scholarly journals High-density Mapping Facilitates Successful Ablation of Postincisional Right Atrial Flutter After Previous Mechanical Mitral Valve Replacement

2020 ◽  
Vol 12 (S1) ◽  
pp. 9-10
Author(s):  
Bernnard Strohmer ◽  
Franz Danmayr ◽  
Johannes Kraus ◽  
Markus Lassnig ◽  
Uta Hoppe
Keyword(s):  
Mitral Valve ◽  
Atrial Flutter ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
High Density ◽  
Right Atrial ◽  
Density Mapping ◽  
Successful Ablation

scholarly journals Comparison of P-Wave Duration and Dispersion in Mitral Valve Replacement Surgery Via Right Atrial Transseptal or Left Atrial Approach in Rheumatic Mitral Stenosis Patients

2020 ◽  
Vol 23 (2) ◽  
pp. E118-E122
Author(s):  
Hakan Gocer ◽  
Ahmet Baris Durukan ◽  
Ahmet Unlu ◽  
Mustafa Unal
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Wave Dispersion ◽  
P Wave ◽  
Right Atrial ◽  
P Wave Dispersion ◽  
Replacement Surgery ◽  
Right Atrial Approach ◽  
Group 1

Background: Predisposition to atrial fibrillation in mitral valve surgery has been well demonstrated. The changes in electrocardiographic parameters (Pmax, Pmin and P-wave dispersion) related to AF risk are unknown. We aimed to document the relationship between electrocardiographic changes and mitral valve replacement through right or left atrial surgical approaches. Methods: We retrospectively studied 154 patients, who underwent mitral valve replacement surgery from 2008 to 2018. Seventy-nine patients were operated with right atriotomy and transseptal approach (Group 1), and 75 patents were operated with left atriotomy (Group 2). ECGs obtained at hospital admittance and postoperatively at 24 hours were blindly analyzed. Results: Preoperative demographic characteristics were similar. Pmax, Pmin and P-wave dispersion were similar preoperatively. All parameters increased in both groups compared with the preoperative values (P < .05). Postoperative Pmax, Pmin and P-wave dispersion all were statistically significantly higher with the right atrial approach (P < .05). Postoperative AF also was more common in Group 1 (P < .05). Conclusion: Right atrial approach may lead to higher P-wave changes and atrial arrhythmias. This may be due to more extensive surgical disruption. The changes in atrial anatomic structure can increase atrial arrhythmic propensity and can cause atrial fibrillation.

scholarly journals Iatrogenic left ventricular--right atrial fistula following mitral valve replacement

Thorax ◽  
1973 ◽  
Vol 28 (2) ◽  
pp. 235-241 ◽  
Author(s):  
R. Seabra-Gomes ◽  
D. N. Ross ◽  
L. Gonzalez-Lavin
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Ventricular ◽  
Right Atrial

Left Ventricular to Right Atrial Communication (Gerbode-type Defect) After Mitral Valve Replacement

2008 ◽  
Vol 21 (4) ◽  
pp. 408.e1-408.e2 ◽  
Author(s):  
Ali Reza Moaref ◽  
Amir Aslani ◽  
Mahmood Zamirian ◽  
Mohammed Bagher Sharifkazemi
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Ventricular ◽  
Right Atrial ◽  
Type Defect

Left ventricular–right atrial fistula complicating redo mitral valve replacement

2001 ◽  
Vol 71 (1) ◽  
pp. 343-345 ◽  
Author(s):  
Malte Weinrich ◽  
Thomas P Graeter ◽  
Frank Langer ◽  
Hans-Joachim Schäfers
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Ventricular ◽  
Right Atrial

scholarly journals Catheter Ablation for Peri-Mitral Atrial Flutter Post Mitral Valve Replacement

2011 ◽  
Vol 27 (Supplement) ◽  
pp. PJ1_010
Author(s):  
Mamoru Hayano ◽  
Kouji Kumagai ◽  
Naofumi Tsukada ◽  
Suguru Nishiuchi ◽  
Keijirou Nakamura ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Mitral Valve ◽  
Atrial Flutter ◽  
Valve Replacement ◽  
Mitral Valve Replacement

scholarly journals Successful case of complex atrial flutter occurring in a patient with congenitally corrected transposition of the great arteries, aberrant left atrial appendage, and situs inversus

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Feng Hu ◽  
Erpeng Liang ◽  
Lihui Zheng ◽  
Ligang Ding
Keyword(s):  
Atrial Flutter ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
High Density ◽  
Atrial Appendage ◽  
Transposition Of Great Arteries ◽  
Density Mapping ◽  
Successful Ablation ◽  
Congenitally Corrected Transposition ◽  
Corrected Transposition

Abstract Background Congenitally corrected transposition of great arteries (ccTGA) is a rare congenital cardiac defect with atrioventricular and ventriculoarterial discordance which leads to heart failure and limits patients’ lifespan. The extremely aberrant cardiac structure makes electrophysiological procedure and radiofrequency ablation very difficult to be performed in such patients. Until now, there were only sporadical cases that have reported the successful ablation of atrial flutter in ccTGA patients. Case presentation We report a case of a 36-year-old male who was diagnosed with dextrocardia, atrial septal defect and congenitally corrected transposition of great arteries (ccTGA) at a young age and received atrial septal defect repair and morphological tricuspid valve plasty in 2014. As for reasons of heart failure and atrial flutter, he frequently suffered from progressively worsening dyspnea and recurrent episodes of palpitations. Cardiac anatomic imaging reconstruction before electrophysiological test revealed an unusually huge left atrial appendage in this patient. After high-density mapping of both right atrium and left atrium, activation mapping showed reentry circuit loops were located in left atrium. Successful ablation strategy was performed under the guidance of high-density mapping and entrainment. Conclusion This is a clinical case showing high-density mapping and successful ablation of a complex dual-loop atrial flutter in a patient with ccTGA and aberrant left atrial appendage. The successful procedure corroborates clinical utility of high-density mapping approach in the treatment of the patients with complex congenital heart disease accompanied by rapid arrhythmia, can be simpler, safer and more effective.

scholarly journals Medical image of the month: Massive right atrial dilation after mitral valve replacement

2019 ◽  
Vol 18 (1) ◽  
pp. 8-9
Author(s):  
Richard Young, MD* and Alexander Ravajy ◽  
◽  
Alexander Ravajy
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Medical Image ◽  
Right Atrial

scholarly journals Left Atrial Ball-Shaped Thrombus with Concomitant Biatrial Appendage Thrombi in a Patient with Prior Mitral Valve Replacement

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Kanako Akamatsu ◽  
Takahide Ito ◽  
Kazushi Sakane ◽  
Yumiko Kanzaki ◽  
Koichi Sohmiya ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Replacement Surgery ◽  
History Of ◽  
Floating Ball ◽  
Right Atrial Appendage

We reported a 67-year-old woman in whom large atrial thrombi were found by chance during discontinuation of therapeutic anticoagulation. The patient, with a history of mitral valve replacement surgery, had stopped anticoagulation for months because of intractable gastrointestinal bleeding, during which she was found to have 3 large thrombi in the atria on transesophageal echocardiography: left atrial free-floating ball-shaped thrombus, left atrial appendage thrombus, and right atrial appendage thrombus. One month following diagnosis, she still had the free-floating thrombus despite adequate anticoagulation. Free-floating ball-shaped thrombus is a rare finding observed on echocardiography in patients with mitral valve disease and an even rarer finding in case of appendage thrombi coexisting.

scholarly journals P1694 Prosthetic mitral valve infective endocarditis complicated by left ventricle to right atrial fistula

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R M Abayazeed ◽  
H Shehata ◽  
O Elgebaly ◽  
M A Abdel-Aziz ◽  
M A Abdel-Hay
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Tricuspid Valve ◽  
Left Ventricular ◽  
Right Atrial ◽  
History Of ◽  
Prosthetic Mitral Valve

Abstract Left ventricle (LV) to right atrial (RA) shunt is a rare type of ventricular septal defect. Acquired LV-RA shunt is rare and may occur as complication of cardiac surgery, endocarditis, thoracic trauma or myocardial infarction. Infective endocarditis is the second most important cause of this type of shunt. Case presentation A 44 year old female patient presented to our hospital complaining of progressive exertional dyspnea and palpitations for 6 months, and high grade fever for 2 weeks. The patient had history of mitral valve replacement with mechanical prosthesis 16 years ago. The patient had no history of recent invasive procedures or dental interventions. General examination revealed an irregular pulse at rate of 100 beats per minute (bpm), blood pressure of 100/60 mmHg, temperature of 38.5 ͦ C and congested neck veins. Cardiac examination revealed an audible prosthetic mitral click with a harsh pansystolic murmur heard on the apex and left sternal border, and an accentuated P2 over the pulmonary area. Her resting electrocardiogram (ECG) showed atrial fibrillation with ventricular response of 110 bpm. Her laboratory investigations revealed normochromic normocytic anemia with Hemoglobin level of 8 g/dl (13-16), and leucocytosis with white blood cell count of 16.24 103 cell/ ul (4.00-11.00); as well as elevated C-reactive protein (CRP) level of 73 (0-3). Her international normalized ratio (INR) was 3 (1-1.3) on warfarin 5 mg. Transthoracic echocardiography (TTE) revealed a dehiscent prosthetic mitral valve with severe paravalvular regurgitation, severe tricuspid valve regurgitation and pulmonary hypertension with predicted resting pulmonary artery systolic pressure of 60 mmHg. It also showed an abnormal jet passing from the LV into the RA above the tricuspid valve during systole, both right and left ventricular systolic functions were preserved. Subsequent 2D/3D transoesophageal echocardiography (TEE) confirmed the TTE findings with detection of LV-RA fistula with significant left to right shunt; it also visualized multiple vegetations attached to the mitral annulus at the site of the valve dehiscence. The patient was diagnosed with prosthetic mitral valve infective endocarditis, empirical antibiotics were started and the patient was referred for another center for urgent surgery. Redo mitral valve replacement, tricuspid valve repair and closure of the defect were done; the patient developed complete heart block postoperatively and permanent pacemaker was inserted. Conclusion Infective endocarditis remains a major health problem with high mortality and severe complications. It is important to keep high index of suspicion in high risk patients for infective endocarditis as delayed diagnosis increases the risk of serious complications and mortality, and makes surgical intervention, if indicated, more demanding with increased incidence of perioperative complications. Abstract P1694 Figure. TTE&TEE of prosthetic mitral IE

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