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CC BY 4.0 · Aorta (Stamford) 2016; 04(03): 91-94
DOI: 10.12945/j.aorta.2016.15.035
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Immediate Improvement in Severe Mitral Regurgitation After Aortic Valve Replacement for Severe Aortic Insufficiency

Ahmad Zeeshan
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut, USA
2   Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA
,
Mojun Zhu
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut, USA
,
John A. Elefteriades
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut, USA
› Author Affiliations
Further Information

Publication History

23 October 2015

02 April 2016

Publication Date:
24 September 2018 (online)

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Abstract

A 57-year-old male with ascending aortic aneurysm, severe aortic regurgitation, and severe mitral regurgitation (MR) underwent ascending aortic replacement and aortic valve replacement. MR in this patient with normal mitral valve morphology was considered secondary to aortic valve incompetency. Consequently, a surgical approach to restore aortic valve function was adopted with successful MR resolution. This case report demonstrates the possibility of reversing early functional mitral regurgitation without surgically approaching the mitral valve.

Key Words

Functional mitral regurgitation - Aortic regurgitation - Aortic aneurysm
 

  • References

  • 1 de Marchena E, Badiye A, Robalino G, Junttila J, Atapattu S, Nakamura M. , et al. Respective prevalence of the different carpentier classes of mitral regurgitation: a stepping stone for future therapeutic research and development. J Cardiac Surg 2011; 26: 385-392 . DOI: 10.1111/j.1540-8191.2011.01274.x
    CrossrefPubMedSearch in Google Scholar
  • 2 Glasson JR, Komeda M, Daughters GT, Bolger AF, Karlsson MO, Foppiano LE. , et al. Early systolic mitral leaflet “loitering” during acute ischemic mitral regurgitation. J Thorac Cardiovasc Surg 1998; 116: 193-205 . DOI: 10.1016/S0022-5223(98)70117-5
    CrossrefPubMedSearch in Google Scholar
  • 3 Lai DT, Tibayan FA, Myrmel T, Timek TA, Dagum P, Daughters GT. , et al. Mechanistic insights into posterior mitral leaflet inter-scallop malcoaptation during acute ischemic mitral regurgitation. Circulation 2002; 106: I40-I45 . DOI: 10.1161/01.cir.0000032874.55215.82
    PubMedSearch in Google Scholar
  • 4 Timek TA, Lai DT, Tibayan F, Liang D, Daughters GT, Dagum P. , et al. Ischemia in three left ventricular regions: insights into the pathogenesis of acute ischemic mitral regurgitation. J Thorac Cardiovasc Surg 2003; 125: 559-569 . DOI: 10.1067/mtc.2003.43
    CrossrefPubMedSearch in Google Scholar
  • 5 Nielsen SL, Hansen SB, Nielsen KO, Nygaard H, Paulsen PK, Hasenkam JM. Imbalanced chordal force distribution causes acute ischemic mitral regurgitation: mechanistic insights from chordae tendineae force measurements in pigs. J Thorac Cardiovasc Surg 2005; 129: 525-531 . DOI: 10.1016/j.jtcvs.2004.07.044
    CrossrefPubMedSearch in Google Scholar
  • 6 Cohn LH. Cardiac surgery in the adult. , 4th Edition. New York: McGraw-Hill Medical; 2013
    Search in Google Scholar
  • 7 Di Mauro M, Gallina S, D’Amico MA, Izzicupo P, Lanuti P, Bascelli A. , et al. Functional mitral regurgitation: from normal to pathological anatomy of mitral valve. Int J Cardiol 2013; 163: 242-248 . DOI: 10.1016/j.ijcard.2011.11.023
    CrossrefPubMedSearch in Google Scholar
  • 8 Schulman DS, Remetz MS, Elefteriades J, Frances CK. Mild mitral insufficiency is a marker of impaired left ventricular performance in aortic stenosis. J Am Coll Cardiol 1989; 13: 796-803 . DOI: 10.1016/0735-1097(89)90218-0
    CrossrefPubMedSearch in Google Scholar
  • 9 Harris KM, Malenka DJ, Haney MF, Jayne JE, Hettleman B, Plehn JF. , et al. Improvement in mitral regurgitation after aortic valve replacement. Am J Cardiol 1997; 80: 741-745 . DOI: 10.1016/S0002-9149(97)00506-7
    CrossrefPubMedSearch in Google Scholar
  • 10 Christenson JT, Jordan B, Bloch A, Schmuziger M. Should a regurgitant mitral valve be replaced simultaneously with a stenotic aortic valve?. Tex Heart Inst J 2000; 27: 350-355 . PMID: 11198307
    PubMedSearch in Google Scholar