Millions of people suffer from heart valve disease every year (“US Markets for Heart Valves”, 2007). Out of all of the heart valve diseases, “mitral regurgitation is the second most common valvular heart disease” (Baumgartner et al., 2006). This is due to the fact that the mitral valve experiences the most pressure and blood flow compared to the other valves in the heart (“US Markets for Heart Valves”, 2007). The disease occurs when blood leaks back into the left auricle from the left ventricle, which is caused by the mitral valve not closing properly (Lantada et al., 2009). The majority of the time, the mitral valve does not function correctly due to a structural abnormality (Buckner et al., 2010). These abnormalities can occur in either the papillary chords or the papillary muscles (Lantada et al., 2009). The frequency of the mitral valve abnormalities, especially in the elderly population, led to extensive research to find a solution (“US Markets for Heart Valves”, 2007).
Many experiments later, a device was born. In the late 1960s a man by the name of Carpentier developed the first annuloplasty ring (Christenson & Kalangos, 2009). He created the device in an attempt to reduce the size of the mitral valve and as a result decrease the severity of the mitral regurgitation (Lantada et al., 2009). Annuloplasty rings are designed to aid in the repair of the mitral valve. The repair of a mitral valve is preferred over complete replacement. This is mainly due to the fact that the patient is not required to use long term drug therapy following surgery (Buckner et al., 2010). After a valve has been repaired, the annuloplasty ring is sutured onto the patient’s native mitral annulus. The ring not only reconstructs the shape of the mitr...
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...Annuloplasty on Anterior Leaflet Three-Dimensional Geometry.” The Journal of Heart Valve Disease 17, 2007. 5 April 2011: 149-154.
Hasenkam, Michael J., Henrik Jensen, Morten O. Jensen, Robert A. Levine, Sten L. Nielsen, Hans Nygaard, Morten Smerup, and Ajit P. Yoganathan. “Saddle-Shaped Mitral Valve Annuloplasty Rings Experience Lower Forces Compared with Flat Rings.” Circulation 118, 2008. 5 April 2011: S250-S255.
Lantada, Andres Diaz, Pilar Lafont Morgado, Julio Munoz-Garcia, Juan Manuel Munoz-Guijosa, Javier Echavarri Otero, Jose Luis Munoz Sanz, and Raquel Del Valle-Fernandez. “Development of Personalized Annuloplasty Rings: Combination of CT Images and CAD-CAM Tools.” Annals of Biomedical Engineering 38, 2009. 28 March 2011: 280-290.
“US Markets for Heart Valves.” SAGE Sourcebook of Modern Biomedical Devices: Business Environments, 2007. 21 April 2011.
Sorin Group. (2009). Mitroflow aortic pericardial heart valve—model LX instructions for use—English. Retrieved from http://www.sorin.com/sites/default/files/roles/3/files/HV/450-07LS002%20(A).pdf
Hypertrophic cardiomyopathy is an inherited disease that affects the cardiac muscle of the heart, causing the walls of the heart to thicken and become stiff. [1] On a cellular level, the sarcomere increase in size. As a result, the cardiac muscles become abnormally thick, making it difficult for the cells to contract and the heart to pump. A genetic mutation causes the myocytes to form chaotic intersecting bundles. A pathognomonic abnormality called myocardial fiber disarray. [2,12] How the hypertrophy is distributed throughout the heart is varied. Though, in most cases, the left ventricle is always affected. [3] The heart muscle can thicken in four different patterns. The most common being asymmetrical septal hypertrophy without obstruction. Here the intraventricular septum becomes thick, but the mitral valve is not affected. Asymmetrical septal hypertrophy with obstruction causes the mitral valve to touch the septal wall during contraction. (Left ventricle outflow tract obstruction.) The obstruction of the mitral valve allows for blood to slowly flow from the left ventricle back into the left atrium (Mitral regurgitation). Symmetrical hypertrophy is the thickening of the entire left ven...
from the left atrium towards the mitral apparatus and positioning the mitral clip. TEE is also
Some advantages of the Total Artificial Heart include: 9.5 L/min of increased blood flow through both ventricles, faster bridge-to-transplant, and it eliminates complications caused by a diseased heart, such as kidney and liver failure. (“Syncardia”) “The first Total Artificial Heart implant was performed in Richmond, Va. on April 4, 2006 by a cardiac surgery team at VCU (Virginia Commonwealth University) in the Pauley Heart Center”(Lepley p.1). The major point to remember is that this is a mechanical heart that totally replaces a person’s own heart.
The patient was taken to the operating room (OR) and was placed under general endotracheal anesthesia. After cannulating the left femoral artery, the valve was positioned and deployed using the TAVR deployment device. During deployment of the new aortic valve, the balloon used to expand the valve was noted to rupture on fluoroscopy and TEE. Diagnostics, performed by the anesthesiologist using TEE, demonstrated the proper placement of percutaneous valve resulting in correction of the aortic stenosis; the mean/peak gradients were reduced to 2mmHg/4mmHg and the AVA increased to 2.69 cm2. Upon attempting to remove the deployment device, cardiology team encountered significant resistance; fluoroscopy determined that the ruptured balloon had become trapped on something. They attempted to free the balloon from its entanglement using a snare, and also by
Both the fast and slow pathways arise in the right atrium, but the slow pathway is the target for the cryoablation therapies. Since the AV node is a special conduction area that conducts electrical impulses from the atria to the ventricles, ablating tissue neighboring the AV node carries a risk of creating heart block. Heart block disrupts regular conduction of electrical impulses from the atria to the ventricles. Physicians opt for the cryoablation technique when there is a complete heart block concern; freezing tissue surrounding the AV node decreases the risk of heart block due to its ability to create lesions that are initially reversible. Cryoablation procedures are more effective in the younger population less than 40 years of age because incidence of recurrence increases with
Burke has had many teachers and coaches; one that pushed him to be revolutionary in medicine was Dr. Castanada. During Burkes training Castanada encouraged him to explore the possibilities of using endoscopic surgical techniques, and/ or designing instruments, and more surgical techniques (Spokeo.com). Through trail and error Burke accomplished the 1st endoscopic vascular ring division, the 1st diaphragm plication, and the 1st thoracic duct ligation. On top of contributing priceless techniques to the surgical field, Burke is the founder of the Congenital Heart Institute of Miami Children’s Hospital and the Arnold Palmer Hospital.
Valve thrombosis is a rare but very serious complication of mechanical heart valve prostheses that can result in significant morbidity and mortality. The prevalence of Mechanical prosthetic valve thrombosis ranges from 0.3% and 1.3% per patient-year depending on the type of anticoagulation used and adherence to therapy (1, 2). The severity of clinical presentation depends on the presence or absence of obstruction (3). Our patient presented with New York Heart Association (NYHA) class IV heart failure, hemodynamically significant murmur and evidence of immobile valve leaflet on fluoroscopy. The goals of management of in managing PVT are to remove the thrombus, preserve normal valve function and prevent embolization (4). Management of PVT is controversial but therapeutic options include surgery, fibrinolysis and anticoagulation with choice of therapy depending on size of thrombus, presence of valve obstruction, valve location and clinical status of the patient (5). Current guidelines rely on expert opinion and limited data from case series, retrospective cohorts and non-randomized studies due to absence of randomized clinical trials to guide therapeutic strategies for PVT.
Have you ever thought about how the strongest muscle in your body is about the size of your fist.The heart is divided up into four chambers, two of these chambers are ventricles and the other two are called atria. Their is one ventricle and one atria on the left side of the heart and one of each on the right side of the heart as well. Each chamber is separated by a valve. On the left side the valves are called mitral valve, aortic valve. The valves on the right side of the heart are called tricuspid valve and the pulmonic valve. The middle portion of the heart is called myocardium. The outer layer is known as the epicardium.
Every year, thousands people get heart valve replacements for various health reasons. There are multiple options for replacement valves that can generally be put into two categories, mechanical and biological. One of the mechanical options from the 1970s and 1980s was the Bjork-Shiley valve, which became infamous because of the controversy surrounding its stress fracture failures. These failures resulted the death of about 400 people, causing the value to be taken off the market. Using various ethical standpoints, the decisions made surrounding this issue must be examine so that an incident like this will not occur in the future. Ultimately, the FDA should require either third party or FDA in-house testing in order to ensure the safety of a
Although the tools and techniques used in such surgeries have evolved dramatically over the past few decades, the basics of such surgeries
The pericardium is a sac that surrounds and protects the heart. It is doubled layered with an outer layer composed of fibrous connective tissue and an inner layer composed of simple squamous epithelium (Farley, McLafferty & Hendry, 2012). The fibrous portion of the pericardium ensures that the heart is anchored in place and prevents over distension (Farley et al., 2012). The inner layer named the serous membrane is further divided into two sections: the parietal and visceral
The human heart is an organ that pumps blood through the circulatory system into the human body. The human heart is a complex organ which has special parts, a complicated way of working and further requires multiple tasks to be done to keep the heart healthy. In, order for the human heart to work properly, it uses specific parts that allow it to run. With these specific parts, the human heart works in a particular way further explain. When certain defects are formed in the heart, many diseases can occur further explained. To help fix the disease in the heart there are many surgeries that are done. In some surgeries, machines are inserted into the heart which allows the heart to behave better than it did without the machine.
Images of human anatomy have been around for more than 500 years now. From the sketches created by Leonardo da Vinci, to the modern day Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scan, images have played a great role in medicine. Evolution in medical imaging brought together people from various disciplines such as Biology, Physics, Chemistry and Mathematics, a collaboration which has further contributed to healthcare as a whole. Modern day imaging improves medical workflows by facilitating a non-invasive insight into human body, accurate and timely diagnostics, and persistence of an analysis.
The valves of the heart have a very, very important role in the function of the