Surgical treatment of anterior mitral valve prolapse using artificial chordal loop

Objective To summarize clinical experience for treating anterior mitral leaflet prolapse with an artificial chordal loop. Methods From January 2008 to August 2009,pre-measured ePTFE loops were used to treat anterior leaflet prolapse in 8 patients,5 males and 3 females, aged from 28 to 68 (average 56.0±8.9) years. The heart

Related mechanisms and research progress in straight back syndrome

Despite the high prevalence of straight back syndrome(SBS),there is still limited research on this condition,posing challenges for effective diagnosis and treatment.The disease has been known for a long time,but there have been few related studies,which mostly consist of case reports.These studies have not been systematically summarized,making it difficult to meet the current needs of diagnosis and treatment.This article summarized the existing literature and comprehensively reviewed the diagnosis,pathogenesis,treatment,and research status of mitral valve prolapse related to SBS.We specifically emphasized the mechanisms and prognosis of SBS combined with mitral valve prolapse and discussed the latest research progress in this disease.

Edge-to-edge chordal transfer repair for anterior leaflet prolapse of mitral valve in 21 patients

Background Repair of anterior mitral leaflet （AML） prolapse is still a technical challenge for cardiac surgeons. It is an important issue to find a way to repair the AML prolapse with a reliable and reproducible technique.Methods Between January 2002 and June 2009, the operation of chordal transfer based on the ＂edge-to-edge＂technique was performed in 21 patients with serious mitral valve regurgitation because of prolapse of the anterior leaflet.After the operation, echocardiography was performed in each patient before discharge and at the time of follow-up.Results All patients survived the operation. One patient required mitral valve replacement because of anterior leaflet perforation 3 days after the operation. The other patients were free from reoperation. At the time of follow-up, all these patients were in New York Heart Association （NYHA） functional class I. In all these patients, pre-discharge and follow-up echocardiography showed neither stenosis nor significant regurgitation of the mitral valve： the cross-sectional area of the mitral valve was 3.3-4.8 cm2 （mean （3.78：±0.52） cm2）, the mean regurgitation area was （0.45：±0.22） cm2. At the same time, both dimension of left atrium and left ventricle reduced significantly （left atrium diameter： pre-operation （48.26±11.12） mm, post-operation （37.57±9.56） mm, P 〈0.05; the end-diastolic diameter of the left ventricle：pre-operation （61.43±8.24） mm, post-operation （42.35±10.79） mm, P〈0.01）.Conclusion ＂Edge-to-edge＂ chordal transfer technique is a simple, reliable, and reproducible technique that can provide good results for repair of anterior leaflet prolapse of mitral valve.

Delayed papillary muscle rupture after radiofrequency catheter ablation: A case report

BACKGROUND With an increased number of surgical procedures involving the mitral annular region,the risk of mitral valve prolapse(MVP)has also increased.Previous studies have reported that worsening of MVP occurred early after radiofrequency catheter ablation(RFCA)at papillary muscles in ventricular tachycardia(VT)patients with preoperative MVP.CASE SUMMARY We report a case where MVP and papillary muscle rupture occurred 2 wk after RFCA in a papillary muscle originated VT patient without mitral valve regurgitation or prolapse before.The patient then underwent mitral valve replacement with no premature ventricular contraction or VT.During the surgery,a papillary muscle rupture was identified.Pathological examination showed necrosis of the papillary muscle.The patient recovered after mitral valve replacement.CONCLUSION Too many ablation procedures and energy should be avoided.

Sequential multidisciplinary minimally invasive therapeutic strategy for heart failure caused by four diseases: A case report

BACKGROUND The coexistence with patent ductus arteriosus(PDA),mitral valve prolapse(MVP),atrial fibrillation(AF)and hyperthyroidism is extremely rare and complex.The optimal therapeutic strategy is difficult to develop.CASE SUMMARY A 27-year-old female with PDA,MVP,AF and hyperthyroidism presented with severe dyspnea.Given that a one-stage operation for PDA,MVP and AF is high risk,we preferred a sequential multidisciplinary minimally invasive therapeutic strategy.First,PDA transcatheter closure was performed.Hyperthyroidism and heart failure were simultaneously controlled via medical treatment.Video-assisted thoracoscopic mitral valve repair and left atrial appendage occlusion were performed when heart failure was controlled.Under this therapeutic strategy,the patient’s sinus rhythm was restored and maintained.Two years after the treatment,the symptoms of heart failure were relieved,and the enlarged heart was reversed.CONCLUSION Sequential multidisciplinary therapeutic strategies,which take advantage of both internal medicine and surgical approaches,might be reasonable for this type of disease.

Ventricular septal rupture and partial left ventricular posterior wall tear resulted from blunt chest trauma

Cardiac contusion and valvular injuries are the most common cardiac injuries after a blunt traumatic chestinjury.1 But ventricular septal rupture （VSR） is a rare finding after a blunt chest wall trauma.2 Here we report a 16 years old young man with no medical history who sustained a chest wall injury after a bookshelf falling on his left chest. He was hospitalized because of his chest pain and heaviness. Initial physical examination showed parasternal Ⅲ-Ⅳ systolic murmur. ECG showed a complete right bundle branch conduction blockage.