China
Africa
Explore chapters and articles related to this topic
Valve Disease
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Patients with mitral stenosis with favourable valve anatomy and pliable leaflets, undergo either open or percutaneous mitral commissurotomy but this is rarely done in developed countries because of advanced disease. Most patients with valve disease will undergo replacement.
Mitral regurgitation, mitral stenosis, and mitral annular calcification in the elderly
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Hasan Ahmad, Wilbert S. Aronow
The major pathology is that of commissural fusion and fusion and shortening of the chordae tendinae. Later, there is increasing fibrosis and calcification of the valve leaflets. Therefore, the obstruction to diastolic flow across the mitral valve can be due to the narrowed mitral orifice caused by commissural fusion and to the thickening and calcification of the leaflets so that they do not open without a pressure gradient in spite of open commissures, or to obstruction due to a subvalvular component caused by fused, shortened chordae tendinae. In these latter two instances, commissurotomy will not relieve the obstruction and valve replacement is necessary.
Cardiovascular system
Published in Brian J Pollard, Gareth Kitchen, Handbook of Clinical Anaesthesia, 2017
Redmond P Tully, Robert Turner
Asymptomatic patients with minor to moderate MS undergoing noncardiac surgery will normally tolerate anaesthesia well with no significant mortality or morbidity. However, in the presence of symptoms, echocardiographic evidence of RV dysfunction and PH or in severe disease (valve area <1.0 cm2), there is increased mortality and cardiac morbidity associated with the perioperative period. These patients should have elective surgery postponed, and referral to cardiology for evaluation and consideration of MV surgery or balloon commissurotomy.
Safety and feasibility of same-day discharge after elective percutaneous balloon mitral valvotomy: a prospective, single-center registry in India
Published in Acta Cardiologica, 2021
Sharad Chandra, Abhishek Gupta, Gaurav Chaudhary, VS Narain, SK Dwivedi, Rishi Sethi, Akshyaya Pradhan, Pravesh Vishwakarma, Akhil Sharma, Monika Bhandari, Salvatore Cassese
A variety of surgical techniques have been studied in patients with MV stenosis (closed or open commissurotomy as well as MV replacement) [4]. However, the development of percutaneous mitral balloon valvotomy (PMBV) by Inoue in 1984 represented a breakthrough for the treatment of selected patients with MV stenosis [5]. Indeed, similar to surgical closed commissurotomy, PBMV consists of mechanical dilatation of fused commissures to increase valve orifice area [4]. Several randomised trials have demonstrated comparable outcomes with PBMV versus surgical commissurotomy [6–10]. For this reason, guideline-writing authorities recommend PBMV in symptomatic patients with severe MV stenosis and in asymptomatic patients with high pulmonary artery pressure [11,12]. Recently, PMBV has emerged as the interventional treatment of choice for eligible patients with symptomatic MV stenosis [4,13].
Percutaneous mitral commissurotomy in women with asymptomatic severe mitral stenosis before pregnancy
Published in Acta Cardiologica, 2021
Çayan Çakır, Yemlihan Ceylan, Ali Karagöz, Mehmet Şefa Ökten, Yüksel Kaya
According to the recommendations of the 2017 ESC guidelines for the management of valvular heart disease, the contraindications for PMC include patients with mitral valve area (MVA) >1.5 cm2, left atrial thrombus, more than mild mitral regurgitation, severe or bicommissural calcification, absence of commissural fusion, severe concomitant aortic valve disease, severe combined tricuspid stenosis and regurgitation requiring surgery, or concomitant coronary artery disease requiring surgery. One patient with a history of commissurotomy, one patient with severe tricuspid regurgitation and four patients with incomplete records were also excluded from this study.
Stress echocardiography in valvular heart disease
Published in Expert Review of Cardiovascular Therapy, 2018
Sveeta Badiani, Peter Waddingham, Guy Lloyd, Sanjeev Bhattacharyya
The AHA guidelines recommend consideration of percutaneous mitral balloon commissurotomy for symptomatic patients with MV area > 1.5 cm2 if there is evidence of hemodynamically significant mitral stenosis based on pulmonary artery wedge pressure greater than 25 mm Hg or mean MV gradient greater than 15 mm Hg during exercise [4]. The ESC guidelines recommend consideration of percutaneous mitral balloon commissurotomy in symptomatic patients with a valve area > 1.5 cm2 if symptoms cannot be explained by another cause and if the anatomy is favorable [3].