Our findings suggest that cumulative effect of both traditional and common genetic risk factors was associated with recurrence of ischemic stroke. We demonstrated for the first time that a combined genotype FVL/MTHFR profile increase the risk of a second cerebral ischemic attack.
Clot-busting drugs are the main treatment for stroke, but they have often not been recommended for people who have an aneurysm in their brains that has not ruptured. An aneurysm is a bulge in the wall of a blood vessel in the brain. A new study finds that these aneurysms rarely burst after treatment with clot-busting drugs, so the drugs may be safe for use. The study is published in the October 6, 2021, online issue of Neurology, the medical journal of the American Academy of Neurology.
A new study finds that Thrombolytic therapy may be safe for people with ischemic stroke even if they have unruptured aneurysms.The study is published in the October 6, 2021, online issue of Neurology®, the medical journal of the American Academy of Theology.
All patients undergoing intervention for complex severe valvular heart disease should be evaluated by a multidisciplinary team at a Primary or Comprehensive Valve Center. This recommendation reflects the increasing number of options available to manage valvular lesions, the complexity of decision-making and the focused expertise necessary to achieve excellent clinical results.Earlier intervention is called for in patients with mitral valve regurgitation. The new document repeatedly emphasizes the need for treatment before the onset of left ventricular dysfunction.
Biological valves are made from animal tissue. They are fashioned from pig, cow, horse, or human (donated) tissue. The animal tissue type is called a xenograft. The human (from a donated heart) type is called an allograft or homograft. The valves are treated to mitigate the need for anti-rejection medications.Mechanical valves are made from a strong material, such as carbon. These valves are more durable than biological valves. A consideration prior to selecting a mechanical valves is that patients currently need to take blood thinners (warfarin) to prevent clot formation on the valve for the rest of their life. However, the PROACT Xa clinical trial is now evaluating whether or not the On-X mechanical valve can use Eliquis instead of warfarin.
Traditional, open-chest surgeries, such as mitral and tricuspid valve surgery, and bypass surgery involve: placing the patient on the heart-lung bypass machine to circulate oxygenated blood during surgery; creating a 6- to 8-inch incision through the sternum; spreading the ribs to view the heart and stopping the heart in order to stabilize the blood vessels.
“The burden of chronic diseases such as arterial disease, hypertension, obesity/diabetes, and other heart-related disorders is rapidly increasing in both developed and developing nations and is fueling market growth,” the report stated. “In addition to a large disease population, shorter recovery time, and shorter hospital stays, favorable outcomes with TAVR and TMVR and technological advancements are also driving the adoption of transcatheter heart valve devices.”
No long-term survival or reoperation difference was found between posterior and anterior repair. On the basis of these findings, surgeons at centers of excellence should aim for repair of both anterior and posterior leaflet pathology with the same decision-making threshold over valve replacement for degenerative mitral disease.
Transcatheter mitral valve replacement is the minimum-invasive method for the treatment of moderate-to-severe mitral regurgitation. The mitral valve is also recognized as the bicuspid valve or left the atrioventricular valve in the heart that lies between the left atrium of the heart and ventricle. The mitral valves help to keep the legitimate blood flow from the left chamber to the left ventricle and to keep away from the backflow of blood back into the left atrium. Mitral valve replacement is carried-out when the valve becomes very tight to flow the blood into the ventricle.
Overall, significant improvement was achieved for the diseased valve after MitraClip implantation. Prior to the introduction of the clip, the diseased valve was subjected to posterior leaflet prolapse which would induce a jet of MR. Once the MitraClip was included in the simulation, the valve leaflets were able to close and seal off, almost entirely at peak systolic condition without a significant impact on the stress distribution of the valve leaflets.
In keeping with the Epic surgical valve platform, the new valves are designed to deliver long-term performance and durability due to Abbott’s anticalcification technology. The Epic Plus Mitral holder, which helps to ensure precise insertion of the valve, also has a lower profile so physicians have a better view of the device for accurate placement during implantation, Abbott said in a press release. The device can be implanted in the aortic or mitral valve position and in patients with more complicated anatomies.
Congestive Heart Failure (CHF) is a complex disease that leads to debilitation and mortality. After an initial insult usually involving ischemic, hypertensive, or idiopathic factors, the heart suffers muscle damage and shifts the workload to the remaining healthy muscle. To compensate, the heart geometrically remodels causing increased load and stress, which causes further damage, thus perpetuating a vicious cycle.
A major potential benefit of the technique, the authors suggest, is the predictable, complete elimination of MR, which is less certain with TEER. This benefit needs to be evaluated against its risks, Rogers and colleagues suggest, including the relative procedural invasiveness, need for anticoagulation, and long-term structural valve deterioration.
Son dernier bébé, Mitral Technologies, a été lancé aux Etats-Unis en mai 2014 avec le docteur Luigi Tozzi et le professeur Piergiorgio Tozzi. La société a développé un dispositif médical permettant de traiter les patients atteints de régurgitation mitrale par un abord non-invasif, soit en utilisant les voies naturelles et le système vasculaire. "Cela s’inscrit dans une nouvelle philosophie qui se développe depuis 20-25 ans et qui consiste à développer des dispositifs rendant la chirurgie moins lourde et moins risquée pour les patients", commente Jean-Paul Rasschaert.
With the growing prevalence of heart valve diseases, it is important to better understand the biomechanical behavior of normal and pathological heart valve tissues. Recent studies showed that heart valve leaflets exhibited a unique functionally elastic behavior, in which valvular tissues exhibited minimal hysteretic and creep behaviors under biaxial loading, yet allowed stress relaxation similar to other types of collagenous tissues. This unique behavior is in favor of heart valve function, enabling leaflets to bear peak physiological loading without time-dependent deformation.
Background. Native valve endocarditis is frequently managed with antibiotics alone, but prosthetic valve endocarditis usually requires an early operation. What is the best treatment of endocarditis after mitral valve repair?
The contradictory results of transcatheter therapies in the MITRA-FR and COAPT trials have generated much controversy. Our understanding of the results of these two trials is that percutaneous edge to edge repair is beneficial in selected patients with severe FMR who remained symptomatic despite guideline medical therapy, but precise criteria to identify these patients remain to be defined.
Transcatheter mitral valve technology represents one of the most promising markets in medtech, likely even surpassing that of aortic transcatheter devices. But so far, no consensus has emerged on the optimum approach. Half Moon Medical, a novel build-to-buy project that brings together The Foundry and Medtronic, is making the case for repair rather than replacement.
Patient interest in robotic mitral valve repair surgery continues to increase. Now, more than ever, I’m getting patient questions about robot-assisted therapies and the surgeons that focus on this super-specialized approach to mitral valve repair. For example, I’m just getting off the phone with Elaine from Georgia. She asked me, “Adam, I have mitral regurgitation. I want a repair not a replacement. What do you think about surgery using the robot?”
The pioneering robot-assisted mitral valve repair ended in catastrophe, with a cascade of failures resulting in the death of retired conductor Stephen Pettitt at Freeman Hospital in Newcastle, according to a continuing inquest as reported in the Daily Mail. Lead surgeon Sukumaran Nair and assisting surgeon Thasee Pillay could hardly hear each other due to a "tinny" sound emanating from the robot console Nair was operating. Nair had to shout to warn his colleague that the robot, called Da Vinci, was stitching up the valve incorrectly – and then shout again when he saw the robot "knocked" one of the surgical assistants' arms.
Cedars-Sinai received the top rating from the Society of Thoracic Surgeons for mitral surgery again this year. The team recently presented their experience from more than 1,000 robotic mitral repairs with near 100% early survival and repair rates at the 2021 Society of Thoracic Surgeons Annual Meeting.
There are two types of treatment available for mitral valve prolapse:
In this propensity-matched analysis, there was no significant difference in 2-years survival between TMVr and SMVr. Compared with SMVr, TMVr resulted in inferior MR reduction and LVEF improvement, and worse functional status at 2 years.
Heart valves open when the heart pumps to allow blood to flow. They close quickly between heartbeats to make sure blood does not flow backward. Any trouble in this normal flow pattern will make it hard for the heart to pump the blood where it needs to go.
The Tria valves reimagine the heart valve by incorporating a new, proprietary biopolymer—LifePolymer—with innovative valve designs intended to resist calcification, withstand stresses and strains without failure, and restore patient quality of life without lifelong use of anticoagulants. Tria is also the first and only heart valve to be robotically produced, which is possible due to its polymer leaflets that can be consistently manufactured with precise thicknesses and are designed to achieve a valve with predictable performance that lasts a lifetime.
Max Super Speciality Hospital, Saket has conducted a mitral valve repair (a leaking heart valve) surgery using the transcatheter technique. A MitraClip, a small, implanted clip, was attached to the mitral valve to close/repair it thereby restoring normal blood flow through the heart. It is the world’s first transcatheter mitral valve repair (TMVr) therapy that delivers a minimally invasive treatment option.
Unique au monde, Electroducer Sleeve s’appuie sur une technique médicale appelée Direct Wire Pacing (DWP®), développée par le fondateur de l’entreprise, le Dr Benjamin Faurie, et utilisée pour la première fois au monde en 2011. Elle consiste à remplacer l’étape d’implantation d’un pacemaker temporaire dans le cœur, traumatique et douloureuse pour le patient, par une stimulation effectuée directement sur l’instrument porteur de la valve, appelé « fil guide ».
Acute severe valvular regurgitation is a surgical emergency, but accurate and timely diagnosis can be difficult. Although cardiovascular collapse is a common presentation, examination findings to suggest acute regurgitation may be subtle, and the clinical presentation may be nonspecific. Consequently, the presentation of acute valvular regurgitation may be mistaken for other acute conditions, such as sepsis, pneumonia, or nonvalvular heart failure. Although acute regurgitation may affect any valve, acute regurgitation of the left-sided valves is more common and has greater clinical impact than acute regurgitation of right-sided valves.
Significant mitral regurgitation (MR) is estimated to afflict >2 million Americans and is anticipated to increase in prevalence as the baby boomer population ages.1 Approximately 10% of people ≥75 years of age have significant MR,1 and these patients have decreased survival regardless of whether MR is caused by a primary leaflet abnormality2 or is secondary to left ventricular (LV) dysfunction.3–7