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IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Paravalvular Leak.

Fatima Qamar1, Rowa H Attar1, Faisal Nabi1

  • 1Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, US.

Methodist Debakey Cardiovascular Journal
|April 18, 2022
PubMed
Summary
This summary is machine-generated.

Paravalvular leaks (PVL) are a complication of prosthetic valve replacement. This case demonstrates successful closure of a posterior mitral PVL using ventricular septal defect occluders.

Keywords:
mitral annulusparavalvular leakprosthetic valve disease

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • Paravalvular leaks (PVL) remain a significant challenge in prosthetic valve disease management.
  • PVL arise from surgical ring dehiscence, with the posterior mitral annulus being particularly susceptible.
  • Risk factors include mitral annular calcification, endocarditis, steroid use, and continuous suturing.

Observation:

  • A 70-year-old male presented with pulmonary edema and a dehiscence of his bioprosthetic mitral valve.
  • Echocardiography revealed a large posterior PVL, depressed biventricular function, tricuspid regurgitation, and pulmonary hypertension.
  • Transesophageal imaging confirmed significant posterior PVL with prosthetic valve dehiscence.

Findings:

  • The paravalvular leak was successfully closed using two 18-mm Amplatzer ventricular septal defect occluders.
  • The procedure resulted in excellent outcomes with only trace residual mitral regurgitation.

Implications:

  • Percutaneous closure of paravalvular leaks is a viable treatment option.
  • Ventricular septal defect occluders can be effectively used for mitral PVL closure.
  • This approach offers a less invasive alternative for managing PVL complications.