MyMedR

Mid-Term Results Comparing the Use of Artificial Chords Versus Native Chords for Mitral Valve Repair in Children

Sivalingam S, Haranal M, Moorthy PSK, Dillon J, Kong PK, Fariza I, et al.

World J Pediatr Congenit Heart Surg, 2020 09;11(5):579-586.

PMID: 32853067 DOI: 10.1177/2150135120930678

BACKGROUND: Our study is aimed at evaluating the mid-term surgical outcomes of mitral valve repair in children using various chordal reconstructive procedures (autologous in situ chords or artificial chords).

METHODS: A retrospective analysis of 154 patients who underwent mitral valve repair using various chordal reconstructive procedures from 1992 to 2012. Patients were divided into group A and group B based on use of artificial chords and autologous in situ chords, respectively, for the repair. There were 102 (66.2%) patients in group A and 52 (33.8%) patients in group B. The mean age at repair was 11.1 ± 4.5 years. Associated cardiac anomalies were found in 94 (61%) patients.

RESULTS: The median follow-up period was 4.2 years (Interquartile range: 2.0-9.9). There were two (1.3%) early deaths and five (3.2%) late deaths. There was no significant difference in survival at 15 years between the two groups (group A: 91.8% vs group B: 95.1%; P = .66). There was no significant difference in the freedom from reoperation at 15 years between group A (79.4%) and group B (97.2%; P = .06). However, there was significant difference in freedom from valve failure between group A (56.5%) and group B (74.1%; P = .03). Carpentier functional class III and postoperative residual mitral regurgitation (2+ MR, ie, mild-moderate MR) were the risk factors for valve failure.

CONCLUSIONS: Severity of the disease and its progression has profound effect on the valve repair than the technique itself. Both chordal reconstructive procedures can be used to produce satisfactory results in children.

Matched MeSH terms: Mitral Valve/surgery*; Mitral Valve Insufficiency/diagnosis; Mitral Valve Insufficiency/surgery*

Tricuspid valve papillary fibroelastoma: a rare tumor with a diagnostic dilemma

Haron H, Yusof MR, Maskon O, Ooi J, Rahman MR

Heart Surg Forum, 2012 Feb;15(1):E59-60.

PMID: 22360910 DOI: 10.1532/HSF98.20111000

Papillary fibroelastoma is a rare primary tumor of the heart valves. This lesion can occur on any of the valves or endothelial surface of the heart and has been detected by echocardiography, by cardiac catheterization, during open heart operations for other conditions, and at autopsy. Because of the potential for comorbidities, this tumor should be removed. We present the case of an elderly man with a diagnosis of severe mitral valve regurgitation and moderate tricuspid valve regurgitation who was suspected to have a tricuspid valve vegetation. Mitral valve replacement, tricuspid valve repair, and excision of the lesion were performed successfully. A histologic examination of the vegetation confirmed it to be a papillary fibroelastoma. We present this case to emphasize the rarity of this tumor and the importance of a correct diagnosis to avoid delaying its prompt and definitive management.

Matched MeSH terms: Mitral Valve Insufficiency/pathology; Mitral Valve Insufficiency/surgery; Mitral Valve Insufficiency/ultrasonography

Fulltext A forgotten clinical sign making a comeback

Chiam KH, A Hing CT, Low LL

Med J Malaysia, 2014 Feb;69(1):40-1.

PMID: 24814630 MyJurnal

We report a case of Staphylococcus aureus infective endocarditis in a patient presenting with fever and rare cutaneous manifestations of Osler Nodes and Janeway Lesions. There had not been any distinct risk factors. His echocardiography subsequently revealed vegetation at the anterior mitral valve leaflet. As Staphylococcus aureus infective endocarditis is of utmost significance in morbidity and mortality, a sharp clinical acumen and follow up investigations is required alongside a prolonged course of antibiotics. Our patient was then started on intravenous cloxacillin for 28 days and gentamicin for 5 days to which he made good progress and recovery.

Matched MeSH terms: Mitral Valve

Fulltext Moxifloxacin-warfarin interaction

Yew KL, Lee WC

Med J Malaysia, 2012 Aug;67(4):420-1.

PMID: 23082454 MyJurnal

Matched MeSH terms: Mitral Valve*

Fulltext Barlow's Repair: Light in the Dark Tunnel: A Case Report Could Omit 'Light in A Dark Tunnel'

Mohd Alkaf AL, Simon V, Taweesak C, Abdul Rahman I

Med J Malaysia, 2015 Apr;70(2):106-7.

PMID: 26162389

Barlow's disease has a complex pathology requiring reconstructive surgery. Despite the complicated surgery it holds a positive outcome. We report a successful case of Barlow's disease who underwent mitral valve reconstructive surgery at our centre. Post-operative echocardiography shows a well-functioning repaired mitral valve without significant mitral regurgitation.

Matched MeSH terms: Mitral Valve; Mitral Valve Insufficiency

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: Mitral Valve/surgery*

Fulltext Early experiences of intra-operative trans-oesophageal echocardiography (TEE) in mitral valve repair

Sim EK, Mestres CA, Lim MC, Adebo OA, Lee CN

Med J Malaysia, 1992 Mar;47(1):77-80.

PMID: 1387456

Whenever possible Mitral valve repair should be performed instead of Mitral valve replacement. It is important to assess the adequacy of the repair during the operation so that any corrective steps may be taken immediately. We present three cases of Mitral valve repair in which the intraoperative TEE was used to assess the adequacy of the repair. There was good correlation of the immediate post bypass TEE findings and early post operative transthoracic echocardiographic findings. Intraoperative TEE is a useful tool in the early assessment of Mitral Valve Repair.

Matched MeSH terms: Mitral Valve/surgery*

Fulltext A case of left atrial myxoma

Segasothy M

Med J Malaysia, 1982 Sep;37(3):221-2.

PMID: 7177002

Left atrial myxoma almost always arises in the inter-atrial septum. A case is described where it arose from the posterior wall of the left atrium. Clinical presentation was suggestive of mitral stenosis and sub-acute bacterial endocarditis and diagnosis was arrived at necropsy.

Matched MeSH terms: Mitral Valve Stenosis/diagnosis

Fulltext Beneficial effects of ACE inhibitors in severe mitral stenosis

Sebastian VJ, Bhattacharya S, Ray S, Jaafar SM

Med J Malaysia, 1989 Dec;44(4):291-5.

PMID: 2562442

There are several reports of beneficial effects of ACE inhibitors in both primary and secondary pulmonary hypertension. However the effect of ACE inhibitors in mitral stenosis is not documented. The authors report three patients with severe mitral stenosis in whom surgery was delayed. They had initial symptomatic improvement with diuretics and sodium restriction, but had recurrence of their symptoms while on treatment. Enalapril not only relieved their symptoms in particular exertional dyspnoea and haemoptysis but prevented recurrence and improved their effort tolerance without causing excessive fall of blood pressure or impairment of renal function.

Matched MeSH terms: Mitral Valve Stenosis/drug therapy*

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: Mitral Valve Stenosis/surgery

The significance of atrial fibrillation in rheumatic mitral stenosis: an echocardiographic study

Singham KT, Ariffin M

Med J Malaysia, 1979 Dec;34(2):136-9.

PMID: 548714

Matched MeSH terms: Mitral Valve Stenosis/diagnosis*

Echocardiography in the evaluation of mitral valve disorders

Singham KT

Med J Malaysia, 1979 Jun;33(4):307-10.

PMID: 522741

Matched MeSH terms: Mitral Valve Insufficiency/diagnosis*; Mitral Valve Stenosis/diagnosis*

Editorial: Mitral stenosis

SAMBHI JS

Med J Malaysia, 1963 Sep;18:1-2.

PMID: 14064292

Matched MeSH terms: Mitral Valve Stenosis*

Complete heart block in young adult with acute rheumatic fever

Nor Hidayah ZA, Azerin O, Mohd Nazri A

Med J Malaysia, 2018 10;73(5):323-325.

PMID: 30350813 MyJurnal

Acute Rheumatic fever (ARF) is commonly associated with ECG abnormalities particularly atrioventricular block. However, third degree atrioventricular block or complete heart block is a rare manifestation. Most cases occurred in children. We reported a 25 year old man who developed complete heart block during an acute episode of ARF. He presented to hospital with five days history of fever, malaise and migrating arthralgia, followed by pleuritic chest pain. One day after admission his electrocardiogram (ECG) revealed complete heart block. Transthoracic echocardiography showed good left ventricular function with thickened, mild mitral regurgitation with minimal pericardial effusion. ASOT titer was positive with elevated white blood count and acute phase reactant. A temporary pacemaker was inserted in view of symptomatic bradycardia. The complete heart block resolved after medical therapy. He was successfully treated with penicillin, steroid and aspirin. He was discharged well with oral penicillin. The rarity of this presentation is highlighted.

Matched MeSH terms: Mitral Valve Insufficiency

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: Mitral Valve/surgery*

Mitral valvotomy in Malaysian patients of 20 years of age and below

Krishnan M, Snelling MR

Med J Malaya, 1970 Dec;25(2):105-7.

PMID: 4251129

Matched MeSH terms: Mitral Valve Stenosis/epidemiology; Mitral Valve Stenosis/surgery*

Rheumatic tricuspid stenosis: an echocardiographic study

Singham KT, Ariffin M

Med J Aust, 1979 Oct 20;2(8):428-9.

PMID: 318487

Matched MeSH terms: Mitral Valve Stenosis/epidemiology

Comparative long-term results of mitral valve repair in adults with chronic rheumatic disease and degenerative disease: is repair for "burnt-out" rheumatic disease still inferior to repair for degenerative disease in the current era?

Dillon J, Yakub MA, Kong PK, Ramli MF, Jaffar N, Gaffar IF

J. Thorac. Cardiovasc. Surg., 2015 Mar;149(3):771-7; discussion 777-9.

PMID: 25308120 DOI: 10.1016/j.jtcvs.2014.08.066

Mitral valve repair is perceived to be of limited durability for advanced rheumatic disease in adults. We aim to examine the long-term outcomes of repair for rheumatic disease, identify predictors of durability, and compare with repair for degenerative disease.

Matched MeSH terms: Mitral Valve/physiopathology; Mitral Valve/surgery*; Mitral Valve/ultrasonography; Mitral Valve Insufficiency/diagnosis; Mitral Valve Insufficiency/mortality; Mitral Valve Insufficiency/physiopathology; Mitral Valve Insufficiency/surgery*

A stitch too far: The circumflex artery in jeopardy during mitral valve repair

Dillon J

J. Thorac. Cardiovasc. Surg., 2017 11;154(5):1621-1623.

PMID: 29042042 DOI: 10.1016/j.jtcvs.2017.06.056

Matched MeSH terms: Mitral Valve; Mitral Valve Insufficiency*

Double orifice mitral valve: a case report and review of management

Majid AA

J Cardiovasc Surg (Torino), 1991 Nov-Dec;32(6):837-9.

PMID: 1836465

This paper reports a case of double orifice mitral valve which was treated conservatively. A new scheme of classification of this entity linked to the accepted lines of surgical treatment is introduced.

Matched MeSH terms: Mitral Valve/abnormalities*

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