title: Severe mitral regurgitation requiring ECMO therapy treated by interventional valve reconstruction using the MitraClip.
abstract: Surgical repair is considered the gold standard in severe mitral valve regurgitation. Multi-organ failure because of acute mitral insufficiency, however, can be challenging to manage as it aggravates to an inoperable state. We report the case of a 59 year old woman who presented with pulmonary oedema because of high grade mitral regurgitation. A recompensation prior to surgery using medical therapy failed and the patient developed a progressive multi-organ failure including pulmonary, circulatory, and renal failure within days. Symptomatically, our patient could be stabilized employing an extracorporeal membrane oxygenation and an intra-aortic balloon pump. A surgical mitral valve repair was ruled out because of the multi-organ failure. We performed an interventional valve reconstruction using the MitraClip device continuing the extracorporeal membrane oxygenation and the intra-aortic balloon counterpulsation therapy during the procedure. After clipping, multi-organ failure regressed and the extracorporeal membrane oxygenation could be explanted at day two after intervention. © 2013 Wiley Periodicals, Inc.
authors: Department of Cardiology and Angiology, University Heart Center Freiburg, Hugstetterstr.55, Freiburg, 79106, Germany.
authors: Dawid L
authors: DL
authors: Staudacher
authors: Christoph
authors: C
authors: Bode
authors: Tobias
authors: T
authors: Wengenmayer
mesh_terms: D006328:Cardiac Catheterization / Q000295:instrumentation*; D018618:Echocardiography, Doppler, Color; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D009102:Multiple Organ Failure / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011654:Pulmonary Edema / Q000209:etiology / Q000503:physiopathology; D020127:Recovery of Function; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: MitraClip™ device; case reports; extracorporeal membrane oxygenation; interventional mitral valve repair; mitral valve insufficiency; multiple organ failure