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Introduction: Valvular heart diseases (VHD) are a significant problem in the Polish population. Coexistence of coronary artery disease (CAD) in patients with VHD increases the risk of death and affects the further therapeutic strategy. Aim: Analysis of atherosclerotic plaque burden distribution in coronary arteries and long-term prognosis among patients with VHD. Material and methods: Inclusion criteria were met by 1025 patients with moderate and severe VHD. Mean observation time was 2528 ±1454 days. Results: Severe aortic valve stenosis (AVS) occurred in 28.2%, severe mitral valve insufficiency (MVI) in 20%. CAD with severe angiographic stenoses was noted in 42.3% (n = 434). Among patients with severe MVI, CAD was noted in 47.1% of cases, and prior acute coronary syndromes (ACS) in 27.1% of patients (n = 58). In severe AVS patients, significant angiographic atherosclerotic changes were observed in 29.6% (n = 86), and prior ACS in 7.6% (n = 22) of patients. During the observation 52.7% of patients died, including 62.9% of patients with severe MVI and 51.6% of those with severe AVS. Age (OR = 1.038; 95% CI: 1.005-1.072; p = 0.022) and coexisting aortic valve insufficiency (AVI) (OR = 2.39, 95% CI: 5.370-11.065, p = 0.035) increased the mortality rate. Conclusions: Severe AVS is starting to be the most prevalent VHD. CAD is one of the most significant factors deteriorating prognosis of patients with VHD. AVI and age were significant risk factors for mortality. The worst prognosis was observed in severe MVI, which may result from more frequent occurrence of CAD in this group. A lesser burden of CAD and ACS in the group of patients with severe AVS did not affect survival. [ABSTRACT FROM AUTHOR]

Aims Whereas haemodynamic and echocardiographic studies suggest benefits for left ventricular (LV) function and cardiac output following reduction in LV preload by interventional edge-to-edge repair for mitral regurgitation (MR), there is limited data on volumetric and functional LV and right ventricular (RV) changes using cardiac magnetic resonance (CMR) imaging. Methods and results Patients with moderate to severeMRand high surgical risk underwent MitraClipTM-implantation andCMRimaging before and within 7 days after the procedure. In addition to volumetric and flow studies, myocardial feature tracking (FT) technology for quantification of myocardial strainwas applied.Twenty patients (age: 76+8 years) with functional (n = 15) or degenerative MR (n = 5) with a mean logistic Euroscore I of 33+16 underwent both successful MitraClipTM implantation and CMR imaging. MR fraction (36+10 vs. 19+12%; P , 0.001) and LV end-diastolic volume (115+36 vs. 105+41 mL/m2; P = 0.002) decreased significantly, whereas LV ejection fraction (42+15 vs. 41+16%, P = 0.8) and cardiac index (1.7+0.5 vs. 1.8+0.4 L/min/2, P = 0.4) remained unchanged. MitraClipTM implantation resulted in a significant impairment of circumferential (212.8+4.8 vs. 28.2+3.3; P = 0.002) and radial strain (15.4+7.7 vs. 9.6+5.3; P = 0.02) on basal short-axis view. On RV level, there were no significant changes in end-diastolic volume (83+19 vs. 84+18 mL/2, P = 0.8), ejection fraction (42+9 vs. 43+11%, P = 0.8), or tricuspid regurgitation fraction (24+17 vs. 25+19%, P = 0.7). MitraClipTM implantation led to a significant improvement in New York Heart Association functional class (patients in functional class III-IV pre 100% vs. post 45%; P , 0.001). Conclusion In severely compromised patients, marked reduction in MR by MitraClipTM implantation might not result in immediate improved cardiac output and effective biventricular forward flow. [ABSTRACT FROM AUTHOR]

The combination of congenital left ventricular aneurysm associated with mitral insufficiency is rare. We describe the case of a girl aged 11 years, bearing these two entities simultaneously. Aneurysmal resection of the left ventricle was performed with Dor technic to allow remodelation of the anatomy of the left ventricle. Mitral annuloplasty was performed through a transseptal approach. Three months after surgery, the child presents a good myocardial contractility without mitral regurgitation and normal ejection fraction. [ABSTRACT FROM AUTHOR]