure. New HI signals were found exclusively in the white matter in 8 of 18 patients and in only 3 of 18 were HI signs larger than 1 cm. One patient, with an HI signal >1 cm in the thalamus and another 8; 4, patients from western countries vs the others) were not statistically significant, probably because the number of patients in each subgroup was low. Patients in atrial fibrillation had slightly more (not significant) HI before PMBC (15/20, 75%) than patients in sinus rhythm (23/43, 53%), but after PMBC their HI frequencies were similar (atrial fibrillation: 5/20, 25%; sinus rhythm: 13/43, 30%). Conclusion: Brain microembolism is frequent during PMBC, but is often anatomically limited and free from clinical signs in most cases. Brain embolism seems to be related mainly to the procedure itself and not the features of the patient

  4. Effect of mitral orifice shape on intra-ventricular filling fluid dynamics

    Science.gov (United States)

    Okafor, Ikechukwu; Angirish, Yagna; Yoganathan, Ajit; Santhanakrishnan, Arvind

    2013-11-01

    The natural geometry of the mitral orifice is D-shaped. However, most current designs of prosthetic valves employ O-shaped orifice geometry. The goal of this study was to compare the effect of geometrical modification between the D and O orifice on the intra-ventricular fluid dynamics during diastolic filling. The different mitral orifice geometries were incorporated into an in vitro left heart simulator consisting of a flexible-walled anatomical left ventricle (LV) physical model enclosed in an acrylic housing. Physiological flow rates and pressures were obtained via tuning systemic resistance and compliance elements in the flow loop. A programmable piston pump was used to generate the LV model wall motion. 2D Particle image velocimetry measurements were conducted along multiple longitudinal planes perpendicular to the annulus plane. During peak diastole, the incoming jet width at the LV central plane was smaller for the D-orifice than that of the O-orifice. Further, the core of the vortex ring in the D-orifice was reduced in size compared to that of the O-orifice. The spatiotemporal spreading of the inflow jet as well as the propagation of the vortex ring will be discussed. This study was funded by a grant from the National Heart, Lung and Blood Institute (RO1HL70262).

  5. Tratamiento endovascular de una fuga paraprotésica mitral con dispositivo Amplatzer®

    Directory of Open Access Journals (Sweden)

    Alberto Sciegata

    2012-10-01

    Full Text Available El leak o fuga paraprotésica mitral se presenta entre el 5 y el 17% de los pacientes tratados con cirugía de reemplazo valvular. En general, los defectos son únicos, la mayoría se encuentran localizados en la región postero-medial del anillo valvular y solo la tercera parte produce reflujo de grado grave. El cierre percutáneo por vía endovascular es una alternativa terapéutica válida en pacientes con elevado riesgo para re-operación. La estrategia de abordaje depende de la localización, tamaño, morfología y relaciones adyacentes del o los defectos. El procedimiento debe ser realizado por profesionales con experiencia en el tratamiento de cardiopatías estructurales y en el manejo de estos dispositivos de cierre, y se considera imprescindible la utilización de un ecocardiograma transesofágico tridimensional. Se presenta el caso de un paciente con una fuga paraprotésica valvular mitral que fue cerrada con un dispositivo Amplatzer ® introducido en forma percutánea desde la vena femoral.

  6. Mitral Valve Regurgitation in the LVAD-Assisted Heart Studied in a Mock Circulatory Loop.

    Science.gov (United States)

    May-Newman, K; Fisher, B; Hara, M; Dembitsky, W; Adamson, R

    2016-06-01

    Permanent closure of the aortic valve (AVC) is sometimes performed In LVAD patients, usually when a mechanical valve prosthesis or significant aortic insufficiency is present. Mitral valve regurgitation (MVR) present at the time of LVAD implantation can remain unresolved, representing a limitation for exercise tolerance and a potential predictor of mortality. To investigate the effect of MVR on hemodynamics of the LVAD-supported heart following AVC, studies were performed using a mock circulatory loop. Pressure and flow measured for a range of cardiac function, LVAD speed, and MVR show that cardiac contraction augments aortic pressure by 10-27% over nonpulsatile conditions when the mitral valve functions normally, but decreases with MVR until it reaches the nonpulsatile level. Aortic flow displays a similar trend, demonstrating a 25% decrease from fully functioning to open at 7 krpm, a 5% decrease at 9 krpm, and no observable effect at 11 krpm. Pulsatility decreases with increased LVAD speed and MVR. The data indicate that a modest level of cardiac output (1.5-2 L/min) can be maintained by the native heart through the LVAD when the LVAD is off. These results demonstrate that MVR decreases the augmentation of forward flow by improved cardiac function at lower LVAD speeds. While some level of MVR can be tolerated in LVAD recipients, this condition represents a risk, particularly in those patients that undergo AVC closure, and may warrant repair at the time of surgery. PMID:27008972

  7. Validation of a decision-making strategy for systolic anterior motion following mitral valve repair

    Directory of Open Access Journals (Sweden)

    Landoni Giovanni

    2011-01-01

    Full Text Available Low cardiac output syndrome and hypotension are dreadful consequences of systolic anterior motion (SAM after a mitral valve (MV repair. The management of SAM in the operating room remains controversial. We validate a recently suggested two-step management method and classification of this complication. This was a teaching hospital-based observational study. We validated a novel two-step conservative management method, consisting in intravascular volume expansion and discontinuation of inotropic drugs (step 1, and increasing the afterload by ascending aorta manual compression while administering esmolol e.v. (step 2. We also validate a novel classification of SAM: easy-to-revert (responding to step 1, difficult-to-revert (responding to step 2, or persistent. Fifty patients had an easy-to-revert while 26 had a difficult-to-revert SAM; 4 patients had a persistent condition (promptly diagnosed through our decisional algorithm and underwent an immediate second pump run to repeat the mitral repair surgery. We confirmed that SAM after a repair of a degenerative MV is common and validated a simple two-step conservative management method that allows to clearly identify those few patients who require immediate surgical revision.

  8. A biomimetic bi-leaflet mitral prosthesis with enhanced physiological left ventricular swirl restorative capability

    Science.gov (United States)

    Tan, Sean Guo-Dong; Kim, Sangho; Leo, Hwa Liang

    2016-06-01

    Mechanical heart valve prostheses are often implanted in young patients due to their durability and long-term reliability. However, existing designs are known to induce elevated levels of blood damage and blood platelet activation. As a result, there is a need for patients to undergo chronic anti-coagulation treatment to prevent thrombosis, often resulting in bleeding complications. Furthermore, recent studies have suggested that the implantation of a mechanical prosthetic valve at the mitral position results in a significant alteration of the left ventricular flow field which may contribute to flow turbulence. This study proposes a bi-leaflet mechanical heart valve design (Bio-MHV) that mimics the geometry of a human mitral valve, with the aim of reducing turbulence levels in the left ventricle by replicating physiological flow patterns. An in vitro three-dimensional particle velocimetry imaging experiment was carried out to compare the hemodynamic performance of the Bio-MHV with that of the clinically established ATS valve. The Bio-MHV was found to replicate physiological left ventricular flow patterns and produced lower turbulence levels.

  9. Doppler echocardiographic evaluation of Bjork-Shiley and St. Jude Medical prostheses in the mitral position.

    Directory of Open Access Journals (Sweden)

    Shigenobu,Masaharu

    1991-10-01

    Full Text Available 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 significant difference in the effective orifice area at rest among each sizes of the B-S valve. In the SJM valve, on the contrary, the effective valve orifice area increases in parallel to the size of the SJM valve. There was a clear relation between the valve size and pressure gradient. The pressure gradient directly depends on the valve size and the effective orifice area in the SJM valve. High pressure gradient group in both prostheses had a tendency to take negative values of percent increase in stroke volume. Further, there were no cases showing positive values of percent increase in end-diastolic volume among the patients whose pressure gradients were assumed to be more than 10 mmHg at rest. It is suggested that impairment of inflow caused by the artificial valve, prosthetic valve stenosis, is possibly a significant factor causing left ventricular dysfunction, notably a decrease in stroke volume during exercise.(ABSTRACT TRUNCATED AT 250 WORDS

  10. Prolonged Intracellular Na+ Dynamics Govern Electrical Activity in Accessory Olfactory Bulb Mitral Cells.

    Directory of Open Access Journals (Sweden)

    Asaph Zylbertal

    2015-12-01

    Full Text Available Persistent activity has been reported in many brain areas and is hypothesized to mediate working memory and emotional brain states and to rely upon network or biophysical feedback. Here, we demonstrate a novel mechanism by which persistent neuronal activity can be generated without feedback, relying instead on the slow removal of Na+ from neurons following bursts of activity. We show that mitral cells in the accessory olfactory bulb (AOB, which plays a major role in mammalian social behavior, may respond to a brief sensory stimulation with persistent firing. By combining electrical recordings, Ca2+ and Na+ imaging, and realistic computational modeling, we explored the mechanisms underlying the persistent activity in AOB mitral cells. We found that the exceptionally slow inward current that underlies this activity is governed by prolonged dynamics of intracellular Na+ ([Na+]i, which affects neuronal electrical activity via several pathways. Specifically, elevated dendritic [Na+]i reverses the Na+-Ca2+ exchanger activity, thus modifying the [Ca2+]i set-point. This process, which relies on ubiquitous membrane mechanisms, is likely to play a role in other neuronal types in various brain regions.

  11. Retention of gene expression in porcine islets after agarose encapsulation and long-term culture.

    Science.gov (United States)

    Dumpala, Pradeep R; Holdcraft, Robert W; Martis, Prithy C; Laramore, Melissa A; Parker, Thomas S; Levine, Daniel M; Smith, Barry H; Gazda, Lawrence S

    2016-08-01

    Agarose encapsulation of porcine islets allows extended in vitro culture, providing ample time to determine the functional capacity of the islets and conduct comprehensive microbiological safety testing prior to implantation as a treatment for type 1 diabetes mellitus. However, the effect that agarose encapsulation and long-term culture may have on porcine islet gene expression is unknown. The aim of the present study was to compare the transcriptome of encapsulated porcine islets following long-term in vitro culture against free islets cultured overnight. Global gene expression analysis revealed no significant change in the expression of 98.47% of genes. This indicates that the gene expression profile of free islets is highly conserved following encapsulation and long-term culture. Importantly, the expression levels of genes that code for critical hormones secreted by islets (insulin, glucagon, and somatostatin) as well as transcripts encoding proteins involved in their packaging and secretion are unchanged. While a small number of genes known to play roles in the insulin secretion and insulin signaling pathways are differentially expressed, our results show that overall gene expression is retained following islet isolation, agarose encapsulation, and long-term culture. PMID:27261433

  12. Telomere reprogramming and maintenance in porcine iPS cells.

    Directory of Open Access Journals (Sweden)

    Guangzhen Ji

    Full Text Available Telomere reprogramming and silencing of exogenous genes have been demonstrated in mouse and human induced pluripotent stem cells (iPS cells. Pigs have the potential to provide xenotransplant for humans, and to model and test human diseases. We investigated the telomere length and maintenance in porcine iPS cells generated and cultured under various conditions. Telomere lengths vary among different porcine iPS cell lines, some with telomere elongation and maintenance, and others telomere shortening. Porcine iPS cells with sufficient telomere length maintenance show the ability to differentiate in vivo by teratoma formation test. IPS cells with short or dysfunctional telomeres exhibit reduced ability to form teratomas. Moreover, insufficient telomerase and incomplete telomere reprogramming and/or maintenance link to sustained activation of exogenous genes in porcine iPS cells. In contrast, porcine iPS cells with reduced expression of exogenous genes or partial exogene silencing exhibit insufficient activation of endogenous pluripotent genes and telomerase genes, accompanied by telomere shortening with increasing passages. Moreover, telomere doublets, telomere sister chromatid exchanges and t-circles that presumably are involved in telomere lengthening by recombination also are found in porcine iPS cells. These data suggest that both telomerase-dependent and telomerase-independent mechanisms are involved in telomere reprogramming during induction and passages of porcine iPS cells, but these are insufficient, resulting in increased telomere damage and shortening, and chromosomal instability. Active exogenes might compensate for insufficient activation of endogenous genes and incomplete telomere reprogramming and maintenance of porcine iPS cells. Further understanding of telomere reprogramming and maintenance may help improve the quality of porcine iPS cells.

  13. Nursing supports neonatal porcine testicular development.

    Science.gov (United States)

    Rahman, K M; Lovich, J E; Lam, C; Camp, M E; Wiley, A A; Bartol, F F; Bagnell, C A

    2014-07-01

    The lactocrine hypothesis suggests a mechanism whereby milk-borne bioactive factors delivered to nursing offspring affect development of neonatal tissues. The objective of this study was to assess whether nursing affects testicular development in neonatal boars as reflected by: (1) Sertoli cell number and proliferation measured by GATA-4 expression and proliferating cell nuclear antigen immunostaining patterns; (2) Leydig cell development and steroidogenic activity as reflected by insulin-like factor 3 (INSL3), and P450 side chain cleavage (scc) enzyme expression; and (3) expression of estrogen receptor-alpha (ESR1), vascular endothelial growth factor (VEGF) A, and relaxin family peptide receptor (RXFP) 1. At birth, boars were randomly assigned (n = 6-7/group) to nurse ad libitum or to be pan fed porcine milk replacer for 48 h. Testes were collected from boars at birth, before nursing and from nursed and replacer-fed boars at 50 h on postnatal day (PND) 2. Sertoli cell proliferating cell nuclear antigen labeling index increased (P relaxin family peptide receptor 1 (RXFP1) levels increased (P < 0.01) with age and were greater in replacer-fed boars on PND 2. Results suggest that nursing supports neonatal porcine testicular development and provide additional evidence for the importance of lactocrine signaling in pigs. PMID:24906933

  14. Analysis of porcine MHC expression profile

    Institute of Scientific and Technical Information of China (English)

    JIANG Fanbo; CHEN Chen; DENG Yajun; YU Jun; HU Songnian

    2005-01-01

    The porcine major histocompatibility complex (MHC, also named swine leukocyte antigen, SLA) is associated not only with immune responsibility and disease susceptibility, but also with some reproductive and productive traits such as growth rate and carcass composition. As yet systematical research on SLA expression profile is not reported. In order to illustrate SLA expression comprehensively and deepen our understanding of its function, we outlined the expression profile of SLA in 51 tissues of Landrace by analyzing a large amount of ESTs produced by "Sino-Danish Porcine Genome Project". In addition, we also compared the expression profile of SLA in several tissues from different development stages and from another breed (Erhualian). The result shows: (i) classical SLA genes are highly expressed in immune tissues and middle part of intestine; (ii) although SLA-3 is an SLA Ia gene, its expression abundance and pattern are quite different from those of the other two SLA Ia genes. The same phenomenon is seen in HLA-C expression, suggesting that the two genes may function similarly and undergo convergent evolution; (iii) except in jejunum, the antigen presenting genes are more highly expressed in breed Erhualian than in Landrace. The difference might associate with the higher resistance to bad conditions (including pathogens) of Erhualian and higher growth rates of Landrace.

  15. Phylogeny and evolution of porcine parvovirus.

    Science.gov (United States)

    Ren, Xiaofeng; Tao, Ye; Cui, Jin; Suo, Siqingaowa; Cong, Yingying; Tijssen, Peter

    2013-12-26

    Porcine parvovirus (PPV), a member of the genus Parvovirus, family Parvoviridae, is a significant causative agent in porcine reproductive failure, causing serious economic losses in the swine industry. Previous phylogenetic studies based on the NS1 or VP2 genes indicated that current PPV strains diverged 30 years ago and that VP2 was under neutral or positive selection. Our analysis of NS1, VP2 and complete ORFs indicated that the most recent common ancestor of PPV strains existed about 250 years ago and that the 127-nt repeat in the 3'NTR was present in viruses of some subclades that evolved about 80 years ago. Nucleotide substitution rates of NS1 and VP2 genes were 3.03 × 10(-5) and 1.07 × 10(-4), respectively. Both the NS1 and VP2 proteins were under purifying selection and recombination did not contribute to the genetic diversity of PPV. As expected, surface amino acids are hydrophilic and make up the majority of mutations in the VP2 protein; residues in VP2 interfaces were substituted gradually, often in conjunction with complementary substitutions in the neighboring VP2. PMID:24050995

  16. Molecular epidemiology and evolution of porcine parvoviruses.

    Science.gov (United States)

    Streck, André Felipe; Canal, Cláudio Wageck; Truyen, Uwe

    2015-12-01

    Porcine parvovirus (PPV), recently named Ungulate protoparvovirus 1, is considered to be one of the most important causes of reproductive failure in swine. Fetal death, mummification, stillbirths and delayed return to estrus are predominant clinical signs commonly associated with PPV infection in a herd. It has recently been shown that certain parvoviruses exhibit a nucleotide substitution rate close to that commonly determined for RNA viruses. However, the PPV vaccines broadly used in the last 30 years have most likely reduced the genetic diversity of the virus and led to the predominance of strains with a capsid profile distinct from that of the original vaccine-based strains. Furthermore, a number of novel porcine parvovirus species with yet-unknown veterinary relevance and characteristics have been described during the last decade. In this review, an overview of PPV molecular evolution is presented, highlighting characteristics of the various genetic elements, their evolutionary rate and the discovery of new capsid profiles driven by the currently used vaccines. PMID:26453771

  17. Phenotypic and Functional Analysis of Porcine T Lymphocytes

    Institute of Scientific and Technical Information of China (English)

    李华; 陈应华

    2001-01-01

    Porcine and other higher mammals express clusters of differentiation (CD) antigens on the surface of T lymphocytes, such as CD2, CD3, CD4, CD8, etc. However, in porcine, a high percentage of the CD4+ CD8-T lymphocyte subpopulation exist in the peripheral blood and the ratio of the CD4+ and CD8+ T lymphocyte subpopulations is reversed. These differences bring new challenges to better understanding of the phenotype and function of porcine T lymphocytes in antigen recognition and immune response.

  18. Edge-to-edge percutaneous repair of severe mitral regurgitation--state-of-the-art for Mitraclip® implantation

    DEFF Research Database (Denmark)

    Alegria-Barrero, Eduardo; Chan, Pak Hei; Paulo, Manuel; Duncan, Alison; Price, Susana; Moat, Neil; Di Mario, Carlo; Serra, Antoni; García, Eulogio; Franzen, Olaf

    2012-01-01

    MitraClip® therapy is a percutaneous edge-to-edge plication of the mitral leaflets, mimicking the Alfieri surgical technique. MitraClip® implantation is a safe procedure, and survival outcomes in high-surgical-risk patients are superior to historical controls. Despite these results, questions...

  19. Brain-natriuretic peptide and cyclic guanosine monophosphate as biomarkers of myxomatous mitral valve disease in dogs

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Falk, Bo Torkel; Teerlink, Tom; Guðmundsdóttir, Halldóra Hrund; Sigurðardóttir, Sif; Rasmussen, Caroline Elisabeth; Olsen, Lisbeth Høier

    2011-01-01

    Elevations in the plasma concentrations of natriuretic peptides correlate with increased severity of myxomatous mitral valve disease (MMVD) in dogs. This study correlates the severity of MMVD with the plasma concentrations of the biomarkers N-terminal fragment of the pro-brain-natriuretic peptide...

  20. A meta-analysis of MitraClip system versus surgery for treatment of severe mitral regurgitation

    DEFF Research Database (Denmark)

    Wan, Benjamin; Rahnavardi, Mohammad; Tian, David H;

    2013-01-01

    BACKGROUND: Mitral regurgitation (MR) is the second most common valvular heart disease after aortic stenosis. Without intervention, prognosis is poor in patients with severe symptomatic MR. While surgical repair is recommended for many patients with severe degenerative MR (DMR), as many as 49% of...

  1. Effect of gender on results of percutaneous edge-to-edge mitral valve repair with MitraClip system

    DEFF Research Database (Denmark)

    Estévez-Loureiro, Rodrigo; Settergren, Magnus; Winter, Reidar; Jacobsen, Per; Dall'Ara, Gianni; Sondergaard, Lars; Cheung, Gary; Pighi, Michele; Ghione, Matteo; Ihlemann, Nikolaj; Moat, Neil E; Price, Susanna; Rosenberg, Tine Streit; Di Mario, Carlo; Franzen, Olaf

    2015-01-01

    Knowledge regarding gender-specific results of percutaneous edge-to-edge mitral valve repair is scarce. The aim of this study was to investigate gender differences in outcomes in a cohort of patients treated with MitraClip implantation. A multicenter registry of 173 patients treated with Mitra...... and effective treatment of MR in men and women....

  2. Evaluation of the Human Host Range of Bovine and Porcine Viruses that may Contaminate Bovine Serum and Porcine Trypsin Used in the Manufacture of Biological Products

    OpenAIRE

    Marcus-Sekura, Carol; Richardson, James C.; Rebecca K. Harston; Sane, Nandini; Sheets, Rebecca L.

    2011-01-01

    Current U.S. requirements for testing cell substrates used in production of human biological products for contamination with bovine and porcine viruses are U.S. Department of Agriculture (USDA) 9CFR tests for bovine serum or porcine trypsin. 9CFR requires testing of bovine serum for seven specific viruses in six families (immunofluorescence) and at least 2 additional families non-specifically (cytopathicity and hemadsorption). 9CFR testing of porcine trypsin is for porcine parvovirus. Recent ...

  3. Advances in the understanding of the pathogenesis, progression and diagnosis of myxomatous mitral valve disease in dogs

    Directory of Open Access Journals (Sweden)

    Richard K. Burchell

    2014-02-01

    Full Text Available A number of key questions remain unanswered in the pathogenesis of myxomatous mitralvalve disease (MMVD. As MMVD typically afflicts small-breed dogs, a genetic basis hasbeen implied. In addition, the fact that not all dogs within a risk group develop MMVDis still unexplained. Research into the pathogenesis of MMVD typically falls under threecategorical divisions, namely genetic factors, mechanical factors of the valve and systemicfactors. Genetic studies have implicated certain loci in the pathogenesis of MMVD. Ofparticular interest is the insulin-like growth factor (IGF-1 locus, as IGF-1 is also associatedwith growth. The mechanical structure and function of the mitral valve have also receivedmuch attention in recent years. What has emerged is the notion of a highly complex dynamicstructure, which has an uneven distribution of stress and strain according to the flow ofblood. Research efforts have also identified a number of systemic factors such as cytokinesand signalling pathways that may contribute to the failure of the valve. Serotonin remainsan area of interest in this field. Taken together, the amalgamation of research efforts inthese three areas will go a long way towards resolving the understanding of this disease.Another area of focus in MMVD has been the development of clinical tests to diagnose theonset of congestive heart failure. To this end, echocardiographic indices and biochemicalmarkers have been investigated. Echocardiographic indices such as left atrial to aortic ratioand the N-terminal of the prohormone brain natriuretic peptide (NT-proBNP have beenidentified as specific risk factors to predict progression. Advanced imaging studies such ascardiac magnetic resonance imaging have enabled investigators to determine the earliestremodelling changes that occur in MMVD.

  4. Risk Factors Associated with the Incidence and Progression of Mitral Annulus Calcification: The Multi-Ethnic Study of Atherosclerosis

    Science.gov (United States)

    Elmariah, Sammy; Budoff, Matthew J.; Delaney, Joseph A. C.; Hamirani, Yasmin; Eng, John; Fuster, Valentin; Kronmal, Richard A.; Halperin, Jonathan L.; O’Brien, Kevin D.

    2013-01-01

    Background Significant cardiovascular morbidity has been associated with mitral annulus calcification (MAC), but limited data exist regarding its progression. The purpose of this study was to examine the natural history of and risk factors for MAC progression. Methods The Multi-Ethnic Study of Atherosclerosis (MESA) is a longitudinal cohort study of participants aged 45–84 years without clinical cardiovascular disease who underwent serial cardiac computed tomography studies with quantification of MAC. Regression models were used to identify risk factors associated with MAC incidence and progression. Results Prevalent MAC was observed in 534 of 5,895 (9%) participants. Over a median 2.3 years, 280 (5%) developed incident MAC. After adjustment, age was the strongest predictor of incident MAC (adjusted OR, 2.25 per 10 yrs; 95% CI, 1.97 to 2.58; P<0.0001). Female gender, white ethnicity, body mass index, diabetes, hypertension, hyperlipidemia, serum cholesterol, smoking, and interleukin-6 were also significant predictors of incident MAC. In participants with prevalent MAC, the median rate of change was 10.1 [IQR, −6.7, 60.7] Agatston units (AU)/year. Baseline MAC severity was the predominant predictor of rate of MAC progression (β-coefficient per 10 AU, 0.88; 95% CI, 0.85 to 0.91; P<0.0001), although ethnicity and smoking status possessed modest influence. Conclusions Several cardiovascular risk factors predicted incident MAC, as did female gender. Severity of baseline MAC was the primary predictor of MAC progression, suggesting that, while atherosclerotic processes may initiate MAC, they are only modestly associated with its progression over these time frames. PMID:24176447

  5. Mitral E wave deceleration time to peak E velocity ratio and cardiovascular outcome in hypertensive patients during antihypertensive treatment (from the LIFE echo-substudy)

    DEFF Research Database (Denmark)

    Chinali, Marcello; Aurigemma, Gerard P; de Simone, Giovanni;

    2009-01-01

    .01). Unadjusted Cox regression analysis showed a positive association between the baseline MDI and CV events (hazard ratio 1.21, 95% confidence interval 1.07 to 1.37, p = 0.002). In the time-varied Cox models, a greater in-treatment MDI was associated with a greater rate of CV events (hazard ratio 1.43, 95...... for mitral peak E-velocity (mitral deceleration index [MDI]) might better predict incident cardiovascular (CV) events in hypertensive patients during treatment compared to DTE alone or other traditional indexes of diastolic function, such as the mitral E/A ratio. We evaluated 770 hypertensive patients...

  6. Meta-analysis of concomitant mitral valve repair and coronary artery bypass surgery versus isolated coronary artery bypass surgery in patients with moderate ischaemic mitral regurgitation.

    Science.gov (United States)

    Kopjar, Tomislav; Gasparovic, Hrvoje; Mestres, Carlos A; Milicic, Davor; Biocina, Bojan

    2016-08-01

    Ischaemic mitral regurgitation (IMR) is a complication of coronary artery disease with normal chordal and leaflet morphology. Controversy surrounds the issue of appropriate surgical management of moderate IMR. With the present meta-analysis, we aimed to determine whether the addition of mitral valve (MV) repair to coronary artery bypass grafting (CABG) improved clinical outcome over CABG alone in patients with moderate IMR. Databases were searched for studies reporting on clinical outcomes after CABG and MV repair or CABG alone for moderate IMR. Clinical end-points were operative mortality, survival, New York Heart Association (NYHA) class ≥2 and MR grade ≥2 at last follow-up. A total of five observational and four randomized controlled trials (RCTs) were identified. The mean follow-up was 2.7 years. An analysis of all studies revealed increased operative risk in the concomitant CABG and MV repair group {risk ratio [RR] 2.02 [95% confidence interval (CI) 1.15, 3.56], P = 0.01, I(2) = 0%}. However, an analysis of RCTs only showed that the operative risk was equivalent [RR 1.05 (95% CI 0.34, 3.30), P = 0.93, I(2) = 0%]. Pooled hazard ratio (HR) on survival did not favour either procedure [all studies: HR 1.08 (95% CI 0.77, 1.50), P = 0.66, I(2) = 0%; RCTs only: HR 0.89 (95% CI 0.47, 1.70), P = 0.73, I(2) = 0%]. The incidence of exercise intolerance quantified as NYHA class ≥2 was similar between groups (all studies: RR 0.72 (95% CI 0.42, 1.24), P = 0.24, I(2) = 77%; RCTs only: RR 0.61 (95% CI 0.24, 1.55), P = 0.30, I(2) = 83%]. Risk of residual MR grade ≥2 was higher in the CABG only group [all studies: RR 0.30 (95% CI 0.16, 0.60), P < 0.001, I(2) = 83%; RCTs only: RR 0.20 (95% CI 0.04, 0.90), P = 0.04, I(2) = 72%]. There is neither increased operative mortality nor survival benefit associated with concomitant CABG and MV repair for IMR of moderate degree over CABG alone. Further studies with long-term follow-up data and sub-group analyses of current data are

  7. MitraClip therapy in mitral regurgitation: a Markov model for the cost-effectiveness of a new therapeutic option.

    Science.gov (United States)

    Guerin, Patrice; Bourguignon, Sandrine; Jamet, Nicolas; Marque, Sébastien

    2016-07-01

    Introduction Mitral regurgitation is a heart condition resulting from blood flowing from the left ventricle towards the left atrium, increasing the risk of heart failure and mortality. While surgery can greatly reduce these risks, some patients are not eligible, resulting in medication being their only therapeutic alternative. The MitraClip (Abbot Vascular) is a medical device that is percutaneously implanted and designed to eliminate leaking of the mitral valve. Methods The efficacy of the MitraClip strategy vs medical management was assessed using a 4-state Markov model based on the mitral regurgitation grade (mitral regurgitation grade 0, I/II, and III/IV, and death). At each 1-month cycle, patients were or were not hospitalized. The model analyzed a fictional population of 1000 patients over a 5-year period from a national Health Insurance perspective. The primary end-point was the number of deaths avoided. Data from the EVEREST II High Risk Study patients were used along with a literature review. Results At 5 years, among the 1000 patients, 276 deaths were found to be avoidable with the MitraClip strategy. The incremental cost-effectiveness ratio (ICER) was €93,363 per death avoided. The annual ICER was calculated to take into consideration excess costs resulting from the MitraClip over the first year (€29,984 vs €8557 for the reference strategy) and the reduction of costs in following years (€3122 for MitraClip vs €8557 for reference strategy). Thus, the mean ICER was calculated to be €20,720 per death avoided. Conclusion The MitraClip is a novel alternative therapy for mitral insufficiency in patients ineligible for surgery that may offer a medico-economic advantage. PMID:26909557

  8. Fluid-Structure Interaction Analysis of Papillary Muscle Forces Using a Comprehensive Mitral Valve Model with 3D Chordal Structure.

    Science.gov (United States)

    Toma, Milan; Jensen, Morten Ø; Einstein, Daniel R; Yoganathan, Ajit P; Cochran, Richard P; Kunzelman, Karyn S

    2016-04-01

    Numerical models of native heart valves are being used to study valve biomechanics to aid design and development of repair procedures and replacement devices. These models have evolved from simple two-dimensional approximations to complex three-dimensional, fully coupled fluid-structure interaction (FSI) systems. Such simulations are useful for predicting the mechanical and hemodynamic loading on implanted valve devices. A current challenge for improving the accuracy of these predictions is choosing and implementing modeling boundary conditions. In order to address this challenge, we are utilizing an advanced in vitro system to validate FSI conditions for the mitral valve system. Explanted ovine mitral valves were mounted in an in vitro setup, and structural data for the mitral valve was acquired with [Formula: see text]CT. Experimental data from the in vitro ovine mitral valve system were used to validate the computational model. As the valve closes, the hemodynamic data, high speed leaflet dynamics, and force vectors from the in vitro system were compared to the results of the FSI simulation computational model. The total force of 2.6 N per papillary muscle is matched by the computational model. In vitro and in vivo force measurements enable validating and adjusting material parameters to improve the accuracy of computational models. The simulations can then be used to answer questions that are otherwise not possible to investigate experimentally. This work is important to maximize the validity of computational models of not just the mitral valve, but any biomechanical aspect using computational simulation in designing medical devices. PMID:26183963

  9. Biological and binding activities of ovine and porcine prolactins in porcine mammary tissue

    International Nuclear Information System (INIS)

    The concentration of prolactin receptors may play a critical role in regulating growth and development of the mammary gland during gestation and tumor development; however, the discrepancy between specific binding of ovine prolactin (oPRL) and porcine prolactin (pPRL) in porcine mammary tissue was disturbing. It was possible that 125I-oPRL may be an unsuitable ligand for the procine prolactin receptor. The validate the use of oPRL in binding assays, the biological and binding activities of oPRL and pPRL were compared. A lactogenic bioassay of pPRL was developed using porcine mammary explants cultured in Medium 199 containing insulin, cortisol, and pPRL. The potencies of oPRL and pPRL were compared using this bioassay. Oxidation of glucose and incorporation of glucose into lipids were similarly enhanced by physiological concentrations of both oPRL and pPRL. However, specific binding of 125I-oPRL was 20%, while less than 1% of 125I-pPRL was bound. 125I-oPRL bound to high affinity sites

  10. Porcine aminopeptidase N mediated polarized infection by porcine epidemic diarrhea virus in target cells

    International Nuclear Information System (INIS)

    Infection of polarized intestinal epithelial cells by porcine epidemic diarrhea virus (PEDV) was characterized. Indirect immunofluorescence assay, real-time PCR, and transmission electron microscopy confirmed PEDV can be successfully propagated in immortalized swine small intestine epithelial cells (IECs). Infection involved porcine aminpeptidase N (pAPN), a reported cellular receptor for PEDV, transient expression of pAPN and siRNA targeted pAPN increased and decreased the infectivity of PEDV in IECs, respectively. Subsequently, polarized entry into and release from both Vero E6 and IECs was analyzed. PEDV entry into polarized cells and pAPN grown on membrane inserts occurs via apical membrane. The progeny virus released into the medium was also quantified which demonstrated that PEDV is preferentially released from the apical membrane. Collectively, our data demonstrate that pAPN, the cellular receptor for PEDV, mediates polarized PEDV infection. These results imply the possibility that PEDV infection may proceed by lateral spread of virus in intestinal epithelial cells. - Highlights: • PEDV infection of polarized intestinal epithelial cells (IECs) was characterized. • Porcine aminpeptidase N (pAPN) facilitated PEDV infection in IECs. • PEDV entry into and release from polarized cell via its apical membrane. • PEDV infection may proceed by lateral spread of virus in IECs

  11. Porcine aminopeptidase N mediated polarized infection by porcine epidemic diarrhea virus in target cells

    Energy Technology Data Exchange (ETDEWEB)

    Cong, Yingying; Li, Xiaoxue; Bai, Yunyun [College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030 (China); Lv, Xiaonan [College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030 (China); CAS Key Lab for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience & Technology of China, Beijing 100090 (China); Herrler, Georg [Institute for Virology, University of Veterinary Medicine, Hannover D-30559 (Germany); Enjuanes, Luis [Department of Molecular and Cell Biology, Centro Nacional de Biotecnología (CNB-CSIC), Campus Universidad Autónoma de Madrid, Cantoblanco, Madrid (Spain); Zhou, Xingdong [College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030 (China); Qu, Bo [Faculty of Life Sciences, Northeast Agricultural University, Harbin 150030 (China); Meng, Fandan [Institute for Virology, University of Veterinary Medicine, Hannover D-30559 (Germany); Cong, Chengcheng [College Animal Husbandry and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110161 (China); Ren, Xiaofeng; Li, Guangxing [College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030 (China)

    2015-04-15

    Infection of polarized intestinal epithelial cells by porcine epidemic diarrhea virus (PEDV) was characterized. Indirect immunofluorescence assay, real-time PCR, and transmission electron microscopy confirmed PEDV can be successfully propagated in immortalized swine small intestine epithelial cells (IECs). Infection involved porcine aminpeptidase N (pAPN), a reported cellular receptor for PEDV, transient expression of pAPN and siRNA targeted pAPN increased and decreased the infectivity of PEDV in IECs, respectively. Subsequently, polarized entry into and release from both Vero E6 and IECs was analyzed. PEDV entry into polarized cells and pAPN grown on membrane inserts occurs via apical membrane. The progeny virus released into the medium was also quantified which demonstrated that PEDV is preferentially released from the apical membrane. Collectively, our data demonstrate that pAPN, the cellular receptor for PEDV, mediates polarized PEDV infection. These results imply the possibility that PEDV infection may proceed by lateral spread of virus in intestinal epithelial cells. - Highlights: • PEDV infection of polarized intestinal epithelial cells (IECs) was characterized. • Porcine aminpeptidase N (pAPN) facilitated PEDV infection in IECs. • PEDV entry into and release from polarized cell via its apical membrane. • PEDV infection may proceed by lateral spread of virus in IECs.

  12. Gastrin-releasing peptide in the porcine pancreas

    DEFF Research Database (Denmark)

    Holst, J J; Poulsen, Steen Seier

    1987-01-01

    to consist of one main form, namely the 27-amino acid peptide originally extracted from porcine stomach, and small amounts of a C-terminal fragment identical with the C-terminal 10-amino acid peptide. Gastrin-releasing peptide-like immunoreactivity released from the isolated perfused porcine pancreas during...... electrical vagal stimulation was shown by gel filtration to consist of the same two forms. By use of immunocytochemical techniques employing an antiserum directed against its N terminus, GRP was localized to varicose nerve fibers in close association with the exocrine tissue of the porcine pancreas...... in particular. Some fibers were found penetrating into pancreatic islets also. Immunoreactive nerve cell bodies as well as fibers were found within intrapancreatic ganglia. The potency of GRP in stimulating exocrine as well as endocrine secretion from the porcine pancreas, its presence in close contact...

  13. The neutrophil to lymphocyte ratio is associated with severity of rheumatic mitral valve stenosis

    Directory of Open Access Journals (Sweden)

    Baysal E

    2015-05-01

    Full Text Available Erkan Baysal,1 Cengiz Burak,2 Serkan Cay,2 Tolga Aksu,3 Bernas Altintaş,1 Bariş Yaylak,1 Utkan Sevük,4 Önder Bilge1 1Department of Cardiology, Diyarbakir Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey; 2Department of Cardiology, Ankara Yüksek Ihtisas Education and Research Hospital, Ankara, Turkey; 3Department of Cardiology, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey; 4Department of Cardiovascular Surgery, Diyarbakir Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey Background: Rheumatic heart disease (RHD is a serious health concern in developing countries. Rheumatic mitral stenosis (RMS is the most long-term sequel in RHD. The neutrophil to lymphocyte ratio (NLR is a novel marker, and a higher NLR has been associated with poor clinical outcomes in various cardiovascular disorders. We evaluated the availability of NLR to predict severity of mitral stenosis (MS in patients with RHD. Methods: We analyzed 300 consecutive patients with RMS. The patients were divided into tertiles according to NLR: 0.85< NLR ≤1.85 (n=100, tertile 1, 1.86≤ NLR ≤2.46 (n=100, tertile 2, and 2.47≤ NLR ≤7.08 (n=100, tertile 3. Patients with RMS were divided into three groups based on the degree of MS as mild, moderate, and severe MS. After the initial evaluation, 187 patients with moderate-to-severe RMS (Group 1 and 113 patients with mild RMS (Group 2 were reassessed. Results: The patients with severe RMS had significantly elevated NLR, mean platelet volume, and pulmonary artery systolic pressure values compared to patients with moderate and mild MS (P<0.001, P<0.001, P<0.001 respectively. Multivariate binary logistic regression analysis revealed that high levels of NLR was an independent predictor of severe RMS (odds ratio =0.68, P=0.008. Moderate-to-severe RMS incidence was significantly higher among patients in the tertile 3 (odds ratio =2.8, P=0.001. Conclusion: NLR is a new inflammatory marker

  14. Surgery of secondary mitral insufficiency in patients with impaired left ventricular function

    Directory of Open Access Journals (Sweden)

    Weber Raluca

    2009-07-01

    Full Text Available Abstract Background Secondary mitral insufficiency (SMI is an indicator of a poor prognosis in patients with ischemic and dilated cardiomyopathies. Numerous studies corroborated that mitral valve (MV surgery improves survival and may be an alternative to heart transplantation in this group of patients. The aim of the study was to retrospectively analyze the early and mid-term clinical results after MV repair resp. replacement in patients with moderate-severe to severe SMI and left ventricular ejection fraction (LVEF below 35%. Methods We investigated 40 patients with poor LVEF (mean, 28 ± 5% and SMI who underwent MV repair (n = 26 resp. replacement (n = 14 at the University Hospital Muenster from January 1994 to December 2005. All patients were on maximized heart failure medication. 6 pts. had prior coronary artery bypass grafts (CABG. Twenty-seven patients were in New York Heart Association (NYHA class III and 13 were in class IV. Eight patients were initially considered for transplantation. During the operation, 14 pts had CABG for incidental disease and 8 had tricuspid valve repair. Follow-up included echocardiography, ECG, and physician's examination and was completed in 90% among survivors. Additionally, the late results were compared with the survival after orthotope heart transplantation (oHTX in adults with ischemic or dilated cardiomyopathies matched to the same age and time period (148 patients. Results Three operative deaths (7.5% occurred as a result of left ventricular failure in one and multiorgan failure in two patients. There were 14 late deaths, 2 to 67 months after MV procedure. Progress of heart failure was the main cause of death. 18 patients who were still alive took part on the follow-up examination. At a mean follow-up of 50 ± 34 (2–112 months the NYHA class improved significantly from 3.2 ± 0.5 to 2.2 ± 0.4 (p 0.05. Conclusion High risk mitral valve surgery in patients with cardiomyopathy and SMI offers a real mid

  15. Quantification of mitral regurgitation on cardiac computed tomography: comparison with qualitative and quantitative echocardiographic parameters.

    LENUS (Irish Health Repository)

    Arnous, Samer

    2012-02-01

    PURPOSE: To assess whether cardiac computed tomographic angiography (CCTA) can quantify the severity of chronic mitral regurgitation (MR) compared to qualitative and quantitative echocardiographic parameters. MATERIALS AND METHODS: Cardiac computed tomographic angiography was performed in 23 patients (mean +\\/- SD age, 63 +\\/- 16 years; range, 24-86 years) with MR and 20 patients without MR (controls) as determined by transthoracic echocardiography. Multiphasic reconstructions (20 data sets reconstructed at 5% increments of the electrocardiographic gated R-R interval) were used to analyze the mitral valve. Using CCTA planimetry, 2 readers measured the regurgitant mitral orifice area (CCTA ROA) during systole. A qualitative echocardiographic assessment of severity of MR was made by visual assessment of the length of the regurgitant jet. Quantitative echocardiographic measurements included the vena contracta, proximal isovelocity surface area, regurgitant volume, and estimated regurgitant orifice (ERO). Comparisons were performed using the independent t test, and correlations were assessed using the Spearman rank test. RESULTS: All controls and the patients with MR were correctly identified by CCTA. For patients with mild, moderate, or severe MR, mean +\\/- SD EROs were 0.16 +\\/- 0.03, 0.31 +\\/- 0.08, and 0.52 +\\/- 0.03 cm(2) (P < 0.0001) compared with mean +\\/- SD CCTA ROAs 0.09 +\\/- 0.05, 0.30 +\\/- 0.04, and 0.97 +\\/- 0.26 cm(2) (P < 0.0001), respectively. When echocardiographic measurements were graded qualitatively as mild, moderate, or severe, strong correlations were seen with CCTA ROA (R = 0.89; P < 0.001). When echocardiographic measurements were graded quantitatively, the vena contracta and the ERO showed modest correlations with CCTA ROA (0.48 and 0.50; P < 0.05 for both). Neither the proximal isovelocity surface area nor the regurgitant volume demonstrated significant correlations with CCTA ROA. CONCLUSIONS: Single-source 64-slice CCTA provides a

  16. Porcine Bocavirus: Achievements in the Past Five Years

    OpenAIRE

    Feng Zhou; Haoting Sun; Yuyan Wang

    2014-01-01

    Porcine bocavirus is a recently discovered virus that infects pigs and is classified within the Bocavirus genus (family Parvoviridae, subfamily Parvovirinae). The viral genome constitutes linear single-stranded DNA and has three open reading frames that encode four proteins: NS1, NP1, VP1, and VP2. There have been more than seven genotypes discovered to date. These genotypes have been classified into three groups based on VP1 sequence. Porcine bocavirus is much more prevalent in piglets that ...

  17. A Large Chondroitin Sulfate Proteoglycan, Versican, in Porcine Predentin

    OpenAIRE

    Okahata, Saori; Yamamoto, Ryuji; Yamakoshi, Yasuo; Fukae, Makoto

    2011-01-01

    Proteoglycans and their constituent glycosaminoglycan (GAG) have been proposed to be involved in the inhibition of mineralization in unmineralized tissue, predentin. Among the proteoglycans secreted by odontoblasts, we focused on the large chondroitin sulfate proteoglycan, versican, for its large binding capacity for calcium ions. The aims of this study were the determination of the full-length sequence and splicing variants of the porcine versican, and the detection of versican in the porcin...

  18. Immunological half-life of porcine proinsulin C-peptide

    International Nuclear Information System (INIS)

    Immunological half-lifes of injected porcine C-peptide and insulin with RIA were studied and calculated as 9.8 and 8.0 minutes. Higher circulating levels of C-peptide as compared to insulin in normal young swines lead to speculation about a longer half-life of C-peptide. This hypothesis was verified in this study. Immunological half-lifes of porcine proinsulin and insulin in the pig were 20 and 6 minutes, respectively. (GSE)

  19. A novel porcine bocavirus harbors a variant NP gene

    OpenAIRE

    Yoo, Sung J; Sunwoo, Sun Young; Ko, Seong Sik; Je, Sang H; Lee, Dong Uk; Lyoo, Young S

    2015-01-01

    Background Porcine bocavirus is classified within the genus Bocaparvovirus, family Parvoviridae. Unlike other parvoviruses, the members of genus Bocaparvovirus (bocaparvoviruses) encode an additional open reading frame (NP1). Many strains of PBoVs have been identified in domestic pigs and recognized as a potential emerging pathogen causing respiratory and gastrointestinal disease. Findings A new strain of porcine bocavirus (PBoV) that harbored the shortest NP1 gene among all currently charact...

  20. Structural Determination and Daily Variations of Porcine Milk Oligosaccharides

    OpenAIRE

    Tao, Nannan; Ochonicky, Karen L.; German, J Bruce; Donovan, Sharon M.; Lebrilla, Carlito B.

    2010-01-01

    Free milk oligosaccharides (OS) is a major component of mammalian milk. Swine are important agricultural species and biomedical models. Despite their importance, little is known of the OS profile of porcine milk. Herein, the porcine milk glycome was elucidated and monitored over the entire lactation period by liquid chromatography profiling and structural determination with mass spectrometry. Milk was collected from second parity sows (n=3) at farrowing and on days 1, 4, 7 and 24 of lactation...