Mitral valve replacement in a patients with an extensively calcified mitral anulus: Report of a case

Toyoda, Yoshiya; Shida, Tsutomu; Wakita, Noboru; Matoba, Yasumi; Ozaki, Nobuchika

doi:10.1007/s005950050156

Cited by 4 publications

(8 citation statements)

References 6 publications

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“…When MAC limits the annulus and an appropriate‐sized prosthesis can be inserted, the prosthetic valve can be secured onto the mitral leaflet itself 2 . When a partial debridement of MAC makes it possible to implant an appropriate‐sized prosthetic valve, the usual MVR suturing the valve onto the calcified annulus sometimes causes perivalvular leakage and valve dehiscence 3,4 . Carpentier et al described the “sliding atrioplasty,” which includes the complete removal of MAC and suturing the LA wall to the LV wall covering the annular area, and they performed an MVR after this procedure for cases with extensively developed MAC 5 .…”

Section: Discussionmentioning

confidence: 99%

“…In a case with severe MAC, it is very important to secure the prosthetic valve so as not to cause any perivalvular leakage. For this reason, suturing the prosthesis onto the annulus where the calcification remains should be avoided, because such procedure eventually results in perivalvular leakage and prosthetic valve dehiscence 3,4 . David et al devised the mitral annular reconstruction using a pericardial patch, and reported an excellent long‐term result of this procedure 6 .…”

Section: Discussionmentioning

confidence: 99%

“…2 When a partial debridement of MAC makes it possible to implant an appropriatesized prosthetic valve, the usual MVR suturing the valve onto the calcified annulus sometimes causes perivalvular leakage and valve dehiscence. 3,4 Carpentier et al described the "sliding atrioplasty," which includes the complete removal of MAC and suturing the LA wall to the LV wall covering the annular area, and they performed an MVR after this procedure for cases with extensively developed MAC. 5 The authors reported excellent results with this technique; however, some surgeons have reported reservations regarding the risk of AVD accompanied with this procedure.…”

Section: Discussionmentioning

confidence: 99%

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Mitral Valve Replacement for a Severely Calcified Mitral Annulus

et al. 2007

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We herein describe a surgical technique in a mitral valve replacement for a hemodialysis patient presenting with mitral valve stenosis and severe mitral annular calcification. Mitral annular calcification extending to the left ventricular myocardium was resected using a cavitron ultrasonic surgical aspirator (CUSA) to make a flat plane from the left atrium to the left ventricle. An autologous pericardium was secured to the posterior left ventricular wall and to the left atrial wall covering the mitral annulus for annular reconstruction. In the posterior mitral annulus, the prosthetic valve was fixed onto this pericardial patch. After the operation, the patient recovered well without any embolic complications. The prosthetic valve functions normally without any perivalvular leakage. Decalcification using the CUSA and the annular reconstruction with a pericardial patch is therefore indicated in valve replacement for patients with severe mitral annular calcification.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mitral Valve Replacement for a Severely Calcified Mitral Annulus

et al. 2007

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“…Using a different methodology, VIRMANI et al [13] affirmed that, in this subgroup of patients, the distance between the structures in question, in the proximal portion of the circumflex artery, is 8.4 mm.…”

Section: Commentsmentioning

confidence: 99%

“…However, there have been few works that analysed this anatomical relationship, just as the numbers of patients that have been studied is small [1,2,[5][6][7][8][9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Relação anatômica entre a porção posterior do ânulo mitral e as artérias coronárias: implicações no tratamento cirúrgico

Pessa¹,

Gomes²,

Catani³

et al. 2004

Rev Bras Cir Cardiovasc

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Objective: This work aimed at analyzing the anatomical relationship among the mitral annulus, the circumflex artery and the posterior left ventricular artery, correlating the distance among these structures to the pattern of coronary network dominance.Method: Eighty-five human hearts, previously preserved in 10% formaldehyde solution, were studied. The coronary network dominance pattern was initially evaluated. Next, atriotomy and left ventriculotomy in the posterior wall of the heart were performed, starting from the pulmonary veins toward the heart apex through the mitral annulus.

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Regulation of wound healing and organ fibrosis by toll-like receptors

Huebener

Schwabe

2013

Biochimica et Biophysica Acta (BBA) - Molecular Basis of Diseas

125

102

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Chronic injury often triggers maladaptive wound healing responses leading to the development of tissue fibrosis and subsequent organ malfunction. Inflammation is a key component of the wound healing process and promotes the development of organ fibrosis. Here, we review the contribution of Toll-like receptors (TLRs) to wound healing with a particular focus on their role in liver, lung, kidney, skin and myocardial fibrosis. We discuss the role of TLRs on distinct cell populations that participate in the repair process following tissue injury, and the contribution of exogenous and endogenous TLR ligands to the wound healing response. Systemic review of the literature shows that TLRs promote tissue repair and fibrosis in many settings, albeit with profound differences between organs. In particular, TLRs exert a pronounced effect on fibrosis in organs with higher exposure to bacterial TLR ligands, such as the liver. Targeting TLR signaling at the ligand or receptor level may represent a novel strategy for the prevention of maladaptive wound healing and fibrosis in chronically injured organs.

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Mitral valve replacement in a patients with an extensively calcified mitral anulus: Report of a case

Cited by 4 publications

References 6 publications

Mitral Valve Replacement for a Severely Calcified Mitral Annulus

Mitral Valve Replacement for a Severely Calcified Mitral Annulus

Relação anatômica entre a porção posterior do ânulo mitral e as artérias coronárias: implicações no tratamento cirúrgico

Regulation of wound healing and organ fibrosis by toll-like receptors

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