Dear Sir, Timing of surgery in chronic mitral valve regurgitation has been a long term matter of debate. Data from European Society of Cardiology suggest that a number close to 36 % of surgical treatment in mitral valve regurgitation is performed too early or too late according to guidelines suggestions (Iung et al., 2003). Bileaflet mitral valve prolapse (Barlow’s disease) as correctly reporte...

Mitral valve repair with the MitraClip device has emerged as an effective treatment option for patients with severe mitral regurgitation and contraindications for surgical interventions. While the procedure is not known to cause pulmonary complications, we describe two cases of pulmonary hemorrhage following percutaneous mitral valve repair. The patients did well with supportive care and reinit...

BACKGROUND Human tissue valves for aortic valve replacement have a limited durability that is influenced by interrelated determinants. Hierarchical linear modeling was used to analyze the relation between these determinants of durability and valve regurgitation measured by serial echocardiography. METHODS AND RESULTS In adult patients, 218 cryopreserved aortic allografts were implanted with t...

of breathlessness for the past 5 years. On examination, the pulse rate was 90/min, regular with frequent ectopics, and BP was 90/50 mmHg. On cardiovascular examination, S1 and P2 were loud with mid diastolic murmur (MDM), pan systolic murmur (PSM) and early diastolic murmur (EDM) heard. Electrocardiography (ECG) showed normal sinus rhythm (NSM) with huge P wave. Echocardiography examination rev...

Among 74 survivors of the Fontan type of operation abnormal cardiac signs were detected in 46 (62%) at postoperative examination. The findings were analysed in relation to the state of the cardiovascular system of these patients. Cyanosis was present in 10 (13.5%) patients. The causes of cyanosis included residual interatrial shunt (six patients), acquired pulmonary arteriovenous fistulas (thre...

The patterns of aortic and tricuspid valve motion in 50 patients with mitral valve prolapse were analyzed by wide-angle, phased-array, two-dimensional echocardiography. Twelve patients (24%) had redundant aortic leaflets bulging into the left ventricular outflow tract during diastole. Eight of 12 patients had aortic regurgitation and seven of 12 had M-mode echocardiographic evidence of aortic v...

Pulmonary incompetence is a common sequel of pulmonary valvotomy, but many authors believe that the haemodynamic consequences of this regurgitation are well tolerated (Talbert, Morrow, Collins, and Gilbert, 1963). In this paper we report a patient who had severe pulmonary incompetence after valvotomy and who failed to maintain her initial clinical improvement. Because of the severe leak it was ...

BACKGROUND Pulmonary hypertension complicating severe aortic stenosis increases morbidity and mortality. Causes and mechanisms of this are unclear. METHODS This is a retrospective observational study of 626 patients with severe aortic stenosis who had measurable pulmonary arterial pressure by Doppler echocardiography. Clinical, echocardiographic and pharmacological data were related to the pr...

OBJECTIVE To determine how severe tricuspid regurgitation influences exercise capacity and functional state in patients who have undergone successful mitral valve replacement for rheumatic mitral valve disease. DESIGN 9 patients in whom clinically significant tricuspid regurgitation developed late after mitral valve replacement were compared with 9 patients with no clinical evidence of tricus...