Morphometric Study of Mitral Valve Annulus in Iran.

BACKGROUND: This study aimed to determine the normal dimensions of the mitral annulus (MA) in Iranian population. MATERIALS AND METHODS: This cross-sectional study was conducted using 88 fresh hearts of male and female cadavers for six months in Mashhad, Iran. Normal data were determined by measuring the exact dimensions of the MA in fresh hearts of patients who had died of non-cardiac causes and considering some parameters such as age, gender, stature, and weight. Images of the valves and leaflets were prepared by marking the anterior (A2, midpoint of anterior) and posterior areas of P1, P2, and P3 using a needle. To analyze the data, SPSS version 16 was used. RESULTS: The means of anatomic area, anatomic perimeter, inter-commissural distance, A2-P1, A2-P2, A2-P3, Base-P1, Base-P2, Base-P3, and Base-A were 14±1.28, 8.3±1, 2.7±0.42, 2.27±0.37, 2.3±0.43, 2.06±0.35, 1.66±0.43, 1.2±0.97, 1.5±0.66, and 3.2±0.52, respectively. Comparison of the age groups regarding valve leaflets showed that Strut-P1 and Base-P2 were significantly different. Comparison of the valve leaflets and sub-valve indicators between the two genders reflected no significant differences. Age groups differed significantly in terms of Strut-P1 and Base-P2 (P=0.004 and P=00.1, respectively). CONCLUSIONS: A2-P3, A2-P1, anatomic perimeter, and anatomic area were found to be related to gender. A2-P1 and A2-P2 and some leaflet indicators such as Strut-P1 and Base-P2 were associated with age, whereas Base-P2 was affected by body mass index.

Effects of a 3D segmental prosthetic system for tricuspid valve annulus remodelling on the right coronary artery: a human cadaveric coronary angiography study.

OBJECTIVES: A prosthetic system to repair secondary tricuspid valve regurgitation was developed. The conceptual engineering of the current device is based on 3D segmental remodelling of the tricuspid valve annulus in lieu of reductive annuloplasty. This study was designed to investigate the operational safety of the current prosthetic system with regard to the anatomical integrity of the right coronary artery (RCA) in fresh cadaveric human hearts. METHODS: During the study period, from January to April 2016, the current prosthetic system was implanted on the tricuspid valve annulus in fresh cadaveric human hearts that met the study's inclusion criteria. The prepared specimens were investigated via selective coronary angiography of the RCA in the catheterization laboratory. The RCA angiographic anatomies were categorized as normal, distorted, kinked or occluded. RESULTS: Sixteen specimens underwent implantation of the current prosthetic system. The mean age of the cadaveric human hearts was 43.24 ± 15.79 years, with vehicle accident being the primary cause of death (59%). A dominant RCA was noticed in 62.5% of the specimens. None of the specimens displayed any injury, distortion, kinking or occlusion in the RCA due to the implantation of the prostheses. CONCLUSIONS: In light of the results of the present study, undertaken on fresh cadaveric human heart specimens, the current segmental prosthetic system for 3D remodelling of the tricuspid valve annulus seems to be safe vis-à-vis the anatomical integrity of the RCA. Further in vivo studies are needed to investigate the functional features of the current prosthetic system with a view to addressing the complex pathophysiology of secondary tricuspid valve regurgitation.

Right-sided reverse T composite arterial grafting to complete revascularization of the right coronary artery / Enxerto arterial composto reverso T do lado direito para completar a revascularização da artéria coronária direita

Complete arterial revascularization for the right coronary artery is underused mainly due to technical issues. Herein we report on a new approach for complete arterial revascularization of arterial revascularization for the right coronary artery branches. Complete arterial revascularization for the right coronary artery revascularization was performed in 8 patients using a reverse T composite arterial graft. None of the patients suffered perioperative myocardial infarction. All patients underwent noninvasive coronary imaging, displaying an early patency rate of 100%. Complete arterial arterial revascularization for the right coronary artery revascularization using a reverse T graft offers a new paradigm with enhanced technical flexibility in performing all arterial myocardial complete revascularizations in selected patients.

Revascularização arterial completa para a artéria coronária direita é subutilizada, principalmente devido a problemas técnicos. Nós relatamos uma nova abordagem para a revascularização arterial completa para os ramos da artéria coronária direita. Revascularização arterial completa da artéria coronária direita foi realizada em 8 pacientes usando um enxerto T arterial composto inverso. Nenhum dos pacientes sofreu infarto do miocárdio perioperatório. Todos os pacientes foram submetidos a exame de imagem não invasivo coronária não invasiva, exibindo taxa de patência precoce de 100%. Revascularização arterial completa da artéria coronária direita com enxerto inversa T oferece um novo paradigma com maior flexibilidade técnica na execução todas as revascularizações arteriais completas do miocárdio em pacientes selecionados.

Right-sided reverse T composite arterial grafting to complete revascularization of the right coronary artery.

Complete arterial revascularization for the right coronary artery is underused mainly due to technical issues. Herein we report on a new approach for complete arterial revascularization of arterial revascularization for the right coronary artery branches. Complete arterial revascularization for the right coronary artery revascularization was performed in 8 patients using a reverse T composite arterial graft. None of the patients suffered perioperative myocardial infarction. All patients underwent noninvasive coronary imaging, displaying an early patency rate of 100%. Complete arterial arterial revascularization for the right coronary artery revascularization using a reverse T graft offers a new paradigm with enhanced technical flexibility in performing all arterial myocardial complete revascularizations in selected patients.

Right atrial chemodectoma with atypical chest pain: a 6-year surgical follow-up.

Paragangliomas are rare neoplasms of neural crest origin and arise from the chromaffin (pheochromocytomas) or chemoreceptor (chemodectomas) tissues. Patients with cardiac chemodectomas, hormonally inactive paragangliomas, may have chest pain or various obstructive or compressive symptoms, depending on the location of the tumor. We report the case of a right atrial chemodectoma causing atypical chest pain. The tumor was discovered at transthoracic echocardiography. Coronary angiography showed a vascular tumor fed by a branch of the circumflex artery. En bloc tumor resection was carried out under cardiopulmonary bypass, with an uneventful surgical course. After 6 years of follow-up, the patient remains asymptomatic and disease-free.

Pericardial sewing-cuff: an alternative surgical technique for full-root implantation of aortic allograft and pulmonary autograft.

The following is a description of a modified technique for the reinforcement of proximal anastomosis regarding the process of aortic allograft or pulmonary autograft full root implantation. A double width pericardial strip is used to create a pericardial sewing-cuff to be used as a neo-ring. This technique is said to be best suited for decreasing the operative bleeding, reducing anastomotic pitfalls and concomitant repair of the aortic annulus.