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Fulltext The trans-septal approach to the mitral valve (letter)

Lim KG

Med J Malaysia, 2001 Dec;56(4):513; author reply 513.

PMID: 12014775

Comment on: Eng JB. The trans-septal approach to the mitral valve. Med J Malaysia. 2001; 56(2): 236-39.

Matched MeSH terms: Heart Valve Diseases/surgery*

Mitral valve repair for congenital mitral valve disease: impact of the use of a biodegradable annuloplasty ring

Yakub MA, Sivalingam S, Dillon J, Matsuhama M, Latiff HA, Ramli MF

Ann Thorac Surg, 2015 Mar;99(3):884-90; discussion 890.

PMID: 25579160 DOI: 10.1016/j.athoracsur.2014.09.016

This study compares the midterm results of mitral valve repair using the biodegradable ring versus repair with non-ring annuloplasty techniques for congenital mitral valve disease in young children where it was not possible to use standard commercial rings.

Matched MeSH terms: Heart Valve Diseases/surgery*

Fulltext Obstruction of mechanical heart valve--diagnosis, surgical treatment and outcome

Pau KK, Yakub A, Sallehuddin A, Awang Y

Med J Malaysia, 2001 Jun;56(2):196-200.

PMID: 11771080

From 1982 till 1999, our department performed a total of 2970 heart valve replacements--92% of which were with mechanical heart valves. During this period, there were 8 patients who came to our department with mechanical heart valve obstruction. All these patients presented with signs of heart failure or compromised haemodynamic. Confirmatory tests included transthoracic or transoesophageal echocardiography and cine fluoroscopy. Seven patients were operated upon urgently. Four of the patients had valve thrombosis. The time interval between the initial implantation and presentation varies from 4 months to 11.3 years. Six of the seven patients who were operated on recovered well from the surgery.

Matched MeSH terms: Heart Valve Diseases/surgery*

Fulltext The trans-septal approach to the mitral valve

Eng JB

Med J Malaysia, 2001 Jun;56(2):236-9.

PMID: 11771086

To assess the efficacy of the trans-septal approach to the mitral valve, 40 patients who underwent mitral valve surgery via this approach were compared to 37 patients who underwent surgery via the standard left atriotomy. Concomitant procedures included tricuspid annuloplasty, aortic valve replacement, closure of atrial septal defect, coronary artery bypass grafting and aortic valve repair. There was one (1.2%) operative mortality. No patients required pacemaker implantation. Follow-up of up to 18 months showed that all patients were in NYHA classes I and II. One third of the patients who had trans-septal approach to the mitral valve achieved conversion from atrial fibrillation to sinus rhythm while none of the patients who underwent conventional left atriotomy had conversion (p < 0.02). The trans-septal approach to the mitral valve is a useful approach in selective patients requiring mitral valve surgery.
Comment in: Lim KG. The trans-septal approach to the mitral valve. Med J Malaysia. 2001 Dec;56(4):513

Matched MeSH terms: Heart Valve Diseases/surgery*

Fulltext Cardiac surgery in General Hospital, Kuala Lumpur: review of all open-heart operations. April 1982 to February 1987

Awang Y, Haron A, Sallehuddin A

Med J Malaysia, 1987 Jun;42(2):81-5.

PMID: 3503194

The Cardiothoracic Department, General Hospital, Kuala Lumpur which was set up in April 1982, deals with a wide range of cardiac disease, general thoracic and also vascular cases. A total of 2,450 operations were performed from April 1982 to February 1987, and 79.3% of these were for cardiac cases (open and closed heart). This paper reports a review of the 1,110 consecutive open heart operations performed by the Department during the stated period.

Matched MeSH terms: Heart Valve Diseases/surgery

Intraoperative echocardiographic delineation of the high take-off coronary ostia during an extensive surgical repair of the bicuspid aortic valve and dilated sinotubular junction: a case report

Jung HJ, Kwon WK, Lee SJ, Mohamed N, Shin BM, Lee J, et al.

BMC Anesthesiol, 2016 10 04;16(1):83.

PMID: 27716083

BACKGROUND: This study reports the efficacy of intraoperative transesophageal echocardiography (TEE) for evaluation of high take-off coronary ostia and proximal coronary arterial flows as an alternative to preoperative coronary angiography.

CASE PRESENTATION: In a 65-year old male undergoing the bicuspid aortic valve (BAV) repair and the extensive remodeling of dilated sinus and tubular junction, and preoperative coronary angiography were unsuccessfully completed due to an allergic reaction to the contrast medium. Intraoperative TEE by employing various 3-dimensional volume images of coronary ostia and Doppler tracings of the coronary arterial flows enabled a thorough pre-procedural evaluation of the high take-off coronary arteries and post-procedural evaluation by confirming the absence of any compromise in coronary arterial flow.

CONCLUSION: In the present case, intraoperative application of various TEE imaging modalities enabled comprehensive evaluation of high-taking off coronary artery, as an alternative to preoperative coronary angiography, in a patient undergoing an extensive aortic valve and aortic root repair procedure.

Matched MeSH terms: Heart Valve Diseases/surgery*

Fulltext Isoflurane's Effect on Intraoperative Systolic Left Ventricular Performance in Cardiac Valve Surgery Patients

Kim JD, Son I, Kwon WK, Sung TY, Sidik H, Kim K, et al.

J Korean Med Sci, 2018 01 22;33(4):e28.

PMID: 29318795 DOI: 10.3346/jkms.2018.33.e28

BACKGROUND: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S') in patients undergoing cardiac surgery.

METHODS: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography.

RESULTS: Mean S' values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8-12.2), 9.5 (8.3-10.8), and 8.4 (7.3-9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were -1.0 (-1.6, -0.3), -1.1 (-1.7, -0.6), and -2.1 (-3.1, -1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001).

CONCLUSION: Isoflurane increments (1.0-2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.

Matched MeSH terms: Heart Valve Diseases/surgery*

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