Systematic review and meta-analysis of chordal replacement versus leaflet resection for posterior mitral leaflet prolapse

Mazine, Amine; Friedrich, Jan O.; Nedadur, Rashmi; Verma, Subodh; Ouzounian, Maral; Jüni, Peter; Puskas, John D.; Yanagawa, Bobby

doi:10.1016/j.jtcvs.2017.07.078

Cited by 60 publications

(61 citation statements)

References 47 publications

(71 reference statements)

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“…Die operative Mitralklappenrekonstruktion ist die Therapie der Wahl bei der MI, da sie dem Mitralklappenersatz hinsichtlich der perioperativen Letalität und der Langzeitergebnisse überlegen ist [45]. Im Grundsatz werden Mitralklappenpathologien heute zunehmend in minimalinvasiver Technik durchgeführt, derzeit in über 60 (von insgesamt 80) Zentren, mit einem Rekonstruktionsanteil von 40-70 %.…”

Section: Minimalinvasive Mitralklappenchirurgieunclassified

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Kardioanästhesie: anästhesiologisches Management

Renner¹,

Bein²,

Broch³

2018

Anästhesiol Intensivmed Notfallmed Schmerzther

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The anaesthesiological management of patients scheduled for cardiac surgery has been refined distinctively over the last decade due to different reasons. The continuing growth of the elderly patient population and the increasing number of combined cardiac surgery procedures in octogenarians on the one hand are one aspect. The rapid development of minimally invasive cardiac surgery and the enhancements in mechanical, artificial heart assist devices on the other hand can be seen as additional decisive factors. All of these innovations in the field of cardiac surgery implicate further enhancements regarding the anaesthesiological management. This review article addresses the following subareas of cardiac anaesthesia: significance of pharmacological myocardial protection, anaesthetic management during cardiopulmonary bypass, importance of "Enhanced Recovery After Cardiac Surgery"-protocols as well as innovations in the field of minimally invasive cardiac surgery like transcatheter aortic valve implantation.

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Section: Minimalinvasive Mitralklappenchirurgieunclassified

“…Eigene Analysen aus unserem Zentrum zeigen eine Häufigkeit von 19,9 % sowie in 1,9 % die Notwendigkeit eines extrakorporalen Lungenunterstützungssystems (▶ Abb. 6)[45].…”

unclassified

Kardioanästhesie: anästhesiologisches Management

Renner¹,

Bein²,

Broch³

2018

Anästhesiol Intensivmed Notfallmed Schmerzther

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“…Grade 4 had complex MAC that may require some resection and annular reconstruction. [21][22][23][24] In our patient, prolapse of anterior leaflet is seen, with grade 3 disease, so surgery is more complex and requires intense surgical expertise. Generally, to correct AML prolapse caused by a ruptured or elongated chord, surgeon will create new Gore-Tex chords.…”

Section: Managementmentioning

confidence: 84%

Progeroid Syndrome with Mitral Regurgitation: A Rare Case Report

Chakravarthi

Kishore

Kumar

2020

Indian Journal of Cardiovascular Disease in Women WINCARS

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Progeroid syndromes (PS) involve the disorder of early aging. Although survival of progeria syndrome patients is nearly 15 years as per literature, the adult onset progeroid starts manifesting in the third decade. Here, we are presenting a rare case of progeroid at the age of 45 years with mitral regurgitation (MR). The patient has alopecia, dry skin, frontal bossing, up staring eyes with bilateral corneal opacities, prominent nose with parrot beak appearance, thin upper lip, large, low-set ears, periorbital hyperpigmentation, micrognathia, retrognathia, and hyperpigmentation over lower abdomen/both feet and hands. Facial and skeletal manifestation are the major clinical features of the PS; along with the characteristics mentioned above, the patient also had severe eccentric MR. This patient has PS with mitral valve prolapse and severe MR. Most of the features of progeria exist in this patient, which manifested at a younger age. However, the progression of the external features and survival up to 45 years favors PS instead of progeria. Therefore, genetic analysis is mandatory to confirm. We are reporting this case due to the rarity of onset of symptoms within a younger age group; however, the progression of the disease was very slow, which may be a another variant of progeria/PS.

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“…5 We are thus in the presence of 2 very efficient alternative techniques that, however, have never been appropriately compared. It is in this milieu that Mazine and colleagues 6 from Toronto have performed a review and meta-analysis of chordal replacement versus leaflet resection for posterior leaflet prolapse, published in this edition of our Journal. In this study, Mazine and colleagues 6 found that ''leaflet resection and chordal replacement are associated with similar survival and freedom from recurrent MR.…”

mentioning

confidence: 99%

“…It is in this milieu that Mazine and colleagues 6 from Toronto have performed a review and meta-analysis of chordal replacement versus leaflet resection for posterior leaflet prolapse, published in this edition of our Journal. In this study, Mazine and colleagues 6 found that ''leaflet resection and chordal replacement are associated with similar survival and freedom from recurrent MR. However, chordal replacement may be associated with greater freedom from reoperation and improved post-operative left ventricular function.…”

mentioning

confidence: 99%