Secondary mitral regurgitation repair techniques and outcomes: Initial clinical experience with mitral valve translocation
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2022-01-01Journal
JTCVS TechniquesPublisher
ElsevierType
Article
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School of Medicine, University of MarylandIdentifier to cite or link to this item
http://hdl.handle.net/10713/18345ae974a485f413a2113503eed53cd6c53
10.1016/j.xjtc.2022.01.025
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Life-threatening hemoptysis following mitral valvuloplasty for rheumatic mitral stenosisSutherland, M.E.; Haji, H.; Borgan, S.M.; Reed, R.M.; McCurdy, M.T. (W.B. Saunders Ltd, 2019)Background: Massive hemoptysis is a rare complication of rheumatic mitral valve stenosis. Its recurrence following successful initial treatment of the stenosis has not, to our knowledge, been described. Case report: We describe a 58-year-old African American woman with a history of balloon valvuloplasty for the treatment of severe rheumatic mitral valve stenosis who presented to our institution with massive life-threatening hemoptysis due to recurrent mitral valve stenosis. Repeat balloon valvuloplasty was complicated postoperatively by severe mitral regurgitation and the patient expired from refractory cardiopulmonary collapse not amenable to further intervention. Conclusion: Life-threatening hemoptysis is a medical emergency requiring rapid source identification and treatment of the underlying etiology. A high degree of suspicion should be maintained for recurrence of mitral valve stenosis in patients presenting with life-threatening hemoptysis and risk factors of rheumatic heart disease, regardless of previous surgical management or unilateral chest x-ray signs. Copyright 2019 The Authors
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Commentary: Late tricuspid valve insufficiency following mitral valve repair: A marker or a cause for inferior outcome?Ad, N.; Gammie, J.S. (Mosby Inc., 2020)
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Intensive care and anesthesia management for HARPOON beating heart mitral valve repair.Diprose, Paul; Fogg, Katheryn J; Pittarello, Demetrio; Gammie, James S; D'Ambra, Michael N (Wolters Kluwer Health, 2020-07-01)Patients with severe mitral valve regurgitation secondary to degenerative disease are known to benefit from mitral valve repair surgery. Novel techniques for achieving mitral valve repair on the beating heart have been developed and are being introduced into clinical practice. The HARPOON Beating Heart Mitral Valve Repair System (MVRS) in recent studies has demonstrated efficacy and safety for the repair of degenerative mitral valve disease on the beating heart. The device uses transoesophageal echocardiographic guidance to implant artificial expanded polytetrafluoroethylene (ePTFE) cords on prolapsed mitral valve leaflets in the beating heart. It requires general anaesthesia and there are specific intensive care and anaesthesia considerations for the safe management of these cases. This article describes the general principles of intensive care and anaesthesia management employed for the initial patients treated with the HARPOON Beating Heart MVRS, the outcomes for these patients, and the potential challenges for the future management of these cases.