Abstract:
BACKGROUND:Left ventricular outflow tract obstruction (LVOTO) occurs in 4% to 5% of patients after prosthetic ring mitral valve repair. Major anatomic factors incriminated in the genesis of LVOTO include degenerative mitral valve insufficiency with excess leaflet tissue, nondilated left ventricular cavity, and narrow mitro-aortic angle. We have previously reported a 14% incidence of LVOTO after prosthetic ring mitral valve repair in this high-risk group of patients. Serial echo Doppler studies demonstrated an overlapping and/or inversion of the left ventricular functional compartments generating systolic anterior motion of the posterior leaflet and paradoxical opening (eversion) of the anterior leaflet. In an attempt to eliminate LVOTO after mitral valve repair, a new surgical procedure was developed in 1988 by Carpentier: the sliding leaflet technique, which reduces the height of the posterior leaflet. The purpose of this study was to analyze the results of the new technique in terms of the occurrence of LVOTO: METHODS AND RESULTS:Eighty-two patients undergoing prosthetic ring mitral valve repair between 1988 and 1991 and identified as high risk for LVOTO were operated on using the sliding leaflet technique. There were 52 men and 30 women. Ages ranged from 28 to 75 years. The surgical techniques used included prosthetic ring annuloplasty (n = 82), leaflet resection (n = 82), chordal shortening or transposition (n = 36), and other (n = 19). Intraoperative and/or immediate postoperative echo Doppler studies were obtained in all cases. Two patients (2.4%) died, and 2 (2.4%) required reoperation. Nonsignificant LVOTO was identified in 2 cases (2.4%), in whom instantaneous maximal subaortic gradients were 20 and 18 mm Hg, respectively. CONCLUSIONS:This study was not done on a concomitant series of patients but on patients with the same type of pathology. It demonstrates that (1) the sliding leaflet technique eliminates significant LVOTO in the high-risk patients; (2) the sliding leaflet technique is associated with a low mortality; and (3) no reoperations for mitral insufficiency were required in this series.
journal_name
Circulationjournal_title
Circulationauthors
Jebara VA,Mihaileanu S,Acar C,Brizard C,Grare P,Latremouille C,Chauvaud S,Fabiani JN,Deloche A,Carpentier Asubject
Has Abstractpub_date
1993-11-01 00:00:00pages
II30-4issue
5 Pt 2eissn
0009-7322issn
1524-4539journal_volume
88pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:Arteriogenesis serves as an efficient mechanism for flow restoration after arterial occlusion. This process is associated with inflammatory mediators such as tumor necrosis factor-alpha (TNF-alpha), although their role in arteriogenesis remains unclear. We hypothesized that arteriogenesis is reduced in mice ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000014987.32865.8e
更新日期:2002-04-09 00:00:00
abstract::The nitrovasodilators are a diverse group of pharmacological agents that produce vascular relaxation by releasing nitric oxide. The mechanisms by which these compounds release nitric oxide vary, depending on their chemical structure. Compounds with lower oxidation states of nitrogen such as nitroprusside, nitrosamines...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/01.cir.87.5.1461
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:The clinical efficacy of alcohol septal ablation for drug-refractory hypertrophic cardiomyopathy remains unclear. This study examines the outcome of alcohol septal ablation performed at a tertiary hypertrophic cardiomyopathy referral center. METHODS AND RESULTS:Among 601 patients with severely symptomatic o...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.738740
更新日期:2008-07-08 00:00:00
abstract::Cerebral and retinal ischemic events have been described in mitral valve prolapse. To determine whether platelets play a part in the pathogenesis of thromboembolism we studied 29 patients with mitral valve prolapse, including nine (group I) with thromboembolism (cerebral, retinal and deep venous), eight (group II) wit...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.63.3.552
更新日期:1981-03-01 00:00:00
abstract:BACKGROUND:Mechanical dyssynchrony is a potential means to predict response to cardiac resynchronization therapy (CRT). We hypothesized that novel echocardiographic image speckle tracking can quantify dyssynchrony and predict response to CRT. METHODS AND RESULTS:Seventy-four subjects were studied: 64 heart failure pat...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.571455
更新日期:2006-02-21 00:00:00
abstract::In a porcine preparation of cardiac arrest, we demonstrated that there is a marked paradox of venous acidemia and arterial alkalemia. This paradox is related to decreased clearance of CO2 from the lungs when pulmonary blood flow is critically reduced. Accordingly, increased venous PCO2 rather than metabolic acidosis d...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.74.5.1071
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Children stable at home with dilated cardiomyopathy remain at risk of death; there is evidence of survival benefit for transplantation out to 4 years postoperatively. The limited supply of donor organs makes risk stratification imperative, but although cardiopulmonary exercise test is well established as a p...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.035956
更新日期:2011-10-18 00:00:00
abstract::Genetic analysis can be performed to identify the molecular substrate of inherited arrhythmogenic diseases; however, the role of this information in helping the management of patients is still debated. Here, we support the view that the practical value of genetic analysis is different in the various inherited conditio...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.105.563205
更新日期:2006-02-28 00:00:00
abstract::We studied the effects of experimentally induced emotional stress (mental arithmetic) on different hemodynamic parameters, catecholamine levels, and serum and platelet function tests in 25 postinfarction patients and in 10 apparently healthy, age-matched control subjects. Mental stress (10 minutes) induced significant...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:Vascular Ehlers-Danlos syndrome (vEDS), also known as EDS type IV, an inherited disorder of connective tissue, results from mutations in the gene encoding type III procollagen (COL3A1). Affected patients are at risk for arterial dissection or rupture, the main cause of death. To understand the pathogenesis o...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000121741.50315.C2
更新日期:2004-03-30 00:00:00
abstract:BACKGROUND:Peak dP/dt is a good index of ventricular performance that is not influenced by afterload, wall motion abnormalities, or the variations in ventricular anatomy and morphology commonly encountered among patients with congenital heart disease. Unfortunately, the clinical utility of peak dP/dt has been limited b...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.88.6.2693
更新日期:1993-12-01 00:00:00
abstract::This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations for advanced life support includes updates on multiple advanced life support topics addressed with 3 different types of reviews. Topics were prioritized on the basis of both recen...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIR.0000000000000893
更新日期:2020-10-20 00:00:00
abstract:BACKGROUND:Mitral regurgitation (MR) represents the principal indication for reoperation in patients after repair of atrioventricular septal defects (AVSD). Reports of mitral valvuloplasty (MVP) in such patients are few; the alternative, mitral valve replacement (MVR), necessitates commitment to future valve replacemen...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.suppl_3.iii-160
更新日期:2000-11-07 00:00:00
abstract:BACKGROUND:Regional myocardial blood flow has been quantified using transaxial positron emission tomographic (PET) imaging and tracer kinetic modeling. However, the use of transaxial images limits the accuracy of regional partial volume corrections and the localization of the quantified regional flow values. The purpos...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.86.3.1004
更新日期:1992-09-01 00:00:00
abstract::We evaluated the effects of selective activation of H1 receptors on coronary hemodynamics in 16 patients divided into two groups: group A, 11 patients with atypical angina or valvular heart disease and normal coronary arteries, and group B, five patients with spontaneous angina, four of whom had significant (greater t...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.73.6.1175
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:This study aimed to assess if clampless off-pump coronary artery bypass grafting (CABG) decreases risk-adjusted mortality, stroke rate, and morbidity in unselected patients in comparison to conventional CABG. METHODS AND RESULTS:Between July 2009 and November 2010, data of 1282 consecutive patients undergoi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.084285
更新日期:2012-09-11 00:00:00
abstract:BACKGROUND:The detection and differentiation of intracardiac masses is still challenging and may include neoplasms and thrombi. The aim of this study was the investigation of a targeted, fibrin-specific contrast agent (EP-2104R) for molecular targeted magnetic resonance imaging (MRI) of left atrial clots. METHODS AND ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.529941
更新日期:2005-07-19 00:00:00
abstract:BACKGROUND:Endothelial integrity is essential for maintaining vascular homeostasis, and endothelial denudation results in neointimal thickening. Balloon-expandable endovascular stents provide a luminal scaffolding within atherosclerotic arteries with minimal direct contact between balloon and endothelium. We wondered w...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.11.2909
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Atherosclerosis is associated with immune responses to oxidized lipoproteins and certain microorganisms, but the role of specific immunity has remained unclear. METHODS AND RESULTS:To study the role of immunity in atherosclerosis, we crossed atherosclerosis-prone apoE(-/-) mice with immunodeficient scid/sci...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.24.2919
更新日期:2000-12-12 00:00:00
abstract:BACKGROUND:Since the clinical introduction of dynamic cardiomyoplasty, a discrepancy has been observed between unchanged measurements of cardiac function and improved clinical outcome. METHODS AND RESULTS:We performed a beat-to-beat analysis of cardiac performance at rest in nine cardiomyoplasty patients 6 to 24 month...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.7.2010
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:The concept of natriuretic peptide guidance has been extensively studied in patients with chronic heart failure (HF), with only limited success. The effect of NT-proBNP (N-terminal probrain natriuretic peptide)-guided therapy in patients with acute decompensated HF using a relative NT-proBNP target has not b...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.117.029882
更新日期:2018-04-17 00:00:00
abstract:BACKGROUND:Current guidelines recommend mitral valve surgery for asymptomatic patients with severe degenerative mitral regurgitation and preserved left ventricular systolic function when exercise pulmonary hypertension (PHT) is present. However, the determinants of exercise PHT have not been evaluated. The aim of this ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.938241
更新日期:2010-07-06 00:00:00
abstract::Ventilation with positive end-expiratory pressure (PEEP) is associated with reduced cardiac output, but the mechanisms involved are controversial. Possible explanations include increased intrathoracic pressure, reflex changes in myocardial inotropism, pulmonary vascular obstruction and abnormal ventricular interaction...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.66.1.108
更新日期:1982-07-01 00:00:00
abstract::Forty adult patients underwent Doppler and two-dimensional echocardiographic examination of the pulmonary artery from multiple views to determine the variability in the magnitude of Doppler-determined flow velocity and pulmonary arterial diameter from various echocardiographic windows. Flows were recorded from two or ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.74.5.1002
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Endothelial dysfunction is associated with atherosclerosis and may contribute to ischemic syndromes. We assessed the contribution of endothelium-derived nitric oxide (NO) and vasodilator prostanoids to resting blood flow, metabolic vasodilation, and flow reserve in the human coronary circulation. METHODS AN...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.100.19.1951
更新日期:1999-11-09 00:00:00
abstract:BACKGROUND:Inflammation and thrombosis coexist in several disorders. Although it is recognized that leukocytes may induce a procoagulant state at sites of inflammation, the critical molecular determinants of this process remain largely unknown. METHODS AND RESULTS:To examine mechanisms of inflammation-induced thrombos...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.873695
更新日期:2009-09-29 00:00:00
abstract:BACKGROUND:Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a puzzling clinical entity with no previous evaluation of the literature. This systematic review aims to (1) quantify the prevalence, risk factors, and 12-month prognosis in patients with MINOCA, and (2) evaluate potential pathophysiolog...
journal_title:Circulation
pub_type: 杂志文章,meta分析,评审
doi:10.1161/CIRCULATIONAHA.114.011201
更新日期:2015-03-10 00:00:00
abstract:BACKGROUND:Airborne particulate matter has been linked to excess morbidity and mortality. Recent attention has focused on the effects of particulate exposure on cardiac autonomic control. Inhaled particulates may affect the autonomic nervous system either directly, by eliciting a sympathetic stress response, or indirec...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/hc3401.095038
更新日期:2001-08-28 00:00:00
abstract:BACKGROUND:Inhibitors of adenosine membrane transport cause vasodilation and enhance the plasma adenosine concentration. However, it is unclear why the plasma adenosine concentration rises rather than falls when membrane transport is inhibited. We tested the hypothesis that the cytosolic adenosine concentration exceeds...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.15.2041
更新日期:1999-04-20 00:00:00
abstract:BACKGROUND:Convincing evidence suggests that atherosclerosis is an inflammatory disease. The inflammatory response is an important determinant of atherosclerotic plaque instability. Therefore, we investigated the prognostic impact of key inflammatory players, namely the inflammatory marker C-reactive protein (CRP) and ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000065232.57371.25
更新日期:2003-04-29 00:00:00