Index. B B-type natriuretic peptide (BNP), 76

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1 Index A ACCESS-EU registry, Acute kidney injury (AKI), 76, 88 Annular enlargement, RV, Annuloplasty chordal cutting, 113 complete ring, 99 etiology-specific ring, 100 evolution, 98 flexible bands and rings, GeoForm ring, 100 IMR ETlogix ring, 100 optimal prosthesis, identification, pathophysiological basis, pericardial, 99 PMVI Carillon Mitral Contour System, 161 direct devices, energy/waves remodeling, limitation, MitraClip, MONARC device, 161 Neochordae implantation, 162 PTMA, 161 TVIR, 162 results of, 101 rigid and semi-rigid ring, 100 saddle ring and profile 3D ring, suture, 99 Apical 4-chamber view (A4CV), 179, 181 B B-type natriuretic peptide (BNP), 76 C Cardiac resynchronization therapy (CRT) MR and remodeling, impact of, NYHA, 142 papillary muscle dyssynchrony, postoperative LV ejection fraction, prevalence and implications, surgical mitral valve repair, tethering and closing forces, imbalance acute changes, 146 comparitive study, effective regurgitant orifice area, 146 Cardiogenic shock (CS) clinical scenarios, CPB, 85 IABP, Cardiomyocyte apoptosis, 177 Cardiopulmonary bypass (CPB) CS, 85 inotrope support, post-cardiopulmonary bypass ventricular dysfunction and failure, Carillon Mitral Contour System, 161 Carpentier s functional classification type I, type II, 21 type IIIB ischemic MR (see Ischemic MR) non-ischemic dilated cardiomyopathy, 24 treatment, 24 Chordae tendianeae, 9 Chordal cutting with annuloplasty, 113 clinical experience, principle, 110 safety and preserved LV function Doppler tissue velocity and strain rate, 111 therapeutic applications, 112 Chronic ischemic mitral regurgitation (cimr) development of, 185 echocardiographic parameters annulus dimension, CD, CH, 188 interpapillary muscles distance, 187 leaflet tethering, 187 left ventricle dilatation, 186 left ventricle dyssynchrony, 188 left ventricular diastolic filling, 188 mitral valve severity, 188 SI, 186 tenting area, 186 surgical strategies and recurrence PM relocation, 189 repair vs. replacement, 189 ring type, sizing technique, 189 Coapsys device animal studies, configuration, implications and analysis, 136, 139 initial clinical trials, Myosplint device, 132 preliminary results, RESTOR-MV trial, Coaptation depth (CD), Coaptation height (CH), 188 Complete ring annuloplasty, 99 K. Fattouch, P. Lancellotti, and G.D. Angelini, Secondary Mitral Valve Regurgitation, DOI / , Springer-Verlag London

2 202 Index Coronary artery bypass grafting (CABG) Coapsys (see Coapsys device) indications, mild-moderate ischemic MR, 52 mitral valve repair vs. mitral valve replacement, 52 moderate ischemic MR, moderate-severe ischemic MR, predictors of outcome, 53 persistent/recurrent ischemic MR, 56 D Data acquisition, 3D TTE focused wide sector/3d zoom, 30 full volume color flow Doppler, full volume gated acquisition, real time 3D acquisition/live 3D, 30 simultaneous multiplane mode/biplane mode, Degenerative mitral regurgitation (DMR), 153 Dobutamine stress echocardiography (DSE), 44 Dynamic stress evaluation clinical information, 46 ESE assessed parameters, clinical information, patients, 46 to perform, 45 uses of, 41 pathophysiology, 41, 44 prognostic impact, 46 stress test modalities DSE, 44 ESE, 45 PEE, E Echocardiography 2D TTE (see 2D transthoracic echocardiography (TTE)) 3D TTE (see 3D transthoracic echocardiography (TTE)) EE technique, 118 ESE (see Exercise stress echocardiography (ESE)) functional MR, 62 ischemic MR, 63 parameters, cimr annulus dimension, CD, CH, 188 interpapillary muscles distance, 187 leaflet tethering, 187 left ventricle dilatation, 186 left ventricle dyssynchrony, 188 left ventricular diastolic filling, 188 mitral valve severity, 188 SI, 186 tenting area, 186 pathophysiology, 61 TEE, 62 TTE, 63, 64 Echo guided surgical technique, Edge-to-edge (EE) technique echocardiography, 118 echo guided surgical technique, results of, role of, 118 Effective regurgitant orifice (ERO), 17 Effective regurgitant orifice area (EROA) 2D echocardiography, 36 estimation, PISA method, 45 exercise induced changes, 44 quantitative measures, severity, 64 65, 69 End diastolic pressure-volume relations (EDPVR), 136, 139 Endovascular Valve Edge-to-edge REpair of mitral regurgitation STudy (EVEREST) ACCESS-EU registry, 159 anatomical inclusion criteria, 155 echocardiographic examples, 155, 156 HRR enrolled patients, limitations, 157 residual mitral regurgitation, 157 End systolic pressure-volume relations (ESPVR), 136, 139 Etiology-specific ring annuloplasty, 100 EuroSCORE, 74 Exercise Doppler echocardiography, 52 Exercise echocardiography, 66 Exercise stress echocardiography (ESE) assessment parameters, clinical information, patients, 46 to perform, 45 stress test modalities, 45 uses of, 41 F Finite element (FE) model, 136, 139 Flexible bands and rings, FMR. See Functional mitral regurgitation (FMR) Focused wide sector/3d zoom, 30 Full volume color flow Doppler, Full volume gated acquisition, Functional mitral regurgitation (FMR) acute phase, myocardial infarction incidence, 15 prognosis studies, 13, 14 survival free, 13, 14 chronic phase, post myocardial infarction, 15 clinical outcomes, 17 Coapsys (see Coapsys device) disadvantages, 17 MPI (see Mitral prosthesis insertion (MPI), FMR) non-ischemic dilated cardiomyopathy, optimal annuloplasty, identification, perioperative anesthesia management, PMVI, 153 predictors, patient outcome, 17 Functional tricuspid regurgitation (FTR) assessment, TR grade, 182 RV annular enlargement, apical 4-chamber view (A4CV), 179, 181 cardiomyocyte apoptosis, 177 dimensions (RVD), 179, 181 3D TEE, 181 2D TTE, 179 ejection fraction (RVEF), 181 ejection mechanism, MRI assessment, 182 papillary muscle (PM) displacement,

3 Index 203 peristaltic pattern, 175 pressure-volume relationship, walls and components, surgical consideration, TV, Fundaro et al. functional classification, 24 G GeoForm ring annuloplasty, 100 H Heart failure (HF) perioperative anesthesia management (see Perioperative anesthesia management) systolic dysfunction estimation difficulties, 3 prevalence of, 4 High risk registry (HRR) enrolled patients, I Implantable cardioverter-defibrillator (ICD), 77 IMR ETlogix ring annuloplasty, 100 Interpapillary muscles distance, 187 Intraaortic balloon pump (IABP) CS, LV dysfunction, 119 Ischemic MR estimation difficulties, 2 3 vs. functional MR, 8, 9 left ventricle dysfunction, 9 10 prevalence of, 3 4 type IIIB Carpentier SMR characterisation, 21 chordae restriction, 23 LV remodeling, 24 mechanisms, tethering types, 24 L Leaflet tethering, 187 Left ventricular (LV) diastolic filling, 188 dilatation, 186 dysfunction, 9 10 dyssynchrony, 188 remolding, 56 Levosimendan, 81 Lone atrial fibrillation (AF), M Miller s classification system, MitraClip system ACCESS-EU registry, advantage, 154 anatomical assessment, 166, 167 annuloplasty, complications, D TEE, 154, 155 eligibility criteria and exclusion criteria, 153, 154 EVEREST study (see Endovascular valve edge-to-edge repair of mitral regurgitation study (EVEREST)) follow up, HRR enrolled patients, initial results, intraprocedural monitoring, 167, 168 mitral regurgitation (MR) etiology and mechanism, 166 severity, 165, 166 patient selection, 160, 165 system advance, mitral valve, 168 system alignment, MR orifice, system delivery, transseptal puncture, 168 Mitral annulus (MA) functional vs. ischemic, 8, 9 geometry, 8, histology, 8 Mitral leaflet morphology, Mitral prosthesis insertion (MPI), FMR definition, 123 MVA cut off values, long term results, vs. MVR/MPI data, repair vs. replacement, 126 natural history, surgical indication, 125 Mitral regurgitation (MR), MitraClip system etiology and mechanism, 166 severity, 165, 166 system alignment, Mitral valve (MV) anatomy and mechanisms, annuloplasty (MVA) cut off values, long term results, vs. MVR/MPI data, repair vs. replacement, 126 annulus, 67 deformation, 67, 68 morphology assessment, severity, 188 subvalvular apparatus morphology, Mitral valve repair cimr (see Chronic ischemic mitral regurgitation (cimr)) CRT, EE technique (see Edge-to-edge (EE) technique) vs. mitral valve replacement CABG, 52 preoperative echocardiographic parameters, MONARC device, 161 Myocardial infarction acute phase incidence, 15 prognosis studies, 13, 14 survival free, 13, 14 chronic phase, 15 Myosplint device, 132 N Neochordae implantation, 162 New York Heart Association (NYHA) CRT, 142 FMR, 15 Noninvasive ventilation (NIV), 87 Non-ischemic dilated cardiomyopathy, 15 16, 24

4 204 O Organic mitral regurgitation, 1 P Papillary muscle (PM) displacement anatomic representation, 178, 180 annulus area vs. control, septal and posterior, 178, 181 dyssynchrony, relocation animal studies, clinical results, subvalvular apparatus, 9 Percutaneous mitral valve intervention (PMVI) annuloplasty Carillon Mitral Contour System, 161 direct devices, energy/waves remodeling, limitation, MitraClip, MONARC device, 161 Neochordae implantation, 162 PTMA, 161 TVIR, 162 devices, 153, 154 diagnostic-therapeutic pathway, 153 DMR, 153 FMR, 153 MitraClip ACCESS-EU registry, advantage, 154 3D TEE, 154, 155 eligibility criteria and exclusion criteria, 153, 154 EVEREST study (see Endovascular valve edge-to-edge repair of mitral regurgitation study (EVEREST)) HRR enrolled patients, initial results, patient selection, 160 Percutaneous transvenous mitral annuloplasty (PTMA), 161 Pericardial annuloplasty, 99 Perioperative anesthesia management AKI, 76 BNP, 76 CPB, CS clinical scenarios, CPB, 85 IABP, EuroSCORE, 74 intraoperative management anesthetic agents and techniques, 79 functional MR, hemodynamic factors, 79 ICD, 77 monitoring, 77 reperfusion injury, 78 TEE, 78 medication management, PH, 75 post-cardiopulmonary bypass ventricular dysfunction and failure CPB, definitions, 80 fluid administration, 81 inotropic agents, 81 intravenous therapy, 84 levosimendan, 81 multifactorial potential causes, 82, 83 vasopressors, 83 postoperative management issues AKI, 88 blood glucose control, 88 NIV, 87 nutritional support, 87 postoperative pulmonary dysfunction, 87 potential etiologies and pathophysiologic mechanisms, 87, 88 RV protective ventilation, 86 revascularization, 74 Persistent MR, 56 Post exercise echocardiography (PEE), Predictors, cimr. See Chronic ischemic mitral regurgitation (cimr) Preoperative echocardiographic evaluation echocardiography functional MR, 62 ischemic MR, 63 pathophysiology, 61 TEE, 62 TTE, 63, 64 exercise echocardiography, 66 left ventricular size and shape, mitral valve anatomy and mechanisms, annulus, 67 deformation, 67, 68 repair, 67 non-ischemic causes, 59 parameters, 69 post myocardial infarct, 59 quantification, MR, 69 quantitative measures, severity, stress echocardiography, 65 TEE, 66 TTE, Prosthetic ring choice annuloplasty complete ring, 99 etiology-specific ring, 100 evolution, 98 flexible bands and rings, GeoForm ring, 100 IMR ETlogix ring, 100 optimal prosthesis, identification, pathophysiological basis, pericardial, 99 results of, 101 rigid and semi-rigid ring, 100 saddle ring and profile 3D ring, suture, 99 measurement and size, 101 Proximal isovelocity surface area (PISA) method 2D echocardiography, 36 EROA estimation, 45 quantitative measures, severity, 64 65, 69 Pulmonary hypertension (PH) perioperative anesthesia management, 75 SMR, 198 R Real time 3D acquisition/live 3D, 30 Recurrent ischemic MR, 56 Regurgitant volume (RV), 36 RESTOR-MV trial, Index

5 Index 205 Restrictive annuloplasty, Right ventricle (RV) FTR annular enlargement, apical 4-chamber view (A4CV), 179, 181 cardiomyocyte apoptosis, 177 dimensions (RVD), 179, 181 2D TTE, 179 3D TEE, 181 ejection fraction (RVEF), 181 ejection mechanism, MRI assessment, 182 papillary muscle (PM) displacement, peristaltic pattern, 175 pressure-volume relationship, walls and components, function, 198 RVD, 179, 181 RVEF, 181 Rigid and semi-rigid ring annuloplasty, 100 S Saddle ring and profile 3D ring annuloplasty, Secondary mitral regurgitation (SMR) antithrombotic management, average temporal prevalence, 196, 197 Carpentier s functional classification type I, type II, 21 type IIIB, clinical assessment, 198 clinical practice, 196 clinical prognostic value ( see Functional mitral egurgitation (FMR)) definition, 1 2 3D TTE (see 3D transthoracic echocardiography (TTE)) dynamic stress evaluation ( see Dynamic stress evaluation) echocardiography parameters, 196 estimation difficulties bias sources, 2 detection and evaluation, 2 heart failure and systolic dysfunction, 3 ischaemic MR, 2 3 Fundaro et al. functional classification, 24 histology, 7 8 left atrial size, 198 lone AF, LV dilatation/myocardial ischemia, LV remodelling, MA functional vs. ischemic, 8, 9 geometry, 8 histology, 8 medical therapy, 198 Miller s classification system, mitral gradients, objective, 193 perioperative anesthesia management (see Perioperative anesthesia management) permanent pacing, potential implications, 5 preoperative evaluation (see Preoperative echocardiographic evaluation) prevalence of heart failure and systolic dysfunction, 4 ischaemic MR, 3 4 prosthetic ring (see Prosthetic ring choice) pulmonary hypertension, 198 residual, 197 RV function, 198 subvalvular apparatus chordae tendianeae and papillary muscles, 9 left ventricle dysfunction, 9 10 surgical repair (see Surgical repair, timing and patient s selection) tricuspid valve, 198 Simultaneous multiplane mode/biplane mode, SMR. See Secondary mitral regurgitation (SMR) Sphericity index (SI), 186 Stress echocardiography, 65 Stress test modalities, dynamic SMR DSE, 44 ESE, 45 PEE, Surgical repair, timing and patient s selection coronary artery bypass grafting (CABG) indications, mild-moderate ischemic MR, 52 moderate ischemic MR, moderate-severe ischemic MR, mild-moderate ischemic MR, 52 mitral valve repair vs. mitral valve replacement CABG, 52 preoperative echocardiographic parameters, predictors of outcome, 53 persistent/recurrent ischemic MR, 56 Suture annuloplasty, 99 T Tenting area, 186 Tenting height. See Coaptation depth (CD) Tenting volume, 35 Tethering and closing forces acute changes, 146 comparitive study, effective regurgitant orifice area, 146 Tethering distance, 36 3D echocardiographic imaging. See 3D transthoracic echocardiography (TTE) 3D transthoracic echocardiography (TTE) data acquisition focused wide sector/3d zoom, 30 full volume color flow Doppler, full volume gated acquisition, real time 3D acquisition/live 3D, 30 simultaneous multiplane mode/biplane mode, MitraClip system implantation, 154, 155 to monitor, 170, 171 system alignment, 168, 169 system delivery, 169, 170 mitral annular geometry, mitral leaflet morphology, mitral valve morphology assessment, MV subvalvular apparatus morphology, pre-procedural selection and intervention guiding, RV, 181 severity assessment, 36 37

6 206 Index Transcatheter mitral valve-in-ring implantation (TVIR), 162 Transesophageal echocardiography (TEE) 3D (see 3D transthoracic echocardiography (TTE)) 2D (see 2D transthoracic echocardiography (TTE)) perioperative anesthesia management, 78 preoperative evaluation, 62, 66 Tricuspid valve (TV) FTR, mitral valve surgery, 198 2D transthoracic echocardiography (TTE) MitraClip system to monitor, 170, 171 system alignment, 168, 169 system delivery, 169, 170 RV, 179 V Valve annulus. See Mitral annulus (MA) Vena contracta width (VC), 36