1/61. Malfunction of a Bjork-Shiley prosthetic heart valve in the mitral position producing an abnormal echocardiographic pattern.This report presents an echocardiographic study of a patient with fibrous ingrowth about the sewing ring and hinges of a Bjork-Shiley valve in the mitral position. The valve was obstructed and produced a distinct motion pattern. In addition to having a rounded diastolic motion, the disk excursion was decreased.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/61. Transient severe mitral regurgitation complicating myocardial stunning due to coronary vasospasm.As in papillary muscle dysfunction complicating mitral prolapse, dyskinesis of the left ventricular wall underlying the papillary muscles has been shown to cause mitral regurgitation following myocardial infarction. myocardial stunning has been experimentally evidenced to cause mitral regurgitation due to a wall motion abnormality, but it has not yet been clinically defined. We report a clinical case of transient severe mitral regurgitation complicating myocardial stunning caused by coronary vasospasm. Transient wall motion abnormality beneath the anterolateral papillary muscle was considered to be responsible for the mitral regurgitation.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/61. Severe intermittent intraprosthetic regurgitation after mitral valve replacement with subvalvular preservation.Preservation of the subvalvular apparatus during mitral valve replacement preserves left ventricular function and improves long-term survival. Complications of subvalvular preservation include left ventricular outflow tract obstruction and prosthesis impingement. We report a case of severe intermittent intraprosthetic mitral regurgitation detected by transesophageal echocardiography after mitral valve replacement by a bileaflet mechanical prosthesis with subvalvular preservation. Intravalvular prosthetic valve regurgitation was caused by remnants of the subvalvular apparatus, which were shown at reoperation to interfere with prosthetic leaflet motion and which were excised. Postoperative transesophageal echocardiography showed neither abnormal mitral regurgitation nor residual mass. The use of intraoperative transesophageal echocardiography could enable the detection of this rare complication.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
4/61. Mitral valve plasty for mitral regurgitation after blunt chest trauma.A 21 year-old woman was admitted to our hospital because of chest and back pain after blunt chest trauma. On admission, consciousness was clear and a physical examination showed labored breathing. Her vital signs were stable, but her breathing gradually worsened, and artificial respiration was started. The chest roentgenogram and a subsequent chest computed tomographic scans revealed contusions, hemothorax of the left lung and multiple rib fractures. A transthoracic echocardiography (TTE) revealed normal left ventricular wall motion and mild mitral regurgitation (MR). TTE was carried out repeatedly, and revealed gradually progressive MR and prolapse of the posterior medial leaflet, although there was no congestive heart failure. After her general condition had recovered, surgery was performed. Intraoperative transesophageal echocardiography (TEE) revealed torn chordae at the posterior medial leaflet. The leaflet where the chorda was torn was cut and plicated, and posterior mitral annuloplasty was performed using a prosthetic ring. One month later following discharge, the MR had disappeared on TTE.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
5/61. Severe mitral regurgitation with right ventricular pacing, successfully treated with left ventricular pacing.A case of severe mitral regurgitation with refractory heart failure, after atrioventricular junction ablation and pacemaker implant, was solved with left ventricular pacing. Mitral regurgitation was related to a change in segmental left ventricular motion during right ventricular pacing.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
6/61. Patch enlargement of the posterior mitral leaflet in ischemic regurgitation.We discuss our early experience in 2 patients with a patch enlargement technique for treating chronic ischemic mitral regurgitation due to restricted motion of the posterior mitral leaflet. This technique corrects the restricted motion and offers better coaptation without compromising the mitral orifice.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/61. diagnosis of prosthetic mitral valve malfunction with combined echo-phonocardiography.Fifty-three patients were studied with combined echo-phonocardiography or phonocardiography alone following prosthetic valve replacement. In sixteen of these patients, clinical deterioration developed, and all subsequently underwent cardiac catheterization and/or surgery. Two patients came to autopsy. Included in this group of sixteen patients were five with obstructed prosthesis, six with paravalvular regurgitation, and five with left ventricular dysfunction. Measurements were made of the time interval from the aortic valve closure sound to the peak opening of the mitral prosthesis determined echocardiographically or to the mitral prosthetic opening click (A2-MVO). Echocardiographic studies of left ventricular wall motion were also performed. The A2-MVO interval was significantly shortened (P less than 0.01) with prosthetic valve obstruction (.05 /- .02 sec) and paravalvular regurgitation (.05 /- .01 sec) compared with normally functioning prostheses (Starr-Edwards ball valves .10 /- .02 sec, Lillehei-Kaster tilting disc prostheses .09 /- .01 sec). Shortening of this interval was not specific for these conditions because it was sometimes shortened with left ventricular dysfunction. Echocardiographic studies of left ventricular wall motion were helpful in distinguishing among prosthetic valve obstruction, paravalvular regurgitation and left ventricular dysfunction. The combined echo-phonocardiographic technique was especially helpful in detecting malfunction of tilting disc prostheses, because the technique enables measurement of the A2-MVO interval in the absence of an audible opening click.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/61. Membranous subaortic stenosis complicated by aneurysm of the membranous septum and mitral valve prolapse.The clinical, echocardiographic, and catheterization findings in a patient with discrete subaortic stenosis, aneurysm of the membranous interventricular septum, and mitral valve prolapse are presented. echocardiography showed a subaortic membrane, abnormal aortic valve motion, accentuated systolic anterior motion of the membranous interventricular septum, and prolapsing mitral leaflets. cardiac catheterization confirmed the diagnoses. The possible functional interrelationship of these lesions is discussed.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/61. Thrombolysis for prosthetic valve malfunction: case report and review.A 40 year old female with severe mitral valve stenosis, underwent mitral valve replacement by single disc valve 4 years ago. She presented at this admission with a new onset of congestive heart failure. The prothrombin time was inadequate with international normalized ratio (INR) 1.43. Transthoracic echocardiography revealed high pressure gradient across the mitral valve. fluoroscopy demonstrated restrictive opening of single disc motion. Intravenous thrombolysis was given for presumptive diagnosis of prosthetic valve thrombosis. The patient gradually improved and did not have to undergo surgical correction.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
10/61. Modified septal myectomy and repair of mitral valve apparatus for the treatment of hypertrophic cardiomyopathy.A modified technique is described of septal myectomy using a resectoscope and mitral valve repair to relieve left ventricular outflow tract obstruction and correct mitral regurgitation in a young patient with hypertrophic cardiomyopathy. This modification offers better control over the extent of septal tissue excision and may reduce the incidence of iatrogenic ventricular septal defect. Using this procedure it was possible to correct systolic anterior motion of the anterior mitral leaflet while obviating the need to replace the mitral valve.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
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