PubMed · 3596580
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
R Virmani, J B Atkinson, M B Forman, M Robinowitz. 1987. Mitral valve prolapse.. https://doi.org/10.1016/s0046-8177(87)80359-3
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
A method of complete chordal preservation based on posterior transposition of anterior leaflet is presented. The anterior leaflet and chordae are completely detached from the annulus and reimplanted as a large patch under the posterior leaflet. The excess tissue without chordae is excised and the remnant with all the chordae is plicated by sutures used to implant the prosthesis. The posterior leaflet is left intact. The technique is safe and reproducible and no complications related with the procedure have been observed at mid-term follow-up. These results have led to a wider application of total chordal preservation during mitral valve replacement.
Leukocytopenia can be caused by depressed production, increased peripheral destruction, or excessive peripheral pooling. Leukocyte margination is one of the mechanisms responsible for excessive peripheral pooling. A reversible leukocyte margination is caused by an increase in pro-inflammatory cytokines. However, there are limited data for this phenomenon in clinical conditions. We describe a case of unexpected transient leukocytopenia after exchanging an extracorporeal membrane oxygenation (ECMO) system used to treat severe cardiogenic pulmonary edema. To assess the cause of the leukocytopenia, the serum concentrations of pro-inflammatory cytokines and selectins were measured. The concentrations of tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-8 were markedly, but transiently, elevated in relation to the leukocytopenia. The transient leukocytopenia with pulmonary margination appeared to be caused by a steep surge of pro-inflammatory cytokines stimulated by hypoxia/reoxygenation during the exchange of the ECMO system. This case may suggest the mechanisms responsible for leukocytopenia in the clinical entity referred to as "systemic inflammatory response syndrome"
The upside-down technique is a method for 'in situ' secondary cordae transposition for posterior leaflet lesions. The segmental prolapse of the posterior leaflet is corrected by rotating the resected segment upside-down and reattaching it to the annulus and adjacent leaflet segments. As the procedure is completed, the original annular attachment becomes the new free edge. The secondary chords, originally positioned at the base of the segment, become primary chordae. It is indicated in all cases when quadrangular resection is not feasible such as in case of calcified annulus, posterior leaflet hypoplasia, or when the prolapsing portion is wide.