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Results for “MITRAL VALVE STENOSIS”

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PubMed1983

Measurement of mitral valve orifice area in infants and children by two-dimensional echocardiography.

Two-dimensional echocardiograms of the mitral valve orifice area were obtained in 50 normal pediatric subjects, 15 patients with congenital mitral stenosis and 7 patients with tricuspid atresia. The mitral area was measured near the tips of the mitral valve leaflets from a diastolic cross-sectional image of the left ventricle. The cardiac images were recorded on videotape and later transferred to video disc for high resolution contour tracing. Contour analysis was performed by a special purpose microcomputer system for calculation of the enclosed calibrated area. In normal patients, there was an excellent correlation (r = 0.95) between mitral valve area (MVA) (in cm2) and body surface area (BSA) (in m2) described by MVA = 4.83 X BSA - 0.07. Each patient with mitral stenosis had a mitral valve area that measured less than the third percentile predicted from the normal regression formula. In eight patients in whom the Gorlin formula could be applied, there was excellent correlation (r = 0.95) between echocardiographic and hemodynamic measurements of mitral valve area. Each patient with tricuspid atresia had a very large mitral valve area (greater than 99th percentile of normal). It is concluded that noninvasive measurement of mitral valve orifice area can be accurately achieved by two-dimensional echocardiography in pediatric patients with congenital mitral stenosis, allowing serial measurement of their mitral valve area.

Child↗
PubMed2004

[Significant aortic valve stenosis in the prenatal period--diagnosis, treatment, outcome. Two-center study].

OBJECTIVE: Retrospective analysis of the spectrum of fetal aortic valve stenosis with completed neonatal follow-up. METHODS: Fetal echocardiograms of 12 fetuses with aortic stenosis (AS) were analyzed. Mean gestational age at the time of diagnosis was 29.6 weeks. RESULTS: In all 12 cases critical AS has been detected. The left ventricle was estimated as small in three cases, in 7 cases as enlarged and hypokinetic LV (SF<28%) and in the next two cases the LV was well formed. In 6 AS cases, endocardial fibro-elastosis has been detected. Six fetuses presented mitral valve insufficiency; in three cases small LV mitral valve stenosis was diagnosed. Cardiomegaly occurred in 7 cases, including 5 cases with HA/CA > 0.5. Hypoplastic aorta has been detected in 2 cases and in one coarctation of the aorta. Retrograde flow in aortic arch and poor left ventricular function was diagnosed in ten cases. In 2 fetuses extracardiac malformations were present: hydrocephalus and pylorostenosis. In 83% of the cases CS had been performed and 17% were delivered vaginally (2 intrauterine fetal deaths). Four neonates had been qualified to percutaneous balloon valvuloplasty, in three cardiac surgery had been performed. Three neonates with AS (25%) survived--two after valvuloplasty (one of them required also cardiac surgery) and one after Norwood procedure. CONCLUSIONS: 1. Poor prognostic factors for neonates with critical fetal AS were as follows: small LV, retrograde flow in aortic arch, poor left ventricular function and presence of extracardiac anomalies. 2. Neonates who survived with fetal SA, had isolated CHD and well formed LV (also with endocardial fibroelastosis).

Aortic Valve Stenosis↗
PubMed2003

Sutureless robot-assisted mitral valve repair: an animal model.

BACKGROUND: Robotic mitral valve repair with the da Vinci robotic surgical system has been performed in more than 70 patients at our institution. This procedure reduces the need for blood transfusions, shortens hospital stay, and hastens return to normal activities. However, the robot-assisted repair also requires longer cardiopulmonary bypass and arrested-heart times than conventional open repairs. Because of increased risk of myocardial damage, arrhythmia, and other significant morbidities associated with longer arrested-heart time, a more efficient tissue approximation and adherence technique was evaluated to reduce operating time. METHODS: Twelve Dorset sheep were divided equally into 2 groups. In the control group Cosgrove-Edwards annuloplasty bands were secured to the posterior annulus with conventional 2-0 Ticron mattress sutures placed with robotic assistance. In the experimental group, the band was secured with double-armed nitinol U-clips placed with robotic assistance. Postoperative echocardiography was used to assess mitral valve function, and the animals were sacrificed at 3 or 6 months for histological evaluation. RESULTS: Total U-clip placement time was significantly decreased at 2.6 +/- 0.2 (mean +/- SEM) minutes versus total suture placement time at 4.9 +/- 0.4 minutes (P =.001). The main difference in time occurred between clip deployment at 0.75 +/- 0.1 minutes and suture tying at 2.78 +/- 0.2 minutes (P =.000003). Pathologic review showed excellent band incorporation at 3 and 6 months. Echocardiographic imaging showed no discernible mitral valve stenosis or regurgitation. CONCLUSIONS: With more cardiac procedures progressing toward minimally invasive approaches, novel technology to improve existing techniques must be evaluated. Nitinol U-clips help to reduce arrested-heart time and may improve outcome by decreasing morbidity. U-clip placement is intuitive, easily learned, and effective in securing the annuloplasty band to the mitral annulus.

Animals↗
PubMed1987

Catheter balloon valvuloplasty of aortic and mitral stenosis in adults: 1987.

CBV for adults with aortic and mitral stenosis is investigational at the present time and should usually be performed within the guidelines of clinical investigation. The technology is an evolving one with regard to types of catheters and balloons, methods of catheter insertion and placement, and patients and valves that are suitable for and will respond well to CBV. The initial results range from disappointing to excellent and must be kept in perspective. The procedure is clearly a palliative one; ideal results are not being achieved at present. Some of the complications are very serious. Nevertheless, CBV is a most promising catheter interventional technique for patients with valvular heart disease. Proper selection of patients and complete reporting of results is important.

Adult↗