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At least 343 records · Page 19Linked to original sources
PubMed2004

[Fever, malaise and new onset mitral valve insufficiency. Subacute Streptococcus bovis mitral valve endocarditis ].

A 62-year-old patient with low grade fever, fatigue, arthralgia and newly discovered mitral regurgitation was diagnosed with subacute endocarditis. Streptococcus bovis grew from all six blood culture bottles. Streptococcus bovis is known to be associated with gastrointestinal neoplasias. Therefore a colonoscopy was performed and two polyps were removed. Histological analysis revealed a tubulovillous adenoma and a serrated adenoma. Colonoscopy is mandatory for all patients with Streptococcus bovis endocarditis even without any symptoms for colorectal neoplasia. The significance of Streptococcus bovis for the carcinogenesis of colorectal neoplasias and the possible alternative pathway for colorectal carcinomas through serrated adenomas will be discussed.

Diagnosis, Differential↗
PubMed1986

[Acute mitral valve insufficiency caused by a broken mitral valve prosthesis].

Breaks in a mechanical heart valve prosthesis with resulting acute valvar insufficiency are extremely rare. The case is reported of a 49-year-old man who, two-and-a-half years after implantation of a mitral valve prosthesis, suddenly went into acute cardiogenic shock, after having been in good health since the valve replacement. Although the symptoms were unequivocal, the correct diagnosis was not made for more than 40 hours. Emergency re-operation could not prevent death from severe interstitial pulmonary oedema with hyaline membranes. Within the last 20 years 25 similar cases have been reported.

Acute Disease↗
PubMed2001

Anxiety, depression and functional capacity in older women with mitral valve stenosis.

Mitral valve stenosis can lead to a range of symptoms that affect daily life. As many of the people with this problem are elderly, the difficulties resulting from age can be exacerbated by illness. A pilot descriptive study was designed to examine the differences in anxiety, depression and functional capacity in women with mitral valve stenosis who were aged over 60 years when compared to a similar group of volunteers who did not have any cardiac disease. Measurement was undertaken using the Hospital Anxiety and Depression scale, the SF-36 Health Status questionnaire and the Functional Limitations Profile. Forty women were recruited to the study: 20 women with mitral valve stenosis and 20 volunteers. Each person was asked to complete the three questionnaires on one occasion only. Non-parametric statistics were used for analysis. Patients fared worse than volunteers with significant differences between groups in respect of anxiety (P = 0.03), depression (P = 0.02) and overall function (P < 0.001), but not in physical (P = 0.52) or mental health (P = 0.32). Future research could focus on strategies that would help alleviate anxiety and depression and improve functional capacity in older women with mitral valve stenosis.

Aged↗
PubMed2000

[Mitral valve prolapse].

Mitral valve prolapse has previously been found to be associated with severe cardiovascular complications such as embolic insults, infectious endocarditis, and sudden cardiac death. However, at the same time, in particular after adopting M-mode and 2D echo for diagnosis, prevalence of the disease was found to be very high, especially in the young. The dilemma of a disease which is frequent and mostly asymptomatic, but in some cases has catastrophic complications, has been solved by implementation of more restrictive diagnostic criteria based on an appreciation of the spatial morphology of the mitral annulus. These criteria call for diagnosis exclusively based on long axis views and a prolapse of > 2 mm beyond a line connecting the leaflet insertion points. "Classic prolapse" additionally requires diastolic thickness of the mitral leaflets of at least 5 mm. Two recent studies, a population-based study of mitral valve prolapse prevalence, and a case-control study of juvenile stroke patients compared to a group of young patients without a history of stroke, shed further light on this disease. The authors found that prevalence of mitral valve prolapse in an average population is 2-3% (1.3% for classic prolapse), without age or sex preponderance; the rate of cerebrovascular insults, congestive heart failure, and atrial fibrillation of patients with prolapse does not exceed that of the rest of the population; however, mitral insufficiency is more frequent; young patients with a history of cerebrovascular insult do not have higher mitral valve prolapse rates than young patients without previous insult.

Cross-Sectional Studies↗
PubMed1985

Frequency of mitral valve dysfunction from mitral anular calcium as detected by Doppler echocardiography.

Doppler echocardiography is useful for detecting and quantifying mitral regurgitation (MR) and mitral stenosis (MS). To determine the prevalence of these abnormalities in patients with mitral anular calcium (MAC), 51 consecutive patients who had an echocardiographic diagnosis of MAC were examined by Doppler ultrasound. Transmitral flow was evaluated to determine the presence of MR or left ventricular inflow obstruction (MS) by continuous and pulsed-wave Doppler echocardiography. The severity of these hemodynamic abnormalities was quantitated by previously described techniques. Eleven patients (22%) had mild MR, 17 (33%) had moderate to severe MR and 4 (8%) had significant MS. Clinical findings such as a systolic murmur, evidence of congestive heart failure, and dyspnea on exertion were not helpful in distinguishing patients with no or mild MR from those who had moderate to severe MR. M-mode measured left atrial size was significantly larger (p less than 0.05) in patients with moderate to severe MR. This study suggests that MR is often associated with MAC, that MS is not a rare finding with MAC, and that Doppler echocardiography can quantitate these lesions in the elderly when symptoms are not specific and physical findings are inconclusive or absent.

Aged↗
PubMed1985

[Complications of mitral valve prolapse].

Mitral valve prolapse, usually a benign condition, is aggravated in 15% of the cases by one or the other of five different complications. Mitral regurgitation may develop progressively or abruptly following rupture of the chordae tendinae and requiring prompt surgical repair. Bacterial endocarditis has been observed in 2.9% of the cases, hence the need for preventive antibiotic therapy prior to dental treatments or surgical operations in patients with holosystolic or end-systolic mitral murmur. Among arrhythmias, only ventricular extrasystoles (which are frequent and most often occur in pairs or salvos or are polymorphous) tachycardia and ventricular fibrillation may be considered as true complications of mitral valve prolapse and should be treated initially with beta-blockers. Sudden death is the major complication encountered in 1.4 to 2.4% of the patients; particularly exposed are women around 40 years of age who previously experienced syncopes or episodes of faintness due to attacks of tachycardia or ventricular fibrillation. Ophthalmic or cerebral ischaemic accidents occur with an incidence of 3.5%; some 20 to 30% of subjects under 45 who suffer from these accidents present with mitral valve prolapse.

Arrhythmias, Cardiac↗
PubMed1977

Mitral valve prolapse in rheumatic mitral stenosis.

Four adult women with histories of rheumatic fever and clinical findings of mitral stenosis and regurgitation had echocardiograms demonstrating moderately severe mitral stenosis (EF slope less than 20 mm/sec, mean left atrial size 3.0 cm/m2, mean anterior mitral leaflet excursion 25 mm) as well as typical mitral valve prolapse. Three patients underwent cardiac catheterization which confirmed the presence of mitral stenosis, as well as systolic prolapse and excessive scalloping of the mitral valve with no visible mitral calcium and no coronary artery disease. One patient had associated mild aortic stenosis and regurgitation. Two patients underwent mitral valve surgery which revealed anterior and posterior commissural fusion consistent with rheumatic disease and intact chordal apparatus. Both leaflets were large and the anterior leaflets were redundant. There were no vegetations. Pathology revealed myxomatous degeneration of the valve leaflets. In the absence of heavy calcification and thickening, the presence of mitral stenosis with commisural fusion does not exclude the possibility of a redundant mitral valve. When these entities coexist, systolic clicks may be absent.

Aged↗
PubMed1986

Mitral valve repair for mitral regurgitation secondary to coronary artery disease.

Mitral regurgitation secondary to ischemic heart disease carries a significant mortality in the untreated patient. We report on 141 patients with mitral regurgitation secondary to ischemic heart disease who underwent complete coronary revascularization and correction of mitral regurgitation by either repair (101 patients) or replacement (40 patients). Good long- and short-term palliation was obtained. Left ventricular function (ejection fraction) and recent myocardial infarction were important preoperative determinants of outcome. Repair of the mitral apparatus rather than valve replacement was associated with better long- and short-term survival, especially in the patient with a low ejection fraction. The repaired valve is durable and repair minimizes the risks of thromboembolism, hemolysis, anticoagulation, and intracardiac infection associated with prosthetic valve replacement. Mitral valve repair was possible in 70% of the patients in this series. The benefit to the patient, especially the patient with compromised ventricular function, compensates the surgeon for any extra effort involved in conservation of the mitral apparatus.

Adult↗
PubMedDate not supplied

Increased platelet aggregation response in Cavalier King Charles Spaniels with mitral valve prolapse.

Mitral valve prolapse (MVP) is a fundamental feature of myxomatous mitral valve disease in the dog. In humans, primary MVP is associated with increased platelet reactivity. In Cavalier King Charles Spaniels (CKCS), a breed predisposed to myxomatous mitral valve disease, there is a high prevalence of hypomagnesemia and platelet anomalies, such as thrombocytopenia and macrothrombocytosis. The objective of this study was to evaluate platelet aggregation responses in CKCS and to determine the relationship between the platelet aggregation response and serum magnesium concentration, MVP, mitral regurgitation (MR), and platelet count. In 19 CKCS with MVP and 7 control dogs (not CKCS), the platelet aggregation response to 3 different agonists was compared. The CKCS with >100,000 platelets/microL (n = 10) had a significantly higher maximum aggregation response with regard to all tested agonists than the CKCS with <100,000 platelets/microL (n = 9) and control dogs (n = 7). The CKCS with <100,000 platelets/microL had a platelet aggregation response similar to the control dogs. There was no correlation between degree of MVP and platelet aggregation response. Platelet diameter increased (P = .006) and serum magnesium concentration decreased (P = .04) with lower platelet concentration. In conclusion, CKCS with MVP appeared to separate into 2 groups--1 group with <100,000 platelets/microL, normal platelet aggregation, low serum magnesium concentration, and enlarged platelets, and another group with >100,000 platelets/microL, increased platelet aggregation, and normal serum magnesium concentration and platelet size.

Animals↗
PubMed1990

[Surgical mitral valvuloplasty in the treatment of mitral valve diseases].

Mitral valve repair surgery, in presence of a pure mitral leakage or one associated to a stenosis, is not only possible but has been well codified for a decade. According to damage, there are two methods of operation: valvular mobilization surgery and valvular motion amplitude reduction surgery. They are usually associated to annuloplasty with a Carpentier prosthetic ring. The incidence of late mortality is of 0.6 p. 100 pt/yr, that is to say 91.7 p. 100 at 13 years. This late survival rate is about 20 p. 100 better than for a valvular replacement. Reoperations rate is 1.6 p. 100 pt/yr. The incidence of thromboembolic event occurrence is low: 0.5 p. 100 pt/yr. The ideal indications for mitral valve repair are represented by damage of prolapse from a degenerative origin for which results are better and more constant. For rheumatic damage, the valvular repair indication depend on the valvular tissue elasticity and area. The presence of calcification and extensive fibrosis remain on principle counter-indications.

Adult↗
PubMed2005

Future of transcatheter repair of the mitral valve.

Percutaneous mitral valve repair is under investigation as a novel method to treat mitral valve insufficiency with a catheter-based, closed-heart, nonsurgical approach. Two techniques of mitral valve reconstruction have been adapted from surgery to the percutaneous approach: edge-to-edge repair and annuloplasty. The devices that have been developed to perform these 2 procedures are described, and preliminary clinical experience is presented. Expectations for the future are discussed.

Cardiac Catheterization↗
PubMed1990

[Mitral valve replacement in 12-month-old infant with parachute mitral valve associated with ventricular and coronary sinus septal defect].

A 12-month-old infant, weighting 6.7 kg, underwent mitral valve replacement with a 17 mm Björk-Shiley prosthetic valve for parachute mitral valve, and patch closure of the associated ventricular and coronary sinus septal defects. Progressive pulmonary artery hypertension and heart failure required surgical intervention. The diagnosis of parachute mitral valve and associated lesions was established by echocardiogram and angiogram. Postoperative recovery was uneventful and he is doing well 3 years after the operation. To our knowledge this is the first successful case to be reported in the literature with such combination of the congenital anomalies.

Age Factors↗
PubMed2006

Systolic anterior motion of the mitral valve despite the sliding leaflet technique for repair of the mitral valve.

We report a systolic anterior motion of the anterior mitral leaflet despite employing the sliding leaflet technique for repair of mitral valve regurgitation. A 65-year-old man with chronic, symptomatic mitral regurgitation due to ruptured chordae tendineae underwent mitral valve repair by quadrangular resection of the posterior leaflet and sliding leaflet technique with ring annuloplasty. After weaning from cardiopulmonary bypass, left ventricular outflow obstruction developed and transesophageal echocardiography demonstrated systolic anterior motion of the mitral valve and severe mitral regurgitation. Non-operative treatment resolved the outflow tract obstruction, systolic anterior motion and mitral regurgitation. We conclude that post-repair systolic anterior motion can still occur after the sliding plasty procedure and that medical treatment can successfully resolve systolic anterior motion and outflow tract obstruction in most patients.

Aged↗