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 ...

RUPTURE of the chordae tendineae is an uncommon event that may lead to sudden mitral regurgitation, the severity of which generally depends on the number and location of the chordae involved.1 It has been reported to occur with active bacterial or rheumatic endocarditis, in association with healed rheumatic valvulitis, following healed bacterial endocarditis or trauma, or "spontaneously" in hea...

OBJECTIVES This study examines the outcome of mitral valve repair with chordal replacement using expanded polytetrafluoroethylene over the past 25 years. METHODS From July 1988 to February 2013, 224 consecutive patients (mean age 57 years, 34% women) underwent mitral valve repair with chordal replacement using expanded polytetrafluoroethylene sutures at our institution. Isolated anterior leaf...

A quantitative assessment of mitral valve orifice area can be achieved in patients with pure mitral stenosis by cardiac catheterization. In the presence of mitral regurgitation, however, accurate measurement often is impossible because total diastolic flow through the mitral valve frequently is unknow. Using a recently developed real-time, two-dimensional echocardiography system, we are able to...

BACKGROUND No agreement has been reached for the best surgical treatment for patients with chronic ischemic mitral regurgitation (IMR) undergoing coronary artery bypass grafting (CABG). Our objective was to meta-analyze the clinical outcomes of repair and replacement. METHODS A computerized search was performed using Pubmed, Embase, Ovid medline and Cochrane Library. The search terms "ischemi...

We report the case of a man in his 60s who had dilated cardiomyopathy with severe functional mitral regurgitation. Four years after a cardiac resynchronization therapy (CRT) device with an implantable cardioverter defibrillator was implanted, this device was replaced with an adaptive CRT device because of battery consumption. Seven months after replacement of this device, the left ventricular p...

Background—Durability assessment of mitral valve repair for degenerative valve incompetence is actually limited to reoperation as the primary indicator, with valve-related risk factors for late death as a secondary indicator. We assessed serial echocardiographic follow-up of valve function as an indicator of the durability of mitral valve repair. Methods and Results—In 242 patients who had unde...

A 74-year-old Japanese female was diagnosed as chronic atrial fibrillation, and anticoagulant therapy with warfarin started. One year after anticoagulant therapy, she was referred to our center for evaluation of cardiac function. Transthoracic echocardiography by Philips iE33 ultrasound system with S5-1 transducer (USA) revealed huge left atrial thrombus (53 × 36 mm) (Fig. 1A). Left ventricular...

A 53-year-old woman with a history of hypertension was referred for an echocardiogram by her primary care physician after an unspecified abnormal ECG. The echocardiogram showed normal left ventricular size and function; however, an isolated cleft posterior mitral valve leaflet was identified with concomitant bileaflet prolapse and mild mitral regurgitation. She was subsequently referred to a ca...

BACKGROUND Functional mitral valve regurgitation plays a key role in the symptomatic severity and progression of heart failure. In an ovine model of dilated cardiomyopathy, we examined the chronic functional consequences of mitral regurgitation reduction using a recently developed novel percutaneous mitral annular reduction (PMAR) device. METHODS AND RESULTS Fourteen adult sheep were paced ri...