Marco Hernández-Enríquez1, Xavier Freixa1,4, Laura Sanchis1, Ander Regueiro1, Felip Burgos2, Ricard Navarro3, Mónica Masotti1, Marta Sitges1, Manel Sabaté11Cardiology Department, Cardiovascular Institute (ICCV), Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
2Respiratory Diagnostic Center, Hospital Clínic, University of Barcelona, Barcelona, Spain
3Anesthesiology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
4Electronic correspondence: firstname.lastname@example.org
|A patient with ischemic myocardiopathy who had undergone resynchronization therapy was admitted to the authors’ institution with progressive dyspnea. Echocardiography demonstrated a left ventricular ejection fraction (LVEF) of 25%, with a massive mitral regurgitation (MR) secondary to anterior leaflet prolapse and posterior leaflet restriction. Despite intensive medical treatment, the patient developed cardiogenic shock and required mechanical ventilation, inotropic support and intra-aortic balloon pumping. The patient was rejected for surgery due to the high operative risk, but subsequently underwent a successful percutaneous||repair with two MitraClip® devices. Immediately after the intervention there was a progressive improvement that allowed the patient to be discharged, such that the clinical outcome was favorable at the six-month follow up (NYHA class II/IV). This case report describes the benefits of minimally invasive therapy in selected patients who are at very high surgical risk and who, despite being in a critical condition and with low LVEF, experience an outstanding clinical improvement following the resolution of a massive MR.
The Journal of Heart Valve Disease 2018;27:114-116
|MitraClip® Repair in Cardiogenic Shock Due to Acute Mitral Regurgitation: From Near-Death to Walking|
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