Surgery for Cardiomyopathy
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This document discusses the management of valvular regurgitation in patients with cardiomyopathy. It notes that secondary mitral regurgitation is common in end-stage cardiomyopathy and can affect up to 60% of heart failure patients. While medical management focuses on treating the underlying heart failure, the document finds that mitral valve repair with an undersized annuloplasty ring can significantly improve symptoms and survival rates, comparable to heart transplantation. Several studies showed mitral valve repair improved ejection fraction and functional status while carrying an acceptable mortality risk in this high-risk group. The conclusion is that mitral valve surgery should be considered for symptomatic patients with severe secondary mitral regurgitation who remain symptomatic despite medical optimization.
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This document discusses hybrid approaches for treating thoracoabdominal aneurysms and aortic arch disease. It describes using endovascular stent grafts in combination with open surgical debranching of visceral arteries. The conclusions state that hybrid procedures may have lower early morbidity than open surgery while providing similar long-term survival outcomes, making them a safer alternative for high-risk patients.
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2) At baseline, systemic right ventricular volumes were larger but ejection fraction was lower in CCTGA patients compared to controls. However, all groups responded appropriately to dobutamine stress with increases in stroke volume and cardiac index.
3) While CCTGA patients had diminished ejection fraction at baseline compared to controls, their systemic right ventricle responded similarly to dobutamine stress, suggesting preserved cardiac reserve. MRI dobutamine stress may help identify CCTGA patients who can be observed without operation.
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2) Surgical techniques discussed include different types of composite graft replacements, valve sparing procedures, and re-do operations. Specific procedures mentioned are the Bentall procedure and the Ross procedure.
3) Factors that determine whether the aortic valve should be replaced or repaired are discussed. Guidelines for intervention based on aortic root size are also provided.
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This document discusses strategies and prevention of slow flow and no-reflow phenomenon during percutaneous coronary intervention (PCI). It defines no-reflow as inadequate myocardial perfusion through a coronary artery without mechanical obstruction. No-reflow occurs in 8-11% of primary PCIs and is associated with worse clinical outcomes. The pathophysiology involves distal embolization, ischemic injury, reperfusion injury, and individual patient susceptibility. Preventing no-reflow requires reducing thrombus burden, ischemia time, reperfusion injury through anti-inflammatory drugs, and addressing risk factors like diabetes.
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Hybrid coronary revascularization (HCR) combines coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) to treat multivessel coronary artery disease. HCR aims to perform CABG on the left anterior descending artery using a left internal mammary artery graft via minimally invasive surgery while treating other vessels with PCI. This approach seeks to provide the benefits of CABG for the LAD while reducing surgical trauma compared to traditional CABG. The optimal strategy and order of CABG versus PCI, as well as antiplatelet management, are debated due to the lack of large randomized controlled trials on HCR. HCR shows promise for high surgical risk patients but further research is still needed to define appropriate patient selection
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This document discusses the current state of multi-arterial grafting for coronary artery bypass grafting (CABG). It notes that CABG remains the most common cardiac operation performed and enjoys a gold standard role for severe coronary artery disease (CAD). However, aging populations mean more patients will have CAD combined with other cardiac issues. While left internal mammary artery to left anterior descending plus radial artery grafts is a very good operation, the document questions if it can be made better by increased use of multiple arterial grafts. A literature review shows lower long-term patency rates for saphenous vein grafts compared to arterial grafts. However, adoption of multiple arterial grafting techniques still remains low internationally.
Hybrid coranary revascularization
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Carotid revascularization in cad patients
Carotid artery disease is common in patients with coronary artery disease undergoing coronary artery bypass grafting (CABG). The incidence of perioperative stroke after CABG is around 1.6-3.1%, with risks increased by factors like aortic atherosclerosis, atrial fibrillation, prior stroke, and carotid stenosis. Strokes are often embolic and occur during or soon after surgery. Asymptomatic carotid stenosis alone may not increase stroke risks significantly, but bilateral or recently symptomatic stenosis does. Careful screening and management of atherosclerotic risk factors can help reduce perioperative stroke risks in patients with coexisting carotid and coronary artery disease.
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The document discusses different techniques for aortic valve-sparing operations, including the remodeling technique and the reimplantation technique. It provides details on how each technique is performed surgically and discusses findings from studies comparing the techniques. The main points are:
1) The remodeling technique preserves some aortic root distensibility but the reimplantation technique causes higher pressure gradients due to a more rigid fixation of the valve.
2) Bending deformation of the valve leaflets is higher for both techniques compared to native aortic roots, due to the use of synthetic graft material.
3) Aortic root distensibility decreases for both techniques compared to native roots, with less distensibility observed with
Aortic dissection
This document provides guidelines and recommendations for the surgical management of aortic aneurysms and dissections. Some key points:
- Ascending aortic aneurysms or dissections require urgent surgical repair. Descending aortic involvement can often be managed medically unless complications occur.
- Medical management of acute dissections involves beta blockers and blood pressure control. Surgical repair is recommended for ascending aorta involvement or complications in the descending aorta.
- Genetic conditions like Marfan syndrome require close imaging monitoring and often early elective surgery due to higher risk of complications. Surgery is typically recommended for aneurysms over 5.0-5.5cm depending on the condition.
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An extensive calcified left ventricular aneurysm
This document summarizes a case study of a surgical procedure to repair a calcified left ventricular aneurysm. A 66-year-old man presented with shortness of breath and a history of cardiac arrest. Tests revealed a dilated cardiomyopathy and large aneurysm in the left ventricle. The patient underwent open-heart surgery using cardiopulmonary bypass to perform an endarterectomy on a blocked coronary artery and repair the aneurysm using an internal circular patch technique known as the Dor procedure. The surgery was successful and the patient was discharged after a week without complications. Surgical repair of large or symptomatic aneurysms can help restore normal heart geometry and reduce strain on the left ventricle.
Coronary ectasia
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Surgical Treatment of Ischemic Mitral Regurgitation
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RECENT ADVANCES IN THE MANAGEMENT OF REFRACTORY HEART FAILURE
Heart failure is a pathophysiological state in which structural or functional cardiac disorder impairs the ability of the heart to function as a pump to support the physiological circulation. The medical therapy remains the
mainstay of treatment in these patients. The medical therapy can improve the quality of life and the longevity in
these patients, but this becomes insufficient in refractory heart failure. The heart failure is considered refractory when patients continued to be symptomatic despite optimal dose of medications, characterized by advanced structural heart disease. These patients will need frequent hospitalizations and the overall prognosis is very poor.
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This document discusses diagnostic and surgical treatment options for mitral valve stenosis. It presents the case of a 46-year-old female patient with severe mitral stenosis who has not responded well to pharmacological treatment. Two main surgical interventions are considered: balloon mitral valvuloplasty and mitral valve annuloplasty. Studies are presented showing that valvuloplasty can improve left ventricular function and strain, while annuloplasty may be associated with higher gradients and worse quality of life. Based on the patient's history and characteristics, the document recommends valvuloplasty as it allows for variable improvement in health compared to mitral surgery, which carries a higher risk of compromising health. Close monitoring is still advised
SURGICAL MANAGEMENT OF HEART FAILURE
This document discusses various surgical options for treating heart failure, including:
- Coronary artery revascularization to improve blood flow in ischemic cardiomyopathy.
- Valve surgery like mitral valve repair to address functional mitral regurgitation and reduce ventricular volume overload.
- Left ventricular reconstruction to remove scar tissue, restore a more elliptical chamber shape, and decrease wall stress.
- Passive cardiac support devices like the CorCap that provide external diastolic support to facilitate reverse remodeling.
- Mechanical circulatory support options for short-term support like IABP or long-term support like left ventricular assist devices as a bridge to transplant.
- Cardiac transplantation as the gold
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1) The document discusses various surgical procedures for treating aortic root pathologies. It describes the anatomy of the aortic root and various conditions that can affect it like aneurysms and dissections.
2) Surgical techniques discussed include different types of composite graft replacements, valve sparing procedures, and re-do operations. Specific procedures mentioned are the Bentall procedure and the Ross procedure.
3) Factors that determine whether the aortic valve should be replaced or repaired are discussed. Guidelines for intervention based on aortic root size are also provided.
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This document discusses strategies and prevention of slow flow and no-reflow phenomenon during percutaneous coronary intervention (PCI). It defines no-reflow as inadequate myocardial perfusion through a coronary artery without mechanical obstruction. No-reflow occurs in 8-11% of primary PCIs and is associated with worse clinical outcomes. The pathophysiology involves distal embolization, ischemic injury, reperfusion injury, and individual patient susceptibility. Preventing no-reflow requires reducing thrombus burden, ischemia time, reperfusion injury through anti-inflammatory drugs, and addressing risk factors like diabetes.
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Hybrid coronary revascularization (HCR) combines coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) to treat multivessel coronary artery disease. HCR aims to perform CABG on the left anterior descending artery using a left internal mammary artery graft via minimally invasive surgery while treating other vessels with PCI. This approach seeks to provide the benefits of CABG for the LAD while reducing surgical trauma compared to traditional CABG. The optimal strategy and order of CABG versus PCI, as well as antiplatelet management, are debated due to the lack of large randomized controlled trials on HCR. HCR shows promise for high surgical risk patients but further research is still needed to define appropriate patient selection
Introduction to Ischemic Heart Disease Surgery
The document discusses coronary artery bypass grafting (CABG), including its history, evidence supporting its use, planning and techniques. It notes that CABG has been shown to be superior to angioplasty and stenting for many patients in large randomized trials. Planning involves tests to assess patient and coronary anatomy. Arterial and venous grafts can be used. Techniques have evolved from conventional open surgery to minimally invasive and endoscopic approaches. The hybrid operating room allows combination with angioplasty procedures. Overall, CABG remains an important treatment for coronary artery disease.
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This document discusses the current state of multi-arterial grafting for coronary artery bypass grafting (CABG). It notes that CABG remains the most common cardiac operation performed and enjoys a gold standard role for severe coronary artery disease (CAD). However, aging populations mean more patients will have CAD combined with other cardiac issues. While left internal mammary artery to left anterior descending plus radial artery grafts is a very good operation, the document questions if it can be made better by increased use of multiple arterial grafts. A literature review shows lower long-term patency rates for saphenous vein grafts compared to arterial grafts. However, adoption of multiple arterial grafting techniques still remains low internationally.
Hybrid coranary revascularization
1) The document describes the use of off-pump coronary artery bypass grafting (OPCAB) and hybrid procedures combining OPCAB and angioplasty to perform minimally invasive coronary revascularization without cardiopulmonary bypass.
2) Of 216 patients who underwent OPCAB, the procedure was successful in achieving technically complete revascularization in 84% of patients with multivessel disease, either through multivessel OPCAB or a hybrid approach.
3) Postoperative outcomes were good with a low mortality rate of 1.4% and few complications. Graft patency rates improved to over 93% with the use of heart stabilizers during surgery. The hybrid procedures were effective but carried a risk
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This document discusses a randomized clinical trial called Compare-Acute that examined whether an FFR-guided strategy to treat non-infarct related lesions in patients with STEMI and multivessel disease is superior to treating only the infarct-related artery. The trial enrolled 885 patients across 24 centers in Europe and Asia. Patients were randomized 1:2 to either complete FFR-guided revascularization or treatment of just the infarct artery. The primary outcome was a composite of death, myocardial infarction, or ischemia-driven revascularization at 1 year.
Carotid revascularization in cad patients
Carotid artery disease is common in patients with coronary artery disease undergoing coronary artery bypass grafting (CABG). The incidence of perioperative stroke after CABG is around 1.6-3.1%, with risks increased by factors like aortic atherosclerosis, atrial fibrillation, prior stroke, and carotid stenosis. Strokes are often embolic and occur during or soon after surgery. Asymptomatic carotid stenosis alone may not increase stroke risks significantly, but bilateral or recently symptomatic stenosis does. Careful screening and management of atherosclerotic risk factors can help reduce perioperative stroke risks in patients with coexisting carotid and coronary artery disease.
Myocarditis
This document discusses myocarditis, including its clinical presentation and findings on cardiac MRI. Regarding clinical presentation, it notes that symptoms can range from subclinical to fulminant heart failure, with the most common symptoms being chest pain, dyspnea, and arrhythmias. Cardiac MRI is useful for identifying myocarditis and can detect tissue edema, hyperemia, and fibrosis. Findings on MRI include increased T2 signal from edema, early contrast enhancement indicating hyperemia, and late gadolinium enhancement of replaced fibrotic tissue. Morphological abnormalities seen include transient increases in wall thickness and LV volumes during active myocarditis.
Journal club drug eluting balloon for cad
This document discusses treatment options for in-stent restenosis (ISR) in a patient with a past history of percutaneous coronary intervention. It summarizes the findings of several studies comparing drug-eluting balloons (DEBs) and drug-eluting stents (DES) for treating ISR. The studies found that DES were superior to DEBs for reducing repeat revascularization, while safety outcomes like death and heart attack were similar. However, DEBs may be preferred over DES in certain high risk cases, like those with multiple stent layers or who are at high risk of bleeding complications from long-term dual antiplatelet therapy. Additional research with longer follow-ups is still needed to further compare DEBs
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The document discusses different techniques for aortic valve-sparing operations, including the remodeling technique and the reimplantation technique. It provides details on how each technique is performed surgically and discusses findings from studies comparing the techniques. The main points are:
1) The remodeling technique preserves some aortic root distensibility but the reimplantation technique causes higher pressure gradients due to a more rigid fixation of the valve.
2) Bending deformation of the valve leaflets is higher for both techniques compared to native aortic roots, due to the use of synthetic graft material.
3) Aortic root distensibility decreases for both techniques compared to native roots, with less distensibility observed with
Aortic dissection
This document provides guidelines and recommendations for the surgical management of aortic aneurysms and dissections. Some key points:
- Ascending aortic aneurysms or dissections require urgent surgical repair. Descending aortic involvement can often be managed medically unless complications occur.
- Medical management of acute dissections involves beta blockers and blood pressure control. Surgical repair is recommended for ascending aorta involvement or complications in the descending aorta.
- Genetic conditions like Marfan syndrome require close imaging monitoring and often early elective surgery due to higher risk of complications. Surgery is typically recommended for aneurysms over 5.0-5.5cm depending on the condition.
- Endovascular
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This document discusses infrainguinal arterial procedures, focusing on femoropopliteal bypass surgery. It begins with an overview of preoperative testing and imaging, including duplex scanning, MRI angiography, CT angiography, and conventional angiography. The key steps of an above-the-knee femoropopliteal bypass are then described in detail, including harvesting the great saphenous vein, exposing the femoral artery, and exposing the popliteal artery distally. The bypass is performed by anastomosing the vein graft proximally to the femoral artery and distally to the popliteal artery above the knee. Precise surgical technique is important for successful bypass outcomes.
An extensive calcified left ventricular aneurysm
This document summarizes a case study of a surgical procedure to repair a calcified left ventricular aneurysm. A 66-year-old man presented with shortness of breath and a history of cardiac arrest. Tests revealed a dilated cardiomyopathy and large aneurysm in the left ventricle. The patient underwent open-heart surgery using cardiopulmonary bypass to perform an endarterectomy on a blocked coronary artery and repair the aneurysm using an internal circular patch technique known as the Dor procedure. The surgery was successful and the patient was discharged after a week without complications. Surgical repair of large or symptomatic aneurysms can help restore normal heart geometry and reduce strain on the left ventricle.
Coronary ectasia
Coronary artery ectasia (CAE) is an inappropriate dilatation of the coronary arteries. It has an unknown etiology but may be due to genetic or inflammatory factors. CAE is detected in 3-8% of angiograms and can be diffuse or localized. It can cause angina due to turbulent blood flow. Diagnosis is typically made using angiography, CT, or MRI imaging. Treatment involves aspirin due to risk of thrombosis, with surgical revascularization for significant coronary artery disease.
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Similar to Surgery for Cardiomyopathy
Surgical Treatment of Ischemic Mitral Regurgitation
This document discusses surgical treatment options for ischemic mitral regurgitation (IMR). It begins by describing the anatomy and physiology behind IMR, as well as medical therapies. Revascularization alone often does not sufficiently reduce IMR. The document then reviews evidence on mitral valve repair versus replacement. While repair traditionally had higher recurrence rates, newer techniques like leaflet augmentation and edge-to-edge repair are showing promise. Overall, the optimal surgical approach for treating IMR remains unclear due to heterogeneity in patient populations and outcomes data.
RECENT ADVANCES IN THE MANAGEMENT OF REFRACTORY HEART FAILURE
Heart failure is a pathophysiological state in which structural or functional cardiac disorder impairs the ability of the heart to function as a pump to support the physiological circulation. The medical therapy remains the
mainstay of treatment in these patients. The medical therapy can improve the quality of life and the longevity in
these patients, but this becomes insufficient in refractory heart failure. The heart failure is considered refractory when patients continued to be symptomatic despite optimal dose of medications, characterized by advanced structural heart disease. These patients will need frequent hospitalizations and the overall prognosis is very poor.
Tratamiento de Estenosis de Válvula Mitral
This document discusses diagnostic and surgical treatment options for mitral valve stenosis. It presents the case of a 46-year-old female patient with severe mitral stenosis who has not responded well to pharmacological treatment. Two main surgical interventions are considered: balloon mitral valvuloplasty and mitral valve annuloplasty. Studies are presented showing that valvuloplasty can improve left ventricular function and strain, while annuloplasty may be associated with higher gradients and worse quality of life. Based on the patient's history and characteristics, the document recommends valvuloplasty as it allows for variable improvement in health compared to mitral surgery, which carries a higher risk of compromising health. Close monitoring is still advised
SURGICAL MANAGEMENT OF HEART FAILURE
This document discusses various surgical options for treating heart failure, including:
- Coronary artery revascularization to improve blood flow in ischemic cardiomyopathy.
- Valve surgery like mitral valve repair to address functional mitral regurgitation and reduce ventricular volume overload.
- Left ventricular reconstruction to remove scar tissue, restore a more elliptical chamber shape, and decrease wall stress.
- Passive cardiac support devices like the CorCap that provide external diastolic support to facilitate reverse remodeling.
- Mechanical circulatory support options for short-term support like IABP or long-term support like left ventricular assist devices as a bridge to transplant.
- Cardiac transplantation as the gold
Successful Valve in Ring Abolishing the Stenosis and Regurgitation with Robus...
Transcatheter mitral valve-in ring implantation (TMViRI), is a novel alternative treatment strategy and promising technique for patients at high risk of repeat open-heart surgery. In this report we demonstrate a case of 61 years old male with multiple co morbidities who underwent mitral valve repair long time ago who successfully treated and dramatically improved through trans-septal approach, under trans oesophageal echocardiography and fluoroscopic guidance in Hybrid catheterization laboratory.
An Unusual Cause of Left Ventricular Volume Overload after Aortic Valve Repla...
A 67-year-old female presented with syncope and was found to have left ventricular volume overload. Transthoracic echocardiography revealed a patent ductus arteriosus causing a left-to-right shunt, elevating pulmonary pressures and resulting in functional mitral and tricuspid regurgitation. While the PDA may have been an incidental finding, it was thought to be the primary cause of left ventricular volume overload. The patient was referred for percutaneous closure of the PDA to treat her symptoms.
Multivalvular disease
This document discusses multivalvular heart disease (MVD), which refers to two or more diseased cardiac valves. It defines MVD and provides epidemiological data showing its prevalence. The most common causes of acquired MVD are rheumatic heart disease and degenerative calcific disease. Congenital disorders can also cause MVD. The document examines the pathophysiology and interactions of different valve combinations, such as aortic stenosis with mitral regurgitation. Echocardiography is key for diagnosis but has limitations in MVD, so cardiac catheterization may be needed in some cases.
1 s2.0-s0140673616005584-main
The document discusses current management and future challenges in treating mitral valve disease, specifically focusing on primary mitral regurgitation, secondary mitral regurgitation, and mitral stenosis due to annular calcification.
For primary mitral regurgitation, surgical repair is the standard of care for symptomatic patients or those with left ventricular dysfunction. New transcatheter mitral valve repair options like the MitraClip are also producing good outcomes in high-risk surgical patients. Clinical trials are underway to evaluate transcatheter options versus surgery for intermediate risk patients.
The management of secondary mitral regurgitation, caused by left ventricular issues, is less clear. Outcomes from ongoing clinical trials of new treatments will help
Transcatheter therapy for mitral regurgitation
Trans catheter intervention is emerging field in cardiac intervention. due to complex anatomy of mitral valve understanding of anatomy and three dimensional imaging is most important aspect of successful intervention and could be life saving in high risk surgical candidate
When do you advice mitral valve replacement for - Copy.pptx
- Mitral valve replacement is recommended for patients with severe primary mitral regurgitation who are symptomatic or have left ventricular systolic dysfunction, defined as an LVEF below 60% or a LVESD over 40mm.
- Transcatheter mitral valve repair using an edge-to-edge technique may be considered for severely symptomatic patients who are at high or prohibitive risk for surgery if their mitral valve anatomy is suitable.
- Aggressive medical management targeting left ventricular dysfunction is recommended for secondary mitral regurgitation and may significantly reduce the regurgitation in 30-40% of patients.
Posibilidades del tratamiento percutáneo
XIII Reunión anual de la sección de Insuficiencia Cardiaca de la SEC
OVIEDO, 16-18 JUNIO 2016 HOSPITAL UNIVERSITARIO CENTRAL DE ASTURIAS (HUCA)
http://secardiologia.es/insuficiencia/cientifico/ic-oviedo-2016
Simposio: Abordaje integral y multidisciplinar de la Insuficiencia Mitral
VIERNES, 17 DE JUNIO 12:45-14:00 SALA A
Posibilidades del tratamiento percutáneo
Xavi Freixa Rofastes, Barcelona
refractory heart failure
This document discusses advanced treatments for refractory heart failure, including devices and surgery. Cardiac resynchronization therapy (CRT), implantable cardioverter defibrillators (ICD), and combination devices are recommended implantable options. Percutaneous and surgical interventions include coronary revascularization, stem cell therapy, mitral valve procedures, LV assist devices, cardiac reshaping surgeries, and heart transplantation. Other treatments mentioned are ultrafiltration to remove fluid overload and CPAP for patients with heart failure and sleep apnea.
Whom to refer for mitral valve repair and whom not
This document discusses the treatment of mitral regurgitation in patients with heart failure. It describes the mechanisms of functional and ischemic mitral regurgitation. While medical therapy can improve symptoms and survival, cardiac resynchronization therapy may also help reduce mitral regurgitation severity and improve outcomes. Surgery to repair the mitral valve is an option but the risk of recurrence of mitral regurgitation is high, especially with more advanced left ventricular remodeling. Randomized trials are still needed to determine whether surgical correction provides clear benefits over medical therapy alone in high-risk patients. Percutaneous mitral valve repair may be a lower risk option for inoperable patients to reduce symptoms.
JET surgical substrates
This study analyzed surgical factors that may contribute to the development of junctional ectopic tachycardia (JET) after surgery for congenital heart defects. The study reviewed 343 patients who underwent repair of tetralogy of Fallot, truncus arteriosus, ventricular septal defect, or atrioventricular septal defect. Resection of muscle bundles, higher bypass temperatures, and relief of right ventricular outflow tract obstruction through the right atrium were independently associated with increased risk of postoperative JET. Relieving obstruction through the right atrium may cause direct trauma or hemorrhage to the conduction system, a potential mechanism for JET. Surgical techniques that avoid extensive muscle resection and excessive traction should be applied
Harb griffin2017 article-mitral_valvediseasea_comprehensi
This document provides a comprehensive review of mitral valve disease, including both mitral stenosis and mitral regurgitation. It discusses the anatomy of the mitral valve and the disease processes that can affect it. Rheumatic fever is still the leading cause of mitral stenosis worldwide. Mitral regurgitation can be classified as primary, due to lesions of the mitral valve apparatus, or secondary, caused by left ventricular geometric alterations. Optimal treatment requires an understanding of mitral valve anatomy and the specific causes of valve dysfunction in each patient.
Contemporary Perspectives on the Diagnosis and Management of Hypertrophic Car...
Hypertrophic cardiomyopathy (HCM) is a cardiovascular disorder with genetic predisposition. The number of treatment modalities has grown in the contemporary era, with use of pharmacotherapy, device therapy, and surgical intervention, though with the relative paucity of data derived from randomized trials. Its clinical course and prognosis are relatively good. The ongoing quest is to establish the optimal treatment strategy in patients with HCM. This is of direct relevance in reducing the mortality burden associated with sudden cardiac death primarily secondary to dysrhythmias. This review summarizes the clinical features, course, and management of HCM. In particular, we highlight advances in cardiac magnetic resonance imaging assessment of HCM and how risk stratification criteria for suitability of implantable cardioverter defibrillators differ between continents.
PERCUTANEOUS TREATMENT STRATEGIES OF VALVULAR HEART DISEASE
This document discusses various percutaneous treatment strategies for valvular heart disease, focusing on mitral valve repair techniques. It provides an overview of early balloon valvuloplasty procedures and more recent advances like the MitraClip device for mitral regurgitation repair. The document reviews clinical trials that demonstrated the safety and efficacy of the MitraClip, as well as its current FDA approval status. It also discusses alternative percutaneous mitral repair approaches like indirect annuloplasty via the coronary sinus.
Surgical management of heart failure
Coronary artery revascularisation
Valve surgery
Left ventricular reconstruction
Passive cardiac support devices
LV Assist devices
Cardiac transplantation
Flail MV.pdf
This document discusses flail mitral valve, which occurs when one or both mitral valve leaflets fail to coapt due to rupture of chordae tendineae or papillary muscle. This can result in acute, subacute, or chronic mitral regurgitation. Acute mitral regurgitation secondary to flail mitral valve is discussed, including its presentation and management in the intensive care unit with vasodilators, inotropes, and intra-aortic balloon counterpulsation if needed. Indications for surgical repair or replacement of the mitral valve are also summarized.
in the footsteps of Senning
This document summarizes the long-term outcomes of the Senning operation for repair of transposition of the great arteries (TGA). It discusses:
1) The Senning operation was initially developed as a complete repair for TGA but has fallen out of favor due to risks of right ventricular failure and arrhythmias. It is still used for anatomic repair of congenitally corrected transposition of the great arteries (CCTGA).
2) Long-term follow-up studies of Senning operations show risks of reduced exercise capacity, arrhythmias, and sudden death even in asymptomatic patients. Surgical re-intervention is also required in some cases due to complications.
3) While initial mortality
Similar to Surgery for Cardiomyopathy (20)
Surgical Treatment of Ischemic Mitral Regurgitation
Surgical Treatment of Ischemic Mitral Regurgitation
RECENT ADVANCES IN THE MANAGEMENT OF REFRACTORY HEART FAILURE
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Successful Valve in Ring Abolishing the Stenosis and Regurgitation with Robus...
Successful Valve in Ring Abolishing the Stenosis and Regurgitation with Robus...
An Unusual Cause of Left Ventricular Volume Overload after Aortic Valve Repla...
An Unusual Cause of Left Ventricular Volume Overload after Aortic Valve Repla...
When do you advice mitral valve replacement for - Copy.pptx
When do you advice mitral valve replacement for - Copy.pptx
Whom to refer for mitral valve repair and whom not
Whom to refer for mitral valve repair and whom not
Harb griffin2017 article-mitral_valvediseasea_comprehensi
Harb griffin2017 article-mitral_valvediseasea_comprehensi
Contemporary Perspectives on the Diagnosis and Management of Hypertrophic Car...
Contemporary Perspectives on the Diagnosis and Management of Hypertrophic Car...
PERCUTANEOUS TREATMENT STRATEGIES OF VALVULAR HEART DISEASE
PERCUTANEOUS TREATMENT STRATEGIES OF VALVULAR HEART DISEASE
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Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Surgery for Cardiomyopathy
- 1. The myopathic patient with significant valvular regurge Presentation subtitle
- 2. The myopathic patient with significant valvular regurge Ahmed El-Minshawy, M.D. Prof. of Cardiothoracic surgery Head of Paediatric Cardiothoracic Surgery Unit Assiut University Hospitals
- 7. Valvular pathology in secondary mitral regurgitation * Left ventricular dilation alters the alignment of the papillary muscles and contributes to the development of valve incompetence. In secondary mitral regurgitation, the transmitral pressure exceeds the tethering forces of the papillary muscles.
- 9. Idiopathic cardiomyopathy * Geometric changes of the left ventricle producing central MR (Non-ischemic dilated cardiomyopathy).
- 10. Ischemic cardiomyopathy * Asymmetric geometric ventricular changes secondary to myocardial infarction (Ischemic dilated cardiomyopathy).