A46-year-old man presented with a 48-hour history of fevers, sweats, and dyspnea. He had bacterial endocarditis of the native mitral valve 12 years earlier with subsequent mitral valve replacement (MVR) with a Hancock II porcine valve (Medtronic Inc). Examination revealed a Grade 3/6 holosystolic murmur at the apex radiating into the axilla with crackles heard halfway up both lung fields. A dia...

Mitral valve repair is shown to have better survival, preservation of ventricular function and decreased thromboembolic complications compared to mitral valve replacement for mitral regurgitation (MR).13–15 At our institution, we have developed a simple algorithm for mitral valve repair in myxomatous disease, which allows reproducible and durable repair. Our general plan is described by the fol...

giant left atria are defined as those measuring larger than 8 cm and are typically found in patients who have rheumatic mitral valve disease with severe regurgitation. enlargement of the left atrium may create compression of the surrounding structures such as the esophagus, pulmonary veins, respiratory tract, lung, inferior vena cava, recurrent laryngeal nerve, and thoracic vertebrae and lead t...

A 70-year-old man was admitted to our hospital for surgical treatment of mitral insufficiency. A preoperative echocardiogram revealed a prolapsed anterior mitral leaflet, membranous septal aneurysm (MSA), and unusual chordae extending from the ventricular septum to the anterior mitral leaflet (Movies I and II in the online-only Data Supplement). In surgery, the aneurysm was examined through the...

repair of the mitral valve is the treatment of choice for mitral valve regurgitation when the anatomy is favorable. it is well known that mitral valve repair enjoys better clinical and functional results than any other type of valve substitute. this fact is beyond doubt regardless of the etiology of the valve lesion and is of particular importance in degenerative diseases. this review analyzes ...

A 77-year-old woman with a fractured femur was referred to our hospital because preoperative echocardiography raised suspicion of a mitral valve tumor. She had no history of unknown fever or heart murmur. Transthoracic and transesophageal echocardiography showed severe mitral regurgitation and aortic regurgitation. A mobile lesion that appeared to be a cystic tumor (14 15 mm) was on the posteri...

Chordal replacement with expanded polytetrafluoroethylene (ePTFE) sutures has proven to be a simple, versatile, and durable technique for the treatment of prolapsed cusps causing mitral valve regurgitation. ePTFE is known for its strong resistance to tension, and is judged to be unbreakable under physiological conditions. Herein are reported two cases of rupture of synthetic chordae tendineae; ...

RESULTS Compared with surgical diagnosis, the accuracy of TEE was high: 99% for cause and mechanism, presence of vegetations and prolapsed or flail segment, and 88% for ruptured chordae. Diagnostic accuracy was higher for TEE than TTE for all end points (p ! 0.001), but the difference was of low magnitude (!10%) except for mediocre TTE imaging or flail leaflets (both p ! 0.001). The type of mit...