Twenty-two patients with severe mitral regurgitation were observed to have turbulent systolic antegrade flow on pulsed Doppler mapping of the left atrium. All were studied by color flow imaging to delineate the mechanism of this peculiar flow. Pulsed Doppler findings of an eccentric regurgitant flow in one side, an antegrade systolic flow with slightly delayed onset in the other side, and a low velocity flow near the posterior wall, were consistant with the theory of a large eccentric regurgitant jet swirling in the left atrium. Color flow imaging confirmed this mechanism in all patients. Nineteen patients had flail mitral valve with a positive predictive value of 86%. The other three patients had deformed rheumatic mitral valve. The severity of mitral regurgitation was confirmed in all 16 patients studied by left ventricular cineangiography. We have shown that the antegrade systolic left atrial flow is the result of the swirling of a large regurgitant eccentric jet, is commonly observed with flail mitral valve, can occur in patients with deformed rheumatic mitral valve without flail leaflet, and most significantly indicates the presence of severe mitral regurgitation.
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http://dx.doi.org/10.1016/s0894-7317(89)80008-2 | DOI Listing |
BMC Cardiovasc Disord
January 2025
Department of Cardiology, Xuzhou Central Hospital, No.199 Jiefang South Road, Quanshan District, Xuzhou, 221009, People's Republic of China.
Background: The aim of this study is to identify factors associated with the development of long-term severe tricuspid regurgitation (TR) following mitral valve replacement (MVR).
Methods: A retrospective analysis was conducted involving 308 patients who underwent single-valve MVR at Xuzhou Central Hospital between April 2017 and December 2022. Preoperative color Doppler ultrasound indicated that all patients had either no or mild to moderate tricuspid regurgitation.
BMC Anesthesiol
January 2025
Department of Anaesthesiology, West China Hospital, Sichuan University & The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, 610041, China.
Background: Given the prevalence of cardiovascular disease, encountering difficult airways in this patient population is quite common. The challenge for anesthesiologists lies not only in establishing the airway but also in managing the hemodynamic instability caused by sympathetic activation during intubation. The purpose of this report is to describe the anesthetic experience of this patient with severe mitral and tricuspid regurgitation, atrial fibrillation with rapid ventricular response, and moderate pulmonary hypertension with an anticipated difficult airway.
View Article and Find Full Text PDFFront Cardiovasc Med
January 2025
Department of Cardiovascular Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background: Atrial fibrillation (AF) is a prevalent cardiac arrhythmia, with ventricular rate control being a critical therapeutic target. However, the optimal range for ventricular rate control remains unclear. Additionally, the relationship between different levels of ventricular rate control and cardiac remodeling in patients with atrial fibrillation remains unclear.
View Article and Find Full Text PDFIndian J Thorac Cardiovasc Surg
February 2025
Ankara City Hospital Cardiovascular Surgery, Ankara, Turkey.
Unlabelled: The Bland-White-Garland syndrome, or Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) syndrome, is a rare congenital cardiac anomaly often associated with high mortality, if left untreated. We present a case of a 43-year-old female with undiagnosed ALCAPA who initially underwent mitral valve surgery for severe mitral regurgitation, only to require reoperation due to adult-type ALCAPA. Intraoperatively, the discovery of dilated right coronary artery and its branches and absence of the left coronary ostium prompted further investigation, leading to the diagnosis of adult-type ALCAPA.
View Article and Find Full Text PDFIndian J Thorac Cardiovasc Surg
February 2025
Government Medical College, Omandurar Government Estate, Chennai 02, Tamilnadu India.
Minimally invasive mitral valve surgery (MIMVS) is revolutionizing the field of cardiothoracic surgery by offering patients less invasive alternatives to conventional sternotomy. This article reviews recent research and studies on the outcomes, challenges, and considerations surrounding MIMVS. Comparative studies reveal that while MIMVS offers advantages such as shorter hospital stays and reduced recovery times, it shows no significant differences in mortality or long-term quality-of-life outcomes compared to traditional methods.
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