Beijing, April 9, 2018: The new journal Cardiovascular Innovations and Applications (CVIA) has just published the fourth issue of Volume 2. This is a Special Issue on Valvular Heart Disease with Guest Editor Blase A. Carabello of East Carolina University. This issue contains several important case reports and major reviews which will make a significant research contribution to this field.
Highlighted papers in this issue are as follows:
Blase A. Carabello
Low-Gradient, Low Ejection Fraction Severe Aortic Stenosis: Still a Management Conundrum . In this paper Dr Carabello writes 'The management of patients with severe symptomatic aortic stenosis and a high transvalvular gradient is straightforward. It requires aortic valve replacement. Management of aortic stenosis patients with low flow, low ejection fraction and low gradient is fraught. Such patients rarely fulfill all the tenets of "severity" and also have severe left ventricular dysfunction. Both circumstances make the outcome of aortic valve replacement uncertain. Thus the management of this group of patients requires integration of all diagnostic modalities available. The physical examination, degree of valve calcification, the appearance of the valve during sonographic examination and the presence of inotropic reserve all contribute importantly in judging stenosis severity and the likelihood of successful valve replacement.'
Marc Katz and D. Scott Lim
Ischemic Mitral Regurgitation . In this important Case Report, Dr Scott and Dr Lim conclude 'Ischemic secondary MR is a complex process requiring the input of a multidisciplinary team that includes heart failure specialists, electrophysiologists, structural cardiologists, and cardiac surgeons. With the advent of newer technologies, hope is available for patients such as the one presented.'
William B. Weir, Matthew A. Romano and Steven F. Bolling
In this review the authors write that '...Functional tricuspid regurgitation (TR) primarily arises from asymmetric dilation of the tricuspid annulus in the setting of right ventricular dysfunction and enlargement in response to left-sided myocardial and valvular abnormalities. Even if the TR is not severe at the time of mitral valve surgery, it can worsen and even appear late after successful mitral valve surgery, which portends a poor prognosis. Despite data demonstrating inferior outcomes in the presence of residual TR, surgical repair for functional TR remains underused. Acceptance of TR, in the presence of tricuspid annular dilation, may be unacceptable. Surgical repair should consist of placement of a rigid or semi-rigid annular ring, which has been shown to provide superior durability as compared with suture and flexible band techniques. Finally, percutaneous annuloplasty for correction of functional TR may allow treatment of patients with recurrent TR at high risk of reoperation.'
Other papers in this issue are as follows:
Jared G. Breyley and Brian R. Lindman
Clinical Evaluation of a Patient with Asymptomatic Severe Aortic Stenosis
Thoralf M. Sundt
Valvular Heart Disease and Aortic Dilatation
Blase A. Carabello
An Asymptomatic Patient with Severe Mitral Regurgitation
Yee-Ping Sun and Patrick T. O'Gara
Management of Mitral Regurgitation in a Patient Contemplating Pregnancy
Niya Mileva, Dobrin Vassilev, Robert Gil and Gianluca Rigatelli
Misdiagnosed Aortic Intramural Hematoma and the Role of Intravascular Ultrasound Imaging in Detection of Acute Aortic Syndrome: A Case Report
C. Richard Conti
Mitral Stenosis: A Review
C. Richard Conti
Decision Making in the Cardiovascular Patient
Abstracts from 28th Annual Great Wall International Cardiology Conference (GW-ICC)
12-15 October 2017, Beijing, China