Chronic ischemic mitral regurgitation is a prevalent problem among patients following a myocardial infarction. Until recently, the pathophysiology was poorly understood, resulting in surgical strategies with suboptimal results and limited durability. The surgical approach has evolved from revascularization alone to an additional mitral valve procedure, replacement, or repair. When the valve was...

OBJECTIVE To report the first 100 mitral valve repairs performed in a unit with an aggressive approach to conservative mitral valve surgery. DESIGN Case notes were reviewed retrospectively and patients invited for clinical examination and cross sectional and Doppler echocardiography. SETTING Tertiary cardiothoracic referral centre. PATIENTS Between December 1985 and April 1991 mitral valv...

BACKGROUND Moderate secondary tricuspid incompetence has variable natural history if left unattended during mitral valve surgery. Recent data suggest progression of the secondary tricuspid incompetence over time.Secondary moderate tricuspid regurgitation in rheumatic mitral valve disease may regress after mitral valve surgery without direct intervention. OBJECTIVES The present study was done ...

Indices have been developed that provide an improved means for evaluation of the degrees of severity of mitral stenosis and regurgitation. The severity of anatomic mitral valve disease found at surgery or autopsy was considered to be the determinant of the state of the valve. An index of the time for the diastolic atrioventricular pressure gradient to fall to half its value multiplied by 100 an...

The prevalence and clinical significance of aortic valve prolapse were determined prospectively in 2000 consecutive patients undergoing routine clinical cross sectional echocardiography. Two hundred and twelve patients were excluded because the aortic cusps were not adequately visualised. Aortic valve prolapse was defined as downward displacement of cuspal material below a line joining the poin...

(Figure 1A,B). Mitral valve mean pressure gradient was elevated to 16 mmHg and MVA was reduced to around 1.0 cm2. The orifice of the mitral valve was located in the lateral site, and both anterior and posterior commissures were fused and unclear. There was also mild tricuspid valve regurgitation, but no other valve stenosis, regurgitation, septal defect, hypoplastic left heart, or abnormal stru...

BACKGROUND This study was undertaken to compare mitral valve repair and replacement as treatments for ischemic mitral regurgitation (IMR) with left ventricular dysfunction (LVD). Specifically, we sought to determine whether the choice of mitral valve procedure affected survival, and discover which patients were predicted to benefit from mitral valve repair and which from replacement. METHODS ...

Congenital quadricuspid aortic valve is a rare cardiac anomaly. More than half of the patients with this abnormality will develop aortic insufficiency in adulthood. It is vital that patients with quadricuspid aortic valve who present with progressive aortic regurgitation undergo valve replacement or repair at appropriate time. Here, we present two cases of quadricuspid aortic valve. We first de...

Mitral valve repair is considered the procedure of choice for correcting mitral regurgitation in myxomatous disease, providing long-term results that are superior to those with valve replacement. The use of artificial chordae to replace elongated or ruptured chordae responsible for mitral valve prolapse and severe mitral regurgitation has been the subject of extensive experimental work to defin...

M itral valve leaflets consist of thin, pliable, fibrous material. The two leaflets—anterior and posterior—open by unfolding against the ventricular wall and close by apposition when the pressure in the left ventricle becomes greater than that in the left atrium. Mitral stenosis occurs when the mitral valve leaflets become stiffened, calcified, and unable to open completely during diastole. Thi...