250:(port access) options available pioneered by Hugo Vanerman in Belgium. The minimally invasive approach does not involve cutting the breastbone, but instead uses multiple incisions in the side of the chest and the leg. Cardiac surgeons are not unanimous about the relative merits of sternotomy versus the minimally invasive approach. The minimally invasive approach can produce a less prominent scar, is beneficial for very obese patients, and may allow the patient to return to their normal activity sooner than a sternotomy. But some cardiac surgeons argue that unless performed by the most experienced cardiac centers, minimally invasive surgery can involve a longer time on a bypass machine, a lower repair rate, and higher (although still low) risk of stroke. One cardiac surgery professor said, "I think the only benefit is for
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Johnston, Douglas R.; Gillinov, A. Marc; Blackstone, Eugene H.; Griffin, Brian; Stewart, William; Sabik, Joseph F.; Mihaljevic, Tomislav; Svensson, Lars G.; Houghtaling, Penny L.; Lytle, Bruce W. (2010). "Surgical Repair of
Posterior Mitral Valve Prolapse: Implications for Guidelines and Percutaneous
210:
for the rest of their lives, which presents a risk of bleeding complications. The artificial mitral valve has an elevated risk of stroke. Patients with mechanical heart valves who use warfarin for anticoagulation have to be on long-term anticoagulation therapy. This means they must go to the clinic
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mitral valve repair â is available in Europe but still in clinical trial in the United States. It is a highly specialized technique only available at select hospitals. Early trial results suggest that it may be a beneficial approach for patients who are at high risk from conventional surgery.
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and may provide a more durable result. Not all damaged valves are suitable for repair; in some, the state of valve disease is too advanced and replacement is necessary. Often, a surgeon must decide during the operation itself whether a
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In the 2000s there have been several trials of a newer strategy of mitral valve repair that does not require major cardiac surgery. Through a catheter inserted in the groin, the valve leaflets are clipped together. This technique â
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have performed beating heart mitral valve repair or replacement. The beating heart mitral valve replacement technique is as safe as the arrested heart technique, and is the recommended alternative to arrested heart technique.
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and have a lab blood draw done, typically once a month but more frequently if the level needs to be closely monitored until it is in the therapeutic range. The therapeutic range for most adults with a mechanical valve is an
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is the best course of action. For patients with the most common type of mitral valve disease, termed "degenerative" or "myxomatous" mitral valve disease, repair rates are very high and long term durability is excellent.
110:. It then closes to keep blood from leaking back into the left atrium or lungs when the ventricle contracts (squeezes) to push blood out to the body. It has two flaps, or leaflets, known as cusps.
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In the past two decades, some surgeons have embraced surgical techniques to repair the damaged native valve, rather than replace it. These techniques were pioneered by a French heart surgeon,
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of the heart. After the left atrium fills with blood, the mitral valve allows blood to flow from the left atrium into the heart's main pumping chamber called the left
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of 2.5â3.5. Finally, artificial tissue valves will wear out â on average lasting between 10 and 15 years, requiring further surgery at an advanced age.
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The techniques of mitral valve repair include inserting a cloth-covered ring around the valve to bring the leaflets into contact with each other (
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for the patient and the benefit is for marketing and growing our practices for ourselves because itâs a good way to grow one's practice."
206:. Infection of the valve can occur, which is dangerous and difficult to treat. Patients with mechanical heart valves are required to take
500:
Mojena Morfa, Guillermo; TaĂn BlĂĄzquez, Julio; Paredes
Cordero, Ăngel M.; PĂ©rez LĂłpez, Horacio; GonzĂĄlez GonzĂĄlez, Lisbeth (June 2008).
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was the only surgical option for patients with a severely diseased mitral valve. However, there are some significant downsides to a
117:), removal of redundant/loose segments of the leaflets (quadrangular resection), and re-suspension of the leaflets with artificial (
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Anterior (frontal) view of the opened heart. White arrows indicate normal blood flow. (Mitral valve labeled at center right.)
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222:. A repair still involves major cardiac surgery but for many patients presents the significant advantage of avoiding
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There has been great debate about timing of surgery in patients with asymptomatic mitral valve regurgitation.
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Mitral Valve
Prolapse, Functional MR, Cardiac Surgery, Degenerative MR, and Cardiomyopathy - Evalve, Inc
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Robotic mitral valve repair operations are also being utilized throughout the United States.
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Cohn, Lawrence H.; Tchantchaleishvili, Vakhtang; Rajab, Taufiek K. (July 9, 2015).
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Wong, R. H.; Lee, A. P.; Ng, C. S.; Wan, I. Y.; Wan, S.; Underwood, M. J. (2010).
159:(coronary artery disease) or non-ischemic heart disease (dilated cardiomyopathy).
151:. In rare instances the mitral valve can be destroyed by infection or a bacterial
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The traditional surgical approach to a mitral valve repair is a full or partial
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performed the worldâs first successful heart valve surgery â a mitral valve
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The development of the heart-lung machine in the 1950s paved the way for
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Medical-Surgical
Nursing: Assessment and Management of Clinical Problems
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132:) allow surgery without a sternotomy (and resulting pain and scar).
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86:. The mitral valve is the "inflow valve" for the left side of the
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is much more technically demanding and may involve higher risk.
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536:"Efficacy and Safety of Beating Heart Mitral Valve Replacement"
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378:(Ninth ed.). St. Louis, MO: Elsevier Mosby. p. 825.
327:"Evolution of the concept and practice of mitral valve repair"
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436:"2011 Heart Valve Summit: Minimally Invasive Surgery - Facts"
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91:
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143:). More often the mitral valve becomes abnormal with age (
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Occasionally, the mitral valve is abnormal from birth (
479:"HFC: Mitral Valve Clip Viable When Surgery Too Risky"
155:. Mitral regurgitation may also occur as a result of
269:As early as January 2000 a team of doctors at the
502:"CirugĂa valvular mitral con el corazĂłn latiendo"
271:Instituto de CardiologĂa y CirugĂa Cardiovascular
124:Procedures on the mitral valve usually require a
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565:"Mitral Valve Repair: Past, Present, and Future"
128:, but advances in non-invasive methods (such as
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562:
658:Cardiology diagnostic tests and procedures
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27:
754:Transcatheter pulmonary valve replacement
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350:
797:shunt from heart chamber to blood vessel
569:Asian Cardiovascular and Thoracic Annals
98:, where it picks up oxygen, through the
897:shunt from blood vessel to blood vessel
134:Minimally invasive mitral valve surgery
1398:
1027:Valve-sparing aortic root replacement
766:enlargement of existing septal defect
604:
476:
373:
761:production of septal defect in heart
343:10.3978/j.issn.2225-319X.2015.04.09
13:
858:transposition of the great vessels
783:creation of septal defect in heart
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14:
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1158:Cardiac resynchronization therapy
198:in the 1960s. For decades after,
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414:10.1016/j.athoracsur.2009.12.070
331:Annals of Cardiothoracic Surgery
179:. The patient was a 12-year-old
1165:Left atrial appendage occlusion
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477:Phend, Crystal (22 May 2011).
470:
452:
428:
402:The Annals of Thoracic Surgery
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367:
318:
1:
1287:Radionuclide ventriculography
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1272:Myocardial perfusion imaging
194:of the mitral valve with an
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173:Peter Bent Brigham Hospital
10:
1422:
879:for univentricular defect
506:Revista Cubana de Medicina
440:Mitral Valve Repair Center
302:Mitral valve insufficiency
162:
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1219:Implantable loop recorder
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863:Arterial switch operation
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653:Interventional cardiology
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185:rheumatic mitral stenosis
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16:Cardiac surgery procedure
1298:Coronary catheterization
788:BlalockâHanlon procedure
749:Mitral valve replacement
732:Aortic valve replacement
582:10.1177/0218492310383916
200:mitral valve replacement
1294:Cardiac catheterization
1236:Electrophysiology study
1136:Radiofrequency ablation
1101:Alcohol septal ablation
220:Dr. Alain F. Carpentier
204:prosthetic mitral valve
70:procedure performed by
1340:Impedance cardiography
962:Coronary artery bypass
374:Lewis, Sharon (2015).
157:ischemic heart disease
1371:Transcutaneous pacing
1175:Heart transplantation
1096:Ventricular reduction
912:BlalockâTaussig shunt
464:June 8, 2007, at the
1345:Ballistocardiography
902:systemic circulation
147:) or as a result of
1224:Cardiac stress test
1202:Electrocardiography
1141:Pacemaker insertion
888:Kawashima procedure
852:compound procedures
727:Aortic valve repair
700:Mitral valve repair
292:Aortic valve repair
64:Mitral valve repair
22:Mitral valve repair
1277:Cardiovascular MRI
1207:Vectorcardiography
1062:Pericardial window
1057:Pericardiocentesis
998:Drug-eluting stent
827:Rastelli procedure
776:Balloon septostomy
248:minimally invasive
1393:
1392:
1250:Angiocardiography
1196:Electrophysiology
1183:
1182:
1126:Catheter ablation
1109:Conduction system
1034:LeCompte maneuver
1022:Bentall procedure
883:Norwood procedure
873:Senning procedure
868:Mustard procedure
771:Atrial septostomy
722:Valve replacement
126:median sternotomy
82:(leakage) of the
61:
60:
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1350:Cardiotocography
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1282:Ventriculography
1255:Echocardiography
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1198:
1114:Maze procedure (
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1077:
1053:
1006:
1005:Obstacle removal
993:Bare-metal stent
989:
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906:pulmonary artery
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838:pulmonary artery
811:Fontan procedure
806:pulmonary artery
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538:. Archived from
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72:cardiac surgeons
54:edit on Wikidata
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1091:Septal myectomy
1081:Cardiomyoplasty
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1067:Pericardiectomy
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939:Cardiac vessels
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928:Glenn procedure
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834:right ventricle
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663:Cardiac imaging
648:Cardiac surgery
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557:Further reading
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78:(narrowing) or
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1148:implantation
1131:Cryoablation
972:Off-pump CAB
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690:Valve repair
680:Heart valves
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544:. Retrieved
540:the original
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520:– via
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483:. Retrieved
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167:In 1923 Dr.
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153:endocarditis
145:degenerative
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123:
115:annuloplasty
112:
84:mitral valve
63:
62:
1308:Cardiac PET
1051:Pericardium
1015:Atherectomy
953:Angioplasty
695:Valvulotomy
233:replacement
192:replacement
104:left atrium
1303:Cardiac CT
1170:Cardiotomy
1075:Myocardium
843:Sano shunt
633:procedures
631:Tests and
546:2016-01-06
445:2024-01-31
313:References
244:sternotomy
183:girl with
141:congenital
683:and septa
518:0034-7523
485:17 August
400:Repair".
307:MitraClip
275:La Habana
121:) cords.
108:ventricle
102:, to the
74:to treat
1400:Category
1387:Category
1120:minimaze
1116:Cox maze
591:21149413
462:Archived
422:20417750
361:26309840
286:See also
252:cosmesis
181:comatose
119:Gore-Tex
76:stenosis
40:ICD-9-CM
672:Surgery
352:4526492
171:of the
163:History
1359:Pacing
967:MIDCAB
958:Bypass
908:shunt
802:atrium
715:mitral
710:aortic
589:
522:SciELO
516:
420:
382:
359:
349:
229:repair
177:repair
1316:sound
1188:Tests
1146:S-ICD
1043:Other
977:TECAB
822:aorta
637:heart
512:(2).
231:or a
96:lungs
92:Blood
88:heart
66:is a
52:[
45:35.12
1118:and
856:for
587:PMID
514:ISSN
487:2012
418:PMID
380:ISBN
357:PMID
279:Cuba
1265:TEE
1260:TTE
1152:ICD
947:CHD
919:SVC
904:to
836:to
820:to
804:to
577:doi
410:doi
347:PMC
339:doi
273:in
213:INR
1402::
923:PA
585:.
573:18
571:.
567:.
510:47
508:.
504:.
438:.
416:.
406:89
404:.
355:.
345:.
333:.
329:.
277:,
187:.
90:.
1296:/
1122:)
960:/
624:e
617:t
610:v
593:.
579::
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341::
335:4
56:]
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