Severe Mitral Regurgitation Due to a “Folded” Anterior Mitral Valve Leaflet After Bentall Procedure Requiring Mitral Valve Replacement

Navas-Blanco, Jose R; Cook, Stephanie; Guerra-Londono, Carlos; Borgi, Jamil; Sanders, Joseph; Szymanski, Trevor

doi:10.1053/j.jvca.2017.08.045

Cited by 1 publication

(12 citation statements)

References 12 publications

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“…18 Thus, the primary literature search yielded 29 studies 1,3,15,16, that satisfied the inclusion criteria. Seven additional studies [44][45][46][47][48][49][50] were identified through hand-searching of reference lists of included studies. Ultimately, 36 studies 1,3,15,16, were included in this analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Across all studies, a total of patients underwent SAVR. The type of prosthesis used differed between the included studies, with 13 3,20,21,[23][24][25][26]30,33,39,41,44,47 implanting a bioprosthesis, 8 15,16,19,29,34,35,40,42 implanting a mechanical prosthesis, and 3 1,36,37 implanting mechanical and biological protheses; 12 studies 22,27,28,31,32,38,43,45,46,[48][49][50] did not specify prosthesis type. The size of the implanted prosthesis ranged from 17 mm 45 to 27 mm 20,24 ; however, 14 studies 1,[27][28][29]31,32,36,37,43,[46][47]…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Of the 207 reported cases of new or worsened MR, 138 patients presented with a worsened severity of MR 1,3,20,[25][26][27]30,32,33,[36][37][38]48 after SAVR, for a reported prevalence of 66.7%. Additionally, 16 patients who received SAVR developed new MR, 15,16,19,21,23,24,34,38,39,44,46,49,50 for a reported prevalence of 7.7%. The remaining 53 cases 22,28,29,31,35,42,45 of reported new or worsened MR could not be specifically categorized due to lack of detail regarding the patients' preoperative status.…”

Section: Prevalence Of Reported New or Worsened Mrmentioning

confidence: 99%

“…The etiology of MR was reported for 120 3,15,16,[19][20][21][22][23][24][25][26][28][29][30][31]33,34,[39][40][41][42][43][44][45][46][47][48][49][50] of the 207 cases of new or worsened MR following SAVR (Table 3). Notably, the mechanism of new or worsened MR was unspecified in the remaining 87 patients.…”

Section: Etiology Of Mrmentioning

confidence: 99%

“…1,27,32,36,37,42,43 Organic Etiology. A total of 15.97% (20/120) of reported MR were classified as organic (ie, Carpentier's Type I or Type II), with 70.00% (14/20) 15,16,19,22,23,28,31,34,41,44,46,49 being classified as Type I, and 30.00% (6/20) 21,40,45,46 being classified as Type II. Of the 20 cases of organic MR (ie, Carpentier's Type I and Type II), 30.00% (6/20) 15,23,28,38,41,44,46 were thought to be caused by an extravalvular mechanism, and 70.00% (14/20) 16,19,21,22,31,37,40,45,46,49 by an intravalvular mechanism.…”

Section: Etiology Of Mrmentioning

confidence: 99%

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New or Worsened Mitral Regurgitation After Surgical Aortic Valve Replacement: A Systematic Review

Kumar

Hussain

et al. 2020

Semin Cardiothorac Vasc Anesth

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Background New or worsened mitral regurgitation (MR) is an uncommon yet serious complication after surgical aortic valve replacement (SAVR). While there have been numerous reports of its occurrence, there is little consensus regarding its presentation and management. This systematic review summarizes the evidence in the current literature surrounding new or worsened MR after SAVR and analyzes its potential implications. Methods Databases were examined for all articles and abstracts reporting on new or worsened MR after SAVR. Data collected included number of patients studied; patient characteristics; incidences of new or worsened MR; timing of diagnosis; and treatment. Results Thirty-six full-text citations were included in this review. The prevalence of new or worsened MR after SAVR was 8.4%. Sixteen percent of new MR occurrences were from an organic etiology, and 83% of new MR occurrences were that of a functional etiology. Most diagnoses were made in the late or unspecified postoperative period using echocardiography (range: 0 minutes to 18 years postoperatively). While no patients died from this complication, 7.7% of patients (16 out of 207) required emergent procedural re-intervention. Conclusions This systematic review underscores the importance of identifying new or worsened MR following SAVR and accurate scoring of MR severity to guide treatment. It also outlines the associated clinical measures commonly documented following this complication, and the usefulness of transesophageal echocardiography for the detection of significant MR. These results reflect the current, limited state of the literature on this topic and warrant further investigation into MR detection and management strategies in SAVR patients.

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