Transcatheter mitral valve repair with mitraclip for significant mitral regurgitation long after heart transplantion.
The role of transcatheter mitral valve repair with MitraClip implantation is becoming increasingly important for high-risk surgical patients with significant mitral regurgitation. Eligibility criteria for MitraClip are however rather strict, and the risk-benefit balance of this device in off-label settings remains unclear. Patients with prior heart transplantation may represent particularly challenging candidates for MitraClip, given their peculiar atrial anatomy. We hereby present the case of a 72-year-old gentleman with prior heart transplantation and significant mitral regurgitation who, after heart team consensus, was referred to us for MitraClip implantation. After careful planning, we were able to successfully implant two clips, achieving a significant improvement in the severity of the mitral regurgitation. Similarly favorable findings were confirmed at 3-month clinical and transthoracic/transesophageal echocardiographic follow-up. This clinical vignette highlights the key procedural milestones for successfully implanting MitraClip in patients with significant mitral regurgitation and prior heart transplantation. © 2015 Wiley Periodicals, Inc.
Presidio Ospedaliero Pineta Grande, Unità Operativa Di Interventistica Cardiovascolare, Castel Volturno, Italy.|Casa Di Salute Santa Lucia, Unità Operativa Di Emodinamica, San Giuseppe Vesuviano, Italy.
Paolo
P
Ferraro
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.|Eleonora Lorillard Spencer Cenci Foundation, Rome, Italy.
Giuseppe
G
Biondi-Zoccai
Presidio Ospedaliero Pineta Grande, Unità Operativa Di Interventistica Cardiovascolare, Castel Volturno, Italy.|Casa Di Salute Santa Lucia, Unità Operativa Di Emodinamica, San Giuseppe Vesuviano, Italy.
Arturo
A
Giordano
D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
MitraClip; heart failure; heart transplantation; mitral regurgitation