Changes in Left Ventricular Morphology and Function in End-Stage Dilated Cardiomyopathy After Reductive Annuloplasty of Double Mitral and Tricuspid Orifices

Radovanović, N; Petrovic, Lj.; Zorc, M.; Mihajlovic, B.; Kovac, M.; Nicin, S.; Popov, Mikhail А.; Torbica, Vladimir; Uscumlic-Kovacevic, D.

doi:10.1111/j.1540-8191.2002.tb01200.x

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Section: Introductionmentioning

confidence: 99%

“…With the continuity of the hypertrophic process, several genetic, biochemical and structural alterations can occur that can result in ventricular dysfunction [4]. When this process is due to valvar insufficiency, after valvuloplasty or valve replacement, it is possible to obtain a morphological ventricular change, with reversal of the remodeling process, a reduction of the sphericity and improvement of the hemodynamic function, decreasing considerably the process of ventricular dysfunction [5,6].Measurement of the size of the annulus of the valves depends intrinsically on the method by which the heart is preserved, as measurements performed on annuli of preserved valves result in a smaller size than those in fresh hearts. In pathological conditions, such as in regurgitation, the circumference of the annulus is significantly greater.…”

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Coeficientes de proporcionalidade nas valvas atrioventriculares: estudo anatômico dos segmentos valvares em indivíduos normais

Andrade¹,

Tinóis²,

Vieira³

et al. 2005

Rev Bras Cir Cardiovasc

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RBCCV 44205-756 Coeficientes de proporcionalidade nas valvas atrioventriculares: estudo anatômico dos segmentos valvares em indivíduos normaisCoefficients of proportions of the atrioventricular valves: an anatomical study of valvar segments of normal individuals Abstract Objective: To describe the anatomical relationships that exist between the heart valve structures taking into consideration the segments of the fibrous annuli and the left ventricular volumeMethod: Digital photographs of 41 hearts from autopsies performed by a Coroner's Office were analyzed. The photographs were processed using MATLAB ® software, which supplies measurements of the valvar perimeter and area and the left ventricular volume.Results: The average age of the studied corpses was 33 years old (standard deviation ± 17 years). Several correlations involving the tricuspid and mitral valves were tested, with strongly significant correlations found between the intercommissural distance (ItD) and the perimeter of the anterior annulus (PA) of the tricuspid valve (r = 0.72; p-value < 0.05) and between the inter-commissural distance (ImD) and the perimeter of the posterior annulus (PP) of the mitral valve (r = 0.63; p-value < 0.05). The proportions between the parameters were PA/ItD = 1.36 ± 0.24 and PP/ImD = 1.38 ± 0.16. Conclusion:The proportions between the perimeter of the anterior annulus (tricuspid) and the perimeter of the posterior annulus (mitral) and their respective distances have high statistical significance and can be applied as part of surgical techniques of valvar reconstruction. Descriptors INTRODUCTIONThe analysis of the dimensions of the heart valves has advanced very much over the last few years following the introduction of biotechnology in medical research. Thus, 3-dimensional reconstructions using echocardiography, nuclear magnetic resonance or computed tomography have given us a better knowledge to plan surgical techniques of valve diseases. Even so, the return to anatomical studies has brought unexpected findings of great scientific value, highlighting the importance of post mortem research in cardiovascular surgery.Research on valve diseases explains that pathological changes may be congenital, related to age, acquired or secondary to hemodynamics. As they get older, valves start to suffer a process of expansion and excessive bulging which does not generally result in insufficiency [1,2]. The case of valve insufficiency the consequent regurgitation may be the result of several pathological processes, such as rheumatic fever, degenerative diseases or even, infectious endocarditis, an acute disease caused by highly virulent microorganisms that culminates in severe heart injuries, as well as the involvement of one or more valve components (leaflets, fibrous annulus, chordae tendineae, papillary muscles) or abnormalities in the ventricle or the atrium [1,3].The reason the ventricular chambers increase in size is to maintain the heart function stable after a specific injury. There is an increase in the radius (dilatation) o...

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%