Month: September 2024

Long-term follow-up of posterior mitral leaflet extension for Type IIIb ischemic mitral regurgitation

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JTCVS Open. 2024 Jan 22;18:33-42. doi: 10.1016/j.xjon.2024.01.007. eCollection 2024 Apr.

ABSTRACT

OBJECTIVE: Ischemic mitral regurgitation (MR) is generally associated with very poor outcomes and disappointing results, despite a seemingly perfect initial repair and optimal revascularization. We previously published our intermediate-term results of posterior leaflet augmentation without follow-up extending beyond 4 years. Our objective is to assess long-term durability of the repair, survival, and the causes of late mortality.

METHODS: Ninety-one patients with severe (4+) Carpentier Type IIIb ischemic MR underwent repair in a single center between 2003 and 2022 by method of posterior leaflet extension using a patch of bovine pericardium and a true-sized remodeling annuloplasty ring, with or without surgical revascularization. Serial echocardiography was performed over the years to ascertain valve competence and degree of ventricular remodeling, in addition to telephone follow-up and chart reviews.

RESULTS: The average age of patients was 67 ± 9.6 years. Mean follow-up was 8 ± 5 years with some extending to almost 20 years. One-, 5-, and 10-year freedom from recurrent significant MR, characterized as moderate or severe MR, was 98.6%, 85.5%, and 71.3%, respectively. Thirty-day mortality was 6.5%. One-, 5-, and 10-year survival was 85.5%, 64.4%, and 43.3%, respectively. Of all the mortalities, only 17.5% were proven to be directly cardiac related.

CONCLUSIONS: The suggested repair technique offers satisfactory long-term outcomes with minimal residual regurgitation in surviving patients when used in context of ischemic MR. Despite durable repair, we have discovered that poor long-term survival is not directly related to cardiovascular causes.

PMID:38690431 | PMC:PMC11056449 | DOI:10.1016/j.xjon.2024.01.007

“One-stop” interventional therapy for quadricuspid aortic valve combined with severe coronary artery disease: a case report

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Congenital Quadricuspid Aortic Valve (QAV) malformation is a relatively rare cardiac valve malformation, especially with abnormal coronary opening and severe stenosis of Coronary Artery Disease (CAD). The pati…  Read More

A retrospective study on safety and efficacy of recombinant human soluble thrombomodulin to acute aortic dissection with disseminated intravascular coagulation

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Recombinant human soluble thrombomodulin (rTM) has recently been used as a promising therapeutic natural anti-coagulant drug for disseminated intravascular coagulation (DIC). Here we investigated the safety an…  Read More

Spontaneous avulsion of left internal mammary artery graft a complication of coronary artery bypass surgery: case report and review of the literature

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Coronary artery bypass grafting (CABG) surgery is a common procedure for managing multi-vessel coronary artery disease to revascularize the myocardium. Among the various conduits used, the left internal mammar…  Read More

Surgical treatment of a left ventricular pseudoaneurysm with an extracellular matrix patch

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Indian J Thorac Cardiovasc Surg. 2024 May;40(3):381-383. doi: 10.1007/s12055-023-01669-3. Epub 2023 Dec 28.

ABSTRACT

Left ventricle pseudoaneurysm is a rare and life-threatening complication of myocardial infarction that is formed as a result of left ventricle free wall rupture contained by the overlying pericardium. Urgent surgical repair is crucial, and in most reports, left ventricle was reconstructed with a Dacron or bovine pericardial patch. We present a case of a 66-year-old female with left ventricle pseudoaneurysm which was successfully repaired with an extracellular matrix patch.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-023-01669-3.

PMID:38681700 | PMC:PMC11045679 | DOI:10.1007/s12055-023-01669-3