J Heart Valve Dis
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Comparative Study
Tailored surgical therapy for acute native mitral valve endocarditis.
Mitral valve repair has been shown superior to valve replacement for the treatment of non-infectious valve disease. The criteria and results of valve repair for native valve endocarditis are still being defined. The study aim was to examine the short- and long-term results of mitral valve repair and replacement for acute infective endocarditis and to define criteria for the use of each technique. ⋯ Mitral valve repair is a safe and effective technique to treat acute native mitral valve infective endocarditis with favorable short- and long-term morbidity and mortality. Patients with advanced endocarditis and annular destruction require valve replacement. Mitral valve repair should be performed when technically feasible.
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Right ventricular dilatation observed after tetralogy of Fallot repair regresses after pulmonary valve implantation, unless the dilation is too severe. The presence of an akinetic patch in the right ventricular outflow tract (RVOT), a known factor promoting right ventricular dilatation, may prevent right ventricular recovery after valve implantation. The exclusion of a large akinetic RVOT area during reoperation of patients presenting with severe post-repair right ventricular dilatation was investigated. ⋯ Pulmonary infundibuloplasty may be a useful adjunct in reoperation of tetralogy of Fallot patients presenting with severe right ventricular dilatation and large akinetic area of the RVOT.
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Comparative Study
Should a video-assisted mini-thoracotomy be the approach of choice for reoperative mitral valve surgery?
Reoperative cardiac surgery carries a greater morbidity and mortality than primary cardiac surgery. The study aim was to compare perioperative outcomes in patients undergoing mitral valve surgery who had already undergone a previous cardiac operation using either a minimally invasive video-assisted (MIVA) mini-thoracotomy or a redo median sternotomy (MS). ⋯ Minimally invasive video-assisted mitral valve operations may be performed safely and efficiently in patients with prior cardiac surgery. Demonstrated advantages include fewer red blood cell and blood product transfusions, as well as decreased intubation time and length of hospital stay.
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Comparative Study
Comparison of echocardiographic methods in assessing severity of mitral regurgitation in patients with mitral valve prolapse.
Mitral regurgitation (MR) shows different characteristics in mitral valve prolapse (MVP); hence, it is important to assess MR severity accurately in these patients. The study aim was to compare Doppler echocardiographic methods in making such assessment. ⋯ PISA, VCW, E velocity and SPVFR measurements may be used to evaluate MR severity semi-quantitatively in patients with MVP; however, the ratio of JA/LAA appears to be a less reliable method in this respect.
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The study aim was to develop a three-dimensional coupled fluid-structure finite element model of the aortic valve and root. This model extends previous purely structural finite element models, and represents a significant step toward realistic simulation of the complex interactions among tissue material properties and valvular function. ⋯ The addition of blood flow to structural models of the aortic valve and root is a significant advance in modeling, and allows a closer simulation of valvular function. The model will be used to further assess normal and abnormal physiology as well as the effects of surgical intervention.