Displaying publications 1 - 20 of 56 in total

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  1. Al-Atabi M, Espino DM, Hukins DW, Buchan KG
    Proc Inst Mech Eng H, 2012 Apr;226(4):275-87.
    PMID: 22611868
    Repair of the mitral valve is defined (loosely) as a procedure that alters the valve structure, without replacement, enabling the natural valve itself to continue to perform under the physical conditions to which it is exposed. As the mitral valve is driven by flow and pressure, it should be feasible to analyse and assess its function, failure and repair as a mechanical system. This article reviews the current state of mechanical evaluation of surgical repairs of the failed mitral valve of the heart. This review describes the anatomy and physiology of the mitral valve, followed by the failure of the mitral valve from a mechanical point of view. The surgical methods used to repair failed valves are introduced, while the use of engineering analysis to aid understanding of mitral valve repair is also reviewed. Finally, a section on recommendations for development and future uses of engineering techniques to surgical repair are presented.
    Matched MeSH terms: Mitral Valve/physiopathology*; Mitral Valve/surgery*; Mitral Valve Insufficiency/physiopathology*; Mitral Valve Insufficiency/surgery*; Mitral Valve Annuloplasty/instrumentation*; Mitral Valve Annuloplasty/methods
  2. Singham KT
    Med J Malaysia, 1979 Jun;33(4):307-10.
    PMID: 522741
    Matched MeSH terms: Mitral Valve Insufficiency/diagnosis*; Mitral Valve Stenosis/diagnosis*
  3. SAMBHI JS
    Med J Malaysia, 1963 Sep;18:1-2.
    PMID: 14064292
    Matched MeSH terms: Mitral Valve Stenosis*
  4. Krishna Moorthy PS, Sivalingam S, Dillon J, Kong PK, Yakub MA
    Interact Cardiovasc Thorac Surg, 2019 02 01;28(2):191-198.
    PMID: 30085022 DOI: 10.1093/icvts/ivy234
    OBJECTIVES: Contemporary experience in mitral valve (MV) repair for children with rheumatic heart disease (RHD) is limited, despite the potential advantages of repair over replacement. We reviewed our long-term outcomes of rheumatic MV repair and compared them with the outcomes of MV replacement in children with RHD.

    METHODS: This study is a review of 419 children (≤18 years) with RHD who underwent primary isolated MV surgery between 1992 and 2015, which comprised MV repair (336 patients; 80.2%) and MV replacement (83 patients; 19.8%). The replacement group included mechanical MV replacements (MMVRs) (n = 69 patients; 16.5%) and bioprosthetic MV replacements (n = 14 patients; 3.3%). The mean age with standard deviation at the time of operation was 12.5 ± 3.5 (2-18) years. Mitral regurgitation (MR) was predominant in 390 (93.1%) patients, and 341 (81.4%) patients showed ≥3+ MR. The modified Carpentier reconstructive techniques were used for MV repair.

    RESULTS: Overall early mortality was 1.7% (7 patients). The mean follow-up was 5.6 years (range 0-22.3 years; 94.7% complete). Survival of patients who underwent repair was 93.9% both at 10 and 20 years, which was superior than that of replacement (P mitral lesion and postoperative residual MR (≥2+) were the predictors for reoperation in the repair group, whereas lower body surface area and usage of bioprosthesis were significant factors for the replacement group. Freedom from thrombotic, embolic and haemorrhagic events at 10 and 20 years for patients with repair was 98.2% compared to 90.1% in patients with replacement and 67.6% for patients with MMVR (P = 0.004).

    CONCLUSIONS: Twenty-three years of follow-up shows that MV repair is superior to MMVR in children with RHD. Hence, the rheumatic MV should be repaired when technically feasible to maximize the survival and reduce the valve-related morbidity with comparable durability to MMVR.

    Matched MeSH terms: Mitral Valve/surgery*; Mitral Valve Insufficiency/diagnosis; Mitral Valve Insufficiency/etiology; Mitral Valve Insufficiency/surgery*; Mitral Valve Annuloplasty/methods*
  5. Kunwar MA, Muhammad I, Khan MN, Sumreen B, Soomro NA, Naseeb K, et al.
    Cureus, 2020 Jun 03;12(6):e8419.
    PMID: 32642335 DOI: 10.7759/cureus.8419
    Background Acute myocardial infarction (MI) is the leading cause of worldwide cardiac morbidities and mortalities. Mitral regurgitation (MR) is a common complication of MI. The severity of ischemic MR (IMR) can range widely, both clinically and hemodynamically. Mitral valve (MV) repair by lifting annuloplasty is a surgical procedure used to correct the pathology of IMR. The immediate outcomes of this technique have not yet been determined. The present study, therefore, evaluated the immediate results of MV annuloplasty performed to complement MV repair in patients with IMR. Methodology All adult patients with IMR who underwent lifting posterior mitral annuloplasty (LPMA) plus concomitant coronary artery bypass grafting (CABG) were included. Immediate outcomes were evaluated by transesophageal color Doppler echocardiography. The frequency of successful outcomes was compared in patients with different baseline characteristics. Results Posterior mitral annuloplasty was successful in 93.1% of patients, including in 92.8% of men and 94.1% of women. The percentages of successful immediate outcomes differed significantly in patients with and without diabetes and hypertension, and in patients with two- and three-vessel disease. Conclusion LPMA resulted in a high percentage of successful immediate outcomes in patients with IMR. Further studies should compare rates of immediate, intermediate, and late outcomes of this technique.
    Matched MeSH terms: Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Annuloplasty
  6. 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*
  7. 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*
  8. 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
  9. 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*
  10. 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*
  11. 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: Mitral Valve/surgery*; Mitral Valve Annuloplasty*
  12. Abdullah HN, Khairina WW
    South. Med. J., 2008 Oct;101(10):1035-7.
    PMID: 18791521 DOI: 10.1097/SMJ.0b013e31817fbeb8
    Atrial myxoma is rarely seen in practice. We report a 67-year-old female who presented with acute cardiac insufficiency and pulmonary edema. Cardiac murmur was not detected on precordial examination. Urgent echocardiography, however, revealed atrial myxoma causing mitral valve obstruction. We point out that a normal cardiac examination does not exclude atrial myxoma. The diagnosis may be delayed until significant myocardial dysfunction occurs, as reported here. The clinical presentation of cardiac myxoma is discussed, along with appropriate investigations and treatment.
    Matched MeSH terms: Mitral Valve Stenosis/complications; Mitral Valve Stenosis/etiology; Mitral Valve Stenosis/ultrasonography
  13. Loch A, Sadiq MA, Wan Ahmad WA
    Eur Heart J, 2013 Apr;34(13):981.
    PMID: 23391585 DOI: 10.1093/eurheartj/eht021
    Matched MeSH terms: Mitral Valve*; Mitral Valve Insufficiency/surgery
  14. 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*
  15. 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*
  16. Chan BT, Lim E, Ong CW, Abu Osman NA
    PMID: 23521137 DOI: 10.1080/10255842.2013.779683
    Despite the advancement of cardiac imaging technologies, these have traditionally been limited to global geometrical measurements. Computational fluid dynamics (CFD) has emerged as a reliable tool that provides flow field information and other variables essential for the assessment of the cardiac function. Extensive studies have shown that vortex formation and propagation during the filling phase acts as a promising indicator for the diagnosis of the cardiac health condition. Proper setting of the boundary conditions is crucial in a CFD study as they are important determinants, that affect the simulation results. In this article, the effect of different transmitral velocity profiles (parabolic and uniform profile) on the vortex formation patterns during diastole was studied in a ventricle with dilated cardiomyopathy (DCM). The resulting vortex evolution pattern using the uniform inlet velocity profile agreed with that reported in the literature, which revealed an increase in thrombus risk in a ventricle with DCM. However the application of a parabolic velocity profile at the inlet yields a deviated vortical flow pattern and overestimates the propagation velocity of the vortex ring towards the apex of the ventricle. This study highlighted that uniform inlet velocity profile should be applied in the study of the filling dynamics in a left ventricle because it produces results closer to that observed experimentally.
    Matched MeSH terms: Mitral Valve/physiopathology
  17. Kannan P, Jeyamalar R
    Cathet Cardiovasc Diagn, 1995 Mar;34(3):220-1; discussion 222-3.
    PMID: 7497488
    Mitral incompetence (MR) is a complication of balloon mitral valvuloplasty. There are few reports of long-term outcome. We believe this is the first report in the literature of complete resolution during follow-up of severe mitral regurgitation resulting from balloon valvuloplasty.
    Matched MeSH terms: Mitral Valve Stenosis/therapy*
  18. 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
  19. 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*
  20. 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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