mitral valve repair

• 僧帽弁形成術、僧帽弁形成、僧帽弁修復術、僧帽弁修復

WordNet

1. move, travel, or proceed toward some place; "He repaired to his cabin in the woods" (同)resort
2. restore by replacing a part or putting together what is torn or broken; "She repaired her TV set"; "Repair my shoes please" (同)mend, fix, bushel, doctor, furbish up, restore, touch_on
3. a formal way of referring to the condition of something; "the building was in good repair"
4. the act of putting something in working order again (同)fix, fixing, fixture, mend, mending, reparation
5. control consisting of a mechanical device for controlling the flow of a fluid
6. device in a brass wind instrument for varying the length of the air column to alter the pitch of a tone
7. one of the paired hinged shells of certain molluscs and of brachiopods
8. the entire one-piece shell of a snail and certain other molluscs
9. a structure in a hollow organ (like the heart) with a flap to insure one-way flow of fluid through it
10. relating to or resembling the miter worn by some clerics
11. of or relating to or located in or near the mitral valve; "mitral insufficiency"
12. (of brass instruments) having valves

PrepTutorEJDIC

1. …‘を'『修繕する』,修理する / …‘を'『償う』;…‘を'訂正する』 / …‘を'回復する / 修繕(修理)できる / 『修繕』,『修理』,修繕作業 / 〈U〉手入れ(修理)の状態
2. (大挙して)(…へ)行く(GO)《+『to』+『名』》
3. (液体・ガスなどの流れを調節する)『バルブ』,弁 / (血液の流れを調節する)弁,弁膜 / (管楽器の)バルブ / (2枚貝の)から,貝がら / 《英》真空管

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/05/19 06:58:34」(JST)

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[Wiki en表示]

Mitral valve repair
Intervention
Anterior (frontal) view of the opened heart. White arrows indicate normal blood flow. (Mitral valve labeled at center right.)
ICD-9-CM	35.12

Mitral valve repair is a cardiac surgery procedure performed by cardiac surgeons to treat stenosis (narrowing) or regurgitation (leakage) of the mitral valve. The mitral valve is the "inflow valve" for the left side of the heart. Blood flows from the lungs, where it picks up oxygen, through the pulmonary veins, to the left atrium 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 ventricle. 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.

The techniques of mitral valve repair include inserting a cloth-covered ring around the valve to bring the leaflets into contact with each other (annuloplasty), removal of redundant/loose segments of the leaflets (quadrangular resection), re-suspension of the leaflets with artificial (Gore-Tex) cords.

Procedures on the mitral valve usually require a median sternotomy, but advances in non-invasive methods (such as keyhole surgery) allow surgery without a sternotomy (and resulting pain and scar). Minimally invasive mitral valve surgery is much more technically demanding and may involve higher risk.

Occasionally, the mitral valve is abnormal from birth (congenital). More often the mitral valve becomes abnormal with age (degenerative) or as a result of rheumatic fever. In rare instances the mitral valve can be destroyed by infection or a bacterial endocarditis. Mitral regurgitation may also occur as a result of ischemic heart disease (coronary artery disease) or non-ischemic heart disease (dilated cardiomyopathy).

History

In 1923 Dr. Elliott Cutler of the Peter Bent Brigham Hospital performed the world’s first successful heart valve surgery - a mitral valve repair. The patient was a 12-year-old girl with rheumatic mitral stenosis.

The development of the heart-lung machine in the 1950s paved the way for replacement of the mitral valve with an artificial valve in the 1960s. For decades after, mitral valve replacement was the only surgical option for patients with a severely diseased mitral valve. However, there are some significant downsides to a prosthetic mitral valve. Infection of the valve can occur, which is dangerous and difficult to treat. Patients with mechanical heart valves are required to take blood thinners for the rest of their lives which presents a risk of bleeding complications. The artificial mitral valve has an elevated risk of stroke. Finally, artificial tissue valves will wear out - on average lasting between 10 and 15 years, requiring further surgery at an advanced age.

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, Dr. Alain F. Carpentier. A repair still involves major cardiac surgery but for many patients presents the significant advantage of avoiding blood thinners 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 repair or replacement is the best course of action.

There has been great debate about timing of surgery in patients with asymptomatic mitral valve regurgitation.

The traditional surgical approach to a mitral valve repair is a full or partial sternotomy, in which the surgeon cuts through the breastbone at the center of the chest to access the heart. There are minimally invasive (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 cosmesis for the patient and the benefit is for marketing and growing our practices for ourselves because it’s a good way to grow one’s practice."

Robotic mitral valve repair operations are also being tested at some medical centers.

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 -- percutaneous mitral valve repair—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.

See also

• Aortic valve repair
• Cardiac surgery

References

Further reading

• Randolph HL Wong; Alex PW Lee; Calvin SH Ng; Innes YP Wan; Song Wan; Malcolm J Underwood (2010). "Mitral valve repair: past, present, and future". Asian Cardiovasc Thorac Ann. 18 (6): 586–95. doi:10.1177/0218492310383916. 
• Visit the educational website www.themitralvalve.org. This is the first and the most comprehensive web portal tracing the history of valvular heart disease over a five-century period. The Historic Review component of the website has an extensive section on the history of mitral valve surgery.

External links

• Mitral Valve Repair at The Mount Sinai Hospital
• Brigham and Women's Hospital Valve Centre
• Mitral Valve Repair at the University of Maryland Medical Center

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 経カテーテル僧帽弁修復 transcatheter mitral valve repair
• 2. 重度の慢性僧帽弁閉鎖不全症に対する外科的手技 surgical procedures for severe chronic mitral regurgitation
• 3. 人工心臓弁における抗血栓療法：適応 antithrombotic therapy for prosthetic heart valves indications
• 4. 慢性の二次性僧帽弁閉鎖不全症のマネージメントおよび予後 management and prognosis of chronic secondary mitral regurgitation
• 5. 慢性の原発性僧帽弁閉鎖不全症のマネージメント management of chronic primary mitral regurgitation

English Journal

• Secondary abdominal compartment syndrome required decompression laparotomy during minimally invasive mitral valve repair.

• Nishi H1, Toda K1, Miyagawa S1, Yoshikawa Y1, Fukushima S1, Yoshioka D1, Saito T1, Sawa Y2.
• Surgical case reports.Surg Case Rep.2016 Dec;2(1):3. doi: 10.1186/s40792-015-0078-5. Epub 2016 Jan 12.
• We treated a 77-year-old patient with secondary abdominal compartment syndrome that caused failure to maintain cardiopulmonary bypass while undergoing elective minimally invasive right mini-thoracotomy mitral valve and tricuspid valve repair procedures. During the operation, a decompression laparoto
• PMID 26943679

• Mitral valve prolapse is associated with altered extracellular matrix gene expression patterns.

• Greenhouse DG1, Murphy A1, Mignatti P2, Zavadil J3, Galloway AC1, Balsam LB4.
• Gene.Gene.2016 Jul 15;586(1):56-61. doi: 10.1016/j.gene.2016.04.004. Epub 2016 Apr 6.
• Mitral valve prolapse (MVP) is the leading indication for isolated mitral valve surgery in the United States. Disorganization of collagens and glycosaminoglycans in the valvular extracellular matrix (ECM) are histological hallmarks of MVP. We performed a transcriptome analysis to study the alteratio
• PMID 27063507

• Quantitative Imaging Assessment of an Alternative Approach to Surgical Mitral Valve Leaflet Resection: An Acute Porcine Study.

• Boronyak SM1, Fredi JL2, Young MN2, Dumont DM1, Williams PE3, Byram BC1, Merryman WD4.
• Annals of biomedical engineering.Ann Biomed Eng.2016 Jul;44(7):2240-50. doi: 10.1007/s10439-015-1494-1. Epub 2015 Oct 27.
• This study reports the initial in vivo use of a combined radiofrequency ablation and cryo-anchoring (RFC) catheter as an alternative to surgical mitral valve (MV) leaflet resection. Radiofrequency ablation thermally shrinks enlarged collagenous tissues, providing an alternative to leaflet resection,
• PMID 26508331

Japanese Journal

• 左室機能低下と僧帽弁閉鎖不全症を有する重症心不全に対する心拍動下手術 (特集 重症心不全に対する外科治療)

• 木山 宏,垣 伸明,塩見 大輔 [他]
• 胸部外科 66(1), 11-16, 2013-01-00
• NAID 40019541614

• Structural Valve Deterioration of Porcine Bioprosthesis Soon after Mitral Valve Repair and Replacement

• Takano Tamaki,Seto Tatsuichiro,Asaka Shiho,Terasaki Takamitsu,Ohashi Noburou,Fukui Daisuke,Amano Jun
• Annals of Thoracic and Cardiovascular Surgery, 2013
• … An 81-year-old woman, who had undergone mitral valve replacement (MVR) with a porcine bioprosthesis after mitral valve repair, presented with hemolysis 4 years and 6 months after MVR. … Transthoracic echocardiography (TTE) revealed trivial mitral regurgitation, which was diagnosed based on the observed perivalvular leakage. …
• NAID 130003377893

• Tricuspid Regurgitation after Mitral Valve Repair for Degenerative Mitral Regurgitation

• Ueno Tetsuya,Sakata Ryuzo,Shigehisa Yoshiya,Kanda Hideaki,Hisashi Yosuke,Yamamoto Hiroyuki,Imoto Yutaka
• Annals of Thoracic and Cardiovascular Surgery, 2013
• … Purpose: We examined changes of TR (tricuspid regurgitation) after mitral valve repair for degenerative mitral regurgitation (MR) and investigated their contributing parameters. … Methods: We divided 205 patients undergoing mitral valve repair for degenerative MR into 3 groups: up-grade (n = 65), down-grade (n = 29), and no-change (n = 111) of TR during postoperative follow-up. …
• NAID 130003377888

Related Links

• Mitral Valve Repair Reference Center

Mitral Valve Repair Reference Center at The Mount Sinai Hospital The Mitral Valve Repair Reference Center at The Mount Sinai Hospital is one of the most advanced in the country. The superiority of mitral valve repair over mitral valve ...

• Mitral valve surgery - minimally invasive: MedlinePlus Medical ...

Mitral valve surgery is surgery to either repair or replace the mitral valve in your heart. Blood flows from the lungs and enters a pumping chamber of the heart called the left atrium. The blood then flows into the final pumping ...

Related Pictures

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★リンクテーブル★

リンク元	「僧帽弁形成術」「僧帽弁修復」「僧帽弁形成」「僧帽弁修復術」
関連記事	「mitral」「valve」

「僧帽弁形成術」

　　[★]

英

mitral annuloplasty, mitral valve plasty, MVP, mitral valve repair

関

僧帽弁修復、僧帽弁形成、僧帽弁修復術

「僧帽弁修復」

　　[★]

英

mitral valve repair

関

僧帽弁形成術、僧帽弁形成、僧帽弁修復術

「僧帽弁形成」

　　[★]

英

mitral valve repair

関

僧帽弁修復、僧帽弁形成術、僧帽弁修復術

「僧帽弁修復術」

　　[★]

英

mitral valve repair

関

僧帽弁修復、僧帽弁形成術、僧帽弁形成

「mitral」

　　[★]

• adj.

• 僧帽弁の、僧帽状の

関

mitral valve

　 　

「valve」

　　[★]

• n.

• 弁