Secondary Mitral Valve Regurgitation 1st edition by Khalil Fattouch, Patrizio Lancellotti, Gianni Angelini – Ebook PDF Instant Download/Delivery: 1447164873, 978-1447164876
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ISBN 10: 1447164873
ISBN 13: 978-1447164876
Author: Khalil Fattouch, Patrizio Lancellotti, Gianni Angelini
Ischemic or idiopathic mitral valve disease (so called secondary mitral valve regurgitation) is a rather new concept. This topic is deeply polarizing the attention of the cardiologist and cardiothoracic community. Although there is an impressive amount of efforts to understand the etiology, mechanism, treatment and prognostic factors, still clear indications and guide-lines are missing. Therefore this group of patients lie in a grey-area and physicians looking after them cannot count on proper recommendations. The main purpose of this book is to review the most relevant knowledge about secondary mitral valve regurgitation, from the anatomy, definition, classification, diagnosis and prevalence to the up-to-date surgical and medical management.
Secondary Mitral Valve Regurgitation 1st Table of contents:
1: Prevalence and Definition of Secondary Mitral Regurgitation
Definition of Secondary Mitral Regurgitation
Methodological Difficulties in the Estimation of the Prevalence of Secondary Mitral Regurgitat
Detection and Evaluation of Secondary MR
Sources of Bias
Ischaemic MR
Secondary MR and Heart Failure due to Systolic Dysfuntion
Prevalence of Ischaemic MR
Prevalence of Secondary MR due to Heart Failure with Systolic Dysfuntion
Potential Implications of the Burden of Secondary MR
References
2: Anatomical Changes Associated with Secondary Mitral Regurgitation: Difference Between Ischemic a
Histology
Anatomy
Valve Annulus
Geometry
Histology
Differences Between Functional and Ischemic Mitral Valve Regurgitation
Subvalvular Apparatus
Chordae Tendianeae and Papillary Muscles
Left Ventricle Dysfunction
References
3: Clinical Prognostic Value of Secondary Mitral Valve Regurgitation
Mitral Regurgitation Diagnosed in the Acute Phase of Myocardial Infarction
Mitral Regurgitation Diagnosed in the Chronic Phase Post Myocardial Infarction and in Patients
Predictors of Outcome in Patients with Functional Mitral Regurgitation
Summary
References
4: Functional Classification of Secondary Mitral Valve Regurgitation
Carpentier Classification of Secondary Mitral Regurgitation
Type I Carpentier SMR
Type II Carpentier SMR
Type IIIB Carpentier SMR
Ischemic Mitral Regurgitation
SMR Due to Non-ischemic Dilated Cardiomyopathy
Treatment for Carpentier IIIb
Other Types of Functional Classification for SMR
Fundaro et al. [60] Functional Classification
Miller’s Classification System
Conclusions
References
5: Three-Dimensional Echocardiographic Imaging of Secondary Mitral Valve Regurgitation
Data Acquisition
Mitral Valve Morphology Assessment by 3D Echocardiography
Mitral Annular Geometry in SMR
Mitral Leaflet Morphology in SMR
MV Subvalvular Apparatus Morphology in SMR
SMR Severity Assessment by 3D Echocardiography
Role of 3D Echocardiography in Pre-procedural Selection of Patients and Intervention Guiding
References
6: Dynamic Stress Evaluation of Secondary Mitral Regurgitation
Pathophysiology of Dynamic SMR
Stress Test Modalities Available for SMR Assessment
How to Perform Exercise Stress Echocardiography in Patients with SMR
Parameters to Be Assessed During Exercise Stress Echocardiography for SMR
Prognostic Impact of Dynamic SMR
In Which Patients Should Stress Echocardiography Be Considered?
Conclusion
Reference
7: Timing and Patient’s Selection for Surgical Repair of Secondary Mitral Valve Regurgitation
Indications for Intervention in Secondary Mitral Valve Regurgitation
Benefit of Surgical Repair in Patients with Moderate-Severe MR (Grade 3–4) Undergoing CABG
Benefit of Surgical Repair in Patients with Moderate MR Undergoing CABG
Stratification of Mild-Moderate MR with Exercise Doppler Echocardiography
Mitral Valve Repair (Restrictive Annuloplasty) Versus Mitral Valve Replacement
Predictors of Outcome After MV Surgery
Predictors of Persistent or Recurrent Ischemic MR After MV Repair
References
8: Preoperative Echocardiographic Evaluation of Secondary Mitral Valve Regurgitation
Mitral Valve Anatomy and Mechanisms Underlying Secondary Mitral Regurgitation
Role of Echocardiography
Quantitative Measures of the Severity of Mitral Regurgitation
The Role of Stress Echo in the Pre-operative Assessment
A Recommended Echocadiographic Approach
Parameters to Assess
Left Ventricular Size and Shape
Mitral Valve Annulus
Mitral Valve Deformation [6, 54, 61]
Information Which Will Help Determine Suitability for Mitral Valve Repair
Quantification of MR
Other Parameters Which Should Also Be Included in the Report
Conclusion
References
9: Perioperative Anesthesia Management in Secondary Mitral Regurgitation and Heart Failure
Preoperative Assessment
Perioperative Medication Management
Intraoperative Management
Post-cardiopulmonary Bypass Ventricular Dysfunction and Failure
Perioperative Cardiogenic Shock
Main Postoperative Management Issues
Conclusion
References
10: Prosthetic Ring Choice in Secondary Mitral Regurgitation
Pathophysiological Basis for Annuloplasty in Secondary Mitral Valve Regurgitation
Evolution of Annuloplasty in Mitral Valve Repair
Identifying the Optimal Annuloplasty for Functional Mitral Regurgitation
Annuloplasty Types in Secondary Regurgitation
Suture Annuloplasty
Pericardial Annuloplasty
Complete Ring Annuloplasty
Flexible Bands and Rings
Rigid and Semi-Rigid Ring Annuloplasty
Etiology-Specific Ring Annuloplasty
IMR ETlogix Ring Annuloplasty
GeoForm Ring Annuloplasty
Saddle Ring and Profile 3D Ring Annuloplasty
Measuring and Sizing of Rings
Results of Annuloplasty
Conclusions
References
11: Papillary Muscle Relocation
Animal Studies
Clinical Results
References
12: Chordal Cutting: State of the Art
Chordal Cutting
Principle
Safety and Preserved LV Function
Chordal Cutting Associated with Annuloplasty
Clinical Experience
Conclusion
References
13: The Role of the “Edge-to-Edge” in Mitral Valve Repair
The Role of the Edge-to-Edge Technique
Echocardiography
“Echo Guided” Surgical Technique
Results
Conclusions
References
14: Mitral Prosthesis Insertion for Functional Mitral Regurgitation: Indications and Results
Definition
Natural History
Surgical Indication
Surgical Treatment and Results
Conclusion
References
15: The Coapsys Device: Technique and Results
Coapsys Background
Coapsys Device Configuration
Animal Studies
Initial Clinical Trials
Preliminary Results
RESTOR-MV Results
Implications and Further Analysis
Conclusions
References
16: Role of Cardiac Resynchronization Therapy
Introduction
Prevalence of Mitral Regurgitation in Heart Failure Patients and Implications for Prognosis
Mechanisms of Improvement in Mitral Regurgitation After Cardiac Resynchronization Therapy
Papillary Muscle Dyssynchrony
Imbalance in Tethering and Closing Forces
Impact of Cardiac Resynchronization Therapy on Mitral Regurgitation and Remodeling
CRT as an Alternative for Surgical Mitral Valve Repair
Conclusion
References
17: Percutaneous Treatment in Mitral Valve Regurgitation
Introduction
MitraClip Treatment
Patient Selection for MitraClip
Percutaneous Annuloplasty and New Frontiers
Conclusion
References
18: Two- and Three- Dimensional Echocardiographic Imaging During Percutaneous Mitral Clip Procedure
Patient Selection
Mitral Regurgitation Severity
Etiology and Mechanism of Mitral Regurgitation
Anatomical Assessment
Intraprocedural Monitoring
Transseptal Puncture
System Advance to the Mitral Valve
System Alignment in the Mitral Regurgitant Orifice
System Delivery
Complications
Follow Up
References
19: Right Ventricle and Functional Tricuspid Regurgitation: An Unpredictable Interaction
Surgical Anatomy
The Tricuspid Valve
The Right Ventricle
Physiology
Interaction Between Right Ventricle and Functional Tricuspid Regurgitation
Annular Enlargement
Papillary Muscle Displacement
Imaging Assessment of the Right Ventricle and the Tricuspid Regurgitation
Right Ventricle
Tricuspid Regurgitation
Surgical Consideration
References
20: Predictors of Recurrent Chronic Ischemic Mitral Regurgitation After Mitral Valve Repair Surgery
Introduction
Echocardiographic Parameters as Predictors of Recurrent Mitral Regurgitation
Left Ventricle Dilatation
Sphericity Index
Tenting Area
Coaptation Depth (Tenting Height)
Leaflet Tethering
Interpapillary Muscles Distance
Annulus Dimension
Left Ventricle Dyssynchrony
Mitral Valve Severity
Left Ventricular Diastolic Filling
Coaptation Height
Surgical Strategies and Recurrence of Ischemic MR
Type of Ring
The Sizing Technique
Papillary Muscles Relocation
Repair vs Replacement in a Context of Depressed Left Ventricular Function
Conclusion
Appendix
References
21: Management After Secondary Mitral Valve Repair
Introduction
Mitral Regurgitation Secondary to Lone Atrial Fibrillation
Mitral Regurgitation Secondary to LV Dilatation or Myocardial Ischemia
Antithrombotic Management
Assessment and Follow up of the Repaired Mitral Valve
Clinical Practice
Mitral Gradients
Residual Mitral Regurgitation
LV Remodelling
Right Ventricular Function
Left Atrial Size
Pulmonary Hypertension
Clinical Assessment
Do Not Forget the Tricuspid Valve
Optimal Medical Therapy and Consideration for Cardiac Resynchronisation Therapy
Medical Therapy
Permanent Pacing
References
Index
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Tags: Khalil Fattouch, Patrizio Lancellotti, Gianni Angelini, Secondary Mitral, Valve Regurgitation